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Emergency Medicine (COMAT) TEST |Q&A’s Latest Update| Verified
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Emergency Medicine (COMAT) TEST |Q&A’s Latest Update| Verified
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Emergency Medicine (COMAT) TEST |Q&A’sLatest Update| Verified
Treatment for patient with beta-blocker over dose and unstable vital signs - ✔✔Glucagon
infusion (competitively inhibits beta receptor in heart muscle)
Normal vital signs in children - ✔✔HR = 80-140/min
RR = 20-30/min
BP = 90-105/55-70 mmHg
Treatment of Lithium, lead or iron overdose - ✔✔Activated charcoal (within 1 hour of
ingestion)
OMT to relieve diarrhea should focused on what spinal segments.. - ✔✔S2-S4
parasympathetics
Treatment alcohol ketoacidosis - ✔✔1st - Thiamine
2nd - Glucose (increase insulin secretion & reduce glucagon secretion which will trigger the
cessation of fatty acid breakdown) & IVF
3rd - correct electrolyte abnormalities (phosphate, potassium, & magnesium)
What unknown substance was consumed in a patient with acute intoxication followed by
stupor and visual disturbances? - ✔✔Alcoholic
Next step in a pregnancy patient with vaginal bleeding - ✔✔1- Nonstress test (NST)
-Nonreactive test is asst'd with adverse fetal or neonatal outcomes
Digital vaginal exam should never be performed in pts in 2nd half of their pregnancy
,Fetal Fibronectin (fFN) - ✔✔Used to distinuish women in true preterm labor from those with
false labor.
FFN - extracellular matrix protein present at the decidual-chorionic interface
Treatment of bite - ✔✔In bites to the hand and/or those that are infected, coverage for P.
multocida is recommended with amoxicillin-clavulanate or the second or third generation
cephalosporins. Rabies and tetanus prophylaxis should also be considered for all bite wounds.
Treatment of SVT - ✔✔1st-vagal maneuvers
2nd-Adenosine
Treatment of unstable SVT - ✔✔cardioversion
Treatment of Ventricular fibrillation & Ventricular tachycardia - ✔✔Amiodarone (class III
anti-arrhythmic agent)
Treatment of Bradycardia - ✔✔Atropine
If atropine fails - use dopamine, epinephrine, & transcutaneous pacing
Treatment of ventricular tachycardia with a pulse - ✔✔Cardioversion
V. tach = absent P waves & widened QRS complex occurring at a rate of 120/min
Treatment of pulseless v. tach or ventricular fibrillation - ✔✔Defibrillation
, Acute Variceal hemorrhage - ✔✔1) Remember A,B,Cs
2) Hemodynamic stabilization: IVF or blood products (for massive hemorrhage) as well as
continual Octreotide
3) Treat Coagulopathies. Reverse if pt is on Coumadin (Vit K & FFP)
4) Empirical antibiotics - Fluoroquinolone or a 3rd generation Cephalosporin
5) Emergent EGD
1st- Variceal ligation
2nd-TIPS procedure (if bleeding continues)
MELD - ✔✔Model for end-stage liver disease (MELD) score is an estimated rate of 3-month
survival in those with cirrhosis. It takes the following variables into account: Creatinine,
bilirubin, INR, dialysis.
Somatovisceral reflexes of small bowel - ✔✔T8-T10 (eg, Ileus)
Three main approaches for the reversal of warfarin-induced coagulopathy - ✔✔1st - stop
warfarin therapy
2nd - is to administer vitamin K
3rd - administer fresh frozen plasma (FFP), prothrombin complex concentrate, or recombinant
Factor VIIa.
For INR between 3.5 and 5 without major bleeding - ✔✔the recommended therapy is to
lower the dose or omit a dose.
For INR of 5 to 9 without major bleeding - ✔✔The recommended therapy is to skip the next
one or two doses or administer 1 to 2.5 mg of vitamin K orally.
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