Emergency Medicine

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Sudbury Clinical Decision Rule for Vertigo

The Sudbury vertigo risk score can identify the risk for a serious diagnosis in patients presenting with vertigo.

  • True
  • False
Volume 41.1 - Question 20

Head Injuries in Older Adults

Which one of the following is not a risk factor for traumatic intracranial hemorrhage in patients 65 years or older presenting in the emergency department for a ground-level fall-related head injury?

  • Focal neurologic signs
  • External signs of head trauma
  • Male sex
  • Oral anticoagulant use
Volume 41.1 - Question 19

Biomarkers in Traumatic Brain Injury

A strategy using the combined measurement of the biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) has 100% sensitivity and 100% negative predictive value for ruling out intracranial injury in patients with mild traumatic brain injury.

  • True
  • False
Volume 41.1 - Question 18

Methoxyflurane for Traumatic Pain

For acute traumatic pain management in the Emergency Department, methoxyflurane can significantly reduce pain scores with pain relief occurring within 10-30 minutes.

  • True
  • False
Volume 41.1 - Question 17

Managing Angioedema

Which one of the following statements regarding angioedema is false?

  • Histamine-mediated angioedema is the most common form.
  • Most patients with hereditary angioedema experience their first episode within the second decade of life.
  • In patients requiring an emergent airway intervention, surgical airway intervention is common.
  • Tranexamic acid has no role in treatment.
Volume 41.1 - Question 16

Multidose Ondansetron in Children with Gastroenteritis

Among children with gastroenteritis-associated vomiting, the provision of ondansetron after an emergency department visit leads to lower risk of moderate-to-severe gastroenteritis during the subsequent 7 days.

  • True
  • False
Volume 41.1 - Question 9

Ultrasound for Acute Coronary Syndrome

The absence of regional wall motion abnormalities on bedside cardiac ultrasound performed by emergency physicians can safely rule out non-ST-elevation acute coronary syndrome as a cause for chest pain.

  • True
  • False
Volume 40.6 - Question 23

Computed Tomography in Children

In CT scans done for blunt abdominal trauma, over a third of children will have non-trauma related incidental findings noted.

  • True
  • False
Volume 40.6 - Question 2

Ketamine versus Ketoralac for Blunt Chest Trauma

Which one of the following statements comparing intravenous ketorolac with intravenous analgesic dose ketamine for the treatment of pain in chest trauma is false?

  • Analgesic dose ketamine is more effective at thirty and sixty minutes post dose.
  • Analgesic dose ketamine use results in much less use of rescue-dose opiate.
  • Hemodynamic instability was not noted with either agent.
  • Analgesic dose ketamine and intravenous ketorolac groups have similar rates of nausea.
Volume 40.5 - Question 18

Nebulized Ketamine for Pain

Nebulized ketamine provides equivalent analgesia for acute pain in the emergency department compared to IV morphine.

  • True
  • False
Volume 40.5 - Question 17

URI and ED Procedural Sedation in Children

There is an increase in respiratory adverse events in children with upper respiratory infection undergoing emergency department sedation.

  • True
  • False
Volume 40.5 - Question 16

Heat Stroke

Which one of the following statements about heat stroke is false?

  • It is defined as a core temperature greater than 40°C presenting with CNS abnormalities.
  • Routine use of acetaminophen is recommended.
  • Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling.
  • Dantrolene is not recommended.
Volume 40.5 - Question 15

Opioids for Headache

Opioid prescriptions for headache in the emergency department are associated with higher rates of long-term prescription opioid use.

  • True
  • False
Volume 40.5 - Question 11

Emergency Department Opioid Prescriptions

Which one of the following outcomes at one year is associated with emergency department opioid prescriptions?

  • Increased rate of overdoses
  • New opioid agonist therapy
  • Increase in mortality
  • Increases in subsequent opioid prescription use
Volume 40.5 - Question 10

Oxygenation for Pediatric Procedural Sedation

In pediatric patients, receiving pre-emptive preprocedural oxygenation or procedural oxygenation is associated with having a lower risk of airway, breathing and circulation interventions during sedation compared with patients not receiving procedural oxygenation.

  • True
  • False
Volume 40.4 - Question 7

Sudden Vision Loss

Which one of the following statements about the management of sudden vision loss is false?

  • Because intravenous thrombolysis may be beneficial in selected patients with central artery occlusion within the first 4.5 hours, emergent consultation with a stroke neurologist is recommended in the hyperacute period.
  • Following embolic central retinal artery occlusion, underlying modifiable systemic risk factors should be addressed because the patient is at high risk of a cerebrovascular event or a similar incident in the second eye.
  • When there is high clinical suspicion for giant cell arteritis, empiric steroids should be delayed until a temporal artery biopsy is obtained.
  • High-dose corticosteroids are the first-line treatment for acute optic neuritis because they shorten visual recovery time compared with placebo.
Volume 40.3 - Question 1

PECARN Prediction Rule for Intraabdominal Injury

Which one of the following statements about CT imaging in abdominal trauma and the Pediatric Emergency Care Applied Research Network (PECARN) intra-abdominal injury prediction rule is true?

  • The presence of a PECARN risk factor necessitates CT imaging.
  • The rule identified all children with intrabdominal injury requiring intervention.
  • CT imaging does not detectably increase risk of radiation induced malignancy.
  • For CT imaging to be considered all PECARN criteria must be positive.
Volume 40.2 - Question 22

Noninvasive Ventilation for Preoxygenation During Emergency Intubation

Among critically ill adults undergoing tracheal intubation, preoxygenation with noninvasive ventilation (bilevel positive airway pressure) results in a lower incidence of hypoxemia during intubation than preoxygenation with an oxygen mask.

  • True
  • False
Volume 40.2 - Question 21

Opioid Prescribing in the Emergency Department

Which one of the following statements regarding opioid prescribing in the emergency department is false?

  • Patients experiencing renal colic required more opioids over a 2 week period than patients with fractures.
  • About 20% of patients with opioid use disorder report that their initial exposure was in the ED.
  • The majority of patients who misuse prescription opioids have a previous substance use disorder.
  • Most opioid tablets prescribed for acute pain in adults are unused.
Volume 40.2 - Question 20

Pediatric Elbow Radiograph Interpretation

Experienced health care practitioners demonstrate high accuracy in diagnosing pediatric elbow fractures on x-ray.

  • True
  • False
Volume 40.2 - Question 18

Evaluation of the Acute Abdomen

Which one of the following statements about the evaluation of the acute abdomen is false?

  • The administration of opiate analgesics results in a significant increase in management errors.
  • Contrast enhanced CT-angiography scans are more accurate than scans without contrast.
  • A wait of at least 2 hours for the final interpretation of by a radiologist is associated with an increase in death.
  • Earlier surgical consultation has been shown to reduce complications.
Volume 40.2 - Question 17

Unstable Bradycardia and Transcutaneous Pacing

In the prehospital setting, the incidence of true electrical capture in patients receiving transcutaneous pacing is less than 20%.

  • True
  • False
Volume 40.2 - Question 16

Defibrillator Pad Position

For out of hospital cardiac arrest with a shockable rhythm, initial anterior-posterior placement of the defibrillator pads by Emergency Medical Services results in higher return of spontaneous circulation than anterior-lateral placement.

  • True
  • False
Volume 40.2 - Question 15

Prevention of Ventilator-Associated Pneumonia

In patients with acute brain injury, a single (2g) ceftriaxone dose decreased the risk of early ventilator-associated pneumonia.

  • True
  • False
Volume 40.2 - Question 4

CT Scanning for Head Injury

Which one of the following statements about CT scanning for head injury is false?

  • Patients who have sustained falls associated with loss of consciousness were found to have increased risk of traumatic intracranial hemorrhage.
  • They are mandatory for older patients on antiplatelet medications who sustained ground-level fall-related head trauma.
  • The cutaneous impact location may help clinicians identify patients at risk of traumatic intracranial hemorrhage.
  • Older patients on anticoagulants or antiplatelets who sustain ground-level fall-related Traumatic Brain Injury and are at their baseline neurological status do not require a follow-up scan if the first head CT scan is normal.
Volume 40.1 - Question 17

Sepsis and Physician Gestalt

Physician gestalt is superior to existing screening tools for identifying sepsis in critically ill patients presenting to the emergency department.

  • True
  • False
Volume 39.6 - Question 28

Knee Joint Injection

Patients should be advised that a steroid flare-up may occur in the first 24 to 48 hours after knee joint injection.

  • True
  • False
Volume 39.6 - Question 27

Blunt Head Injury in the Elderly

Older patients are at risk of sustaining serious intracranial injuries with ground level falls.

  • True
  • False
Volume 39.6 - Question 23

In-hospital Cardiac Arrest Mortality

The likelihood of favorable functional status for patients with in-hospital cardiac arrest receiving CPR for 32 minutes or longer is less than 1%. 

  • True
  • False
Volume 39.5 - Question 26

Treatment of Pulmonary Embolism

Which one of the following statements about the treatment of pulmonary embolism (PE) is false? 

  • Embolectomy or catheter-directed treatments are recommended as the first line treatment of high risk PE.  
  • Patients with cancer-associated thrombosis without high risk of gastrointestinal or genitourinary bleeding can be treated with an oral Xa inhibitor (eg, apixaban and rivaroxaban). 
  • Younger patients with subsegmental PE and no evidence of deep venous thrombosis may not require anticoagulation. 
  • Selected patients with acute PE can be managed as outpatients.   
Volume 39.5 - Question 17

Diagnosis of Pulmonary Embolism

Which one of the following statements about the diagnosis of pulmonary embolism (PE) is false? 

  • The sensitivity of clinician gestalt is comparable to that of risk stratification tools. 
  • The fetal radiation exposure for computed tomography pulmonary angiography is dangerous. 
  • False positive results of subsegmental PEs are common.  
  • A normal D-dimer level in non–high-risk patients can safely exclude PE.  
Volume 39.5 - Question 16

Triage Nurse Application of the Canadian C-Spine Rule

Application of the Canadian C-Spine Rule by emergency department triage nurses resulted in the removal of immobilization in patients with clinically important cervical spine injuries.

  • True
  • False
Volume 35.61 - Question 24

In-flight Medical Emergencies

Which one of the following statements about in-flight medical emergencies is false?

  • Normal oxygen saturation is about 90% at an altitude of 6,000-8,000 feet (1,829-2,438 m).
  • Syncope/presyncope is the most common cause of in-flight medical emergency.
  • Medical on-board volunteers are ultimately responsible for decisions about aircraft diversion.
  • Epinephrine in the on-board medical kit is the medication that carries the highest risk of error in administration.
Volume 35.61 - Question 16

Acute Poisoning

When compared to intubation, non-invasive airway management of comatose patients with acute poisoning is associated with a greater clinical benefit.  

  • True
  • False
Volume 39.4 - Question 27

Sterile Versus Clean Gloves

There is no significant protection against surgical site infection with the use of sterile gloves for wound repairs at the emergency department compared to using clean gloves. 

  • True
  • False
Volume 39.4 - Question 26

Intranasal Ketorolac for Renal Colic

Intranasal ketorolac is inferior to intravenous for the treatment of renal colic in adults in the emergency department.   

  • True
  • False
Volume 39.4 - Question 2

Subarachnoid Haemorrhage

The use of non-contrast multislice CT alone is unable to rule out aneurysmal subarachnoid haemorrhage at 24 hours after headache onset.  

  • True
  • False
Volume 38.21 - Question 15

COVID Croup

There is compelling evidence to support the hypothesis that the omicron variant causes laryngotracheobronchitis. 

  • True
  • False
Volume 38.21 - Question 1

Tranexamic Acid for Trauma

In the context of traumatic injuries, which one of the following statements about the tranexamic acid (TXA) use is false?

  • TXA improves one month mortality.
  • Administering TXA in the out-of-hospital setting improves mortality.
  • TXA administration increases occlusive events.
  • TXA may reduce bleeding by inhibiting the activation of plasmin and maintaining the clot stability and integrity.
Volume 39.3 - Question 25

Cannabis Use Among Injured Drivers

After cannabis legalization, the percentage of moderately injured drivers with a THC level above the legal limit, measured at participating trauma centers, more than doubled.

  • True
  • False
Volume 37.3 - Question 30

PoCUS & Pleural Effusion Detection

Point of care ultrasound assessment is more accurate than comprehensive physical examination in the detection of pleural effusions.

  • True
  • False
Volume 37.3 - Question 18

Button Battery Ingestion

Which one of the following statements about button battery ingestion in children is false? 

  • Tissue damage can occur within 2 hours of ingestion.
  • Lithium batteries and those 20mm or larger are most dangerous.
  • Urgent removal is required no matter the location.
  • Honey should be administered before the patient reaches the hospital.
Volume 37.3 - Question 5

Non-Consensus Transient Ischemic Attack

Which one of the following statements about patients with non-consensus transient ischemic attack (TIA) as compared to classic TIA is false?

  • They had a lower 90–day stroke risk after index event. 
  • They were less likely to seek medical attention on day of event. 
  • They were more likely to have recurrent strokes before seeking medical attention. 
  • There is a similar 10–year risk of all major vascular events. 
Volume 36.6 - Question 1

Esmolol for Sepsis

The use of ultrashort-acting B-blockers in sepsis and septic shock with persistent tachycardia improves mortality.   

  • True
  • False
Volume 36.5 - Question 25

Topical tetracaine for corneal abrasions

In patients with corneal abrasions topical tetracaine drops provide greater pain relief compared to artificial tears without an increased rate of adverse effects.  

  • True
  • False
Volume 36.5 - Question 24

Acute Alcohol and Drug Intoxication

Which one of the following statements about the medical needs of emergency department (ED) patients presenting with acute altered mental status due to presumed alcohol or illicit substance intoxication is false? 

  • The majority of patients require a medical intervention during their ED stay.   
  • A minority of patients receive a medical intervention that is not usually available at a detoxification centre.   
  • Patients require repositioning to open their airway in 10% of encounters.    
  • 1% of patients require admission to the intensive care unit. 
Volume 36.5 - Question 18

PoCUS vs Landmarks for Arthrocentesis

Ultrasound guidance improves overall successful arthrocentesis of medium sized joint effusions (elbow, wrist or ankle).

  • True
  • False
Volume 37.6 - Question 19

Peripheral Nerve Blocks for Primary Headaches

Peripheral nerve blocks are effective as a rapid treatment option for the treatment of primary headache disorders, which include migraine, tension headache, and cluster headaches.

  • True
  • False
Volume 37.6 - Question 18

Nursemaid’s Elbow

 In children diagnosed with radial head subluxation, missed upper extremity fractures are rare. 

  • True
  • False
Volume 36.4 - Question 19

Racial Bias in Pulse Oximetry Measurement

Reliance on pulse oximetry to triage patients and adjust supplemental oxygen levels may place Black patients at increased risk for hypoxemia. 

  • True
  • False
Volume 36.4 - Question 17

Hereditary Angioedema

Which one of the following statements about hereditary angioedema is false?

  • It is mediated by bradykinins. 
  • Urticaria is generally absent. 
  • It does not respond to antihistamines. 
  • It responds to corticosteroids. 
Volume 36.4 - Question 13

NSAIDs Use in Pregnancy

Use of nonsteroidal anti-inflammatory drugs is not advised during pregnancy beginning at 20 weeks’ gestation. 

  • True
  • False
Volume 36.4 - Question 1

Cannabinoid Hyperemesis Syndrome

For the acute treatment of cannabis-associated hyperemesis, IV haloperidol is superior to IV ondansetron. 

  • True
  • False
Volume 36.3 - Question 23

COVID Croup

There is compelling evidence to support the hypothesis that the omicron variant causes laryngotracheobronchitis.

  • True
  • False
Volume 37.6 - Question 3

Cytokine Storm

Which one of the following statements about cytokine storm is false? 

  • Nearly all patients are febrile.   
  • Neurologic toxic effects occur early.    
  • Many patients have hypertriglyceridemia.    
  • Patients can develop a stress-related or takosubo-like cardiomyopathy. 
Volume 36.3 - Question 19

Elevated D-Dimer in COVID-19

Increased D-dimer levels measured on hospital admission are significantly correlated with the severity of COVID-19 pneumonia. 

  • True
  • False
Volume 36.3 - Question 15

Coronary-artery Dissection

Which one of the following statements about spontaneous coronary-artery dissection (SCAD) is false? 

  • It occurs primarily in women between 47 and 53 years of age.  
  • Up to 50% present with STEMI.  
  • Approximately one quarter of initial troponin levels are normal.  
  • Thrombolysis is recommended for acute SCAD.
Volume 36.3 - Question 2

Emergency Department Non-infarct Troponins

Which one of the statements about troponin elevation is false? 

  • In nearly half of patients, it is associated with a condition other than myocardial infarction.   
  • It can be caused by increased membrane permeability in inflammatory states such as sepsis.   
  • It can be caused by myocardial injury without critical coronary vascular obstruction in demand ischemia.   
  • It occurs in 1% of patients with pulmonary embolism. 
Volume 36.2 - Question 32

Subclavian Vein Catheterization

The supraclavicular approach to subclavian vein catheterization is advantageous relative to the infraclavicular approach in terms of operation duration and success rate.   

  • True
  • False
Volume 36.2 - Question 19

Elevated Blood Pressure in the Emergency Department

Elevated blood pressure readings in the emergency department are associated with adverse cardiovascular outcomes within 2 years of the visit.

  • True
  • False
Volume 37.2 - Question 30

Abscess Management

Which one of the following statements about the management of a cutaneous abscess in the emergency department is false?

  • Irrigation has been shown to be of benefit.
  • Needle aspiration is inferior to incision and drainage.
  • The loop drainage technique is an alternate approach to traditional incision and drainage.
  • In settings with high prevalence of MRSA, the addition of a cephalosporin does not reduce the incidence of treatment failures after incision and drainage.
Volume 37.2 - Question 29

Post Lumbar Puncture Headache

Which one of the following has been associated with a reduction in post lumbar puncture headache occurrence?

  • Fluid supplementation
  • Smaller needle diameter
  • Use of non-cutting needle
  • Decubitus position after procedure
Volume 37.2 - Question 21

Transfusion and MI

In patients with acute myocardial infarction and anemia, electing to transfuse patients with an 80g/L hemoglobin threshold is non-inferior to employing a 100g/L threshold.

  • True
  • False
Volume 37.2 - Question 13

Migraine

Volume 37.4 - Question 43

Intracranial Hemorrhage and Anticoagulation

The risk of intracranial hemorrhage after a head injury for patients 65 years and older on a direct oral anticoagulant is significantly higher compared with patients not on anticoagulation.

  • True
  • False
Volume 37.4 - Question 40

Rapid Agitation Control

For patients in the emergency department with severe agitation, intramuscular ketamine resulted in a significantly shorter time to adequate sedation than a combination of intramuscular midazolam and haloperidol.

  • True
  • False
Volume 37.4 - Question 34

Emergency Complaints

Among patients presenting to the emergency department, which one of the following complaints has the worst 7 day mortality?

  • Altered mental status
  • Generalized weakness
  • Abdominal pain
  • Chest pain
Volume 37.4 - Question 22

Cannabis

Which one of the following statements about conditions related to cannabis use is false?

  • Cannabis withdrawal syndrome occurs within 7 days of reducing cannabis use.
  • Cannabis hyperemesis occurs during recurrent cannabis intoxication.
  • Cannabis withdrawal symptoms can last for months.
  • There is no role for selective serotonin reuptake inhibitors in the management of withdrawal symptoms.
Volume 37.4 - Question 19

Distal Radius Fracture

In patients aged 60 years and older with unstable distal radius fractures, there are no clinically meaningful patient-reported outcome differences 24 months after injury between patients choosing surgical treatment and those opting for closed reduction and casting.

  • True
  • False
Volume 37.4 - Question 18

Fluvoxamine in COVID-19

In unvaccinated adults with COVID-19 infection and risk factors for disease progression, treatment with fluvoxamine reduces the risk of hospitalization compared with placebo.

  • True
  • False
Volume 37.4 - Question 17

Drug Induced Akathisia

Which one of the following statements about acute drug induced akathisia is false?  

  • It develops soon after starting new medications or after dosage adjustments.   
  • It lasts less than six months.  
  • It generally resolves when the medicine triggering it is discontinued.  
  • Akathisia rarely occurs concurrently with akinesia.
Volume 36.1 - Question 23

Haloperidol in Headache

Haloperidol (2.5 mg intravenously) is a rapid and effective treatment for acute, severe, benign headache in emergency department patients aged 18 to 55 years. 

  • True
  • False
Volume 36.1 - Question 21

Point of Care Ultrasound in Diagnosis of Skin and Soft Tissue Abscess

Point of care ultrasound used to differentiate between cellulitis and abscess has been shown to lead to a correct change in management in greater than 10% of cases of skin and soft tissue infections in the emergency department. 

  • True
  • False
Volume 36.1 - Question 18

Double Sequential Defibrillation and Vector Change Defibrillation

There is a higher rate of termination of refractory ventricular fibrillation/ventricular tachycardia using double sequential or vector change defibrillation strategies compared to standard defibrillation strategies. 

  • True
  • False
Volume 36.1 - Question 1

Preservation of Amputated Parts

Proper preservation of amputated parts consists of wrapping the part in saline soaked gauze inside a watertight bag and placing it on ice.

  • True
  • False
Volume 38.1 - Question 21

Early Point of Care Ultrasound for Flank Pain

In the assessment of a patient with undifferentiated acute flank pain, earlier use of Point of Care Ultrasound (PoCUS) is associated with a shorter length of stay in the acute care setting, without compromising diagnostic accuracy.  

  • True
  • False
Volume 38.1 - Question 16

Management of Traumatic Hemothorax

Concerning the management of traumatic hemothorax requiring drainage, a 14-Fr percutaneous catheter (pigtail) is as effective as a chest tube.

  • True
  • False
Volume 37.5 - Question 38

Tenecteplase for Acute Ischemic Stroke

For treatment of acute ischaemic stroke, use of tenecteplase results in similar functional outcomes compared to alteplase in patients presenting with acute ischaemic stroke who meet standard criteria for thrombolysis.

  • True
  • False
Volume 38.2 - Question 12

Widow Spiders

Which one of the following statements about widow spiders is false?

  • They are usually found inside the home.
  • Most bites do not result in systemic envenomation (characterized by excessive acetylcholine release).
  • Infants and children typically present as inconsolable with generalized erythema and excessive drooling when bitten.
  • Their bites are rarely life threatening.
Volume 38.2 - Question 11

Quick Point-of-Care Ultrasound for Hydronephrosis

In using point-of-care ultrasound to diagnose hydronephrosis, longitudinal views of the kidney show good sensitivity and specificity compared with a combination of longitudinal and transverse views

  • True
  • False
Volume 38.2 - Question 10

Pulmonary Embolism

In nonhypotensive patients with acute symptomatic pulmonary embolism (PE), a high heart rate portends an increased risk of all-cause and PE-related mortality.

  • True
  • False
Volume 38.2 - Question 9

Torus Fractures in Children

Which one of the following statements about immobilization of torus fractures of the wrist in children is true?

  • Pain is better controlled with soft bandage.
  • Pain is better controlled with splint immobilization.
  • Soft bandages increase the need for surgery.
  • Self-reported function is similar for both splint immobilization and soft bandage.
Volume 38.2 - Question 1

Role of Calcium in Out-of-hospital Cardiac Arrest

The administration of intravenous or intraosseous calcium during out-of-hospital cardiac arrest improves sustained return of spontaneous circulation.

  • True
  • False
Volume 37.5 - Question 31

Subarachnoid Haemorrhage

The use of non-contrast multislice CT alone is unable to rule out aneurysmal subarachnoid haemorrhage at 24 hours after headache onset.  

  • True
  • False
Volume 38.1 - Question 3

Eye Injuries in Athletes

Which one of the following statements about eye injuries in athletes is false?

  • Traumatic hyphema can result in permanent vision loss.
  • Subconjunctival hemorrhage usually resolves in 7 to 10 days.
  • Athletes with subconjunctival hemorrhage should not return to the field if they have no vision changes.
  • Athletes presenting with sharp tearing pain may have a corneal abrasion.
Volume 38.4 - Question 17

Spontaneous Bacterial Peritonitis

Which one of the following statements about spontaneous bacterial peritonitis in patients with cirrhosis is false?

  • Diagnosis should be confirmed by culture of ascitic fluid prior to starting antibiotics.
  • Administration of albumin is recommended to reduce risk of death.
  • Patients often present with decompensation of their cirrhosis.
  • Mortality rates remain high even with appropriate antibiotic treatment.
Volume 38.3 - Question 37

Dental Injuries in Athletes

Which one of the following statements about dental injuries in athletes is false?

  • An avulsed tooth should be handled by the crown to avoid damaging the root.
  • An avulsed tooth can be transported in milk.
  • If an avulsed tooth is reimplanted, then return to play should be delayed one week.
  • Tooth reimplantation must be done as quickly as possible.
Volume 38.4 - Question 16

Head and Neck Injuries in Athletes

Which one of the following statements about the sideline management of head and neck injuries in athletes is false?

  • Any athlete not moving, whether conscious, unconscious, or with decreased consciousness, should be considered to have a cervical spine injury.
  • In sports such as hockey where the athletes are wearing helmets and pads, it is recommended to remove the equipment prior to transfer.
  • If there is altered mental status or an airway needs to be established, the face mask can be removed.
  • If a concussion is suspected, the athlete should be removed immediately from the field of play and should not return to play on the same day.
Volume 38.3 - Question 18

Facial Fractures

For possible mandibular fractures, the sideline physician should have the athlete bite down to check for malocclusion.

  • True
  • False
Volume 38.3 - Question 17

Refractory Ventricular Fibrillation

Among adult patients with refractory ventricular fibrillation during out-of-hospital cardiac arrest, survival to hospital discharge occurs more frequently among those who receive double sequential external defibrillation (DSED; rapid sequential shocks from two defibrillators) than among those who receive standard defibrillation.

  • True
  • False
Volume 38.3 - Question 16

Ring Removal

Regarding entrapped rings, which one of the following statements is false?

  • For lubrication, Windex® has been used successfully in cases refractory to traditional techniques.
  • Compression-based techniques are typically painless.
  • The caterpillar technique doesn’t require any equipment or supplies.
  • Ring cutting devices are the preferred method in patients with fractures.
Volume 38.3 - Question 15

Dexamethasone and Treatment of Pediatric Asthma Exacerbations

In a pediatric patient with a mild to moderate exacerbation of asthma presenting to the emergency department, a single dose of dexamethasone is not inferior to two doses of dexamethasone.

  • True
  • False
Volume 38.3 - Question 3

Local Anesthetic Systemic Toxicity

Which one of the following statements regarding local anesthetic systemic toxicity (LAST) is false?

  • Bupivacaine is most commonly implicated in events.
  • Symptoms of toxicity include a metallic taste.
  • Severe manifestations may appear up to 6 hours after initial symptom onset.
  • Pregnancy may increase the risk of an event.
Volume 38.3 - Question 2

Bacterial Meningitis

Which one of the following statements about bacterial meningitis is false?

  • Streptococcus pneumoniae causes most cases in people older than 16 years.
  • The classic triad of fever, stiff neck, and a change in mental status occurs in more than half of patients.
  • The diagnostic accuracy of Kernig’s sign is poor.
  • Less than 10% of adults presenting with meningitis have bacterial meningitis.
Volume 38.3 - Question 1

Factor Prothrombin Complex Concentrate in Patients with Trauma

Among patients with trauma at risk of massive transfusion, there is no significant reduction of 24-hour blood product consumption after administration of 4 factor prothrombin complex concentrate.

  • True
  • False
Volume 38.6 - Question 25

Emergency Department Treatment of Smoking

The treatment of tobacco dependence with a brief negotiation interview in the emergency department can increase the rate of abstinence at 3 months.

  • True
  • False
Volume 38.6 - Question 23

Stercoral Colitis

Which one of the following statements regarding stercoral colitis is false?

  • It occurs most commonly in people with advanced age and psychological or neurological comorbidities
  • The absence of abdominal pain is common.
  • Short-term mortality rates are less than 1%.
  • Evidence-based guidance for management is lacking
Volume 38.6 - Question 1

Late Endovascular Treatment for Ischemic Stroke

Endovascular treatment is efficacious for patients with ischaemic stroke caused by an anterior circulation large-vessel occlusion who presented 6–24 h from onset or last seen well, and who were selected on the basis of the presence of collateral flow on CTA.

  • True
  • False
Volume 38.5 - Question 38

Intra-articular Lidocaine for Shoulder Reduction

Intra-articular lidocaine may be a safe and effective alternative to intravenous sedation for facilitating reduction of anterior shoulder dislocations in the emergency department.

  • True
  • False
Volume 38.5 - Question 29

Bougie for Paediatric Intubation

Bougie use during emergency tracheal intubation in children is associated with procedural success.

  • True
  • False
Volume 38.5 - Question 4

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