MSFinals-0877
According to the Glasgow coma scale (GCS), what does a verbal score of 1 indicate?
Med Student Finals Category: Emergency Medicine
MSFinals-0878
Which of the following indicates a verbal response score of 1 on the Glasgow Coma Scale?
MSFinals-0879
A 16-year-old boy is brought to the Emergency department by his parents. He has no past medical history of note.
In his parents’ absence, he reveals that he took an overdose of paracetamol after a fight with his girlfriend, but did not intend to end his life.
What is the most reliable indicator of the extent of liver damage?
MSFinals-0880
You are requested by the medical registrar to assess a 65-year-old man who has been admitted to the hospital with fevers, pleuritic chest pain, and a productive cough. The emergency department has initiated initial management, but the registrar wants you to ensure that all the necessary investigations recommended by the surviving sepsis guidelines have been requested. The patient’s vital signs are HR 110 regular, BP 80/50 mmHg, O2 90% room air. Currently, a complete blood count, blood cultures, renal and liver function tests have been ordered, and intravenous fluids have been started. What other investigation is required according to the sepsis guidelines?
MSFinals-0881
You are the medical SHO in A and E. A 25-year-old female is admitted in a distressed state and experiencing shortness of breath. She is finding it difficult to speak in complete sentences and is breathing rapidly. Upon examination, her respiratory rate is 35 breaths per minute, pulse rate is 120 beats per minute, blood pressure is 110/70 mmHg, oxygen saturation is 90%, and her peak expiratory flow rate is less than 50% of predicted. The emergency medical services have administered salbutamol 5 mg twice and provided face mask oxygen. An ABG test is pending. What is the most appropriate next step for this patient?
MSFinals-0882
A 55-year-old woman is scheduled for a routine blood pressure check. As she waits in the reception area, she suddenly experiences severe breathlessness with stridor. She had mentioned to someone else in the room that she was stung by an insect on her way to the clinic. Based on your assessment, you determine that she is having an anaphylactic reaction to the sting. What would be the appropriate dose and route of administration for adrenaline in this scenario?
MSFinals-0883
A 20-year-old college student is rushed to a university hospital after being found semi-conscious at home. Upon examination, the patient has a Glasgow coma scale of 12, a fever of 39.5°C, a pulse of 120/min, a blood pressure of 105/60 mmHg, photophobia, and meningism. The medical team has already inserted a cannula and sent blood cultures. What should be the next course of action?
MSFinals-0884
You are asked to assess a 75-year-old man who has a medical history of hypertension, diabetes, and congestive heart failure. He has come to the hospital with worsening paroxysmal nocturnal dyspnea and three pillow orthopnea, and is currently experiencing acute shortness of breath.
The patient’s vital signs are as follows: heart rate of 120 beats per minute, regular rhythm, blood pressure of 150/80 mmHg, and oxygen saturation of 88% on room air. The nurse has ordered a chest x-ray for the patient.
Which of the following findings would be inconsistent with a diagnosis of congestive heart failure?
MSFinals-0885
A 50-year-old plumber presents to the Emergency department with a saw injury to his right thumb. On examination, there is a 1.5 cm laceration on the ulnar aspect of the thumb. The neurovascular supply is intact, and there is no evidence of injury to other structures. What is the suitable local anaesthetic to use for exploring the wound and suturing the laceration?
MSFinals-0886
A 40-year-old male presents to the clinic with sudden onset of headache while engaging in sexual activity. He reports no focal neurological symptoms but complains of neck stiffness. What is the best course of action for management?