A 25-year-old man is brought to the emergency department 3 hours after rescuing babies and puppies from a burning daycare center. He complains of headache and nausea, which he attributes to running. He is breathing comfortably. What is another likely finding in this patient?
AOxygen saturation of 86% on pulse oximetry
BLow blood lactate levels
CArterial oxygen partial pressure of 20 mmHg
DOxygen saturation of 99% on pulse oximetry
ECherry red facial appearance
A 23-year-old woman presents to the emergency department after being found unresponsive by her friends. The patient is an IV drug user and her friends came over and found her passed out in her room. The patient presented to the emergency department 2 days ago after being involved in a bar fight where she broke her nose and had it treated and packed with gauze. Her temperature is 99.3°F (37.4°C), blood pressure is 90/48 mmHg, pulse is 150/min, respirations are 24/min, and oxygen saturation is 97% on room air. Physical exam is notable for an obtunded woman with nasal packing and EKG tags from her last hospital stay, as well as a purpuric rash on her arms and legs. Her arms have track marks on them and blisters. Which of the following is the best next step in management?
ARemoval of nasal packing
BUrine toxicology screen and empiric naloxone
CNafcillin
DVancomycin
ENorepinephrine
A 75-year-old man with a 35-pack-year history of smoking is found to be lethargic three days after being admitted with a femur fracture following a motor vehicle accident. His recovery has been progressing well thus far, though pain continued to be present. On exam, the patient is minimally responsive with pinpoint pupils. Vital signs are blood pressure of 115/65 mmHg, HR 80/min, respiratory rate 6/min, and oxygen saturation of 87% on room air. Arterial blood gas (ABG) shows a pH of 7.24 (Normal: 7.35-7.45), PaCO2 of 60mm Hg (normal 35-45mm Hg), a HCO3 of 23 mEq/L (normal 21-28 mEq/L) and a Pa02 of 60 mmHg (normal 80-100 mmHg). Which of the following is the most appropriate therapy at this time?
ANaloxone
BHeparin
CGlucocorticoids
DRepeat catheterization
EEmergent cardiac surgery
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