Emergency Medicine
Noha Musa
MCQ 1
Infants and children are more prone to suffer
emergency situations due to the following
except:
- Temperature instability.
- High fluid content with liability to
dehydration.
- Small and narrow airway with large tongue.
- High glycogen stores with liability to
hypoglycemia.
MCQ 2
Assessment of breathing includes :
- Respiratory rate and effort
- Chest expansion and movement
- Lung and airway sounds
- O2 saturation
- All of the above
MCQ 3
Assessment of circulation includes the
following except:
- Heart rate and rhythm
- Respiratory rate
- Capillary refill time
- Skin colour and temperature
- Blood pressure
MCQ 4
Signs of respiratory distress include the
following except:
- Grunting
- Cyanosis
- Tachypnea
- Nasal flaring
- Cold extremities
MCQ 5
Indications of Oxygen therapy include:
- Respiratory distress and respiratory failure
- Circulatory failure
- Neurologic failure
- All of the above
MCQ 6
Methods of Oxygen administration include the
following :
- Nasal cannula
- O2 box
- O2 incubator
- O2 mask
- All of the above
MCQ 7
High flow O2 can be delivered using the
following except:
- O2 cannula
- O2 bag and mask
- Non-rebreathing bag
- Mechanical ventilator
MCQ 8
Low flow oxygen delivery can be given
through:
- Venturi mask
- O2 cannula
- Mechanical ventilator
- Bag and mask
MCQ 9
Complications of O2 therapy include the
following except:
- Retinopathy of prematurity
- Bronchopulmonary dysplasia
- O2 dependancy
- Polycythemia
MCQ 10
Types of shock include the following except:
- Cardiogenic
- Hypovolemic
- Hypothermic
- Septic
- Neurogenic
MCQ 11
A patient who developed tension pneumothorax
can develop which type of shock?
- Septic
- Hypovolemic
- Obstructive
- Distributive
Case 1
A patient 15 mo old came to the casuality
complaining of watery diarrhea (12 motions
/day) and vomiting. Patient was drowsy, with
sunken eyes, lost skin turgor, dry tongue,
oliguria and tachycardia. His periphery was cold,
mottled with poor capillary refill. What is your
provisional diagnosis?
- Peripheral cyanosis
- Heart failure
- Shock
Case 1
What is the type of shock in this case?
- Septic shock
- Cardiogenic shock
- Obstructive shock
- Hypovolemic shock
Case 1
What is the initial management for this case?
- Give inotropic support
- Administer packed RBCs
- Give steroids
- Administer isotonic saline 20 cc/kg
- None of the above
Case 1
If initial management failed, what can be done
next?
- Repeat anti shock
- Give O2
- Give inotropes
- All of the above
Case 1
In this case, which management is wrong?
- Start antibiotics as soon as possible to
prevent mortality.
- Monitor SpO2, HR, BP, capillary refill,
conscious level, temperature, urine output.
- Check blood gases, serum electrolytes, renal
function tests.
- After anti-shock, correct residual
dehydration
MCQ 12
Epinephrine:
- ↑ Heart rate and ↑ cardiac contractility
- May ↓ renal perfusion at high doses
- ↑ Risk of arrhythmias at high doses
- Is a potent vasoconstrictor
- All of the above
MCQ 13
Dopamine can cause significant peripheral
vasoconstriction at doses:
- 3-5 mcg/kg/min
- 5-10 mcg/kg/min
- >10 mcg/kg/min
- None of the above
MCQ 14
Dobutamine is:
- Potent peripheral vasoconstrictor
- Anti-arrhythmic drug
- Peripheral vasodilator
- Increase renal perfusion
MCQ 15
Norepinepherine:
- ↓ Blood pressure secondary to ↑ systemic
vascular resistance
- Potent peripheral vasoconstrictor
- Peripheral vasodilator
- ↑ cardiac contractility
MCQ 16
Dose of Norepinephrine is:
- 0.05-1.5 ug/kg/min
- 1-10 ug/kg/min
- 3-15 ug/kg/min
- 0.5-2.0 ug/kg/min
MCQ 17
Epinephrine dose is:
- 3-20 ug/kg/min
- 0.05-3.0 ug/kg/min
- 0.5-3.0 ug/kg/min
- 1-10 ug/kg/min
MCQ 18
Regarding pain management, all of the
following is correct except:
- Fentanyl is 100 times more potent than
morphine
- Opioids are administered for moderate and
severe pain
- Aspirin can be used for control of pain in
toddlers
- Morphine is the most commonly opioid used
MCQ 19
Aspirin in pediatrics can be used in patients
with:
- High grade fever
- Gastritis
- Reye syndrome
- Thrombocytosis
MCQ 20
Acetaminophen dose is:
- 10-15 mg/kg/day
- 10-15 mg/kg/dose
- 5-10 mg/kg/day
- 5-10 mg/kg/dose
MCQ 21
Regarding paracetamol, all of the following is
correct except:
- Can be given both orally and rectally
- Is safely given in patients with fulminant
hepatic failure
- Dose is 10-15 mg/kg/dose 4-6 hourly
- Has little anti-inflammatory action; no
antiplatelet or adverse gastric effects
MCQ 22
Regarding NSAIDs:
- Ibuprofen may cause gastritis
- Ibuprofen dose is 15-20 mg/kg PO q6h
- Are more potent than opioids in analgesia
- Ketorolac is only given orally
MCQ 23
Which of the following is correct regarding
opioids?
- Opioids are administered for cancer pain.
- Opioids need no dose tapering
- Opioid-induced respiratory depression is
treated by indomethacin
- Oral codeine is the most potent opioid
analgesic
MCQ 24
Regarding Fentanyl:
- It is less potent than morphine
- It is safe for renal patients
- It is extremely hydrophilic, with a rapid
onset and short duration of action.
- Causes significant hypotension
MCQ 25
Fentanyl dose is:
- 0.5-1 μg/kg/hr
- 5-10 μg/kg/hr
- 0.5-1 μg/kg/min
- 5-10 μg/kg/hr
Case 2
A full term newborn delivered by CS, the mother
received heavy opioids during delivery.
Resuscitation was eventful with low APGAR and
flaccidity. If initial tactile stimulation was not
enough for respiratory stimulation, baby can
benefit from:
- Caffeine citrate
- Theophylline
- Naloxone
- None of the above
Case 2
The dose of naloxone is:
- 0.01-0.02 mg/kg up to a full reversal dose of
0.1 mg/kg.
- 0.1-0.2 mg/kg up to a full reversal dose of 1
mg/kg.
- 0.01-0.02 mcg/kg up to a full reversal dose of
0.1 mg/kg.
- 0.1-0.2 mcg/kg up to a full reversal dose of 1
mg/kg.
Case 2
Regarding naloxone:
- Is given only IV
- Dose may be repeated every 2 min to a total
of 10 mg.
- Can cause respiratory depression
- Is a NSAID
Case 2
If the above measure failed:
- Give anti-shock
- Give epinephrine
- Give theophylline
- Put patient on mechanical ventilator
MCQ 26
The most important thing to know in case of
poisoning:
- Timing of ingestion
- Family background
- Social environment
- Whether suicidal or homicidal
MCQ 27
Pin point pupils occur in cases with:
- Phenytoin poisoning
- Organophosphorus poisoning
- Atropine poisoning
- Cocaine poisoning
MCQ 28
Excessive salivation occurs with:
- Organophosphates poisoning
- Salicylates poisoning
- Corrosives
ingestion
- All of the above
- None of the above
MCQ 29
Bradycardia can be caused by:
- Loop diuretics
- β-blockers
- Epinephrine
- Theophylline
MCQ 30
The following drugs can cause hematemesis:
- Iron
- NSAIDs
- Caustics
- All of the above
MCQ 31
Cyanosis unresponsive to oxygen can be due to:
- Respiratory failure
- CNS depression
- Methemoglobinemia
- Heart failure
MCQ 32
GI decontamination is most likely to be
effective:
- Only within 5 min
- In the first hour
- In the first 2 hours
- In the first 4 hours
MCQ 33
Enhanced drug elimination can be done by the
following except:
- Multiple-Dose Activated Charcoal
- Urinary Alkalinization
- Dialysis
- Antidotes
MCQ 34
Antidote for acetaminophen is :
- Atropine
- N-acetyl cysteine
- Deferoxamine
- BAL
MCQ 35
Antidote for OPS :
- Atropine
- N-acetyl cysteine
- Deferoxamine
- BAL
MCQ 36
Dose of atropine in OPS poisoning:
- 0.05-0.1 mg/kg repeated q5-10min
- 0.5-1 mg/kg repeated q5-10min
- 0.05-0.1 mg/kg repeated q20-30min
- 0.5-1 mg/kg repeated q20-30min
MCQ 37
Iron overload is treated by:
- Copper
- N-acetyl cysteine
- Deferoxamine
- Physostigmine
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