Emergency Medicine Examination & Board Review

Susan Promes

Chapter 7 Environmental and Unique Environments Emergencies - all with Video Answers

Educators

Chapter Questions

Problem 1

Which of the following statements is TRUE regarding cold-related injuries?
(A) Chilbain (pernio) is more common in men than women.
(B) Dry heat is the best method for rewarming frostbite.
(C) Early surgical intervention is required for severe frostbite.
(D) Trench foot may result in irreversible damage.

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Problem 2

Which of the following is NOT a predisposing factor for hypothermia?
(A) Extremes of age.
(B) Hyperglycemia.
(C) Severe burns.
(D) Alcoholism.

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01:03

Problem 3

Which of the following types of heat injury is correctly paired with the appropriate treatment?
(A) Heat exhaustion and rapid evaporative cooling.
(B) Heat stroke and oral rehydration.
(C) Heat cramps and fluid and electrolyte replacement.
(D) Prickly heat and talc or baby powder.

Narayan Hari

Numerade Educator

01:12

Problem 4

What is the MOST common finding in a patient with a brown recluse spider bite?
(A) Severe itching.
(B) Local tissue necrosis.
(C) Severe muscle cramps.
(D) Anaphylaxis.

Joanna Quigley

Numerade Educator

Problem 5

A 25-year-old man complains of pain and swelling in his hand and forearm, perioral numbness, and vomiting after trying to catch a rattlesnake. His blood pressure is $90 / 60 \mathrm{mmHg}$. Which of the following therapies is NOT indicated?
(A) Fluid resuscitation.
(B) Immediate fasciotomy of the arm.
(C) Administration of 10 vials of antivenin.
(D) Measurement of coagulation factors and platelets.

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01:23

Problem 6

Which of the following is TRUE regarding marine envenomations?
(A) Jellyfish nematocysts are inactivated by fresh water rinsing.
(B) Sponge dermatitis is treated with antibiotics against gram-negative organisms.
(C) Hot water immersion is an effective pain reliever for venomous fish and stingray injuries.
(D) Tetrodotoxin poisoning from an octopus bite may be reversed with antivenin.

Christina Sorrentino

Numerade Educator

Problem 7

A 55-year-old male diver begins complaining of back pain and urinary retention 1 hour after a dive. What is the MOST likely diagnosis?
(A) Barotrauma to the bladder.
(B) Neurotoxin from a marine envenomation.
(C) Nitrogen narcosis.
(D) Decompression sickness.

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Problem 8

An unconscious teenage near-drowning victim is brought to the ED by ambulance after diving into the shallow end of his friend's pool at a party. A brief period of ventilation was required poolside. Which of the following tests is LEAST likely to impact patient management?
(A) Core temperature.
(B) Electrolytes.
(C) Chest radiograph.
(D) C-spine radiographs.

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Problem 9

Which of the following patients does NOT require referral to a specialized burn care facility?
(A) A 60-year-old diabetic with a full-thickness burn of his entire forearm.
(B) A 25-year-old woman with full-thickness burns of both hands and lower arms.
(C) A 35-year-old man with a few small areas of partial-thickness burns on his back and small full-thickness burns on his upper arm.
(D) A 40-year-old house fire victim with a few small partial-thickness burns on her arms, soot in her nasal pharynx, and wheezing.

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01:04

Problem 10

Which of the following statements about chemical burns is TRUE?
(A) Acids cause deeper tissue injury than alkalis.
(B) Finding and treating with chemical-specific antidotes is usually more critical than irrigation with water or saline.
(C) Calcium gluconate is a specific antidote for sulfuric acid burns.
(D) Time of exposure is the most important factor in determining the extent of tissue damage.

Narayan Hari

Numerade Educator

00:42

Problem 11

Which of the following is TRUE regarding electrical injuries?
(A) Household voltage (110 V) may cause ventricular fibrillation without evidence of electrical burns.
(B) Low-voltage $\mathrm{AC}$ is more likely to produce transient ventricular asystole, and high-voltage AC is more likely to cause ventricular fibrillation.
(C) Labial artery bleeding commonly occurs immediately after oral electrical burns.
(D) Delayed cardiac arrhythmias are common after household voltage electrical injuries.

Sanjeev Kumar

Numerade Educator

02:55

Problem 12

A 35-year-old man presents complaining of a headache, weakness, nausea, and vomiting after working on his car in a closed garage. Which of the following statements regarding management of this patient's problem is TRUE?
(A) Pulse oximetry can aid in assessing the severity of illness.
(B) Hyperbaric oxygen therapy is indicated.
(C) The patient may be discharged if his symptoms resolve after treatment with 100\% oxygen.
(D) Severe metabolic acidosis may be present.

Jennifer Stoner

Numerade Educator

Problem 13

Which of the following best describes a patient with Amanita phalloides mushroom intoxication?
(A) Visual hallucinations and ataxia within 30 minutes after ingestion.
(B) Flushing, tachycardia, and palpitations several hours after mushroom ingestion and shortly after drinking a martini.
(C) Symptoms of the SLUDGE syndrome within 30 minutes after ingestion.
(D) Nausea, vomiting, and diarrhea within 24 hours of ingestion followed by hepatic failure in 3 days.

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00:50

Problem 14

Which of the following plants is correctly matched with its toxic effects?
(A) Foxglove and neuromuscular blockage.
(B) Hemlock and mucous membrane pain and burning.
(C) Jimson weed and hallucinations.
(D) Castor bean and cardiac arrhythmias.

Hast Aggarwal

Numerade Educator

01:20

Problem 15

A patient presents with fever and malaise but without rash, pulmonary, or gastrointestinal symptoms. She returned to the United States 1 week ago after traveling in West Africa for 2 weeks. What is the most likely diagnosis?
(A) Malaria.
(B) Hepatitis A.
(C) Tuberculosis.
(D) Rickettsial infection.

Kamila Zakarian

Numerade Educator

01:48

Problem 16

Which of the following travel exposures is correctly matched to its specific associated infection?
(A) Undercooked meat and schistosomiasis.
(B) Untreated water products and amebiasis.
(C) Rodent contact and African sleeping sickness.
(D) Tsetse flies and viral hemorrhagic fevers.

Dennis Howard

Numerade Educator

02:19

Problem 17

Which of the following statements regarding typhoid fever is TRUE?
(A) The vaccine is highly effective.
(B) The disease is transmitted by insect bites.
(C) Patients usually present with constipation rather than diarrhea.
(D) It is an uncommon cause of prolonged fever in returning travelers.

Ummatul Choudary

Numerade Educator

01:52

Problem 18

Which of the following statements about traveler's diarrhea is TRUE?
(A) Viral causes account for about 50-70\% of all acute cases of traveler's diarrhea.
(B) Giardia lamblia is the most commonly identified cause of chronic diarrhea.
(C) Amebiasis typically causes nonbloody diarrhea without fever.
(D) Antibiotic treatment does not improve outcomes in patients with cholera.

Joanna Quigley

Numerade Educator

04:53

Problem 19

Which of the following statements regarding acclimatization to high altitude is TRUE?
(A) Increased ventilation is the primary initial adaptation to high altitude.
(B) Erythropoetin levels rise only after several weeks at high altitude.
(C) Water retention facilitates adaptation to high altitude.
(D) Given enough time, the body will eventually adapt to any altitude.

Sarah Gao

Numerade Educator

01:24

Problem 20

Which of the following is NOT a common high-altitude syndrome?
(A) Allergic asthma.
(B) Peripheral edema.
(C) Bronchitis and pharyngitis.
(D) Retinopathy.

Joanna Quigley

Numerade Educator

01:47

Problem 21

Which of the following statements regarding Antarctic medicine is TRUE?
(A) Telemedicine has not proved to be helpful to medical practitioners in Antarctica due to polar cap absorption (PCA) radio blackouts.
(B) Practicing medicine at the South Pole does not require specialized knowledge of Antarctica-specific diseases and ailments.
(C) Cold-related injuries are common in Antarctica.
(D) During summer months medical evacuations can easily be obtained when a serious emergency occurs.

Ummatul Choudary

Numerade Educator

05:22

Problem 22

Which of the following is TRUE about medical problems in space?
(A) Adverse psychological reactions are common due to the enclosed living conditions.
(B) Hemostasis is more difficult in microgravity than on Earth.
(C) Space motion sickness is rare.
(D) Ocular foreign bodies are common problems in microgravity.

Sanu Kumar

Numerade Educator