Provided by PEER VIII. PEER (Physician’s Evaluation and Educational Review in Emergency Medicine) is ACEP’s Gold Standard in self-assessment and educational review. These questions are from the latest edition of PEER—PEER VIII, which made its debut at ACEP’s 2011 Scientific Assembly. To learn more about PEER VIII or to order it, go to www.acep.org/bookstore.
- Which of the following is a possible cause of dyspnea?
C. Metabolic acidosis
D. Metabolic alkalosis
- A 53-year-old man undergoing radiation treatment for prostate cancer presents with bloody diarrhea, tenesmus, and occasional stool incontinence of 3 days’ duration. Vital signs include blood pressure 130/82, pulse 82, and temperature 37°C (98.6°F). The abdomen is soft. Rectal examination produces diffuse tenderness, good tone, and bright red blood. Lower extremity strength, reflexes, and sensation are normal. Which of the following is the best management plan?
A. Analgesics and sucralfate
B. Empiric ceftriaxone, doxycycline, and acyclovir
C. Oral steroids and mesalamine
D. Surgical consultation for incision and drainage
- Which of the following materials is most damaging in penetrating intraocular injury?
- A 58-year-old woman presents by ambulance with sudden shortness of breath. Paramedics administered two doses of nitroglycerin 0.4 mg sublingually and furosemide 80 mg IV. She has a history of hypertension and chronic renal disease. Vital signs include blood pressure 150/78, pulse 118, respirations 32, and oxygen saturation 88% on room air. Physical examination reveals crackles diffusely and bilateral lower extremity edema. An ECG reveals sinus tachycardia and no acute ischemia. Which of the following should be administered to decrease the need for intubation?
A. Aspirin 325 mg orally
B. Ipratropium 0.25 mg by nebulizer
C. Milrinone drip
D. Noninvasive positive-pressure ventilatory support
- Which of the following illnesses does hantavirus most commonly cause?
C. Influenza-like illness
Answers 1. C 2. A 3. D 4. D 5. C