EMT Practice Test

1. Question Content...

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Question1: A 67 year old man presenls one month post resection for cancer with breathlessness He is found to have iron deficiency anaemia Resection of what part of the gastrointestinal tract is most likely to be responsible for this deficiency''

Question2: A 48 year old man presents to the ED with sudden onset, severe abdominal pain His CT shows pneumoretroperitoneum. Which of these structures is most likely to have perforated?

Question3: A patient presents with acute cardiac failure and is prescribed a loop diuretic In which part of the nephron will the diuretic inhibit the sodium-potassium-chloride cotransporter?

Question4: A 23 year old man presents to the ED after cutting his wrist with a kitchen knife There is a wound on the flexor aspect of the wrist and you are concerned about median nerve injury.
Which examination of motor function would best test for damage to this nerve?

Question5: An 80 year old woman with an extensive cardiac history is diagnosed with aortic stenosis On auscultation you appreciate an ejection systolic murmur.
Which haemodynamic factor is most likely responsible for the audible murmur?

Question6: You see a patient with steatorrhea, weight loss and abdominal pain You suspect they have exocrine pancreatic insufficiency The secretion of which substance is least likely to be affected by this condition?

Question7: A 45 year old man is brought into the ED by the police following a witnessed seizure. He is suspected to be alcohol dependent Which haematological index best suggests this dependence?

Question8: You are discussing physiology of the body compartments and distribution of body water while teaching nurse practitioners.
Which extracellular fluid compartment is most likely to contain the most water?

Question9: A 15 year old girl with sickle cell anaemia attends with left leg swelling and pain Further investigations suggest a diagnosis of osteomyelitis of her tibia.
What is the most likely causative organism?

Question10: A 43 year old Afghan national presents to the ED with a four month history of cough, weight loss and night sweats What test is most consistent with active tuberculosis?

Question11: A 20 year old woman has an incised wound over the angle of her jaw and you suspect damage to a branch of the facial nerve What action are you most likely to test to confirm your suspicion?

Question12: A 50 year old man complains of pain and reduced movements of the shoulder joint after a fall. He is unable to initiate abduction of his arm Which muscle is most likely to be injured?

Question13: A three year old girl is diagnosed with measles in the ED and is well enough to be discharged Her dad wants to know when she can return to nursery.
What is the recommended absence period?

Question14: A patient presents following a stabbing to his chest and has a cardiac arrest You perform an anterolateral thoracotomy. Which muscle in addition to pectoralis major are you most likely to incise?

Question15: A 40 year old woman taking the oral contraceptive pill was prescribed phenytom following a seizure Some months later she becomes pregnant What is the most likely mechanism by which this treatment has led to tailure of her contraception?

Question16: A keen cyclist attends the ED complaining of clumsiness and tingling in his right hand When he attempts to grip paper in his first web space he is only able to achieve this by flexing his right thumb.
Innervation of which muscle is most likely compromised?

Question17: A 63 year old patienl presents with symptoms of hemiplegia and sensory loss of the right side of face and extremities. Which artery is most likely to be involved?

Question18: A 27 year old woman presents with visual problems and has known optic neuritis. What is the most likely cause of the slowing of impulse conduction in her optic nerve?

Question19: A 34 year old man presents with bruising and swelling over the anterior arm after lifting weights at the gym.
There is pain and weakness on attempted internal rotation and adduction of the shoulder.
Rupture of which muscle best explains these findings?

Question20: An 83 year old woman presents with acute dyspnoea and is diagnosed with cardiac failure She has a history of dysphagia and CT confirms oesophageal cancer.
Compression of which chamber of the heart is most likely to have caused her cardiac failure? A Both ventricles

Question21: You suspect cauda equina syndrome in an 85 year old man with metastatic cancer On examination there is loss of anal tone Which myotomes are most likely to be affected and causing this examination finding?

Question22: A five year old girl presents with a fever, a non-blanching rash and drowsiness. You suspect meningococcal infection What is most likely mode of spread for this infection?

Question23: A 32 year old builder slips with an angle grinder causing a deep facial wound which intersects with the inferomedial edge of the orbit and leaves exposed damaged bone.
What bone is most likely affected?

Question24: A doctor about to sit an important examination has become aware of the urge to detaecate Involuntary relaxation of which muscle is most likely to have occurred?

Question25: A 34 year old woman with Graves' disease presents with fever, palpitations, tremor and anxiety Which hormone is most likely to be causing her symptoms?

Question26: A 50 year old woman with longstanding severe asthma presents with a four day history of diarrhoea and vomiting An imbalance of which hormone is most likely to be causing this clinical picture'?

Question27: A 55 year old heavy smoker presents with cough, sputum production and dyspnoea A chest x-ray shows hyperinflation with diminished pulmonary vasculature Which measurement is likely to be increased on lung function testing?

Question28: A 50 year old man with HIV has not been taking his treatment and presents with severe headache and neck stiffness His current CD4+ count is 180/mmc (normal 500-1400/mmc) What is the most likely causative agent of his meningitis?

Question29: A 32 year old football player attends with a painful right knee after a tackle On examination she is unable to dorsiflex her foot Which nerve is most likely injured''

Question30: A 17 year old girl presents with a maculopapular rash She has a seven day history of fever and sore throat and was prescribed an antibiotic three days ago Which antibiotic is most likely to have been prescribed?

Question31: A patient presents with muscle spasms caused by hypocalcaemia Which substance is used to adjust (or an abnormality in the calcium level?

Question32: A 24 year old woman is admitted to your observation ward with a sudden onset headache. Her CT showed no abnormality and you decide to perform a lumbar puncture What is the next structure the needle will puncture after going through the skin and subcutaneous fat?

Question33: A 37 year old man is injured and has significant blood loss Following blood transfusion his systolic blood pressure increases from 70 to 100 Which physiological parameter is most likely to decrease in response?

Question34: A premature baby is born at 28 weeks' gestation in your ED. They are at risk of respiratory distress syndrome due to lack of surfactant What best describes the composition of this substance?

Question35: A patient is brought into the ED unconscious Calculation from the venous blood gas confirms a low anion gap acidosis What is the most likely cause of this abnormality?

Question36: A 24 year old man sustains an injury to his right eye The x-rays confirm an orbital floor fracture He complains of double vision on upward gaze Entrapment of which muscle is most likely responsible for his symptom?

Question37: A 32 year old woman presents with dizziness She has been laking medication tor low back pain Blood tests reveal a haemolytic anaemia.
Which drug is most likely to be responsible?

Question38: A patient presenting with acute onset neurological symptoms has a CT scan of their brain that shows an acute pontine haemorrhage What is the most likely clinical finding?

Question39: A four year old boy presents with a cough and fever for the last few weeks which became worse in the last 24 hours. There is no record of his vaccination history His temperature is 38.5 °C, heart rate 135 beats per minute, and oxygen saturations are 97% He is coughing frequently and has bilateral subconjunctival haemorrhages.
Which organism is most likely to have caused his condition?

Question40: A young man arrives by ambulance having dislocated his patella playing football. Rehabilitation should focus on which muscle to reduce chances of recurrent dislocation?

Question41: A 75 year old man presents to the ED with burning epigastric abdominal pain You note that he has rheumatoid arthritis and is on diclofenac.
Which step would have been the most beneficial in preventing the development ot ulcers in this patient?

Question42: You intubate a patient in the resuscitation room After inducing anaesthesia you lie the patient supine. Which lung volume is most affected by this change in posture?

Question43: A 19 year old old runner presents with pain in the lateral compartment of the lower leg when running and you suspect intermittent compartment syndrome Which movement of the ankle and foot would most likely replicate the pain?

Question44: A 56 year old man presenls with a rash in the supraclavicular fossa which is typical of herpes zoster Which dermatomal level best describes the area affected?

Question45: A 21 year old woman attends with an earring becoming lodged in the lobule of her ear You decide to perform a nerve block to allow removal of the earring Which nerve are you most likely to need to block?

Question46: A clinical trial suggests that a new dressing for burns works better on men than women, but there is in fact no difference Which term best describes this situation?

Question47: An 88 year old woman presents with haematemesis CT scan identifies a posterior ulcer of the superior part of the duodenum At what vertebral level would this be evident on the CT scan?

Question48: A 21 year old man is diagnosed with diabetic ketoacidosis. A medical student asks you to assist them in calculating the patients blood pH using the Henderson-Hasselbach equation.
What best describes the two required constituents for this equation?

Question49: You review a paper where patients were recruited through a response to an invitation from a heart foundation charity.
What term best describes this sample?

Question50: A 71 year old man with a history of heart failure and type II diabetes mellitus presents with an acute, painful, swollen first metatarsophalangeal joint in his foot You suspect gout.
Which treatment would be most appropriate for the acute management of this patient*?

Question51: A 60 year old woman presents with shortness of breath and signs of pulmonary oedema. An echocardiogram demonstrates reduced left ventricular systolic function.
Which measurement on echocardiogram best demonstrates this?

Question52: A father brings his febrile eight week old child to the ED. He tells you that the child's vaccinations are fully up to date. Which of the following vaccines has the child not yet received'?

Question53: A 78 year old woman presents with a painful shoulder after a fall. On examination she is unable to lift the dorsum of her hand off her mid-lumbar spine (lift-off test).
Which muscle is most likely to have been injured?

Question54: An 85 year old man complains of double vision on looking down. You note his right eye does not move when he looks down and medially.
Impaired (unction of which nerve is most likely responsible?

Question55: A 70 year old woman presents to the ED with symptoms and signs suggestive of sepsis Her BP is 80/40 You think her low BP is because of a drop in the systemic vascular resistance Which type of blood vessels are most likely implicated in causing her hypotension?

Question56: A 35 year old man presents with extensive burns His circulating volume and renal perfusion pressure drop.
Concentration of NaCI in the intraluminal fluid in the kidney decreases.
Which hormone is most likely to be released by the juxtaglomerular apparatus in response?

Question57: A 32 year old man presents with suspected acute appendicitis A medical student asks you what the commonest anatomical position of the appendix is What is the most likely position?

Question58: You are teaching a medical student and are discussing how fluid compartment ratios can change in relation to age and gender You note that some population groups have proportionally higher total body water which increases the extracellular to intracellular fluid ratio What population group best demonstrates this?

Question59: A 54 year old man presents with headaches, palpitations and diaphoresis Imaging findings are consistent with a phaeochromocytoma The cells affected in this condition are most likely to be found in which region?

Question60: You plan to use a local anaesthetic to provide intravenous regional anaesthesia to reduce a patient's wrist fracture Which local anaesthetic is most appropriate?

Question61: A16 year old girl is diagnosed with nephrotic syndrome
What is the most likely mechanism responsible for generalised oedema in this condition?

Question62: A 75 year old man is concerned about having frequent chest infections He is a heavy smoker and you explain to him that this can affect the normal mechanism of mucociliary clearance of microorganisms and pollutants What type of cell is primarily responsible for this method of pathogen clearance?

Question63: A 20 year old woman with known diabetes presents with hypoglycaemia She was given glucagon with good recovery. Which cells ot the pancreas normally secrete this hormone?