Emergency Medicine SHELF EXAM|complete study guide with detailed questions and 100% verified answers.ALREADY GRADED A

Which headache meds should never be combined? - CORRECT ANSWERS️️ergotamine and triptans should never be combined because they both have vasoconstrictive effects, which can lead to complications such as stroke or myocardial infarction. What is the first line med for migraine with auro + vomiting - CORRECT ANSWERS️️first line abortive med for migraine with auro (esp repeated vomiting) - IV prochlorperazine What type of fractures are common low-impact injuries and which are high-impact in elderly? - femoral neck - femoral head - intertrochanteric fractures - CORRECT ANSWERS️️Femoral neck fractures and intertrochanteric fractures are common injuries on a low-impact fall to the hip in the elderly. Intertrochanteric fractures typically result in bruising because the fracture site is extra-capsular Posterior hip dislocation and femoral head fractures commonly occur in high-impact falls (dashboard injuries) Define: rupture of small penetrating artery rupture of a saccular aneurysm - CORRECT ANSWERS️️rupture of small penetrating artery = intracerebral hemorrhage rupture of a saccular aneurysm = berry aneurysm = subarachnoid hemorrhage What is the best diagnostic test for boorehave syndrome? - CORRECT ANSWERS️️hemodynamically stable, contrast esophagography with gastrografin is the preferred confirmatory test. NOT hemodynamically stable, CT scan of the chest is the best test What tests do you order for a patient with concerns of a lower GI bleed? (hemodynamically stable vs unstable) - CORRECT ANSWERS️️Hemodynamically stable - colonoscopy requires bowel prep and will be unreliable in an urgent situation Hemodynamically unstable - angiography because it can be done quickly without the need for bowel prep ( you could do a CT angiography first before proceeding with invasive catheter angiography) When should you be conscerned for bowel perf vs SBO? - CORRECT ANSWERS️️This patient presents with diffuse abdominal pain, nausea, vomiting, high-pitched bowel sounds, and a distended and diffusely tender abdomen, all of which suggest bowel obstruction. If the patient develops guarding or rebound tenderness and bowel sounds are absent, be concerned for a perf What complication after cardiac catheterization can lead to livedo reticularis?- - CORRECT ANSWERS️️cholesterol embolization is a potential complication that can lead to ischemia in many organs, often including the kidney How do nitrates work to reduce myocardial oxygen demand? - CORRECT ANSWERS️️Nitrates, such as nitroglycerin, cause arterial and venous vasodilation by inducing smooth muscle relaxation. Anginal pain relief is mainly achieved by venous dilation (venous pooling), which leads to decreased end-diastolic pressure (i.e., decreased preload), reduced myocardial wall tension, and improved myocardial perfusion. The decreased preload results in reduced heart size and decreased myocardial oxygen demand. What is the management for patient with HELLP at 35 weeks pregnant - CORRECT ANSWERS️️HELLP - Hemolysis, elevated liver enzymes, low platelets. If a patient is over 34 weeks pregnant, then immediate delivery Mag sulfate is indicated in all patients with HELLP for seizure prophylaxis What is the diagnostic test for central retinal vein occlusion? - CORRECT ANSWERS️️Fluorescein angiography (FA) is indicated as a next step to confirm the diagnosis of central retinal vein occlusion (CRVO), evaluate the severity of CRVO, and decide whether laser photocoagulation should be performed. What is TB adrenalitis - - CORRECT ANSWERS️️This is adrenal insufficiency caused by TB, which can occur in patietns in a coutnry with high burden of tb What type of ulcers are you concerned for in burn patients? - CORRECT ANSWERS️️Curling ulcers are a subtype of stress gastritis seen in patients with extensive burns and occur due to hypovolemia and subsequent hypoperfusion of the stomach. The resultant ischemic tissue injury to the stomach epithelium results in an interruption in the normal mucosal barrier of the stomach, and ulcer formation What is the difference between superficial second degree burns, deep second degree burns, and third degree burns? - CORRECT ANSWERS️️Superficial partial thickness burn (superficial second degree burn) is known for blanching and blistering and being extremely tender Deep partial thickness burn (deep second degree burn) is known for blistering as well but as less tender and do not blanch Third degree burns are painless with no blanching that appear black, gray or white and leathery How can you tell the difference between infective endocarditis and a perivalvular abscess? - CORRECT ANSWERS️️Conduction abnormalities on ECG (e.g., AV block) occur when the abscess extends to cardiac conduction tissues, which signals that the disease is not just infective endocarditis but also a perivalvular abscess What are the causes of vasovagal syncope? - CORRECT ANSWERS️️Causes can include pain, fear, the sight of blood, or emotional stress. Patients usually experience a presyncopal prodrome, as seen here. Patients with syncope may also experience myoclonic jerks that last for less than 15 seconds evidence of bronchial wall fibrosis (tram-track opacities) is code for which disease? - CORRECT ANSWERS️️bronchiectasis What is your first thought if someone is intubated and then has assymetrical chest rise and decreased breath sounds on the left - CORRECT ANSWERS️️Absent or decreased breath sounds on the left suggest inadvertent right mainstem bronchus intubation, which is more common than inadvertent left mainstem bronchus intubation because the right mainstem bronchus is more vertically oriented than the left mainstem bronchus at the bifurcation of the trachea. A CT scan of the head shows a hyperdense fluid collection in the right medial temporal lobal and uncal herniation of the hippocampa gyrus. Which cranial nerve is likely affected? - CORRECT ANSWERS️️oculomotor - CNIII What is the first line treatment for symptomatic bradycardia? - CORRECT ANSWERS️️Atropine is an anticholinergic agent that is used to increase heart rate. Intravenous atropine is the first-line treatment in patients who present with symptomatic bradycardia when there are no reversible causes that can be immediately identified