Emergency Medicine
Study Guide Questions
Course Introduction
Emergency Medicine is a multidisciplinary medical specialty focused on the immediate evaluation, diagnosis, and management of acute illnesses and injuries that require urgent attention. This course provides students with foundational knowledge and practical skills necessary for the rapid assessment and stabilization of patients in emergency settings. Topics include primary approaches to trauma, cardiopulmonary resuscitation, airway management, shock, toxicology, and common medical emergencies such as myocardial infarction, stroke, and sepsis. Emphasis is placed on teamwork, critical thinking, and the ability to make swift, evidence-based decisions under pressure to optimize patient outcomes.
Recommended Textbook
Respiratory Disease A Case Study Approach to Patient Care 3rd Edition by James R. Dexter
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20 Chapters
484 Verified Questions
484 Flashcards
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Chapter 1: Introduction to Patient Assessment
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) The pulse oximeter may not be reliable in which of the following conditions?
A)Poor circulation
B)Carbon monoxide poisoning
C)Both A and B
D)None of the above
Answer: C
Q2) What is indicated by abdominal paradox?
A)Liver failure
B)Heart failure
C)Diaphragm fatigue
D)CNS disorder
Answer: C
Q3) Your patient has upper airway inflammation from a viral infection.What adventitious lung sound is expected?
A)Polyphonic wheezing
B)Expiratory rhonchi
C)Fine crackles
D)Inspiratory stridor
Answer: D
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Page 3
Chapter 2: Introduction to Respiratory Failure
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Which of the following modes of therapy is most likely to be effective when the patient has hypoxemia due to physiologic shunting?
A)Simple oxygen mask
B)Nasal cannula
C)Air entrainment mask
D)Positive pressure ventilation
Answer: D
Q2) What weaning parameter may be most useful because it evaluates the patient's breathing endurance as well as current pulmonary status?
A)Peak inspiratory pressure
B)Vital capacity
C)Rapid shallow breathing index
D)Spontaneous respiratory rate
Answer: C
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4
Chapter 3: Asthma
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23 Flashcards
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Sample Questions
Q1) Which of the following conditions is least likely to mimic the symptoms of an asthma attack?
A)Congestive heart failure
B)Bronchitis
C)Acute respiratory distress syndrome
D)Acute upper airway obstruction
Answer: C
Q2) Which of the following physical examination findings is least associated with an asthma attack?
A)Prolonged inspiratory time
B)Polyphonic wheezing
C)Heavy use of accessory muscles
D)Retractions
Answer: A
Q3) Which of the following is NOT associated with provoking an asthma attack?
A)Aspirin use
B)Exercise
C)Viral respiratory infection
D)Use of Atropine to increase heart rate
Answer: D
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Chapter 4: Chronic Obstructive Pulmonary Disease
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) About how many deaths are attributed to COPD each year in the United States?
A)10,000
B)50,000
C)100,000
D)200,000
Q2) What is the most common source of noxious fumes and inhaled particles associated with the cause of COPD?
A)Smog
B)Smoking
C)Occupational dusts
D)Indoor pollutants
Q3) COPD patients with cor pulmonale typically have which of the following physical examination findings?
A)JVD
B)Hepatomegaly
C)Pedal edema
D)All the above
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Chapter 5: Cystic Fibrosis
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20 Flashcards
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Sample Questions
Q1) Why are patients with cystic fibrosis frequently malnourished?
A)Pancreatic exocrine insufficiency
B)Inadequate food intake
C)High metabolic demand from infections
D)All the above
Q2) What is the medical problem that most cystic fibrosis patients first seek help for?
A)Recurrent pulmonary infections
B)Frequent episodes of hyperglycemia
C)Bowel obstructions
D)Weight loss
Q3) Which of the following upper airway problems is common in patients with cystic fibrosis?
A)Nasal polyps
B)Sinusitis
C)Deviated septum
D)A and B only
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Chapter 6: Hemodynamic Monitoring and Shock
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20 Flashcards
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Sample Questions
Q1) Which of the following clinical findings is least consistent with left heart failure?
A)Inspiratory crackles
B)Distended neck veins
C)Cool extremities
D)Elevated pulse pressure
Q2) What hemodynamic monitoring result is most consistent with cardiogenic shock?
A)CVP = 2 mmHg
B)Cardiac output = 5 L/min
C)PCWP = 20 mmHg
D)Mean blood pressure = 85 mmHg
Q3) What is the most common cause of distributive shock?
A)Toxic ingestion
B)Head trauma
C)Sepsis
D)Chest trauma
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Chapter 7: Pulmonary Thromboembolic Disease
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) Your patient has a fairly large pulmonary thromboembolism.What physical exam finding(s)is/are expected?
A)Loud P2
B)Jugular venous distention
C)Hypotension
D)All the above
Q2) What percent of the pulmonary vascular bed must be occluded by emboli before cardiac output drops and hypotension is present?
A)10%
B)25%
C)50%
D)75%
Q3) What finding is most common in the ECG of the patient with pulmonary thromboembolism?
A)Elevated ST segment
B)Normal
C)First degree block
D)Frequent PVCs
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Chapter 8: Heart Failure
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) When looking at the chest radiograph,what term is associated with an abnormal increase in blood flow to the apices?
A)Ascites
B)Cephalization
C)Caudalization
D)Homans' sign
Q2) What is the normal value for ejection fraction in a healthy heart?
A)40%
B)50%
C)60%
D)70%
Q3) Which of the following mechanisms is NOT helpful to the heart in compensating for a failing left ventricle and a falling cardiac output?
A)Increased contractility due to increased stretch
B)Increased heart rate due to release of epinephrine by the nervous system
C)Increased system vascular resistance due to release of catecholemines
D)Increased myocardial muscle thickness due to chronic high work load
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Chapter 9: Smoke Inhalation Injury and Burns
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) A 40-year-old patient was found unconscious in a running vehicle parked in a garage.Burns to the neck appear to have come from the cigarette he had been smoking.Arterial blood gases are as follows: pH = 7.36
PaCO<sub>2 </sub>= 46
PaO<sub>2</sub> = 90
HCO<sub>3</sub> = 24
BE = 0
Regarding oxygen administration,which is the most appropriate device?
A)No oxygen necessary
B)Cannula at 6 L/min
C)Face tent with cool humidity at 40%
D)100% non-rebreathing mask at 10 L/min
Q2) Delayed neuropsychological sequelae of carbon monoxide poisoning include all of the following except:
A)Movement disorders
B)Cognitive deficits
C)Arrhythmias
D)Personality changes
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11
Chapter 10: Near Drowning
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23 Flashcards
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Sample Questions
Q1) Your near drowning patient has an initial Glasgow Coma Scale score of 13.What should be done?
A)Admit patient to the ICU
B)Admit patient to the pulmonary ward
C)Observe patient for 4-6 hours and send him home if SpO<sub>2</sub> is normal
D)Send the patient home as soon as he demonstrates the ability to swallow
Q2) What is the primary concern during the first week for a near drowning victim who is sent home after 24 hours of observation and appears to be doing well?
A)Long-term neurologic damage
B)Sudden heart failure
C)Pulmonary infection
D)Pulmonary embolism
Q3) Your patient has just entered the ER and was pulled from a swimming pool unconscious.Which of the following factors predicts a poor prognosis?
A)Elevated serum glucose levels
B)Hyperthermia
C)Hyperactive pupil response to light
D)All the above
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Chapter 11: Acute Respiratory Distress Syndrome
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Which of the following measurements is obtainable only with a Swan-Ganz catheter?
A)PCWP
B)SaO<sub>2</sub>
C)CVP
D)None of the above (all are obtainable with a Swan-Ganz catheter)
Q2) All of the following are side effects of PEEP except:
A)Decreased lung compliance from overdistended alveoli
B)Barotrauma
C)Increased cardiac output
D)Increased PVR
Q3) Your ARDS patient is being mechanically ventilated with PEEP.The PEEP is increased from 10 cwp to 15 cwp.Subsequently,the mixed venous PO<sub>2</sub> drops from 40 mmHg to 32 mm Hg.What does this indicate?
A)PaO<sub>2</sub> dropped
B)Cardiac output dropped
C)PEEP should be increased more
D)The FIO<sub>2 </sub>should be increased
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Chapter 12: Chest Trauma
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Acute lung injury or acute respiratory distress syndrome is likely to develop following blunt chest trauma if
A)The injury severity score is <25
B)There is hypotension on admission
C)Patient is 15 to 25 years of age
D)Crackles are heard on inspiration
Q2) Your chest trauma patient arrives in the emergency department wearing a cervical collar and is being assisted via a resuscitation bag.Which of the following steps would be least appropriate?
A)Nasotracheal intubation employing a bronchoscope
B)Attempt an orotracheal intubation by hyperextending the neck
C)Set up for a cricothyrotomy
D)Place an oropharyngeal airway
Q3) Which is the most common site of aortic rupture in chest trauma?
A)Descending aorta near its hiatus in the diaphragm
B)Ascending aorta just distal to its semilunar valve
C)Upper thoracic aorta,near the left subclavian artery
D)Arch of the aorta near the brachiocephalic artery
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Chapter 13: Postoperative Atelectasis
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18 Flashcards
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Sample Questions
Q1) Which of the following findings on the chest radiograph suggests that the atelectasis is due to mucus plugging?
A)Air bronchograms
B)Shift of the mediastinum
C)Elevation of the diaphragm
D)Blurring of the right heart border
Q2) What prior diagnosis increases the risk of postoperative atelectasis due to mucus plugging?
A)Chronic bronchitis
B)Pulmonary fibrosis
C)Sarcoidosis
D)Congestive heart failure
Q3) Which of the following factors contributes to the incidence of postoperative atelectasis during general anesthesia?
A)Use of humidified anesthetic gases
B)Excessive blood loss
C)Use of paralytic agents
D)Too little fluid replacement
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15
Chapter 14: Interstitial Lung Disease
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20 Flashcards
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Sample Questions
Q1) Clubbing of the digits
A)Is a frequent finding in ILD
B)Is rare,but always belies serious underlying pathology
C)Is seen particularly with asbestosis
D)None of the above
Q2) What may be the earliest evidence on a standard pulmonary function test of the presence of ILD?
A)Abnormal DLCO
B)Decreased FEV1/FVC
C)Widened P(A-a)O<sub>2</sub>
D)Increased shunt
Q3) A prominent component of the second heart sound (loud P2)is indicative of what?
A)Pulmonary hypertension
B)Mitral regurgitation
C)Gallop rhythm
D)Tricuspid atresia
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16
Chapter 15: Neuromuscular Diseases
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28 Flashcards
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Sample Questions
Q1) What is the response of the central (medullary)chemoreceptors to hypoxemia?
A)None
B)Brisk in contrast to the peripheral chemoreceptors
C)Slower but more sustained response than the peripheral chemoreceptors
D)Response augmented when hypercapnia also present
Q2) Which of these room air ABGs represents acute weakness of the respiratory muscles?
A)pH 7.50,PCO<sub>2</sub> 30,PO<sub>2</sub> 55
B)pH 7.20,PCO<sub>2</sub> 60,PO<sub>2</sub> 55
C)pH 7.55,PCO<sub>2</sub> 40,PO<sub>2</sub> 100
D)None of the above
Q3) Which of these are true regarding myasthenia gravis?
A)There is an approximately 2 to 1 female to male ratio
B)It is typically a descending paralysis
C)It may be diagnosed using the Tensilon test
D)All the above
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Page 17
Chapter 16: Bacterial Pneumonia
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20 Flashcards
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Sample Questions
Q1) Factors that suppress the immune system include all of the following except:
A)Transplantation
B)AIDS
C)Leukemia
D)Poor hand washing
Q2) Lobar pneumonia is evidenced by all of the following except:
A)Unilateral chest expansion on involved side
B)Increased tactile fremitus on involved side
C)Bronchial breath sounds
D)Increased resonance to percussion
Q3) Which of these is not a typical early sign or symptom of pneumonia?
A)Fever
B)Pleuritic pain
C)Dyspnea
D)Nausea
Q4) All of these are pulmonary factors that can predispose to pneumonia except:
A)Asthma
B)Smoking
C)Pulmonary hypertension
D)Bronchial obstruction by tumor
Page 18
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Chapter 17: Pneumonia in the Immunocompromised Patient
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Sample Questions
Q1) Which of these is not a principle characteristic governing immunity?
A)Recognition of non-self
B)Memory
C)Specificity
D)Simplicity
Q2) Which of these statements does not describe empiric therapy for immunocompromised pneumonia patients?
A)Is initiated with a broad-spectrum antibiotic
B)Is directed toward organisms least likely to have caused infection
C)Initiated without waiting for culture results
D)Is not directed at any as yet identified organisms
Q3) IV drug use,sexual promiscuity,and opportunistic lung infection should lead you to suspect
A)AIDS
B)Klebsiella pneumonia
C)Primary atypical pneumonia
D)None of the above
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Chapter 18: Sleep Disordered Breathing
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Sample Questions
Q1) The Epworth sleepiness scale is used to measure the degree of daytime sleepiness.What score suggests excessive daytime sleepiness?
A)11
B)15
C)20
D)All the above
Q2) Your patient has obstructive sleep apnea due to obesity.What initial recommendations would you make to the patient?
A)Weight loss
B)Changing sleep position
C)Avoid sleeping pills
D)All the above
Q3) Why do patients with obstructive sleep apnea complain of excessive daytime sleepiness?
A)CO<sub>2</sub> build up during sleep makes the brain abnormal
B)Sleep is normal,but patient perception is not
C)Sleep is very fragmented
D)Nobody knows
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Chapter 19: Tuberculosis
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Sample Questions
Q1) Which of the following factors are associated with your patient having a higher risk for TB?
A)Immigrant from Asia
B)Cancer patient on chemo
C)Organ transplant patient
D)All the above
Q2) What is the leading killer of HIV-infected patients?
A)Hepatitis
B)Tuberculosis
C)Sarcomas
D)Kidney failure
Q3) What percent of new TB cases diagnosed each year around the world are from the United States?
A)4%
B)12%
C)18%
D)24%
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21
Chapter 20: Lung Cancer
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Sample Questions
Q1) Your patient has one eyelid drooping with a pinpoint pupil,with lack of sweating and arm weakness on that same side.What is the likely cause?
A)Horner's syndrome
B)Erb's paralysis
C)Bell's palsy
D)Eaten-Lambert syndrome
Q2) The fact that the overall survival rate for patients presenting with lung cancer is about 10% reflects what fact?
A)The disease is already advanced at time of diagnosis
B)The patients generally continue smoking
C)Infections are common
D)The patient is noncompliant with antineoplastic regimen
Q3) What percent of lung cancer patients have a surgically resectable tumor at the time of diagnosis?
A)10%
B)20-30%
C)30-50%
D)50-60%
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