Acute Medical Presentations Practice Questions

Question 1

A 31-year-old man presents with acute severe testicular pain. The pain started suddenly 4 hours ago. Doppler ultrasound shows absent blood flow. What is the expected salvage rate for this condition if treated at this time?

Accepted Answer

80-90%

Answer

>95%

Answer

60-70%

Answer

40-50%

Answer

<20%

Question 2

A 39-year-old man presents with acute onset severe headache during sexual intercourse. CT head is normal. What is the most appropriate next investigation?

Accepted Answer

Lumbar puncture

Answer

MRI brain

Answer

CT angiogram

Answer

Carotid Doppler

Answer

EEG

Question 3

A 46-year-old man presents with acute onset severe abdominal pain and shock. He takes warfarin for atrial fibrillation. His INR is 6.8. CT shows retroperitoneal hematoma. What is the most appropriate immediate management?

Accepted Answer

Prothrombin complex concentrate

Answer

Vitamin K 10mg IV

Answer

Fresh frozen plasma

Answer

Stop warfarin only

Answer

Tranexamic acid

Question 4

A 46-year-old man presents with acute severe epigastric pain and vomiting. His amylase (1800 U/L). He has a history of alcohol excess. What is the most important initial assessment?

Accepted Answer

Severity scoring

Answer

CT abdomen

Answer

ERCP

Answer

Nutritional assessment

Answer

Psychiatric evaluation

Question 5

A 67-year-old man with COPD presents with acute confusion and drowsiness. ABG shows pH 7.25, pCO2 8.5 kPa, pO2 7.2 kPa, HCO3- 28 mmol/L. What is the most appropriate immediate management?

Accepted Answer

Non-invasive ventilation

Answer

High-flow oxygen

Answer

Intubation and mechanical ventilation

Answer

IV bicarbonate

Answer

Controlled oxygen therapy

Question 6

A 70-year-old man presents with sudden onset weakness in his right arm and difficulty speaking. CT head shows acute infarct in the left middle cerebral artery territory. He arrived 2 hours after symptom onset. What is the most appropriate treatment?

Accepted Answer

Alteplase

Answer

Aspirin 300mg

Answer

Clopidogrel

Answer

Warfarin

Answer

Heparin

Question 7

A 28-year-old man presents with sudden onset severe headache described as "worst headache of my life." He is photophobic and has neck stiffness. CT head is normal. What is the next most appropriate investigation?

Accepted Answer

Lumbar puncture

Answer

MRI brain

Answer

CT angiogram

Answer

Carotid Doppler

Answer

EEG

Question 8

A 75-year-old man presents with sudden onset weakness of his right arm and leg, and speech difficulties that started 1 hour ago. His NIHSS score is 8. CT head shows no hemorrhage. What is the most appropriate treatment?

Accepted Answer

Alteplase (tPA)

Answer

Aspirin 300mg

Answer

Clopidogrel 75mg

Answer

Heparin

Answer

Warfarin

Question 9

A 72-year-old man presents with sudden onset weakness of his right arm and leg, and speech difficulties that started 1 hour ago. His NIHSS score is 8. CT head shows no hemorrhage. What is the most appropriate treatment?

Accepted Answer

Alteplase (tPA)

Answer

Aspirin 300mg

Answer

Clopidogrel 75mg

Answer

Heparin

Answer

Warfarin

Acute Medical Presentations

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Acute chest pain

Anaphylaxis

Collapse and syncope

Sepsis and septic shock

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