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.
- A 74-year-old man presents with weakness. His wife says that he is otherwise healthy but has had a cold for the past 3 days. Laboratory test results include the following: serum sodium level, 152 mEq/L; BUN, 38 mg/dL; and creatinine, 1.6 mg/dL. Which of the following is the most likely etiology of the hypernatremia?
A. Iatrogenic sodium administration
B. Impaired renal concentrating ability
C. Impaired thirst drive
D. Loss of water in excess of sodium
- What is the most common cause of esophageal perforation in the United States?
A. Boerhaave syndrome
B. Chemical ingestion
C. Esophageal endoscopy
D. Foreign body ingestion
- Which of the following statements regarding complications of anterior shoulder dislocations and reductions is correct?
A. Avulsion fracture of the greater tuberosity of the humerus occurs in 10% to 15% of dislocations
B. Axillary nerve injury is assessed by testing sensation in the axilla
C. Bankart fracture is a compression fracture of the posterolateral humeral head
D. Hill-Sachs deformity refers to a fracture of the anterior glenoid rim
- Which of the following antihypertensive agents is paired with the appropriate indication?
A. ACE inhibitors—hypertension in pregnancy
B. Beta-blockers—acute MI
C. Beta-blockers—hypertension in cocaine toxicity
D. Short-acting dihydropyridine calcium channel blockers—acute MI
- Which lobe of the lung is most likely to be affected in aspiration of a foreign body?
A. Left lower
B. Left upper
C. Right lower
D. Right upper
Answers 1. C 2. C 3. A 4. B 5. C