A 23-year-old college senior visits the university health clinic after vomiting large amounts of blood. He has been vomiting for the past 36 hours after celebrating his team’s win at the national hockey championship with his varsity friends while consuming copious amounts of alcohol. His personal medical history is unremarkable. His blood pressure is 129/89 mm Hg while supine and 100/70 mm Hg while standing. His pulse is 98/min, strong and regular, with an oxygen saturation of 98%. His body temperature is 36.5°C (97.7°F), while the rest of the physical exam is normal. Which of the following is associated with this patient’s condition?
AEsophageal tear
BPortal hypertension
CEsophageal metaplasia
DEsophageal varices
EEsophageal perforation
A 4-year-old boy presents to the emergency department after his parents found him drinking blue liquid out of an unlabeled bottle in the garage. They have no idea what was in the bottle and are concerned for his health. They have brought the bottle with them to the emergency department. The child's past medical history is not remarkable, and he is currently not taking any medications. The patient's vitals are within normal limits for his age. Physical exam reveals a crying child who is drooling. A radiograph is performed, and the child's vitals are closely monitored. It is determined that the blue liquid is a strong alkali. Which of the following is the best next step in management?
AAdministration of a diluent
BGastrografin swallow and endoscopy
CAdministration of a weak acid
DCharcoal
EIpecac
A 48-year-old woman is transferred from her primary care physician's office to the emergency department for further evaluation of hypokalemia to 2.5 mEq/L. She was recently diagnosed with hypertension 2 weeks ago and started on medical therapy. The patient said that she enjoys all kinds of food and exercises regularly, but has not been able to complete her workouts as she usually does. Her temperature is 97.7°F (36.5°C), blood pressure is 107/74 mmHg, pulse is 80/min, respirations are 15/min, and SpO2 is 94% on room air. Her physical exam is unremarkable. Peripheral intravenous (IV) access is obtained. Her basic metabolic panel is obtained below. Serum: Na+: 135 mEq/L Cl-: 89 mEq/L K+: 2.2 mEq/L HCO3-: 33 mEq/L BUN: 44 mg/dL Glucose: 147 mg/dL Creatinine: 2.3 mg/dL Magnesium: 2.0 mEq/L What is the next best step in management?
AObtain an electrocardiogram
BObtain urine sodium and creatinine
CAdminister isotonic saline 1 liter via peripheral IV
DAdminister potassium chloride 40mEq via peripheral IV
EAdminister potassium bicarbonate 50mEq per oral
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