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EM Quiz 12

EM Quiz 12

EM Quiz 12
EM Quiz 12

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EM Quiz 12 Summary – review your personal results below.

To learn more about any of the topics covered in this Revision Block – see the following RCEMLearning content listed:

Q1: Ultrasound: Skills of Carrying Out Abdominal Aortic Aneurysm Assessment (AAA) – Learning Session

Q2: Primary Headache – Learning Session

Q3: Pain Management in Adult Patients – Learning Session

Q4: Paediatric Diabetic Ketoacidosis – Learning Session

Q5: Neonatal Nuggets Part 2: tummy troubles – Learning Session

Q6: Management of Haematuria – Learning Session

Q7: Lower Gastrointestinal Haemorrhage – Learning Session

Q8: Intracranial Infections – Learning Session

Q9: Cervical Artery Dissection – Learning Session

Q10: Cardiogenic Pulmonary Oedema – Learning Session

Why not try another RCEMLearning – EM Quiz

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Question 1 of 10

1. Question

Which one of the following statements is true with regards to normal aortic anatomy?

The diameter is measured from outer wall to outer wall
Correct Incorrect Correct answer

The aorta lies to the right of the midline
Correct Incorrect Correct answer

The maximum external diameter is 3 cm at the bifurcation
Correct Incorrect Correct answer

The origin of the superior mesenteric artery (SMA) is 2 cm above the bifurcation
Correct Incorrect Correct answer

The aorta bifurcates just above the umbilicus (L4)
Correct Incorrect Correct answer

Correct

Incorrect
Question 2 of 10

2. Question

In a patient in whom a diagnosis of migraine is suspected, which of the following diminishes the probability?

Agitation
Correct Incorrect Correct answer

Pulsating
Correct Incorrect Correct answer

Duration 4-72 hours
Correct Incorrect Correct answer

Unilateral
Correct Incorrect Correct answer

Disabling
Correct Incorrect Correct answer

Correct

Incorrect
Question 3 of 10

3. Question

A 24-year-old rugby player presents to the emergency department (ED) with a closed, likely midshaft fracture of his right femur. He is splinted and using entonox.

Which one of the following statements regarding his management is false?

Prophylactic anti-emetics are indicated to prevent opiate induced nausea and vomiting
Correct Incorrect Correct answer

The College recommends 9-18 mg of morphine initially, if he weighs 90 kg
Correct Incorrect Correct answer

Regional anaesthesia is indicated if an x-ray confirms the fracture
Correct Incorrect Correct answer

NSAIDs should be avoided if open reduction and internal fixation is planned
Correct Incorrect Correct answer

Correct

Incorrect
Question 4 of 10

4. Question

A 6-year-old boy (20 kg) is admitted to the ED with suspected DKA. He is vomiting and clinically dehydrated.

On examination he localises to pain, is opening his eyes spontaneously and is confused.

What is his Glasgow Coma Score (GCS)?

15
Correct Incorrect Correct answer

14
Correct Incorrect Correct answer

13
Correct Incorrect Correct answer

9
Correct Incorrect Correct answer

3
Correct Incorrect Correct answer

Correct

Incorrect
Question 5 of 10

5. Question

A 4-week-old baby presents with a seven day history of vomiting small amounts after feeds. She is breast-fed every three hours and her parents describe it as non-projectile and milk coloured. She has plenty of wet and dirty nappies and is thriving. The child is otherwise well, asymptomatic and there is no abnormality on examination. Her weight is 3.5kg.

What is the most appropriate management?

Start lactose-free formula
Correct Incorrect Correct answer

Start infant Gaviscon®
Correct Incorrect Correct answer

Start domperidone
Correct Incorrect Correct answer

Refer to paediatrics
Correct Incorrect Correct answer

Reassurance and SOS advice
Correct Incorrect Correct answer

Correct

Incorrect
Question 6 of 10

6. Question

A gentleman attends your emergency department complaining of suprapubic colicky pain and frank haematuria. He is passing clots and is in a great deal of pain. You discover he has had a TURBT (A trans urethral resection of a bladder tumour) 3 days earlier. You correctly diagnose clot retention. Appropriate management would consist of:

Resuscitate and place a single lumen foley catheter in to relieve the retention
Correct Incorrect Correct answer

Push clear fluids to keep the urine clear
Correct Incorrect Correct answer

Provide analgesia and antibiotics and refer the patient to the next urological clinic
Correct Incorrect Correct answer

Resuscitate as required with iv access and fluids. Insert a three way irrigation catheter of sufficient gauge to allow irrigation and dispersal of the clots
Correct Incorrect Correct answer

Insert a suprapubic catheter as first line measure to irrigate the bladder to decrease the risk of introducing infection
Correct Incorrect Correct answer

Correct

Incorrect
Question 7 of 10

7. Question

A 50-year-old lady presents with a history of fresh PR bleeding.

Which one of the following is true with regards to your initial history and examination ?

Abdominal pain is common with lower GI bleeding
Correct Incorrect Correct answer

A drug history is of little relevance
Correct Incorrect Correct answer

A recent history of cardiac arrhythmia may help guide towards the likely source of bleeding
Correct Incorrect Correct answer

Fresh PR bleeding always indicates a lesion in the left side of the colon
Correct Incorrect Correct answer

Abdominal pain suggests angiodysplasia as the cause of bleeding
Correct Incorrect Correct answer

Correct

Incorrect
Question 8 of 10

8. Question

A young male is brought to you with a 7/7 history of gradually worsening headache and lethargy. He is from Uganda and has recently been home to see his family. He is cachexic and lethargic. He has a temp of 37.9oC. Which of the following is correct?

This presentation is unlikely to be TB meningitis due to the sub-acute course
Correct Incorrect Correct answer

You would expect CSF analysis to show very high levels of protein and high levels of glucose in TB meningitis
Correct Incorrect Correct answer

Immunocompromised patients are at increased risk from Cryptococcus, toxoplasmosis and TB meningitis
Correct Incorrect Correct answer

Brain abscesses are more common in females than males
Correct Incorrect Correct answer

Correct

Incorrect
Question 9 of 10

9. Question

After imaging, your patient is diagnosed as having a vertebral artery dissection. He is otherwise fit and not on any medication. You decide to treat him with which of the following?

Heparin infusion
Correct Incorrect Correct answer

Nitroprusside infusion
Correct Incorrect Correct answer

Aspirin
Correct Incorrect Correct answer

Labetalol infusion
Correct Incorrect Correct answer

Cervical spine immobilisation
Correct Incorrect Correct answer

Correct

Incorrect
Question 10 of 10

10. Question

At 8am a 76-year-old man presents with acute shortness of breath. On examination, he is agitated and fighting for breath, but denies any chest pain. He has widespread inspiratory crackles and his saturations are 84% on room air.

Which one of the following actions would you take first?

Administer high-flow O2 and sit him up
Correct Incorrect Correct answer

Assess his airway and call for an anaesthetist
Correct Incorrect Correct answer

Establish IV access and take baseline bloods including troponin
Correct Incorrect Correct answer

Discuss with his family his wishes for resuscitation
Correct Incorrect Correct answer

Request an urgent ECG and CXR
Correct Incorrect Correct answer

Correct

Incorrect

4 Comments

Dr Kamran Syed Muhammad April 5, 2023 at 8:50 pm

Good questions

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Dr Syed Shahbaz Ahmer July 2, 2023 at 11:06 am

Great review of multiple topics

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Ildiko Osko August 27, 2023 at 1:51 pm

Good

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Mr Abdul Khan Rehman September 3, 2024 at 9:47 am

Excellant MCQs

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