Maxemo EMREE 26-27
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Maxemo EMREE 26-27
A stable 30-year-old woman with pain and bleeding at 8 weeks amenorrhea has ultrasound evidence of a right adnexal mass and no intrauterine pregnancy. Beta hCG is 1200. What is the most appropriate management?
💡 EXPLANATION:
This is a confirmed ectopic pregnancy meeting criteria for medical management with methotrexate due to hemodynamic stability, low beta hCG level, and small adnexal mass.
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A patient with Graves disease develops a subtle high frequency tremor of the outstretched hands. This finding represents which complication?
Anonymous Quiz
19%
Coarse tremor
19%
Pretibial myxedema
14%
Exophthalmos
48%
Fine tremor
Maxemo EMREE 26-27
A patient with Graves disease develops a subtle high frequency tremor of the outstretched hands. This finding represents which complication?
💡 EXPLANATION:
Hyperthyroidism produces an adrenergic state leading to a high frequency low amplitude fine tremor, best seen with hands outstretched.
A patient with an inferior STEMI develops hypotension after nitrates with clear lung fields. What is the most likely cause?
Anonymous Quiz
10%
Papillary muscle rupture
20%
Right ventricular infarction
15%
Ventricular free wall rupture
55%
Cardiogenic shock from left ventricular failure
Maxemo EMREE 26-27
A patient with an inferior STEMI develops hypotension after nitrates with clear lung fields. What is the most likely cause?
💡 EXPLANATION:
Inferior STEMI may involve the right ventricle. Nitrates reduce preload and can precipitate hypotension in right ventricular infarction. Clear lungs argue against left ventricular failure.
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Maxemo EMREE 26-27
The underlying pathophysiology of systemic lupus erythematosus involves:
💡 EXPLANATION:
SLE is a type III hypersensitivity disorder characterized by immune complex deposition from anti-nuclear antibodies.
What is the first-line treatment for a healthy 1-year-old with uncomplicated community-acquired pneumonia due to suspected Streptococcus pneumoniae?
Anonymous Quiz
13%
Azithromycin
47%
Amoxicillin
20%
Ceftriaxone
20%
Vancomycin
Maxemo EMREE 26-27
What is the first-line treatment for a healthy 1-year-old with uncomplicated community-acquired pneumonia due to suspected Streptococcus pneumoniae?
💡 EXPLANATION:
High-dose amoxicillin is the first-line treatment for uncomplicated pediatric CAP due to Streptococcus pneumoniae.
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A 58-year-old man with long-standing diabetes reports early satiety and vomiting of undigested food hours after meals. This is most likely due to:
Anonymous Quiz
8%
Nephropathy
83%
Gastroparesis
8%
Peripheral neuropathy
0%
Retinopathy
Maxemo EMREE 26-27
A 58-year-old man with long-standing diabetes reports early satiety and vomiting of undigested food hours after meals. This is most likely due to:
💡 EXPLANATION:
Autonomic neuropathy affecting the vagus nerve leads to delayed gastric emptying, known as diabetic gastroparesis.
A 58-year-old man presents with crushing chest pain and ECG shows ST elevation in leads V2 to V4. What is the most critical immediate medication?
Anonymous Quiz
25%
Intravenous nitroglycerin
67%
Chewed aspirin 325 mg
8%
Intravenous metoprolol
0%
Unfractionated heparin bolus
Maxemo EMREE 26-27
A 58-year-old man presents with crushing chest pain and ECG shows ST elevation in leads V2 to V4. What is the most critical immediate medication?
💡 EXPLANATION:
Aspirin provides immediate mortality benefit in acute STEMI by inhibiting platelet aggregation and limiting thrombus propagation.