The best preparation for tomorrow is doing your best today. -H. Jackson Brown Jr.
Now onto this week’s podcast!
A 4-year-old boy is brought to the Emergency Department after a drowning. Bystanders noted the child was underwater for less than a minute. After quickly being pulled up from the bottom of the pool, he coughed and vomited once. He arrived at the ED awake and alert with a GCS 15. On examination, he is afebrile with heart rate 105 beats/minute, respiratory rate 20 breaths/minute, and oxygen saturation 96 % on room air. His lungs are clear to auscultation. What is the next step in management?
A. Admit to telemetry unit for 24-hour observation
B. Discharge home
C. Observe for 4–6 hours and discharge home if there is no change in his clinical status
D. Positive pressure ventilation
Which of the following is true regarding older patients with abdominal pain in comparison to younger patients?
A. More likely to need an emergent surgical procedure
B. More likely to present with an elevated white blood cell count
C. More likely to present with fever
D. More likely to present with peritoneal signs
Which of the following conditions, other than postoperative adhesions, is most likely responsible for causing the diagnosis seen in the image above?
B. Incarcerated hernia
How do you calculate mean arterial pressure (MAP)?
A. MAP = [DBP + (2 x SBP)]/3
B. MAP = DBP + 1/3(SBP-DBP)
C. MAP = DBP + 2/3(SBP-DBP)
D. MAP = SBP + 1/3(SBP-DBP)
A 23-year-old man presents with chest pain after a motor vehicle collision. The patient’s chest struck the steering wheel. He has no other complaints or injuries. Chest X-ray is unremarkable. ECG shows sinus tachycardia with anterior ST depressions. A troponin is sent and is positive at 3.50 mg/dl. What management is indicated?
A. Activate the cardiac catheterization laboratory
B. Discharge home with cardiology follow up
Which of the following mechanisms of hypoxemia is associated with the failure of arterial oxygen levels to increase in response to supplemental oxygen?
A. Diffusion impairment
C. Right-to-left shunt
D. Ventilation-perfusion mismatch
A 19-year-old man presents with an ulcer on his penis. He denies pain, tenderness, and itching of the ulcer. He also denies penile discharge and dysuria. Genital examination reveals a clean-based, sharply defined, circular ulcer on the shaft of his penis. There are no other rashes or lymphadenopathy. Which of the following organisms is the most likely cause of his symptoms?
A. Borrelia burgdorferi
B. Haemophilus ducreyi
C. Plasmodium falciparum
D. Treponema pallidum
Hope you enjoyed this week’s episode. Send us feedback and comments to Roshcast@roshreview.com. Do not forget to check out the high-yield questions and explanations in the Rosh Review Emergency Medicine Qbank.
Until next time,
Jeff and Nachi
P.S. If you missed last week’s episode including mushroom toxicity, listen here.
The post Podcast Ep 12: Drownings, Geriatrics, Bowel Obstruction, & More appeared first on RoshReview.com.