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Emergency Medicine
Environmental Emergencies: Review Questions
David Levy, DO, FAAEM, FACEP
Dr. Levy is an Associate Professor of Emergency Medicine, Temple School of Medicine, Philadelphia, PA.
Choose the single best answer for each question.
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1. Which of the following is the most efficient mechanism by which the human body dissipates heat when air temperature exceeds body temperature?
- Convection
- Conduction
- Respiration
- Radiation
- Evaporation
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2. Which of the features listed below best distinguishes heat stroke from heat exhaustion?
- Heat exhaustion patients can sweat, whereas heat stroke patients stop sweating
- Heat exhaustion patients have higher hepatic transaminase levels than heat stroke patients
- Heat stroke patients always demonstrate a core temperature greater than 40°C (105°F)
- Heat stroke patients always present with altered mental status
- Heat exhaustion patients usually do not exhibit volume depletion, whereas heat stroke patients typically are volume depleted
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3. Which of the following statements about near-drowning victims is CORRECT?
- A normal chest radiograph virtually excludes significant lung damage
- An injury to the cervical spine is extremely unlikely
- All near-drowning victims require admission
- Up to 20% of patients who arrive in the emergency department (ED) comatose and flaccid with dilated pupils can be expected to fully recover
- Aspirated water drastically interferes with successful ventilation by mechanical obstruction of the airways
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4. Which of the following marine envenomations is correctly paired to its treatment?
- Jellyfishimmersion in 5% acetic acid and shaving the affected area to remove nematocysts
- Portuguese man-of-war tentaclesremoval of tentacles using surgical gloves and irrigation with fresh water
- Puncture wounds from sea urchinsremoval of foreign bodies and application of ice packs
- Stonefish stingsimmersion in diluted baking soda solution, local wound care, and tetanus-diphtheria toxoid booster if needed
- Sea spongeapplication of a dilute baking soda solution 3 times a day
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5. A 35-year-old male scuba diver returns from a diving trip complaining of joint pain, rash, and vertigo. Which of the following best describes this diving-related condition?
- Type I decompression sickness (DCS I)
- Type II decompression sickness (DCS II)
- Nitrogen narcosis
- Inner ear barotrauma
- Arterial gas embolism
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