EM COMAT questions and answers
graded A+ updated
The first principle in the management of trauma patients - correct answer ✔✔the primary
survey is ABCDE and stands for:
A = airway
B = breathing
C = circulation
D = disability
E = exposure.
Classification of Shock - correct answer ✔✔
SIRS criteria - correct answer ✔✔2/4 of the criteria
-- Temp > 38.5 (101.4F) or < 35 (95 F)
-- Pulse > 90
-- Resp > 20
-- WBC > 12,000, < 4000, > -- 10% bands
Sepsis - correct answer ✔✔
Severe sepsis criteria - correct answer ✔✔*Sepsis + organ dysfunction*
- Sepsis-induced *hypotension*
- Lactate above upper limits of laboratory normal
,- *Urine output < 0.5* mL/kg/hr for >2 hours despite adequate fluid resuscitation
- *Acute lung injury* with PaO2/FIO2 < 250 in the absence of pneumonia or < 200 in the
presence of pneumonia
- Creatinine >2 mg/dL
- Bilirubin >4 mg/dL
- *Platelet count < 100,000/microL*
- Signs of coagulopathy *(INR >1.5)*
Septic shock - correct answer ✔✔sepsis-induced hypotension persisting despite adequate fluid
resuscitation.
the preferred *diagnostic* modality for *toxic megacolon* - correct answer ✔✔*Abdominal x-
ray*
-- bloody diarrhea, abdominal distention, and signs of sepsis
-- *Dilation of the transverse colon > 6 cm* on plain abdominal x-ray confirms the diagnosis
-- Patients with inflammatory bowel disease, such as this patient, are at risk
recent history of alcohol intake followed by several episodes of vomiting, signs of shock, and the
presence of crepitus over the thorax support the diagnosis of - correct answer ✔✔Boerhaave
syndrome
test of choice for *confirming Boerhaave* syndrome in pt who is hemodynamically *unstable* -
correct answer ✔✔*CT Chest*
-- findings include *widened mediastinum*, esophageal wall thickening, and/or
*pneumomediastinum*, and it locates the tear in the esophagus wall
test of choice for confirming Boerhaave syndrome in pt who is hemodynamically *STABLE* -
correct answer ✔✔contrast esophagram with gastrografin
,the test of choice for *diagnosing aortic dissection* in hemodynamically *unstable* patients. -
correct answer ✔✔Transthoracic echocardiography (TTE)
5-year-old boy with abdominal pain and hyperactive bowel sounds is most suggestive of -
correct answer ✔✔functional constipation
first-line of therapy for functional constipation, which is a common cause of abdominal pain in
children who begin toilet training or those who start going to school - correct answer ✔✔oral
administration of osmotic laxatives such as polyethylene glycol for 3-6 days
18 months old boy with *paroxysms of abdominal pain* that *last 15-20 minutes* and clinical
features of *mechanical bowel obstruction*, mass in RUQ is suggestive of - correct answer
✔✔*intussusception*
-- Abd US reveals *target sign*
Tx: *Barium enema*
Orthostatic syncope due to hypovolemia can be confirmed by - correct answer ✔✔Elevated
BUN and Elevated BUN/Creatinine ratio *caused by renal hypoperfusion*
tx for toxic megacolon d/t Clostridium difficile - correct answer ✔✔IV metronidazole and rectal
vancomycin
the treatment regimen of choice in patients with severe UC - correct answer ✔✔Topical
sulfasalazine (suppositories) and oral prednisolone
Severe UC - correct answer ✔✔-- more than 6 bloody stools per day
-- severe abdominal cramps, -- systemic signs of toxicity (fever, tachycardia),
, -- anemia or ESR ≥ 30 mm/hour
*acute onset* of *bloody diarrhea*, abdominal pain and distention, *hypoactive* bowel
sounds, and, in case of bowel necrosis, *signs of sepsis* - correct answer ✔✔*acute mesenteric
ischemia*
-- AMI usually occurs in *patients > 60 years* with cardiovascular risk factors.
*temporary unilateral weakness* (usually of the arm and/or leg) *following a seizure*, which is
sometimes accompanied by *generalized aphasia* - correct answer ✔✔Todd's paralysis
Common medications that may cause a depressed level of consciousness include - correct
answer ✔✔-- opioids
-- barbiturates
-- benzodiazepines
-- tricyclic antidepressants
-- different type of seizure medications
First goal in taking care of patients with sevrely altered mental status - correct answer
✔✔Managing the airway
Glasglow Coma Scale (GCS) - correct answer ✔✔-- eye-opening
-- verbal response
-- motor response
what GCS score requires intubation? - correct answer ✔✔8 or less (not less than 8)
Coma Cocktail - correct answer ✔✔*Mnemonic DON'T*
graded A+ updated
The first principle in the management of trauma patients - correct answer ✔✔the primary
survey is ABCDE and stands for:
A = airway
B = breathing
C = circulation
D = disability
E = exposure.
Classification of Shock - correct answer ✔✔
SIRS criteria - correct answer ✔✔2/4 of the criteria
-- Temp > 38.5 (101.4F) or < 35 (95 F)
-- Pulse > 90
-- Resp > 20
-- WBC > 12,000, < 4000, > -- 10% bands
Sepsis - correct answer ✔✔
Severe sepsis criteria - correct answer ✔✔*Sepsis + organ dysfunction*
- Sepsis-induced *hypotension*
- Lactate above upper limits of laboratory normal
,- *Urine output < 0.5* mL/kg/hr for >2 hours despite adequate fluid resuscitation
- *Acute lung injury* with PaO2/FIO2 < 250 in the absence of pneumonia or < 200 in the
presence of pneumonia
- Creatinine >2 mg/dL
- Bilirubin >4 mg/dL
- *Platelet count < 100,000/microL*
- Signs of coagulopathy *(INR >1.5)*
Septic shock - correct answer ✔✔sepsis-induced hypotension persisting despite adequate fluid
resuscitation.
the preferred *diagnostic* modality for *toxic megacolon* - correct answer ✔✔*Abdominal x-
ray*
-- bloody diarrhea, abdominal distention, and signs of sepsis
-- *Dilation of the transverse colon > 6 cm* on plain abdominal x-ray confirms the diagnosis
-- Patients with inflammatory bowel disease, such as this patient, are at risk
recent history of alcohol intake followed by several episodes of vomiting, signs of shock, and the
presence of crepitus over the thorax support the diagnosis of - correct answer ✔✔Boerhaave
syndrome
test of choice for *confirming Boerhaave* syndrome in pt who is hemodynamically *unstable* -
correct answer ✔✔*CT Chest*
-- findings include *widened mediastinum*, esophageal wall thickening, and/or
*pneumomediastinum*, and it locates the tear in the esophagus wall
test of choice for confirming Boerhaave syndrome in pt who is hemodynamically *STABLE* -
correct answer ✔✔contrast esophagram with gastrografin
,the test of choice for *diagnosing aortic dissection* in hemodynamically *unstable* patients. -
correct answer ✔✔Transthoracic echocardiography (TTE)
5-year-old boy with abdominal pain and hyperactive bowel sounds is most suggestive of -
correct answer ✔✔functional constipation
first-line of therapy for functional constipation, which is a common cause of abdominal pain in
children who begin toilet training or those who start going to school - correct answer ✔✔oral
administration of osmotic laxatives such as polyethylene glycol for 3-6 days
18 months old boy with *paroxysms of abdominal pain* that *last 15-20 minutes* and clinical
features of *mechanical bowel obstruction*, mass in RUQ is suggestive of - correct answer
✔✔*intussusception*
-- Abd US reveals *target sign*
Tx: *Barium enema*
Orthostatic syncope due to hypovolemia can be confirmed by - correct answer ✔✔Elevated
BUN and Elevated BUN/Creatinine ratio *caused by renal hypoperfusion*
tx for toxic megacolon d/t Clostridium difficile - correct answer ✔✔IV metronidazole and rectal
vancomycin
the treatment regimen of choice in patients with severe UC - correct answer ✔✔Topical
sulfasalazine (suppositories) and oral prednisolone
Severe UC - correct answer ✔✔-- more than 6 bloody stools per day
-- severe abdominal cramps, -- systemic signs of toxicity (fever, tachycardia),
, -- anemia or ESR ≥ 30 mm/hour
*acute onset* of *bloody diarrhea*, abdominal pain and distention, *hypoactive* bowel
sounds, and, in case of bowel necrosis, *signs of sepsis* - correct answer ✔✔*acute mesenteric
ischemia*
-- AMI usually occurs in *patients > 60 years* with cardiovascular risk factors.
*temporary unilateral weakness* (usually of the arm and/or leg) *following a seizure*, which is
sometimes accompanied by *generalized aphasia* - correct answer ✔✔Todd's paralysis
Common medications that may cause a depressed level of consciousness include - correct
answer ✔✔-- opioids
-- barbiturates
-- benzodiazepines
-- tricyclic antidepressants
-- different type of seizure medications
First goal in taking care of patients with sevrely altered mental status - correct answer
✔✔Managing the airway
Glasglow Coma Scale (GCS) - correct answer ✔✔-- eye-opening
-- verbal response
-- motor response
what GCS score requires intubation? - correct answer ✔✔8 or less (not less than 8)
Coma Cocktail - correct answer ✔✔*Mnemonic DON'T*
