Emergency Medicine SAEM exam 1 test bank question and answers 100 % correct 2023/2024.
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Emergency Medicine SAEM
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Emergency Medicine SAEM
Emergency Medicine SAEM exam 1 test bank
question and answers 100 % correct 2023/2024."The chest X-ray in the Figure was taken in an intoxicated patient who is conversant, but an unreliable
historian. The X-ray findings are best described as indicating:
[image]
A. Esophageal foreign body
B. I...
Emergency Medicine SAEM exam 1 test bank question and answers 100 % correct 2023/2024. "The chest X -ray in the Figure was taken in an intoxicated patient who is conversant, but an unreliable historian. The X -ray findings are best describe d as indicating: [image] A. Esophageal foreign body B. Intratracheal foreign body C. mediastinitis from esophageal perforation D. normal chest" "A. Esophageal foreign body The answer is A. The film reveals a classic appearance of a round foreign body (in this case, a pull -top from a beer can) in the esophagus. The foreign body appears to lie outside the tracheal shadow. There is no sign of mediastinal air (which would be expected with penetrating trauma). The X -ray reveals no signs of mediastinitis, but th e risk of esophageal perforation and ultimate mediastinitis prompts endoscopic intervention in this patient." "An 18 year old hockey player is hit in the mouth with a puck, fracturing a maxillary canine tooth. He brings the severed piece of tooth with him. On physical exam, the tooth is fractured halfway between the tip and the gumline. The root of the tooth is still firmly intact. The exposed fracture site has a yellowish tinge without blood. Of the following choices, which is the most appropriate manageme nt for this patient? A. No specific treatment required B. Application of calcium hydroxide, placement of aluminum foil, and dental follow -up C. Placement of tooth fragment in saline gauze, outpatient dental follow -up D. Immediate dental consult to avoid ab scess formation E. Replace fractured piece and place acrylic splint" "D. Immediate dental consult to avoid abscess formation The answer is D. Ellis II dental fracture involves enamel and dentin. The fracture site typically has a yellowish tinge. Ellis III dental fractures are characterized by exposure of pinkish pulp and often blood. These fractures require immediate dental consultation to prevent abscess formation." "A 22 year old man is punched in the nose during a fight. He presents to the emergency dep artment with obvious nasal bone deformity. Pressure controls the bleeding. Physical exam reveals no maxillary bone or orbital rim tenderness, intact vision and extraocular movement. The oropharynx and mandible are unremarkable. Nasal inspection reveals a s wollen, ecchymotic, tender nasal septum. Which of the following is the most appropriate initial step? A. Outpatient follow -up with an ENT specialist to surgically correct a deviated septum B. Plastic surgery consult for immediate reduction of nasal fractur e C. Facial CT scan to rule out more serious facial fractures D. Incision and drainage of the septal hematoma followed by nasal packing E. Needle aspiration of the septal hematoma" "D. Incision and drainage of the septal hematoma followed by nasal packing" "A 24 year old woman is playing racquetball and sustains a direct blow from the ball to the right eye. She presents to the emergency department complaining of eye pain and double vision. On exam, her right eye does not track properly with upward gaze. Thi s finding suggests which of the following injuries? A. Inferior orbital wall fracture B. Superior orbital rim fracture C. Ethmoid fracture D. Zygomatic arch fracture E. Inferior orbital rim fracture" "A. Inferior orbital wall fracture The answer is A. The patient most likely has an orbital floor fracture with entrapment." "A 32 year old man is struck several times in the head with a baseball bat. Upon emergency medical service arrival, he is mildly confused, vomits once, and complains of a severe headache. The emergency medical technicians establish two large -bore IVs. Prior to arrival at the emergency department, he loses consciousness and begins to seize. He is actively seizing when he is brought into the trauma bay. What should be the first step in the m anagement of this patient? A. Administration of phenytoin 1000mg IV B. Administration of mannitol 50 g IV C. Rapid sequence intubation using paralytic agent D. Emergency craniotomy E. Administration of 2 liters NS bolus" "C. Rapid sequence intubation using paralytic agent The answer is C. The airway should be managed as the first priority in this patient. The other maneuvers may be helpful but are secondary to securing an airway and providing oxygenation/ventilation. Airw ay comes first!" "A 46 year old man is brought in by EMS after a motor vehicle collision in which he was an unrestrained driver. Although he has no obvious injury to his head or neck, he complains of chest pain and appears very short of breath. His vital s igns are: T 99.2 F, BP 85/57, HR 123, RR 36, SpO2 95% on non -rebreather. The CXR demonstrates a tension pneumothorax. Of the following, which is the most appropriate next step in this man's care? A. Placement of a chest tube followed by a chest xray to det ermine proper placement B. Transfusion of 2 units of O -negative packed red blood cells C. Performance of a chest CT scan to further delineate the pathology D. Placement of a needle decompression device, followed by repeat CXR" "D. Placement of a needle dec ompression device, followed by repeat CXR This patient needs emergent chest decompression and this is rapidly done by needle thoracostomy. A chest CT may be performed, but only once he is stabilized. A formal chest tube will be placed, but placement may n ot be rapid enough and he may decompensate in the meantime. Transfusion of blood does nothing to correct the physiology of a tension pneumothorax" "The most sensitive bedside test for nerve injury in a finger after trauma is: A. light touch B. O'Riain wrin kle test C. pain D. temperature sensation E. two -point discrimination" "E. two -point discrimination The correct answer is E. Light touch is a good screening test, but two -point discrimination is more sensitive and should be used routinely in evaluating in juries to digits. The O'Riain wrinkle test involves placing the digit in warm water and looking for wrinkling of the digital pulps. Presence of wrinkling indicates the nerve is intact." "Which is not part of the Ottawa ankle rules? A. inability to walk 4 s teps at the time of the injury B. inability to walk 4 steps in the emergency department C. tenderness over the lateral malleolus D. tenderness over the medial malleolus E. tenderness over the talus" "E. tenderness over the talus The correct answer is E. T he Ottawa ankle rules are a validated (for adults) set of physical exam findings to determine if an ankle X -ray is needed after an injury. If any of the first 4 answers is present or if there is tenderness over the navicular or base of the 5th metatarsal, an X -ray should be obtained. If the correct answer to all questions is no, then an X -ray is not needed." "Choose the INCORRECT statement regarding thoracentesis from the anterior approach (needle decompression): A. An upright chest X -ray should always be p erformed following a thoracentesis to confirm the successful relief of a tension pneumothorax and the absence of hemothorax or other complications. B. A 14 - to 20 -gauge needle is inserted perpendicularly over the superior edge of the rib. C. The recommende d insertion site is the second intercostal space, midaxillary line. D. After the needle is inserted into the pleural space, a rush of air confirms the presence of a tension pneumothorax. E. If a tension pneumothorax is confirmed via needle decompression, t hen a thoracostomy tube should be placed as soon as possible."
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