Summary: <br> <br> “Live as if you were to die tomorrow. Learn as if you were to live forever.” –Mahatma Gandhi<br> <br> Welcome back! Despite using randomly generating questions, a lot of the question in this episode involved mnemonics. We also review many core concepts in emergency medicine. Enjoy.<br> You can find our <a href="https://itunes.apple.com/us/podcast/rosh-review/id1156487141?mt=2">previous episodes</a> here in case you missed them.<br> Please, please, please <a rel="noopener" target="_blank" href="mailto:feedback@roshreview.com">send us feedback</a>.<br> Lets get started<br> <br> <br> Question 1<br> A 55-year-old woman with a history of gallstones presents to the ED with right upper quadrant abdominal pain. Her blood pressure is 98/64 mmHg, heart rate is 110 beats per minute, respiratory rate is 22 breaths per minute, and temperature is 39.8°C. She has scleral icterus and appears jaundiced. She is also mildly confused. She is tender in the RUQ with guarding. What is the most likely diagnosis?<br> A. Acute cholangitis<br> B. Acute cholecystitis<br> C. Acute pancreatitis<br> D. Spontaneous bacterial peritonitis<br> <a href="https://www.roshreview.com/wp-content/uploads/Image-Ascending-cholangitis-charcot-triad.jpg" rel="lightbox[907]">Teaching image</a><br> <br> Question 2<br> Which of the following is true regarding cervical spine injuries due to trauma?<br> A. A focused neurological exam with active range of motion of the cervical spine is essential to clearing the cervical spine<br> B. A technically adequate 3-view cervical spine x-ray will pick up all cervical spine fractures<br> C. Odontoid fractures in the elderly are easily identified on plain films<br> D. The NEXUS and Canadian cervical spine decision rules have very high specificity<br> <a href="https://www.roshreview.com/wp-content/uploads/Image-National-Emergency-X-Radiography-Utilization-Study-NEXUS.png" rel="lightbox[907]">Teaching image 1</a><br> <a href="https://www.roshreview.com/wp-content/uploads/Image-NEXUS-and-NSAID.jpg" rel="lightbox[907]">Teacing image 2</a><br> <a href="https://www.roshreview.com/wp-content/uploads/Image-C1-fracture-Jefferson-fracture.jpg" rel="lightbox[907]">Teaching image 3</a><br> <a href="https://www.roshreview.com/wp-content/uploads/Image-Hangman-fracture-C2.png" rel="lightbox[907]">Teaching image 4</a><br> <br> Question 3<br> A 5-year-old girl presents to the ED with a rash that started on her face and spread to her neck, axillae, and groin. Mom states that the patient had an upper respiratory infection one week prior. On examination, the patient’s rash is tender to the touch. Which of the following statements regarding the diagnosis of this patient’s condition is correct?<br> A. Deep layers of the dermis are involved<br> B. It often leaves the patient disfigured from scarring<br> C. Mucous membrane involvement is common<br> D. The disease is caused by an exotoxin-producing bacterium<br> <a href="https://www.roshreview.com/wp-content/uploads/Image-Staphylococcal-Scalded-Skin-Syndrome-SSSS-copy.png" rel="lightbox[907]">Teaching image </a><br> <br> Question 4:<br> A 21-year-old man presents with a headache. What feature should raise the concern for a subarachnoid hemorrhage?<br> A. Age <40<br> B. Fever<br> C. History of intravenous drug use<br> D. Sudden onset of headache<br> <a href="https://www.roshreview.com/wp-content/uploads/Image-Subarachnoid-hemorrhage-5-images.jpg" rel="lightbox[907]">Teaching image </a><br> <br> Question 5<br> A 20-year-old woman with a history of depression and previous overdose presents with altered mental status. The patient is disoriented with mumbling speech. Her vitals are: T 101.2°F, HR 122, BP 130/82; RR 16. Physical examination is notable for dilated pupils, dry mucous membranes and flushed skin. On ECG, her QRS interval is 60 ms. Which ingested medication is most likely?<br> A.
