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Question 1. Which presentation is most characteristic of sepsis in the emergency setting? A) Hypotension, fever, tachycardia, and altered mental status B) Bradycardia, hypothermia, and hypertension C) Isolated hypotension without fever or infection signs D) Chest pain with normal vitals Answer: A Explanation: Sepsis typically presents with hypotension, fever, tachycardia, and altered mental status due to systemic infection causing distributive shock. Question 2. Which of the following is the most common cause of acute appendicitis? A) Obstruction of the lumen by fecaliths
B) Bacterial overgrowth C) Viral infection D) Autoimmune response Answer: A Explanation: Appendicitis is usually caused by luminal obstruction by fecaliths, leading to inflammation and infection. Question 3. In a patient with a suspected myocardial infarction, which initial diagnostic test is most appropriate? A) Chest X-ray B) Electrocardiogram (ECG) C) Cardiac MRI D) Cardiac catheterization
Question 5. What is the most common cause of upper gastrointestinal bleeding in the emergency setting? A) Peptic ulcer disease B) Esophageal varices C) Mallory-Weiss tear D) Gastric carcinoma Answer: A Explanation: Peptic ulcers are the most common source of upper GI bleeding, often due to H. pylori infection or NSAID use. Question 6. Which airway management technique is preferred in a patient with suspected cervical spine injury? A) Conventional orotracheal intubation with manual inline stabilization B) Nasotracheal intubation without stabilization
C) Rapid sequence intubation without cervical precautions D) Bag-valve mask ventilation only Answer: A Explanation: Manual inline stabilization during intubation minimizes cervical spine movement in suspected cervical injuries. Question 7. Which of the following is the hallmark of anaphylactic shock? A) Rapid onset, airway edema, hypotension, and urticaria B) Gradual onset with isolated hypotension C) Chest pain with ST elevation D) Fever and rash Answer: A
A) Non-contrast CT scan B) MRI C) X-ray D) Ultrasound Answer: A Explanation: Non-contrast CT is the most rapid and sensitive imaging for detecting intracranial hemorrhage in trauma. Question 10. Which condition is characterized by sudden, severe chest pain, hypotension, and distended neck veins, often caused by cardiac tamponade? A) Beck's triad B) Tension pneumothorax C) Myocardial infarction
D) Aortic dissection Answer: A Explanation: Beck's triad—hypotension, distended neck veins, and muffled heart sounds—indicates cardiac tamponade. Question 11. Which is the first-line treatment for opioid overdose with respiratory depression? A) Naloxone administration B) Activated charcoal C) Flumazenil D) IV fluids only Answer: A Explanation: Naloxone is an opioid antagonist that reverses respiratory depression caused by opioid overdose.
B) Warm blankets and observation C) Antibiotics and antipyretics D) Elevation of extremities only Answer: A Explanation: Rapid cooling with evaporative techniques and IV hydration is vital to prevent organ damage in heat stroke. Question 14. Which medication is the antidote for acetaminophen poisoning? A) N-acetylcysteine B) Atropine C) Naloxone D) Activated charcoal
Answer: A Explanation: N-acetylcysteine replenishes glutathione stores, detoxifying acetaminophen metabolites. Question 15. In a patient with suspected acute aortic dissection, which imaging modality is most definitive? A) Contrast-enhanced CT angiography B) Chest X-ray C) Transthoracic echocardiogram D) MRI Answer: A Explanation: Contrast-enhanced CT angiography provides detailed visualization of the aorta for dissection diagnosis.
C) Diabetic ketoacidosis D) Thyroid storm Answer: A Explanation: Insulin overdose is the most common cause of hypoglycemia in diabetics, especially in overdose situations. Question 18. Which clinical feature best distinguishes meningitis from encephalitis? A) Neck stiffness and photophobia B) Altered mental status only C) Focal neurological deficits only D) Fever only Answer: A
Explanation: Neck stiffness and photophobia are classic signs of meningitis, whereas encephalitis often presents with altered mental status and seizures. Question 19. What is the first step in managing a patient with suspected opioid overdose? A) Airway patency and ventilation support B) Administer activated charcoal C) Administer naloxone immediately D) Perform lumbar puncture Answer: A Explanation: Securing the airway and providing ventilatory support takes priority in respiratory depression from opioid overdose.
C) Mycoplasma pneumoniae D) Legionella pneumophila Answer: A Explanation: Streptococcus pneumoniae is the most common pathogen causing community-acquired pneumonia. Question 22. Which type of shock is characterized by vasodilation, hypotension, and warm extremities? A) Distributive shock (septic shock) B) Cardiogenic shock C) Hypovolemic shock D) Obstructive shock Answer: A
Explanation: Septic shock involves vasodilation and warm extremities due to systemic inflammatory response. Question 23. In trauma, which is the most sensitive indicator of hypovolemia? A) Tachycardia B) Hypertension C) Bradycardia D) Bradyarrhythmia Answer: A Explanation: Tachycardia is an early and sensitive sign of hypovolemia as the body compensates for blood loss.
C) Valproic acid D) Phenobarbital Answer: A Explanation: IV lorazepam is the first-line treatment for status epilepticus due to rapid onset of action. Question 26. Which presentation is most typical of adrenal crisis? A) Hypotension, hyponatremia, hyperkalemia, and hypoglycemia B) Fever, rash, and joint pain C) Chest pain radiating to the back D) Weight gain and hypertension Answer: A
Explanation: Adrenal crisis presents with hypotension, hyponatremia, hyperkalemia, and hypoglycemia due to cortisol deficiency. Question 27. Which of the following is the most sensitive screening test for tuberculosis? A) Tuberculin skin test (TST) B) Chest X-ray C) Sputum acid-fast bacilli (AFB) smear D) Interferon-gamma release assay (IGRA) Answer: D Explanation: IGRA tests are highly specific and sensitive for detecting latent TB infection.
