Medical
What this domain tests
Medical emergencies span respiratory, neurologic, endocrine, toxicologic, and allergic conditions. Items test pattern recognition, targeted history, and medication safety rather than rare diagnoses.
Core rules
- Asthma and COPD: pursed-lip breathing, wheeze, accessory muscle use. Give oxygen to target saturation, nebulized albuterol 2.5 mg, and consider ipratropium and steroids per protocol.
- Anaphylaxis: urticaria, wheeze, hypotension, or throat tightness after exposure. Epinephrine 0.3 mg IM (1:1000) in the lateral thigh, repeated every 5–15 minutes as needed; antihistamines are adjuncts, not the primary drug.
- Opioid overdose: pinpoint pupils, slow respirations. Naloxone 2 mg intranasal or per protocol, titrated to adequate breathing, not full wakefulness.
- Hypoglycemia: check glucose in every altered patient. Oral glucose 15–25 g only if the patient can swallow; glucagon 1 mg IM if not.
- Seizure: protect from injury, do not restrain, time the event, and treat prolonged seizures with benzodiazepine per protocol.
- Stroke and seizure both require a glucose check because hypoglycemia mimics both.
Worked example
A 24-year-old develops hives, wheezing, and a systolic pressure of 78 mmHg minutes after a bee sting. Epinephrine IM is the first drug because airway swelling and shock, not the rash, define the threat; albuterol alone would not reverse the hypotension.
Traps
Treating every seizure as epilepsy, giving oral glucose to an unresponsive patient, and withholding epinephrine while waiting to see whether antihistamines work.