Rosh Review Questions And Answers Graded A+

*abdominal xray of large bowel* Which of the following is prominently visualized in the image above? A Haustra B Plicae circulares C Teniae coli D Valvulae conniventes - A haustra *EKG showing hyperkalemia* A 67-year-old man with hypertension and end-stage renal disease presents after an incomplete dialysis session secondary to shortness of breath. His vital signs are BP 110/95, HR 65, RR 22, T 37.3°C, and oxygen saturation 99% on 2L NC. You obtain the ECG above. Which of the following is the most appropriate next step in this patient's management? A Calcium gluconate B Cardiology consultation C Defibrillation D Transcutaneous pacing - A calcium gluconate *image of one dilated pupil* Which type of cerebral herniation is associated with the finding above? A Central transtentorial B Cerebellotonsillar C Uncal D Upward transtentorial - C Uncal*image of subconjunctival hemorrhage* A 55-year-old woman with a history of chronic bronchitis presents and is concerned about the appearance of her left eye. She denied a change in vision or any discomfort but is concerned because she noticed "blood in my eye" this morning. Evaluation of the patient demonstrates intact extraoccular muscles; pupils that are equal, round, and reactive to light; and visual acuity of 20/30 in each eye. Which of the following is the most appropriate next step in the evaluation and management of her complaint? A CT scan of the orbit and facial bones to evaluate for globe injury B Measure intraocular pressure to rule out a retrobulbar hematoma C Obtain an ophthalmology consultation D Reassure the patient and discharge her home E Stain with fluorescein dye and assess for a corneal abrasion - D Reassure the patient and discharge her home *picture of black widow spider* A 25-year-old man is brought into the ED after he was bit by a spider. He brings the dead spider with him to show you. Which of the following statements is correct regarding this type of spider bite? A A bite causes local necrotic wound toxicity B An antivenom is not available in the United States C Envenomation causes the release of acetylcholine and norepinephrine at nerve terminals leading to severe muscle cramping and systemic effects D The spider's venom contains a variety of cytotoxic enzymes - C Envenomation causes the release of acetylcholine and norepinephrine at nerve terminals leading to severe muscle cramping and systemic effects *radiograph demonstrates a markedly dilated single loop of colon consistent with a sigmoid volvulus* A 85-year-old nursing home patient presents with diffuse abdominal pain and distension, nausea, but no vomiting. The above abdominal radiograph is obtained. What is the management of this patient? A Enema B Nasogastric tube and bowel restC Sigmoidoscopy D Surgical intervention - C Sigmoidoscopy *rhythm strip showing SVT* A 1-year-old boy presents with the rhythm seen above. Physical exam is unremarkable except for tachycardia. Which of the following vagal maneuvers is the most effective to treat this rhythm? A Apply external ocular pressure B Apply ice to the face C Blow on the patient's face with a straw D Perform carotid massage - B apply ice to the face It is important that when performing this maneuver that you do not occlude the nose or mouth, and apply the ice only over the patient's forehead, eyes, and bridge of the nose for 10-15 seconds. Adenosine, an AV-nodal blocking agent, can also be administered in stable patients. *US of empty gestational sac* A 26-year-old woman presents with abdominal cramping after a positive home pregnancy test. Her vitals are T 98.7°F, HR 94, BP 110/66, RR 18, oxygen saturation 97%. Her exam is unremarkable. Labs reveal a serum beta HCG of 1000 mIU and she is Rh positive. She states that the pregnancy is wanted. An ultrasound is performed as seen above. Which of the following is appropriate management for this patient? A Administer methotrexate B Administer Rhogam and discharge home with repeat beta hCG in 48 hours C Administer Rhogam and methotrexate D Discharge home with repeat beta hCG in 48 hours - D Discharge home with repeat beta hCG in 48 hours *xray of scaphoid fracture*Which of the following is the most concerning complication of this injury? A Avascular necrosis B Infection C Malunion D Osteoarthritis - A Avascular necrosis