Heat-Related Illnesses
This mild heat-related illness presents with red papules or pustules in areas where sweat accumulates, such as the neck, groin, and trunk.
A. Heat edema
B. Heat rash
C. Heat cramps
D. Heat syncope
B. Heat Rash
This is the most commonly ingested foreign body in children, with ED visit rates nearly doubling over the past 20 years.
A. Button batteries
B. Toys
C. Magnets
D. Coins
D. Coins
Approximately what percentage of the US population relies on private wells, which receive no federal oversight?
A. 5%
B. 30%
C. 50%
D. 15%
D. 15%
High-flow nasal cannula therapy in infants under 24 months with bronchiolitis reduces hospital stay by approximately how many days compared to low-flow oxygen?
A. No significant difference
B. 1.5 days
C. 2 days
D. 0.65 days
D. 0.65 days
er USPSTF guidelines, all women should be tested for HIV at least once up to this age.
A. 50 years
B. 55 years
C. Only if risk factors are present
D. 65 years
D. 65 years
A marathon runner collapses immediately after crossing the finish line. He is alert, pale, and recovers fully within 10 minutes with legs elevated. The most likely diagnosis is:
A. Heat stroke
B. Severe hyponatremia
C. Exercise-associated collapse
D. Heat exhaustion
C. Exercise-associated collapse
A parent calls about their 18-month-old who swallowed a round object 20 minutes ago. You cannot confirm if it's a coin or battery. What is the safest next step while en route to the ED?
A. Give water to dilute
B. Give sucralfate 1g every 10 minutes
C. Administer 10 mL honey every 10 minutes up to 6 doses
D. Nothing — wait and observe at home
C. Administer 10 mL honey every 10 minutes up to 6 doses
A pregnant patient in a rural agricultural area asks about her well water. Which contaminant poses the most specific risk of preterm birth in this setting?
A. Lead
B. PFAS
C. Arsenic
D. Nitrates
D. Nitrates
AFP recommends this as the first-line pharmacotherapy for trigeminal neuralgia.
A. Gabapentin
B. Lamotrigine
C. Amitriptyline
D. Carbamazepine
D. Carbamazepine
A 4-year-old swallows a small plastic bead. X-ray confirms it has passed the duodenum and the child is asymptomatic. Best management:
A. Urgent EGD within 24 hours
B. Admission for monitoring
C. Watchful waiting — no intervention needed
D. Surgical consult immediately
C. Watchful waiting — no intervention needed
The threshold serum creatine kinase level used to define exertional rhabdomyolysis was updated in 2024 to:
A. Greater than 1,000 U/L
B. Greater than 5,000 U/L
C. Greater than 20,000 U/L
D. Greater than 10,000 U/L
D. Greater than 10,000 U/L
A coin is least likely to pass spontaneously when which feature is present?
A. Coin has passed the duodenum
B. Child is 8 years old with a penny in the distal esophagus
C. Coin has been in the stomach for 3 days
D. Child is under 6 and coin is in the proximal esophagus for over 12 hours
D. Child is under 6 and coin is in the proximal esophagus for over 12 hours
A mother asks if boiling tap water is safe for preparing infant formula. The most accurate counseling point is:
A. Boiling makes all water safe for infants
B. Bottled water is always safer than boiled tap water
C. Boiling kills microbes but does not remove chemicals like nitrates or arsenic
D. Boiling concentrates fluoride to harmful levels
C. Boiling kills microbes but does not remove chemicals like nitrates or arsenic
Per AFP guidance, the minimum recommended duration of buprenorphine treatment for opioid use disorder before considering discontinuation is:
A. At least 3 months
B. At least 6 months
C. Indefinitely from the start
D. At least 1 year
D. At least 1 year
A nasal foreign body cannot be removed on your first instrument attempt. Per AFP, the appropriate next step is:
A. Try instrument removal up to 5 more times
B. Immediately proceed to OR
C. Use positive pressure first, then instrument twice more
D. Refer to ENT after no more than 2 failed instrument attempts
D. Refer to ENT after no more than 2 failed instrument attempts
A patient with heat stroke arrives at the ED. Which agent is explicitly NOT recommended for core temperature reduction?
A. Ice-water immersion
B. Dantrolene
C. Rotating ice-water soaked towels
D. Ice packs on major vessels
B. Dantrolene
A 3-year-old swallows two neodymium magnets and is asymptomatic on arrival. Most appropriate management:
A. Discharge with return precautions and stool checks
B. Observation for 24 hours then repeat X-ray
C. Urgent or emergent EGD with pediatric GI consult
D. Surgical consult only if symptoms develop
C. Urgent or emergent EGD with pediatric GI consult
PFAS contamination is most commonly associated with which setting?
A. Agricultural areas
B. Urban municipal systems
C. Midwest and Southwest aquifers
D. Near industrial or military sites
D. Near industrial or military sites
eta-2 agonists such as albuterol should only be used for acute bronchitis when:
A. All patients to prevent progression to pneumonia
B. Any patient with productive cough lasting more than 5 days
C. Asthma, COPD, or signs of airflow obstruction such as wheezing or reduced FEV1 are present
D. Patients over age 65 with comorbidities
C. Asthma, COPD, or signs of airflow obstruction such as wheezing or reduced FEV1 are present
A 68-year-old male with schizophrenia on haloperidol works outdoors in summer. Which mechanism most directly increases his heat stroke risk?
A. Impaired sweat production
B. Peripheral vasoconstriction
C. Disruption of hypothalamic thermoregulation
D. Increased metabolic heat production
C. Disruption of hypothalamic thermoregulation
A football player collapses early in practice with flaccid lower extremity weakness, "conscious collapse," and a core temp of 101.5°F. Sickle cell trait is confirmed. What distinguishes this from heat stroke and changes management?
A. Serum sodium — treat with hypertonic saline first
B. Flaccid weakness — requires dantrolene
C. Temp below 104°F alone — no intervention needed
D. Conscious collapse with temp below 104°F — avoid aggressive cooling; give fluids
D. Conscious collapse with temp below 104°F — avoid aggressive cooling; give fluids
After emergent endoscopic removal of a 20 mm lithium button battery from the esophagus of a 2-year-old, what is the most important next step?
A. Barium swallow in 48 hours only
B. Observation for 6 hours then discharge
C. Discharge home with follow-up in 1 week
D. MRI to assess tissue injury plus repeat imaging and surgical consult
D. MRI to assess tissue injury plus repeat imaging and surgical consult
An immunocompromised patient on a public water system asks about extra precautions. Which combination is most accurate?
A. Only reverse osmosis is acceptable; boiling adds no benefit
B. Public water is always safe for immunocompromised patients
C. A certified microbial-reduction filter can help; boil water during advisories or flooding; no single filter removes all contaminants
D. Bottled water from any source is sufficient protection
A certified microbial-reduction filter can help; boil water during advisories or flooding; no single filter removes all contaminants
Cold water immersion for post-exercise muscle soreness shows the most consistent benefit under which parameters?
A. 30 minutes at 32°F (0°C)
B. Less than 10–15 minutes at temperatures below 59°F (15°C)
C. 15–20 minutes at 65°F (18°C)
D. Any duration at any temperature below 68°F (20°C)
B. Less than 10–15 minutes at temperatures below 59°F (15°C)
A private well-owning family asks how often to test their water. Which situation warrants MORE frequent testing beyond the annual recommendation?
A. Only if a neighbor's well tested positive
B. Every 5 years is sufficient if prior tests were negative
C. Only during pregnancy
D. After flooding, if taste or odor changes, or if a vulnerable person lives in the home
D. After flooding, if taste or odor changes, or if a vulnerable person lives in the home