Cruiser
A 10 year old with bipolar disorder on lithium and newly prescribed olanzepine presented to ED with progressive motor rigidity and new onset urine retention. His vitals are
Temp 38, HR 110, RR 20 BP 135/85
He looks agitated and tremulous and diaphoretic
Labs showing WBC 15,000 CPK 45000
What should be done next?
A) Administer diphenhydramine and admit the patient
B) IVF, and arrange outpatient follow up in 2 hours to revise the olanzepine dose
C) administer IV ceftriaxone, acyclovir and admit to inpatient
D) Administer IV dantrolene and admit tp intensive care unit
E) obtain psychiatric consultation and admit to their unit
D) Administer IV dantrolene and admit tp intensive care unit
A 1 years old brought to ED with history of frequently induced vomiting. The patient growth parameter showing a weight of 54 Kg and height 157 cm,
Which of the following findings most likely support your diagnosis
A) Amenorrhea
B) U wave on ECG
C) Decrease serum amylase
D) Hypermagnesemia
E) Hyperchoremic metabolic Alkalosis
B) U wave on ECG
In which battle did Prophet Muhammad (PBUH) say, "This is the greatest battle" after returning from it?
A) Battle of Badr
B) Battle of Uhud
C) Battle of the Trench (Khandaq)
D) The Battle against the Nafs (self)
D) The Battle against the Nafs (self)
A 13-year-old man is brought in by EMS from a the park after a lightning strike. He was rapidly resuscitated on the scene. Which of the following is LEAST likely to be observed in this patient?
A) Compartment syndrome.
B) ECG abnormalities.
C) Lower extremity paralysis.
D) Tympanic membrane rupture
A) Compartment syndrome.
A 13 yo previously healthy boy presents after falling from a fourth floor. He is brought to the ED by medics on a backboard and in a cervical collar. His initial vital signs upon arrival to the ED T 36.3°C HR 80 RR I O SpO2 87% BP 122/86 GCS 8. He is breathing spontaneously, 2+ radial pulse. A trauma survey is notable for bloody secretions in the mouth, multiple dental fractures, nasal bridge swelling with deviation, a large right frontotemporal scalp hematoma and bilateral forearm deformities. Which ofthe following techniques should be used to secure his airway?
a.Direct laryngoscopy
b.Supraglottic airway
c.Surgical crichothyroidotomy
d.Video laryngoscopy
d.Video laryngoscopy
An 11 month old brought by father to ED from day care due to observation bruise noticed on the child after coming that was not present in the morning, school teacher reported that he could off fall down or hurt by other children In school
Which of the following is the appropriate action to be taken:
A) Assure the father that wound will heal without sequel and prescribe antibiotic.
B) Measure inter canine distance and if > 3 cm report to protective services
C) contact child protective service to report pattern injury consistent with bite marks
D) Explain to father that children biting is common occurrence and he consider changing daycare.
C) contact child protective service to report pattern injury consistent with bite marks
Which Surah in the Quran is considered the heart of the Quran?
A) Surah Al-Fatiha
B) Surah Al-Baqarah
C) Surah Yaseen
D) Surah Al-Ikhlas
C) Surah Yaseen
A 16 y/o female with h/o lupus nephritis and asthma, presented to the ED with severe headache, blurry vision and confusions. She has been using her albuterol MDI for wheezing for the last 2 days. HER T 36.7 c , HR 80 , RR 16 , BP 205/140. What is the most appropriate medications to administer?
a. Sodium nitroprusside
b. Hydralazine
c. Phentolamine
d. Labetalol
e. Nicardipine
e. Nicardipine
A 17 years old presented to ED with leg pain with limping for 2 months with no systemic manifestation. He had been removed from the soccer team 3 months ago and since then his six started. His parents are worried about his medical health. On interviewing the child he looks withdrawn and not communicating throughly, based on your suspected diagnosis best screening tool in ED is:
A) Evaluate blood work for medial causes
B) Administer adolescent depression self checklist
C) Interview the patient indirectly about his current feelings
D) combine direct patient interview and adolescent parent depression checklist
D) combine direct patient interview and adolescent parent depression checklist
When considering restrain while doing a procedure in the ED, which of the following statements is correct:
A. Human restrains are usually more effective than physical restrains in older children
B. When using Physical restrains, standard methods of pharmacologic sedation is not indicated
C. Could lead to mistrust and future medical procedure fears
D. Airway compromise is a common complication
C. Could lead to mistrust and future medical procedure fears
من القائل :
بكيت على الشباب بدمع عيني فلم يغني البكاء ولا النحيب
فياليت الشباب يعود يوما لأخبره بما فعل المشيب
أبو الطيب المتنبي A)
أبو العتاهية B)
أبو فراس الحمداني C)
أبو تمام D)
أبو العتاهية
15 years old going under intensive training for competitive enrollment on an international Olympics presenting to you with fatiguability. His vitals are:
Temp 35.9 HR 42 RR 18 BP 93/64 weight 60 KG Height 188 cm
Medical complication of this patient condition include:
A) Leukocytosis
B) Hyperthyroidism
C) Palatal abrasion
D) Chronic diarrhea
E) Sudden death
E) Sudden death
A 13 years old with autism spectrum disorder is brought by his parents to your ED due to difficulty awakening him from sleep and noticed to behave abnormally on waking up. He was having URT last week where he was taking OTC treatment for it. Arrival vitals
T 38.8 HR 140 RR 28 BP 125/78
He moves frequently in the exam room and while you are waiting for lab results urine screen came positive for opioids, what should e your next action?
A) Notify child protective services
B) Admit for monitoring
C) administer diphenhydramine 1mg/kg
D) Adminiter naloxone .1 mg/kg
B) Admit for monitoring
A 10 year old presents with H/O myalgia, low grade fever, vulvar pain and dysuria that worsening in the last 4 days. She was prescribed antibiotic by her primary physician 2 days ago. She looks uncomfortable with normal vitals sift abdomen, local exam to the genital area revealed several painful circular shallow ulcers with erythematous cal halo and yellow fibrinous center as in the image . No lymphadenopathy no other rash child denied a nysexual activity and mother confirmed that she lives iwth both parents in safe home.
What is the most likely cause of the findings?
A) sexually transmitted HSV type 2
B) idiopathic aphthous genital ulcers
C) vulvovaginal candidiasis form antibiotic use
D) chlamydia vulvovaginitis
B) idiopathic aphthous genital ulcers
ماهي السورة التي تعد شفيعة لصاحبها؟
البقرة
الكهف
الملك
التوبة
الملك
A 2 weeks old infant brought to the emergency depart. With H/O fever and poor feeding in the last 24 hours. The mother had uneventful NSVD with history of URTI infection currently in multiple family members. A decision for partial septic work up was initiated to plan further for the lumbar puncture, upon discussion with the mother she was worried about the baby experiencing pain with the procedure , your best action would be:
A) Apply EMLA cream 15 minutes before the procedure
B) advice the mother that its minimally painful and the baby will not remember it.
C) Administer oral sucrose before injecting lidocaine locally at the site of the LP.
D) Consider sedating the child with midazolam before starting the procedure .
C) Administer oral sucrose before injecting lidocaine locally at the site of the LP.
You receive a call from emergency medical services about a 2-year-old child who is having a seizure and being transported from a child care center. Due to a large multi car crash, no advanced life support units were available, so a basic life support crew is transporting this girl Of the following, knowing the capabilities and equipment available to a basic life support ambulance crew, you can expect that this child MOST likely may have received
a) airway positioning, suctioning, and placement of a peripheral intravenous catheter
b) bag-valve mask ventilation, oral airway placement, and suctioning
c) blood glucose measurement, airway positioning, and suctioning
d) endotracheal intubation, rectal diazepam, and intravenous fluids
e) rectal acetaminophen, intranasal midazolam, and oxygen
b) bag-valve mask ventilation, oral airway placement, and suctioning
A 2 years arrived to the hospital after he fell down from the slide on the park. On arrival, child was crying irritable with noticeable deformity on his right arm. No LOC or other injuries noticed by parents, on approaching this child all the following is TRUE except:
A) Assessment of pain should be done using appropriate tool such s Neonatal infant pain sale
B) an emergency reduction post medication is needed to maintain limb neurovascular supply
C) parenteral pain medication considered the best option in his situation
D) Consideration for distraction technique is an available option for pain control
A) Assessment of pain should be done using appropriate tool such s Neonatal infant pain sale
10 years old was brought by his school principal as he was found shouting and hitting other kids in school
On arrival to your ED, he was agitated screaming and shouting but controllable, he has medication in his bag including concerts and Prozac
Which of the following medication would best choice to reduce his agitation
A) Midazolam
B) Olanzapine
C) Haloperidol
D) Diphenhydramine
E) Lithium
A) Midazolam
Over the previous week, you’ve evaluated multiple patients for attempted suicide, which of them has the highest likelihood of completing the attempt without appropriate intervention?
A) 15 years old who took handful of acetaminophen, found by her mother and brought to the hospital where she was tearful on arrival.
B) 14 years old who hang himself with a belt at school and brought by ambulance confused but breathing spontaneously. His dad was contacted but stated he cant come to ED at timbering.
C) 17 years who has multiple wrist cut with razor blades with varying stages of healing his parents are aware and following with his primary care physicain.
D) 12 years old who had previous sexual abuse and disclosed to her teacher that she wants to junk from a balcony. Her mother arrived with her to ED where she denied wanting to harm herself.
B) 14 years old who hang himself with a belt at school and brought by ambulance confused but breathing spontaneously. His dad was contacted but stated he cant come to ED at timbering.
A 14 years old girl arrive to your hospital by school personnel upon finding the girl in the bathroom with an open bottle of aspirin. The parents are separated as father in prison and the mother addicted due too psychiatric illness. the girl has gained 50 bounds and stated that in last 1 month she ant sleep and she doesn’t go out of house or do any leisure she cant concentrate in class and thinks of killing herself
Which of the following is important to diagnose major depressive disorder?
A) significant weight Gian
B) Insomnia
C) loss of interest
D) recurrent thoughts of death
C) loss of interest
A 14 years old girl brought to the ED by her parents as they noticed significant weight loss recently. She stated that she is undergoing strict diet with exercise routine. On examination she looked frail gaunt girl. On view of the suspected diagnosis all the following are associated with her condition EXCEPT :
A) Cold intolerance
B) Evidence of lanugo on face and neck
C) Tachycardia and hypotension
D) signs and symptoms of mitral valve prolapse
C) Tachycardia and hypotension
You are caring for adolescents with history of oppositional defiant disorder, the patient is becoming increasingly agitated where he starts to threaten the surrounding you became worried that her will hurt himself or hoers and elected to put him on physical restraint
When utilizing restraint you must:
A) Renew the order every 2 hours
B) Obtain consent from parent before utilizing restraint
C) Transfer the patient to appropriate facility where he can be evaluated by psychiatry
D) Place the restraint by yourself as order only by physician.
A) Renew the order every 2 hours
A 9 years old presents to your ED with complain of vaginal discharge and itchiness for that 2 weeks, no fever or systemic manifestation. The mother thought ts related to itrritation and was treating her with local zinc oxide but her symptoms dint improve. On examination the child was anxious with normal vitals and systemic exam local examination of the vaginal area revealed condyloma accuminata. What is your next step in management of this child?
A) Ask the mother to leave the room, and have private discussion with the girl.
B) Discuss with the mother that condyloma frequently occurs with auto inoculation and need dermatology treatment
C) Advise the mother to start the HPV vaccine series.
D) Call child protective services as condyloma could have been transmitted through sexual abuse
A) Ask the mother to leave the room, and have private discussion with the girl.
كم عدد الشهور في القرن ؟
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