Sal “all Ot 92% [12:49 < @ Online Enterence Test Ims.stmu.edu.pk Question 26 Not yet answered Marked out of 1.00 Flag question A48 years old man fell on his outstretched hand upon attempting to make a catch while playing cricket. He presents to the emergency department complaining of severe wrist pain which is also swollen. There is tenderness felt in the anatomical snuff box. Which of the following carpel bone is most frequently injured ina fall on the outstretched hand (FOOSH)? Select one: a. Triquetrum b. Seaphoid c. Lunate d. Capitate e. Pisiformall al IO 97% Twi 4:15 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 9 Not yet answered Marked out of 1.00 7. A37-year-old male presents to ED witha history of knife attack on the neck. The patient can answer questions himself but is bleeding profusely from the wounD. Vitals: HR: 125 beats/ minutes, BP: 100/60 mm Hg, R/R:22/min, Sats: 94% on room air. The next step should be Select one: a. Recognize Zone II injuries as mandatory for surgical exploration and consult ENT immediately b. Control bleeding with direct pressure and avoid blind clamping of vessels. c. Order fiberoptic esophagoscopy, which if negative excludes a significant esophageal injury. d. Not attempt rapid sequence intubation, as these patients invariably require a surgical airway.Sal “all 1D 96% (a) 12:16 < @ Online Enterence Test Ims.stmu.edu.pk = [2 > Mycourses > 3 > General > Online Enterence Test Question 9 Not yet answered Marked out of 1.00 'F Flag question An umbilical hernia is commonly found in all except: Select one: a. Down's syndrome b. Infants of diabetic mothers c, Congenital hypothyroidism d, Mucopolysaccharide storage diseases e. Preterm babies.Sal! “all 1D 96% (eh 12:12 Question 6 Not yet answered Marked out of 1.00 YF Flag question A58-year- old man is brought to the ED by his family. They state that he has been vomiting large amounts of bright red blooD. The patient is an alcoholic with cirrhotic liver disease and a history of portal hypertension and esophageal varices. His vitals on arrival are HR 110 beats per minute, BP 80/55 mm Hg, RR 22 breaths per minute, and temperature 99°F. The patient appears pale and is in moderate distress. Which of the following is an inappropriate option in the initial management of a hypotensive patient with a history of known esophageal varices presenting with hematemesis? Select one: a. Nasogastric (NG) lavage b. Sengstaken-Blakemore tube placement c.1V octreotide d. Two large-bore IV lines and volume repletion with crystalloid solutions e. Gastrointestinal (Gl) consultall Sn! & OE 94% (vill 4:38 > Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 20 Not yet answered Marked out of 1.00 23. A 15 year old girl has presented in an unconscious state after ingesting large quantity of sleeping pulls which her mother uses. Her GCS is 6/15. Which of the following can be used as an antidote? Select one: a. Flumezanil b, N-acetylcysteine c. Naloxone d. Atropine Next page = Quiz navigationSal “all 1D 93% [th 12:42 [= > Mycourses > 3 > General > Online Enterence Test Question 22 Not yet answered Marked out of 1.00 YF Flag question A4-year-old boy is brought by his parents because he swallowed some of his grandmother's antihypertensive medicinE, He is sleepy, bradycardic, and hypotensivE. Which of the following is the most appropriate treatment? Select one: a. Atropine b, Glucagon c, Atropine, glucagon, calcium and high-dose insulin with glucose d. Atropine, glucagon and calcium e. Atropine and glucagon = m ab a ee (117 nNawiratinn , = o a ( SJ L)all all & IO 95% wilt 4:33 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 17 Not yet answered Marked out of 1.00 21. A 24-years-old male is admitted in ICU, having BP: 110/70 mmHg, Pulse: 112, SPO2 98%, ABGs reveal PH 7.32, PCO2 37, PO2 70 and HCO3 22. His clinical status of oxygenation is not matching with pulse oxy-meter due to: Select one: a. Decreased cardiac out put b, Increased systemic vascular resistance c. Carbon mono-oxide poisoning d, Hypothermia Next page = Quiz navigationSal) ‘all Dt 94% [12:33 VIE CHLETCHe Pee Question 18 Not yet answered Marked out of 1.00 F Flag question A 65-year-old woman with a history of congestive heart failure (CHF) is at a family picnic when she starts complaining of shortness of breath. Her daughter brings her to the ED where she is found to have an oxygen saturation of 85% on roomair with rales halfway up both of her lung fields. Her BP is 185/90 mm Hg and pulse rate is 101 beats per minutE. On examination, her jugular venous pressure (IVP) is 6 cm above the sternal anglE. There is lower extremity pitting edemA. Which of the following is the most appropriate first-line medication to lower cardiac preload? Select one: a. Oxygen b. Metoprolol c. Nitroglycerin d. Nitroprusside e. Morphine sulfateall Sn! & IO 97% Gilt 4:20 > Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test question 10 Not yet answered Marked out of 1.00 30. A 24 years old male presents after developinga bluish discoloration of the body, lips and nails. He denies any relevant past medical history. Examination reveals a central cyanosis and a grey complexion. Investigation revealed: Hemoglobin 17.0 g/dl (13.0-18.0), PaO2 13.0 kPa (11.3-12.6) Sa02 (using an oxy-meter) 85% (>95). The most likely diagnosis is Select one: a. Methylene blue poisoning b, Methaemoglobinaemia c. Cyanotic congenital disease d. Hemochromatosis hag 3all Sn! & OE 93% Gill 4:50 > Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 27 Not yet answered Marked out of 1.00 The best option will be: Select one: a. Leg elevation with IV antibiotics b. IV antibiotics c. Fasciotomy d. FFPs transfusion with fasciotomy Next page = quiz navigation a * q O 0Sal all Dt 95% [ah 12:20 < @ Online Enterence Test Ims.stmu.edu.pk > > Mycourses > 3 > General > Online Enterence Test Question 1] Not yet answered Marked out of 1.00 Flag question A60 years old woman is brought to the ED after a head on motor vehicle collision. Her BP: 90/40, HR: 140/min,she speaks coherently. Her breath sounds are equal bilaterally. After 1.5L of fluid resuscitation, her BP: 90/50. A FAST scan examination reveals fluid in the Morison pouch. Which of the following organ is more likely to be injured in blunt abdominal trauma? Select one: a. Spleen b. Kidney c, Liver d. Small intestine e. BladderSal) “all Dt 95% (iwi 12:24 “> * Mycourses > 3 > weneral > Online Enterence Test Question 15 Not yet answered Marked out of 1.00 'F Flag question A79-year- old woman with a history of congestive heart failure, coronary artery disease, and an “irregular heart beat” is brought to the ED by her family. She has been complaining of increasing abdominal pain over the past several days. She denies nausea or vomiting and bowel movements remain unchangeD. Vitals are HR of 114 beats per minute, BP 110/75 mm Hg, and temperature 98°F. On cardiac examination, her HR is irregularly irregular with no murmur detecteD. The abdomen is soft, non- tender, and non-distendeD. The stool is heme- positivE. This patient is at high risk for which of the following conditions? Select one: a. Mesenteric ischemia b. Perforated gastric ulcer c. Diverticulitis d. Sigmoid volvulus e. Acute cholecystitis“all “all OE 99% (wilt 4:08 Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 5 Not yet answered Marked out of 1,00 10. Which of the following would be cause of oozing in a patient who was being transfused 10 units Of RCC (massive blood transfusion); Select one: a. Low fibrinogen b, Dilutional thrombocytopenia c, Citrate toxicity d, Low factor VIII Next page = quiz navigationall Sn! & OE 99% vill 4:08 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 4 Not yet answered Marked out of 1.00 8.A 45-year-old female had a pelvic fracture after falling from a bikE. The patient was managed in ED according to ATLS guidelines. The most significant immediate complication associated with pelvic fracture is: Select one: @ —a.HemorrhagE. b. Sciatic nerve injury. c. Rectal or vaginal lacerations. d. Urinary bladder injury Next page = Quiz navigation “J VY LtSal) “all Dt 94% [12:29 > My courses > 3 > General > Online Enterence Test Question 16 Not yet answered Marked out of 1.00 'P Flag question An 8-month-old infant is brought to the emergency department (ED) with a bruise on his thigh suffered from falling out of his high chair. Radiographs reveal amidshaft femur fracturE. Which of the following is the most likely contributing factor? Select one: a. Bone cyst b. Bone tumor c. Hypocalcemia d. Osteogenesis imperfecta e. Child abuseall all IO 96% (wilt 4:26 » Mycourses > EmergencyMedicinel > General > Emergency Medicine Admission Test Question 1 Not yet answered Marked out of 1.00 20. A19-years-old boy with multiple stab wounds right side of chest is brought to ER. Heis pale, apprehensive, tachycardiac, tachypnoeic and hypotensive. You received him in emergency. There is blood in the mouth but you visualize larynx and successfully place 7 mm ID cuffed ETT and start ventilating with 6 I/minute 02 using Bag—Mask- Valve devicE. Breath sounds on the right side are absent. There is increasing difficulty to ventilatE. Tachycardia and hypotension worsens and he drops 02 saturation and systemic BP. Chest is hyper- resonant to percussion on the right sidE. The next most appropriate would be: Select one: a. Retract ETT by2cm b. Change ETT by 8.5mm ID ETT c. Needle thoracotomy d. Increase O flow to 14 I/minute Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 19 Not yet answered Marked out of 1.00 24. A four year ald child is brought to emergency with h/o kerosene oil poisoning. Best approach to treatment is to: Select one: a. High dose- steroids b. None of the above c. Give activated charcoal d. Immediately induce emesis Next page = Quiz navigationall Sn! & OE 93% Gill 4:45 > Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 26 Not yet answered Marked out of 1.00 11. 44-year-old child with a 4-day history of wheeze, unresponsive to nebulised salbutamol and to adrenaline who is now cyanosed and restless (PaO2 5kPa, PaCOz 10kPa) should be initially managed by: Select one: a. Mechanical ventilation b. Intravenous aminophylline c. Intravenous bicarbonate d. Intravenous diazepam haa fT = Quiz navigation [a lf2 lls lle ifs ifs liz iis] <] QO CL “J VY LUSal) Sal iD 92% [ial 12:56 < © Online Enterence Test Ims.stmu.edu.pk UTS UU Not yet answered Marked out of 1.00 YF Flag question An umbilical hernia is commonly found in all except: Select one: a. Down’s syndrome b, Infants of diabetic mothers c. Congenital hypothyroidism d. Mucopolysaccharide storage diseases e. Preterm babies. Next page 1Z navigation Qu = = ILE ll 3all Sn! & OE 95% Gill 4:31 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 15 Not yet answered Marked out of 1.00 2. A 63-year-old male suffered a VF cardiac arrest and the first shock was delivered on arrival in the emergency department (ED). After a further 2 minutes of CPR, he was noted to be still in VF on the monitor. What is the next MOST appropriate step to take? Select one: a. Deliver a second shock at 200 J b. Give amiodarone 300 mg intravenously c. Give adrenaline 1mL of 1:1000 intravenously d. Feel for the presence or absence of a pulse Next page = quiz navigationSal “all Dt 97% (Ta) 12:07 < @ Online Enterence Test Ims.stmu.edu.pk Question 3 Not yet answered Marked out of 1.00 'F Flag question Acyanotic newborn having suspicion of congenital heart diseasE. He has an increased left ventricular impulse and a pansystolic murmur or holosystolic along the left sternal border. The ECG done shows left-axis deviation and left ventricular hypertrophy (LVH). Which of the following is the most likely diagnosis in this baby? Select one: a. Persistent fetal circulation b. Truncus arteriosus c. Tricuspid atresia d. Tetralogy of Fallot e. Transposition of the great arteries = Quiz navigation q O 0all nl & OE 95% Gill 4:35 Emergency Medicine Admissio... © | ms.stmu.edu.pk [= » Mycourses > Emergency Medicinel >» General > Emergency Medicine Admission Test Question 18 Not yet answered Marked out of 1.00 Headache and hemiparesis of left arm and leg for the last 3 hours. On CT sean there is no bleed and MRI supports the diagnosis of acute Ischemic strokE. The most appropriate treatment should be: Select one: a. Simvastatin b. Aspirin c. IV acetaminophen d. Thrombolytic Therapy Next page = quiz navigation “J VY Ltall all & IO 95% (wih 4:32 Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 6 Not yet answered Marked out of 1.00 27. A32 years old executive presented with sudden loss of vision on first January after new year night. He is not hypertensive or diabetiC. Systemic examination is normal. What may be the possible cause of visual loss? Select one: a. Multiple sclerosis b. Methyl alcohol intoxication c. Retinal detachment d. Retinal vein thrombosis Next page = quiz navigationSal! ‘all 1D 96% (eal 12:13 [2 > Mycourses > 3 > General > Online Enterence Test Question 7 Not yet answered Marked out of 1.00 ' Flag question Aé6years old girl presents with chicken pox to ED. There are no associated symptoms. She appears non- toxiC. On examination there are vesicles and dried crusted lesions. What is next step in management? Select one: a. Varicella-Zoster vaccine b, Varicella-Zoster immune globulin c. Acetaminophen d. Aspirin e. V acyclovir = Quiz navigationSal “all 1D 96% [al 12:16 > > Mycourses > 3 > General > Online Enterence Test Question 8 Not yet answered Marked out of 1.00 'F Flag question A35-year-old male presented to ER with history of road traffic accident. He has an open fracture of shaft of right femur; patient suddenly develops shortness of breath and hypotension. Chest is bilaterally clear and SATs are 82%. What is your diagnosis? Select one: a. Hemothorax b. Fat Embolism c. Airembolism d. None of the above e. Pneumothorax q O OSal “all Dt 92% (ih 12:52 < @ Online Enterence Test Ims.stmu.edu.pk 2 > Mycourses > 3 > General > Online Enterence Test Question 28 Not yet answered Marked out of 1.00 'F Flag question A 44 years old otherwise healthy smoker with 20- pack year smoking history come ED with cough for 5 days, mild shortness of breath and hemoptysis. What is the most likely condition responsible for hemoptysis? Select one: a. AV malformation b. Bronchogenic carcinoma c. BOOP (bronchiolitis oblitrans with organizing pneumonia d, UIP (usual interstitial pneumonitis) e. Acute bronchitis <] O LJ “J Next pageall Sn! & IO 98% Gill 4:13 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 8 Not yet answered Marked out of 1.00 9. A young male is bitten by e cobra snake on his neck, He developed muscular weakness, drooling of saliva, difficulty in breathing. His 5a02 is 75%, BP is l00/60mmHg, pulse 60/mm. What will be the most significant immediate step in the management of this patient? Select one: a. Anti-cholinestrasa (Neostigmine) to reverse the effect of neurotoxin b. Adrenaline 1mg+ 100mg hydrocortisone c. Anti-snake venom infusion as per protocol d. Endotracheal intubation and ventilatory support Next pageSal “all 1D 93% [12:44 < @ Online Enterence Test Ims.stmu.edu.pk Online Enterence Test Question 24 Not yet answered Marked out of 1.00 ' Flag question Paramedics bring a 45 years old man to ED after he was struck by a motor vehicle traveling at 50 miles/hr. His B.P is 170/80 mm of Hg, HR: 92, RR: 22. Upon arrival he does not opens his eyes, is verbal but not making any sense and withdraws to pain. You assign his GCS score as 8, as you prepare to intubate the patient, a nurse notices that his right pupil has become dilated as compared to left. Which of the following has the quickest effect to reduce ICP? Select one: a. Hyperventilation b, Dexamethasone c. Furosemide d. Cranial decompression e, Mannitol Next pageall Sn! SO 98% Gill 4:10 EmergencyMedicinel >» General > Emergency Medicine Admission Test Question 7 Not yet answered Marked out of 1.00 14. You are an ACLS code team leader and have just received an emergency call from surgical ward where a patient suddenly went into cardiac arrest. Which of the following drug is no longer recommended to be used during advanced cardiovascular life support ina victim of cardiac arrest: Select one: a. Amiodarone b. Atropine c. Adrenaline d. Vasopressin eg srt. = Quiz naviaation ~Sal! “all Dt 97% [12:04 Online Enterence Test Question 2 Not yet answered Marked out of 1.00 'F Flag question A 60-year-old male found collapsed on road and brought to ER. CPR is in progress. You have stopped the CPR for confirmation of pulsE. There is no pulse on palpation of carotid for ten seconds. What is your next order? Select one: a. Give Inj epinephrine mg 1/10,000 IV b. Give Inj amiodarone 300mg IV c. Attach defibrillator d. Resume CPR e. Check pulse again = Quiz navigation (EE) (a (a (en a qJ Ofall ‘all Ot 92% (ea! 12:50 Marked out of 1.00 ' Flag question A30-year- old man who works for a moving company presents to the ED because he thinks he was having a heart attack. He does not smoke, and jogs 3 days a week. His father died of a heart attack in his sixties. He describes a gradual onset of chest pain that is worse with activity and resolves when he is at rest. His HR is 68 beats per minute, BP is 120/70 mm Hg, and RR is 14 breaths per minutE. On examination, his lungs are clear and there is no cardiac murmur. You palpate tenderness over the left sternal border at the third and fourth ribs, An ECG reveals sinus rhythm at a rate of 65. A chest radiograph shows no infiltrates or pneumothorax. Which of the following is the most appropriate next step in management? Select one: a. Administer aspirin, clopidogrel, and heparin, and admit for acute coronary syndrome (ACS). b. Observe the patient for 6 hours. _ ¢ Administer ibuprofen and reassure the patient that he is not havinga heart attack. d. Inject corticosteroid into the costochondral joint to reduce inflammation. e. Administer aspirin and send for a troponin. Next page q O 0all! & IDE 94% (4:42 > Mycourses > Emergency Medicine! > General > Emergency Medicine Admission Test Question 23 Not yet answered Marked out of 1.00 15. A 17 years old girl has presented to emergency room with worst headache of lifE. To be able to diagnose and treat her headache, the most important investigation is: Select one: a. MRI b, ESR (Erythrocyte sedimentation rate) ¢.CT-Scean d. Eye consultation Next page = quiz navigation (1 ]f2]f3|f{4lf{s life lf7 fs) <] QO C] J oSall Sn! IO 95% Gilt 4:30 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 21 Not yet answered Marked out of 1.00 29. A30 year old female presents to the emergency department with a H/o of ingestion of 30 tablets of paracetamol. Past history is insignificant. Poor prognostic factor in this patient would be: Select one: a. Altered level of consciousness b, Increased PT c. Increased APTT d. Deranged LFT's sag alt = quiz navigationSal “all Dt 94% [12:36 > Mycourses > 3 > General > Online Enterence Test Question 19 Not yet answered Marked out of 1.00 Flag question A4O0 years old biker had a head on collision witha bus. He was not wearing helmet. On arrival to ED his B.P was 120/40mmHg, Pulse 100/min, GCS 7/15, Sp02 83%. The patient was intubated and mechanically ventilated with improvement in SpO2 to 96%. His pupils are 4mm bilaterally and reactivE. What is the most important principle in the early management of head injury? Select one: a. Avoid Hypotension b. Aggressive treatment of systemic hypertension c. Avoid hypertension d. Administration of Mannitol e. Distinguish between intracranial hemorrhage and cerebral edema q O 0 Next pageall all IO 96% (will 4:28 Mycourses > Emergency Medicinel > General > Emergency Medicine Admission Test Question 13 Not yet answered Marked out of 1.00 4, Which ONE of the following subset of trauma patients will MOST likely benefit from ‘hypotensive resuscitation’? Select one: a. A 50-year-old male with blunt abdominal trauma and severe closed head injury b.A40-year-old male witha penetrating chest injury c.A 32-year-old female with blunt trauma following a road traffic collision with GCS15 d. A 22-year-old with a compound femur fracture Next page wo . = Quiz navigation “J VY LtSal ‘all Dt 97% (Te 12:03 < @ Online Enterence Test Ims.stmu.edu.pk A40-year- old man found vomiting in the street is brought to the ED by emergency medical services (EMS). He has a known history of aleohol abuse with multiple presentations for intoxication. Today, the patient complains of acute onset, persistent chest pain associated with dysphagia, and pain upon flexing his neck. His BP is 115/70 mm Hg, HR is 101 beats per minute, RR is 18 breaths per minute, and oxygen saturation is 97% on room air. As you listen to his heart, you hear a crunching sounD. His abdomen is soft with mild epigastric tenderness. The ECG is sinus tachycardia without ST-T-wave abnormalities. On chest radiograph, you note lateral displacement of the left mediastinal pleurA. What is the most likely diagnosis? Select one: ® a Esophageal perforation b. Acute pancreatitis c. Aortic dissection d. Pericarditis e. Aspiration pneumonia agar. = Quiz navigation My courses > 3 > General > Online Enterence Test Question 12 Not yet answered Marked out of 1.00 ' Flag question For severity of dehydration in an infant, which is the most reliable indicator among these? Select one: a. Weight loss b. Urinary output c. Mucous membrane appearance d. Capillary refill time e. Sunken anterior fontanelle = Quiz navigation EES q O 0 ea) (ER) ea