EM Quiz 14

EM Quiz 14

EM Quiz 14 EM Quiz 14

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EM Quiz 14 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: Non-traumatic Subarachnoid Haemorrhage – Learning Session

Q2: Plural Effusion – Learning Session

Q3: Rapid sequence inductions in the Emergency Department – Learning Session

Q4: Secondary Headache – Learning Session

Q5: Systematic Interpretation of the Spinal Radiograph – Learning Session

Q6: The Mental Health Act and Emergency Medicine – Learning Session

Q7: Violent Behaviour in the ED – Learning Session

Q8: Zygomatic Complex and Nasal Injury – Learning Session

Q9: Electrical Burns in the ED – Learning Session

Q10: External Eye and Tear Duct Infections – Learning Session

Why not try another RCEMLearning – EM Quiz

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Question 1 of 10

1. Question
It is 02:00 hrs when you see a 44-year-old man who has presented with an acute thunderclap headache (onset 2030 hrs). He is neurologically pristine and his observations are normal. You think that the patient needs investigation but the radiologist is at home.

What do you do?
- You give the patient analgesia and i/v fluids, admit the patient for neuro-observations and arrange a non-contrast CT head scan for 0800hrs
- You should request an urgent non-contrast CT scan of the brain for detection of SAH
- You request a CT angiogram as the first investigation so as to get a good picture of the intracranial vasculature as well as indication of SAH
- MRI would ideally be the investigation of choice to exclude SAH
- Lumbar Puncture with CSF analysis for xanthochromia is the most sensitive investigation for the detection of SAH and given this patient’s normal neurological status this should be the first investigation at this time
Correct

Incorrect
Question 2 of 10

2. Question
Which one of the following statements regarding the physiology of pleural fluid is the most appropriate?
- Parietal pleura lines the lungs and visceral pleura lines the inside of the chest wall
- The LDH level of pleural fluid is usually >50% that of plasma LDH
- The glucose content of pleural fluid and plasma are typically similar
- Transudate effusions can be caused by increase colloid oncotic pressure
- Malignancy is a cause of a transudate effusion
Correct

Incorrect
Question 3 of 10

3. Question
Which of the following is not a component of the LEMON assessment?
- Look externally
- Evaluate the 3-3-2 rule
- Mallampati assessment
- Ensure ventilator tubing and filter is connected and functioning
- Neck mobility
Correct

Incorrect
Question 4 of 10

4. Question
In a patient suspected of SAH, which of the following is true?
- Risk factors include a positive family history
- In patients under 20 years, the cause is most commonly rupture of a berry aneurysm
- In older patients, the commonest cause is haemorrhage from an AV malformation
- The outcome is not directly related to the neurological status at presentation
- Fifty percent of patients have a good outcome
Correct

Incorrect
Question 5 of 10

5. Question
A 35-year-old lady is brought to the emergency department (ED) following a high speed road traffic collision (RTC). Her vehicle was overturned at the scene. She has full spinal immobilisation in situ. She is complaining of pain in the lower cervical spine. Her primary survey is otherwise unremarkable and she has no other significant injuries detectable at this stage.

What do her cervical spine x-rays demonstrate?
- Type I odontoid peg fracture
- Normal 3 series cervical spine films
- Jefferson fracture
- Type II odontoid peg fracture
- Unifacet dislocation C2/3
Correct

Incorrect
Question 6 of 10

6. Question
Concerning Section 136 of the Mental Health Act, which of the following statements are true?
- All patients accompanied by the police in the ED are detained under Section 136
- The twenty-four-hour period of detention starts as soon as the patient arrives in the ED or other Place of Safety
- Under some circumstances the period of detention can be extended for a further 12 hours
- The police are responsible for the safety and any transport necessary for an individual detained under Section 136 until given permission to leave
- Physical health concerns are secondary to mental health issues.
Correct

Incorrect
Question 7 of 10

7. Question
An agitated and dishevelled, 40-year-old woman is brought by ambulance, after being found fully-clothed in a public park. No other history is available. She does not smell of alcohol. She is easily arousable to verbal commands but appears disorientated . She lashes out at staff trying to take her vital signs and conduct other observations. Her blood pressure is 130/90 mm Hg, pulse is 78 beats/minute, respiratory rate is 13 breaths/minute and her temperature is 35⁰C. There is no medic-alert bracelet. There are no obvious signs of injury. She has a GCS of 12 [E3, M5, V4]. Her pupils are 2 mm, equal and reactive. Her rapid bed side glucose is 5.1 mmol/L. As you evaluate her chest she strikes you hard with her right hand and tells you to leave her alone, [that] she ‘just wants to sleep’.

Your actions should be:
- Seek to determine her capacity and need for treatment against her expressed wishes
- Recognize that there are likely to be medical reasons for her behavior and investigate and treat her against her expressed will, using restraint if necessary
- She has committed an assault, call the police and make a complaint
- Accede to her request, she just wants to sleep, go back and review her later
Correct

Incorrect
Question 8 of 10

8. Question
The anatomy of the zygoma and surrounding bones of the midface is complex. One of the following statements is true regarding this anatomy, which one is it?
- The zygomatic complex is best thought of as a tripod as it has three distinct attachments
- The zygoma forms a significant part of both the lateral and inferior orbital margins
- The zygomatic arch is predominantly formed by the temporal process of the zygoma
- The infraorbital nerve is a branch of the mandibular division of the trigeminal nerve
- The orbital walls are formed from seven different bones and are therefore extremely resistant to fracture
Correct

Incorrect
Question 9 of 10

9. Question
Which of the following can result from Rhabdomyolysis caused by electrical current?
- Hyperkalaemia
- Hypercalcaemia
- Renal failure
- Hyperphosphataemia
- Brown discolouration of the urine
Correct

Incorrect
Question 10 of 10

10. Question
A 20-year-old man presents to the ED with a discrete swelling on his right upper eyelid. He believes he has a ‘stye’.

Which of the following findings would lead you to suspect that this was actually a chalazion?
- Sticky discharge noticed on waking
- Duration of more than two weeks
- The lesion is very tender to the touch
- The lesion appears erythematous
- Conjunctivitis also present
Correct

Incorrect

4 Comments

Collapse Comments

Dr Fatma Hassan ElBastwesy Aly May 19, 2023 at 1:53 pm

Very interesting.
Well informative
Thanks

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Ashraf Ali July 31, 2023 at 8:09 pm

good mix of cases

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Dr Atif Munir December 6, 2023 at 4:59 pm

Excellent revision

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Dr Ahmed Mnofala December 5, 2025 at 3:31 pm

Very tricky but very informative
I Really appreciate them

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