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Quiz Questions (48 questions)
1. Gurgly breathing indicates a problem in the airway.
2. In tension pneumothorax, there are absent air sounds on the same side.
3. In the Glasgow Coma Scale, a motor response > 4 means normal flexion.
4. Cardiogenic shock is accompanied by distended neck veins.
5. During the pre-hospital stage, providers apply control of external bleeding.
6. In a shocked patient, resuscitation should be continued until BP and heart rate normalize and urine output reaches 0.5 -1.0 ml/kg/hr.
7. Hemorrhagic shock is accompanied by collapsed neck veins.
8. In the Glasgow Coma Scale, an eye response > 4 means spontaneous eye opening.
9. Criteria of a shocked patient include low BP (<90 mm Hg systolic).
10. In children age < 6, intra-osseous cannulation can be applied in the proximal tibia.
11. In the field or in the ED, a definitive airway can be secured by cricothyroidotomy.
12. In the setting of trauma, transfusion of blood products should be in a 1:1:1 ratio between packed RBCs, fresh frozen plasma, and platelets.
13. In the Glasgow Coma Scale, a motor response > 2 means extension.
14. In case of severe maxillofacial injuries, securing the airway is maintained by cricothyroidotomy.
15. An airway is considered unprotected if the Glasgow Coma Scale is < 8.
16. The first priority in the pre-hospital stage in a trauma patient is directed to airway maintenance.
17. If the patient is conscious and speaking in a loud voice, this means proper airways.
18. The pre-hospital system is set aiming at applying the first aid measures as possible.
19. Satisfactory ventilation is confirmed in the field by symmetrical breath sounds.
20. Critical aspects of hospital preparation include properly functioning airway equipment that is organized, tested, and strategically placed.
21. In pericardial tamponade, there is shock without respiratory distress.
22. The preferred route of fluid resuscitation in the trauma setting is 2 large bore peripheral IV lines.
23. In the Glasgow Coma Scale, a motor response > 6 means obey commands.
24. The most common cause of trauma all over the world is road traffic accidents.
25. In the Glasgow Coma Scale, a verbal response > 4 means confused.
26. In pediatric patients 8 years, cricothyroidotomy is better avoided in securing the airways.
27. A 23-year-old man presents to the ED after a motor car accident. Upon initial presentation to the ED, he was fully conscious, oriented, and obeying commands. However, 20 minutes later, he became lethargic, only opening his eyes to painful stimuli, is making incomprehensible sounds, and only withdraws to painful stimulation. The initial and subsequent Glasgow Coma Scores (GCS) for this patient are 15,8.
28. A 34-year-old male presenting to ED, Primary survey was performed and revealed Airway open and protected, intact breathing but with an evidence of chest trauma. Secondary survey of this patient should be a brief head to toe examination with detailed exam of the respiratory system.
29. A poly trauma patient presented to the ED, the last step of primary survey in this patient will be expose the skin and take a general look.
30. In the ED, When you pinch the trapezius muscle of your trauma patient and he responds by groaning, his level of consciousness will be P.
31. Secondary survey does not include operative fixation of a fractured bone.
32. The basic principles and goals of emergency first aid management include all the above.
33. The goal of primary survey is identify and manage acute life threatening conditions.
34. The letter (E) in SAMPLE focused history in secondary survey denotes all the above.
35. An airway is considered unprotected and/or compromised if there is all are correct.
36. Triage is the sorting of patients in an emergency room according to the urgency of their need of care.
37. Over triage leads to use up of vital beds in the emergency department.
38. Under triage leads to delay vital care to critical patients.
39. A patient with a heart attack is considered to be Triage score 1.
40. A patient with drug overdose should be managed in the emergency department in no more than 10 minutes.
41. A 33 year old male presented to the emergency department after having motor vehicle accident 1 hour ago in which he was an unrestrained passenger. His initial evaluation showed GCS 15, BP 87/49 mmhg, HR 130, cool extremities and RR was 30 breath/min. Two large bore IV lines were inserted and fluid resuscitation with crystalloids started. Arterial blood gas should be done for this patient.
42. Seizures is considered an alert sign for possible clinical deterioration.
43. Unexpected decrease in consious level is considered an alert sign for possible clinical deterioration.
44. A key component of the secondary survey in emergency care is a detailed physical examination.
45. A 22-year old woman with minor cut wound should go to the urgent care.
46. Considering the emergency action plan, it should be fixed with no further changes is EXCEPT.
47. A patient in the emergency department with a red tag should be managed immediately.
48. The primary concern when assisting a person having a seizure is keeping him/her safe from harm.
Previous Exam Questions (54 questions)
1. For a 22-year-old female trauma patient presenting with a scalp laceration, right chest-wall contusions, blood pressure of 90/70 mmHg, heart rate of 120 beats/min, respirations of 24 breaths/min, and vomiting, interventions should include suctioning the airway and preparing for endotracheal intubation to ensure a safe and patent airway.
2. For a patient with a right chest wall contusion, respiratory rate of 24 breaths/min, SpO2 of 92%, and decreased chest rise on the right side, the next steps include inspecting and palpating the neck and chest for tracheal deviation, use of accessory muscles, and any signs of injury, percussing the chest for presence of dullness or hyper-resonance, and auscultating the chest bilaterally.
3. Possible injuries for a patient involved in a motor vehicle collision with chest trauma include fractured ribs (either simple or flail), lung contusions, and hemothorax or pneumothorax, or both.
4. For a patient with a blood pressure of 90/70 mmHg, heart rate of 120 bpm, and cool extremities, interventions should include establishing IV/IO access (if not already in place), initiating fluid resuscitation with crystalloids such as lactated ringer's solution, and sending for ABO matching.
5. When assisting a person having a seizure, the primary concern is to keep them safe from harm.
6. For a 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress, there is a problem with her airway that may need suctioning to maintain patency.
7. A 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress exhibits severe respiratory distress with accessory muscle use, labored breathing, paradoxical respirations, and an SpO2 of 80%.
8. For a 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress, interventions should include applying a non-rebreathing mask on 15 L/min, re-evaluating her oxygen saturation, and ordering an arterial blood gas (ABG).
9. A 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress has a heart rate of 130 bpm in normal sinus rhythm and a blood pressure of 142/87 mmHg, indicating stable circulation apart from sinus tachycardia, which is likely explained by the severe respiratory distress.
10. In a 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress, no interventions are immediately needed for circulation because it appears stable apart from sinus tachycardia, which is explained by the severe respiratory distress.
11. A 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress is unable to communicate due to her decreased level of consciousness.
12. For a 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress, interventions should include checking her blood glucose and arterial blood gas (ABG) to assess for possible CO2 narcosis.
13. A 75-year-old woman with pneumonia who is obtunded and in extreme respiratory distress has a temperature of 37°C.
14. The first step in assessing a 14-year-old girl with difficulty breathing is to start the primary assessment using the ABCDE approach.
15. When assessing breathing in a 14-year-old girl with difficulty breathing, key elements to assess include respiratory rate, depth, chest rise, use of accessory muscles, and auscultation for abnormal breath sounds.
16. A 14-year-old girl with moderate suprasternal and intercostal retractions, prolonged expiratory time, expiratory wheezes in the lower lobes, respiratory rate of 40/min, and SpO2 of 86% on room air has a breathing problem that requires intervention, including applying a non-rebreathing oxygen mask on 10 liters/min and administering nebulized bronchodilators.
17. Key elements to assess in circulation include heart rate, blood pressure, pulse strength, capillary refill, and skin color and temperature.
18. A 14-year-old girl with a heart rate of 140/min, pale skin, strong radial pulse, capillary refill of 2 seconds, and blood pressure of 106/68 mmHg has apparently stable circulation other than sinus tachycardia.
19. In a 14-year-old girl with respiratory distress and hypoxia, the increased heart rate of 140 bpm is likely caused by the respiratory distress and hypoxia.
20. After assessing circulation in a primary assessment, the next points are to assess Disability (level of consciousness) and Exposure (temperature, rashes, etc.).
21. Before proceeding to secondary assessment, a patient should be reassessed, including assessing response to oxygen and nebulized albuterol and considering oral corticosteroids.
22. A secondary assessment for an emergency medical case should focus on obtaining a detailed patient history, performing a thorough physical examination, and considering pertinent diagnostic tests, highlighting key elements such as the mechanism of injury, associated symptoms, and any pre-existing medical conditions to guide differential diagnosis and inform appropriate interventions.
23. The SAMPLE mnemonic in focused history taking refers to Signs and symptoms, Allergies, Medications, Past medical history, Last meal, and Events (onset).
24. The SAMPLE history for a patient with respiratory distress includes: Signs and symptoms (cough, respiratory distress), Allergies (molds and grass), Medications (inhaler that has not been refilled), Past medical history (known asthmatic, poorly controlled, 3 ICU admissions for respiratory failure, family members smoke in the house), Last meal (3 hours ago), and Events (onset) (cold symptoms for the last 3 days, increased cough and distress for past 24 hours).
25. A physical examination of a patient with respiratory distress should include repeat vital signs after oxygen administration, assessment of the head, eyes, ears, nose, and throat/neck, and auscultation of the heart and lungs for wheezing and air movement, as well as assessment of the abdomen, extremities, and back.
26. A patient with suprasternal and intercostal retractions due to lower airway obstruction (as manifested by prolonged expiratory time and wheezes) has respiratory distress.
27. Arterial blood gas (ABG) is a useful lab test to order for a patient with respiratory distress.
28. A chest x-ray is a useful imaging study to order for a patient with respiratory distress.
29. For this patient, suctioning the airway should be started and preparation for ETT intubation should be made to have a safe and patent airway.
30. For a patient with right chest wall contusion, a respiratory rate of 24 breaths/min, an SpO2 of 92%, and decreased chest rise on the right side, the next steps are to inspect and palpate the neck and chest for tracheal deviation and use of accessory muscles and any signs of injury, percuss the chest for presence of dullness or hyper-resonance, and auscultate the chest bilaterally.
31. Possible injuries for this patient include fractured ribs (either simple or flail), lung contusions, and hemothorax or pneumothorax or both.
32. For a patient with a blood pressure of 90/70 mmHg, a heart rate of 120 bpm, and cool extremities, IV/IO access should be obtained if not already in place, fluid resuscitation with crystalloids such as lactated ringer should be started, and a blood sample should be sent for ABO matching.
33. When assisting a person having a seizure, the primary concern is to keep them safe from harm.
34. This patient's airway may need suctioning.
35. This patient has severe respiratory distress with accessory muscle use and labored breathing, and she has paradoxical respirations with an SpO2 of 80%.
36. A nonrebreathing mask should be applied at 15 L/min, the oxygen saturation should be re-evaluated, and an ABG should be ordered.
37. No interventions regarding circulation are needed because circulation seems stable apart from sinus tachycardia which is explained by the severe respiratory distress.
38. The patient is unable to communicate with you because of her decreased level of consciousness.
39. Yes, the patient's blood glucose should be checked and an ABG should be checked because she may be in CO2 narcosis.
40. The patient's temperature is 37°C.
41. The first step in assessing this case is to start the primary assessment with the ABCDE approach.
42. After assessing an unobstructed airway with no abnormal breath sounds, the key elements to be assessed regarding breathing are respiratory rate, depth, and effort, including the use of accessory muscles and the presence of retractions.
43. This child has a breathing problem and a non-rebreathing oxygen mask should be applied at 10 liters/min and nebulized bronchodilators should be given.
44. The key elements to assess regarding circulation are heart rate, blood pressure, pulse quality, capillary refill, and skin color and temperature.
45. The patient has apparently stable circulation other than sinus tachycardia.
46. Respiratory distress and hypoxia are both causing the increase in heart rate.
47. After assessment of circulation, the next points in primary assessment are disability, which includes assessing level of consciousness, and exposure, which includes removing clothing to assess for injuries and controlling temperature.
48. Yes, the patient should be reassessed again by assessing response to oxygen and nebulized albuterol and considering oral corticosteroids.
49. Secondary assessment of that patient should help with obtaining a detailed patient history, performing a thorough physical examination, and considering pertinent diagnostic tests.
50. The SAMPLE mnemonic refers to signs and symptoms, allergies, medications, past medical history, last meal, and events (onset).
51. After oxygen, the patient's repeat vital signs are a heart rate of 140/min, a respiratory rate of 32/min, an SpO2 of 94% after receiving 100% oxygen via nonrebreathing face mask, and a blood pressure of 112/71 mm Hg; the head, eyes, ears, nose, and throat/neck are normal; the heart and lungs show wheezing on expiration in the lower lobes, poor air movement, and persistent moderate suprasternal and intercostal retractions; and the abdomen, extremities, and back are all normal.
52. This patient has respiratory distress (suprasternal and intercostal retractions) due to lower airway obstruction (as manifested by prolonged expiratory time and wheezes).
53. An ABG should be ordered.
54. A chest x-ray should be performed.
Content processed on Dec 27, 2025 9:53 PM
Lecture Summary
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Okay, let's break down these emergency medicine concepts. **Gurgly breathing indicates a problem in the airway.** That's right! Gurgly breathing, often referred to as **"death rattle,"** usually means there's fluid (like saliva, blood, or vomit) obstructing the **upper airway**. The patient can't...
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