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
- The aorta lies to the right of the midline
- The maximum external diameter is 3 cm at the bifurcation
- The origin of the superior mesenteric artery (SMA) is 2 cm above the bifurcation
- The aorta bifurcates just above the umbilicus (L4)
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
- Pulsating
- Duration 4-72 hours
- Unilateral
- Disabling
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
- The College recommends 9-18 mg of morphine initially, if he weighs 90 kg
- Regional anaesthesia is indicated if an x-ray confirms the fracture
- NSAIDs should be avoided if open reduction and internal fixation is planned
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. He has a heart rate of 140 beats/min, capillary refill time of 3-4 seconds, reasonable volume peripheral pulses and blood pressure within normal limits.

What is his Glasgow Coma Score (GCS)?
- 15
- 14
- 13
- 9
- 3
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
- Start infant Gaviscon®
- Start domperidone
- Refer to paediatrics
- Reassurance and SOS advice
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
- Push clear fluids to keep the urine clear
- Provide analgesia and antibiotics and refer the patient to the next urological clinic
- 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
- Insert a suprapubic catheter as first line measure to irrigate the bladder to decrease the risk of introducing infection
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
- A drug history is of little relevance
- A recent history of cardiac arrhythmia may help guide towards the likely source of bleeding
- Fresh PR bleeding always indicates a lesion in the left side of the colon
- Abdominal pain suggests angiodysplasia as the cause of bleeding
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
- You would expect CSF analysis to show very high levels of protein and high levels of glucose in TB meningitis
- Immunocompromised patients are at increased risk from Cryptococcus, toxoplasmosis and TB meningitis
- Brain abscesses are more common in females than males
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
- Nitroprusside infusion
- Aspirin
- Labetalol infusion
- Cervical spine immobilisation
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
- Assess his airway and call for an anaesthetist
- Establish IV access and take baseline bloods including troponin
- Discuss with his family his wishes for resuscitation
- Request an urgent ECG and CXR
Correct

Incorrect

4 Comments

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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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