Medical Emergencies (Respiratory, Neurological, Endocrine, GI/GU, Anaphylaxis)
Questions test pattern recognition across respiratory, neurological, endocrine, GI/GU, and allergic emergencies, with emphasis on early life-saving interventions.
Core rules
- Asthma/COPD: assess speech, work of breathing, and SpO2; give albuterol by nebulizer or spacer, ipratropium for severe asthma, and titrated oxygen.
- Stroke: use FAST; note last known well; check glucose; do not give aspirin if hemorrhagic stroke is suspected; transport to a stroke-capable hospital.
- Seizure: protect the airway, do not restrain, check glucose; terminate prolonged seizures with a benzodiazepine per protocol.
- Hypoglycemia: check glucose in any altered patient; if conscious and able to swallow, give oral glucose; if not, give IV dextrose or glucagon per protocol.
- Anaphylaxis: give epinephrine 0.3–0.5 mg IM (1:1000) into the lateral thigh immediately; repeat every 5–15 minutes if needed; support airway and circulation.
Worked example
A 24-year-old develops hives, wheeze, and hypotension minutes after a bee sting. You give IM epinephrine 0.5 mg in the lateral thigh, high-flow oxygen, and a rapid IV fluid bolus, then reassess. The wheeze improves and BP rises. You do not wait for antihistamines before epinephrine.
Traps
Delaying epinephrine in anaphylaxis; giving oral glucose to an unconscious patient; missing hypoglycemia in a seizure; and treating all wheeze as asthma without considering anaphylaxis or cardiac asthma.