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Self-Assessment Questions

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.

1. Which of the following is the most efficient mechanism by which the human body dissipates heat when air temperature exceeds body temperature?
  1. Convection
  2. Conduction
  3. Respiration
  4. Radiation
  5. Evaporation
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2. Which of the features listed below best distinguishes heat stroke from heat exhaustion?

  1. Heat exhaustion patients can sweat, whereas heat stroke patients stop sweating
  2. Heat exhaustion patients have higher hepatic transaminase levels than heat stroke patients
  3. Heat stroke patients always demonstrate a core temperature greater than 40°C (105°F)
  4. Heat stroke patients always present with altered mental status
  5. 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?

  1. A normal chest radiograph virtually excludes significant lung damage
  2. An injury to the cervical spine is extremely unlikely
  3. All near-drowning victims require admission
  4. Up to 20% of patients who arrive in the emergency department (ED) comatose and flaccid with dilated pupils can be expected to fully recover
  5. 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?
  1. Jellyfish—immersion in 5% acetic acid and shaving the affected area to remove nematocysts
  2. Portuguese man-of-war tentacles—removal of tentacles using surgical gloves and irrigation with fresh water
  3. Puncture wounds from sea urchins—removal of foreign bodies and application of ice packs
  4. Stonefish stings—immersion in diluted baking soda solution, local wound care, and tetanus-diphtheria toxoid booster if needed
  5. Sea sponge—application 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?

  1. Type I decompression sickness (DCS I)
  2. Type II decompression sickness (DCS II)
  3. Nitrogen narcosis
  4. Inner ear barotrauma
  5. Arterial gas embolism
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