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A 30-year-old woman who is 12 weeks pregnant comes to see a doctor because of migraine combined with nausea and vomiting. Which of the following drugs can be considered the most appropriate? | Metoclopramide. |
A 30-year-old male arrived at the hospital from a car accident with contusion marks on his chest. He was conscious, his blood pressure was 145/75 mmHg, his heartbeat was 115 beats/min, and his breathing was 30 times/min. He had dull breath sounds on the right side, and his chest wall bulged when he exhaled. The chest wall indents during inspiration. Which of the following statements about this patient's first aid is incorrect? | Typical radiographic changes in pulmonary contusion often appear 6 hours after injury. |
A 30-year-old man suffered from general weakness for two days. Early this morning he found that the weakness in his limbs worsened and he had palpitations. He was sent to the emergency room by his family. The patient reported that he often had symptoms such as hand tremors and night sweats, and he also experienced weakness in his limbs in the past. During the examination, the body temperature was 36.2°C, pulse 65 beats/min, blood pressure 128/79 mmHg, and respiration 16 times/min. Except for symmetrical weakness of the limbs, there were no other abnormal findings. The blood test found that the potassium ion concentration in the blood was 1.6 mmol/L, TSH was low, and T3 and Free T4 were high. Which of the following statements is wrong? | The patient may have an attack after drinking alcohol or eating a large amount of sweets, and the symptoms are mainly symmetrical distal weakness of the limbs. |
A 28-year-old male was involved in a car accident 1 hour ago and suffered blunt abdominal trauma. Which of the following statements is incorrect? | Perform peritoneal lavage (DPL) immediately upon arrival in the emergency department to rule out pancreatic damage. |
A 26-year-old female who was 32 weeks pregnant and weighed 65 kg was hit by a motorcycle while crossing a zebra crossing. When the ambulance came to the emergency department, she was conscious, breathing 24 times/min, pulse 112 times/min, blood pressure 118/76 mmHg, and body temperature 36.5 ℃. The injured patient complained of lower abdominal pain combined with a small amount of vaginal bleeding. Physical examination revealed lower abdominal tenderness but no rebound pain. Which of the following statements about this pregnant woman is wrong? | When the pH value of vaginal secretions is around 5, it represents amniotic membrane rupture. |
A 26-year-old man drank a lot of mineral water and drinks to replenish his fluids after sweating a lot during a marathon. After resting, I still felt dizzy and had a headache, so I continued to drink lots of water. Later, because the symptoms worsened, he was sent to the emergency room by a friend. During the injury examination, the body temperature was 36.5°C, the pulse was 61 beats/min, the blood pressure was 110/75 mmHg, the respirations were 19 times/min, and the state of consciousness was E3V4M5. A blood test revealed that the blood sodium concentration was 128 mmol/L and the plasma osmolality was 266 mOsm/L. Which of the following statements is wrong? | Correcting blood sodium too quickly may cause cerebral edema, which may lead to death in severe cases. |
A 25-year-old woman came to the emergency department because her right eyelid was red and mucopurulent discharge occurred after wearing contact lenses. Her eyes did not hurt. Which of the following drugs is most suitable for treating this patient? | Ciprofloxacin eye drops. |
A 25-year-old male was riding a bicycle and was run over his abdomen by a truck. When he arrived at the hospital, he had fractures and deformations of his abdomen and pelvis, and a deformation of his right thigh. He was conscious, his blood pressure was 80/45 mmHg, his heartbeat was 145 beats/min, his breathing sounds were clear and symmetrical, and there was tire pressure on his upper abdomen. Hen, regarding this patient's first aid, which of the following statements is correct? | When FAST ultrasound is negative, pelvic immobilization and urgent angiography should be considered. |
A 25-year-old man was randomly stabbed with a knife while riding the MRT. The wound was located in the fourth intercostal space on the left chest. The victim's cardiopulmonary function stopped 1 minute before arriving at the hospital, and the EMT immediately performed cardiopulmonary resuscitation. After arriving at the hospital, the medical staff took over the first aid. At this time, the carotid artery pulse was still not felt, but a fast and narrow QRS wave pattern appeared on the EKG monitor. After emergency cardiopulmonary resuscitation and endotracheal tube intubation, it was found that the breath sounds on both sides were equal and undiminished. What is the most appropriate next step? | Perform emergency thoracotomy (ED thoracotomy) immediately in the emergency department. |
A 1-year-old child had mucus-like bloody stool and continued to have paroxysmal abdominal pain and crying. The emergency department urgently arranged abdominal X-ray and abdominal ultrasound examination. It was found that there was intestinal obstruction. You judged that the possibility of intussusception is very high. Explain the necessity of air reduction. The family members ask if there are any contraindications to this technique. Which of the following is wrong? | It should not be performed when there is bloody stool, as the pressure may cause intestinal perforation. |
One-and-a-half-year-old and three-year-old brothers, their father was driving the motorcycle, and their mother hugged and fixed the children from the back seat. They were not wearing helmets. They accidentally fell down when turning. The two children had full GCS scores, but the younger brother's appearance showed left temporal side ( There was a hematoma on the left temporal), and my brother had a hematoma on the occipital. He was sent to the emergency department by ambulance. He did not vomit at the time and could be comforted. After careful questioning about the accident process, it was not a high-risk injury due to the slow speed of the car. According to Pediatric The Emergency Care Applied Research Network (PECARN) recommends brain computed tomography. Which of the following is correct? | The younger brother is under 2 years old. If the parents are worried, they can arrange a brain computed tomography examination. |
A 10-year-old boy, weighing 20 kilograms, was conscious but breathing slightly. Family members said that the child often wanted to drink water recently and had intermittent abdominal pain and vomiting. The blood test showed acidemia (pH=7.10), ketone body 2+, and blood sugar 911 mg/dL. It was judged to be diabetic ketoacidosis. Which of the following treatments is wrong? | Immediately administer 4 U of insulin per hour. |
An 18-year-old woman underwent a caesarean section 6 days ago and went to the emergency room complaining of abdominal pain and foul-smelling vaginal discharge with blood. The physical examination showed obvious lower abdominal tenderness, the surgical wound was clean and intact, and the breasts on both sides were slightly swollen and tender but without fever. Vital signs: blood pressure 155/79 mmHg, heartbeat 110 beats/min, respiration 20 times/min, body temperature 39°C, below What diagnosis best explains the cause of this fever? | Endometritis. |
A 20-year-old, 50-kg female patient was brought to the emergency room from the gas explosion site for medical treatment. When she arrived at the hospital, she had GCS E4M6V5, body temperature: 36oC, heartbeat 120 beats/min, respiratory rate 20 times/min, and blood pressure 150/88mmHg. About 40% of TBSA were 2nd to 3rd degree burns on the face, chest, back and upper limbs. Which of the following treatments is more appropriate? | If the patient is in pain, analgesic injections can be given. |
A 23-year-old male went diving in Green Island. He suddenly felt weak in his right foot 20 minutes after landing. After preliminary evaluation, the patient was conscious. His blood pressure was 130/80 mmHg, his heartbeat was 100 beats/min, his breathing was 18 times/min, and his right foot strength was 3 points. Other limb strength is normal. If you want to transfer the patient to a hospital in western Taiwan at this time, which of the following methods is best? | Take a helicopter and fly low (less than 300 meters) around the southern tip of Taiwan to the west. |
A 26-year-old woman was 25 weeks pregnant. She was involved in a car accident while driving on a national highway. The ambulance crew found that the airbag was deployed at the scene. When she was transferred to the hospital, she was conscious but complained of lower abdominal pain. When she arrived at the emergency room, her vital signs were: heartbeat 88 beats/min, blood pressure 105 /70 mmHg, which of the following statements is wrong? | If this pregnant woman has right-sided hemothorax after examination, the position of the chest tube will be the same as that of ordinary adults. |
A 28-year-old female was found passed out at home by her family members and sent to the emergency department. Her symptoms included pupil dilation, eye clonus, increased neuromuscular reflexes, and myoclonus. Her blood pressure was 190/108 mmHg, her heartbeat was 126 beats/min, and her breathing was 32 breaths/min. , body temperature is 39.5℃. Which of the following is the patient’s diagnosis least likely to be? | rganophosphorus pesticide poisoning. |
A 28-year-old pregnant woman, 35 weeks pregnant, was driving to a prenatal check-up when she was unable to react quickly enough to hit the car in front of her due to the car in front of her. She was conscious when she arrived at the hospital, her blood pressure was 130/80mmHg, her heartbeat was 100 beats/min, and her breathing was 20 times/min. Physician The examination revealed an obvious seat belt mark under the navel. Regarding the evaluation and treatment of this patient, which of the following statements is incorrect? | Ultrasonography is better than fetal monitoring in detecting placental detachment. |
A 29-year-old woman was 20 weeks pregnant. She came to the emergency department complaining of right lower abdominal pain for 2 days. Before coming to the doctor, she had poor appetite, vomited several times, and had no diarrhea. Vital signs: body temperature 37°C, heartbeat 108 beats/min, respiration 20 times/min, and blood pressure 112/76mmHg. Physical examination revealed significant tenderness and rebound tenderness in the right lower abdomen. Laboratory examination revealed WBC 7,800/μL, Neutrophil 78%, Hb 13 g/dL, and PLT 242,000/μL. Sugar 102 mg/dL, Creatinine 0.8 mg/dL, AST 38 U/L. Which of the following statements is correct? | This patient can choose abdominal magnetic resonance imaging (MRI) to help with diagnosis. |
A 2-year-old girl had a fever for 5 days. She had drooling, ulcers on her tongue, gums, and lips, bad breath, swollen lymph nodes in her neck, and red and swollen right thumb with blisters. The examination of other parts of her body was normal. She still had a fever after the clinic gave her oral amoxicillin. What is the most likely pathogen? | Herpes simplex virus. |
After being bitten by a stray cat, a 30-year-old woman was accompanied by her family to the emergency department for treatment. The patient stated that he had never received tetanus vaccination or rabies vaccination since graduating from elementary school. Wound inspection revealed a 3 cm laceration on the right forearm. Regarding the treatment of cat bites, which of the following is correct? | Because of the possibility of rabies infection, at least 3 doses of rabies vaccine should be administered. |
A 35-year-old male patient was HIV-positive and had not taken medication as prescribed by his doctor in the past three months. He came to the emergency department to register and complained that he had fever and increasingly shortness of breath in the past two weeks. When he arrived at the emergency department, his vital signs: heartbeat 110 beats/min, blood pressure 135/75 mmHg, breathing 22 times/min, blood oxygen concentration 92% (room air), and now the body temperature is normal; the blood test report is as follows: WBC 2,000/uL; chest X-ray found diffuse interstitial infiltrates on both sides ), which of the following drugs is not suitable for the treatment of the current condition? | Pyrimethamine. |
A 37-year-old male went to the outpatient clinic to treat Schizophrenia. He took Seroquel 100 mg and Lexotan (bromazepam) 3 mg (one pill each before going to bed). After a few days, he lost consciousness and became stiff and was sent to the hospital. The measured vital signs are as follows: GCS E4M4V1, blood pressure 85/51 mmHg, heartbeat 168 beats/min, body temperature 40.2°C, respiration 22 breaths/min, SpO₂ 94%. Pupils on both sides are 3.5mm. Other physical examination findings include DTR: hyporeflexia, Babinski sign (-), Rigidity: (+), similar limbs, and night sweats. The computed tomography showed no obvious abnormalities, and the electrocardiogram showed sinus pulse rate. Blood test reference: CK 319 U/L, Cr 1.3 mg/dL, Na 122 mEq/L, AST 94 U/L, ALT 126 U/L. In a case of suspected poisoning, which of the following diagnoses is correct? | Neuroleptic malignant syndrome. |
A 38-year-old female patient was sent to the emergency room by her family due to impaired consciousness. The patient presents with lethargy. Blood sugar is normal and there is no history of medication. According to family members, the patient was unable to breastfeed when she gave birth to her second child 6 years ago. Physical examination revealed that his face was pale, his blood pressure was 90/60 mmHg, his heartbeat was 64 beats/min, and his respiration was 14 beats/min. Decreased body hair. Laboratory tests revealed Hb 8.8 g/dL and Na 124 mEq/L. Which of the following actions is the most appropriate? | This patient may have Sheehan's syndrome and needs to be examined and treated for pituitary hypoactivity. |
A 39-year-old man with a long history of epilepsy was found to have an epileptic seizure at home today by his family. When the patient was taken to the emergency room, he was fully conscious. Which of the following statements about the treatment of this patient is wrong? | If the concentration of anti-epileptic drugs in the patient's serum is appropriate, a supplemental dose should be considered to avoid recurrence of epilepsy. |
A 40-year-old woman hanged herself after taking drugs. She showed no signs of life when she was sent to the emergency room. Which of the following statements is wrong? | If the height of hanging is greater than or equal to the height of the patient, the cause of death should be excessive compression pressure, which causes compression of the internal blood vessels in the neck and leads to brain death. |
A 50-year-old man went to the emergency department because of pain in his left knee joint. When the knee joint was aspirated, it was found to be yellow and turbid and the laboratory analysis showed: WBC 15,000/μL, PMN 70%. Which of the following statements is correct for this patient? | This patient may have an acute gout attack. About 30% of patients have blood uric acid levels within the normal range. |
A 58-year-old man fell from a height of 3 stories. In the emergency department, his blood pressure was 80/40mmHg, heartbeat 120 beats/min, respiration 20 breaths/min, O2 saturation concentration: 88%, GCS E1M4V1, and brain computed tomography showed right intracranial hemorrhage with midline Shift (right intraparenchymal hemorrhage with right to left midline shift), which of the following treatments is inappropriate? | Use mannitol to reduce intracranial pressure. |
A 6-year-old child came to the emergency department because of abdominal pain and diarrhea without fever for a week. Laboratory tests: WBC 3,000/μL (4,000～10,000), Hb 6.0 g/dL (12～16), PLT 100K/μL (150K～ 400K), BUN 235mg/dL, Cr 20.0mg/dL, the diagnosis was infectious diarrhea. Which statement about this disease is wrong? | This disease requires prophylactic antibiotic treatment. |
A 70-year-old male patient was admitted to the hospital for acute myocardial infarction and received thrombolytic treatment. On the fifth day of hospitalization, he developed fever, chest pain, difficulty breathing, and deep vein thrombosis in his lower limbs. The blood pressure is 170/90 mmHg, the heartbeat is 120 beats/min, the respiration is 26 times/min, and the body temperature is 38.0°C. Regarding the possible symptoms and signs of this patient, which of the following statements is incorrect? | This disease occurs more commonly in patients taking low-molecular-weight heparin. |
A 70-year-old man with dementia had a history of cardiac arrhythmia and QTc prolongation on the electrocardiogram. He was brought to the emergency room due to sudden agitation at home. After clinical evaluation, the patient required sedative drugs. Which of the following drugs is the correct choice? | Loraxepam (Ativan) 1 to 2 mg IM/IV. |
A 70-year-old male with no history of smoking in the past went to the emergency department because his cough had not improved for a month and he had exer- tional dyspnea after exercise. A chest X-ray showed a moderate amount of pleural effusion on the right side. After fine needle aspiration, it was found that the total protein of the pleural effusion was 4.8 g/dL, the LDH was 228 U/L, and the total protein in the patient's blood was 5.8 g/dL (normal range is 6.4 to 8.4 g/dL). , LDH is 273 U/L (normal range is 131-250 U/L). Regarding the differential diagnosis of possible diseases, which of the following differential diagnoses is the least likely? | Heart failure. |
A 77-year-old man was treated in the outpatient clinic for Parkinson's disease. He was taking Madopar (levodopa) 250mg 1# tid and Enzil (amantadine) 100mg ½ # bid. Past medical history: Hemodialysis for uremia and bypass surgery on the heart. The patient was sent to the hospital because of unconsciousness, fever, and general stiffness. The measured vital signs are as follows: GCS E4M6V5 (but cannot tell the correct location), blood pressure 162/76 mmHg, heartbeat 84 beats/min, body temperature 39.2°C, respiration 16 times/min, SpO₂ 96%. The pupil size is 3.0mm on both left and right sides. Babinski sign (-), Rigidity: (+) All limbs are similar. There were no obvious signs of infection, no obvious abnormalities in computed tomography, and no obvious abnormalities in electrocardiogram. Blood test reference: CK 319U/L; Cr 1.3mg/dL; Na 142mEq/L; AST 20U/L; WBC 9,450 µ/L. In a case of suspected poisoning, which of the following diagnoses is correct? | Serotonin syndrome. |
A 9-month-old girl (weight 10 kg) continued to have paroxysmal abdominal pain and crying at home. She was sent to the emergency department because of bloody stools. Abdominal X-ray and abdominal ultrasound were urgently arranged. Intestinal obstruction was suspected. You judged it to be an intestinal cuff. The possibility of overlapping is extremely high. Which of the following is wrong? | Bloody stool is a late symptom of intussusception and a contraindication for air reduction. |
The EMT rescued a patient with severe burns from the fire scene and sent him to the nearest emergency hospital. After the emergency treatment, because the hospital did not have a burn intensive care unit, the emergency doctor planned to transfer the patient out, but could not find one in a nearby hospital. The burn intensive care unit was available, but the family insisted on transferring to the emergency room of Medical Center A. Which of the following is correct? | Before transferring out, the doctor should fill out an emergency injury referral form. |
An alcoholic patient with liver cirrhosis went to the emergency department because of esophageal variceal bleeding. He was fasting and receiving medication. Within the 24th hour after entering the emergency room, he developed agitation, night sweats, hand shaking, headache, increased blood pressure, epilepsy, and visual hallucinations. (visual hallucination), which of the following is wrong in the treatment of this patient? | Antiepileptic drugs (such as phenytoin) can be used to prevent recurrence of alcohol withdrawal epilepsy. |
Which of the following statements about diarrhea is correct? | Wright stain is used to detect white blood cells in feces. About 80% of positive reactions can culture pathogenic bacteria. |
Which of the following ways to reach the North Peak of Yushan (elevation 3,850 meters) and stay at the North Peak of Yushan that night will have the highest risk of severe high altitude illness? | Take a helicopter from the ground directly to the north peak of Yushan Mountain. |
Which of the following electrolyte abnormalities would not occur in patients with heat stroke? | Hypercalcemia. |
Which of the following acidic fluid burns requires injection of calcium ion solution for treatment? | Oxalic acid. |
Which of the following drug poisoning patients is not suitable for multidose activated charcoal treatment? | Acetaminophen. |
Which of the following antibiotics is more correct to use? | A 33-year-old alcoholic man with pneumonia was given ceftriaxone 1g intravenously once or twice a day. |
Which of the following statements about hyponatremia is incorrect? | In the treatment of patients with chronic hyponatremia, if the rising rate is greater than 0.5 mEq/L per hour, central putamen myelinolysis is likely to occur and neurological dysfunction may occur. |
Which of the following statements about acute otitis media is incorrect? | The diagnostic criterion is redness of the eardrum (erythema) seen on physical examination. |
Which of the following statements about epistaxis is incorrect? | Hypertension is an important cause of epistaxis. When patients with nasal bleeding have high blood pressure values measured at the same time, they should lower their blood pressure as soon as possible. |
Low back pain is a common emergency room complaint. Regarding common causes of low back pain, which of the following statements is correct? | When epidural compression syndrome is suspected to be caused by a tumor, steroid treatment needs to be given before MRI diagnosis. |
Among the various endogenous factors that cause acute renal failure (intrinsic renal failure), which of the following is incorrect? | Hemorrhagic shock. |
When sudden death of a pregnant woman requires cardiopulmonary resuscitation, which of the following statements is correct? | Amiodarone can have serious adverse effects on the fetus and should be avoided in pregnant women. |
A young child comes to the emergency room for treatment due to trauma. Which of the following injury locations is more consistent with the lowest possibility of accidental injury or child abuse? | The caregiver complained that the 2-year-old child fell while running and the examination revealed a laceration to the jaw. |
When performing a forehead laceration suturing operation on a 5-year-old child in the emergency room, the child was too emotional to cooperate and was still unable to proceed even after appropriate comfort. Which of the following statements is wrong: | Ketamine can be injected intramuscularly to produce a combined sedative and analgesic effect. |