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Rosh Review EM 100 QUESTIONS| WITH COMPLETE SOLUTIONS

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A patient presents with dizziness. Romberg testing with the eyes open is normal, but with the eyes closed, the patient sways and almost falls over. Given this Romberg test result, pathology in which of the following syst ...

A patient presents with dizziness. Romberg testing with the eyes open is normal, but with the eyes closed, the patient sways and almost falls over. Given this Romberg test result, pathology in which of the following systems is most likely? A Cardiovascular B Cerebellar C Vestibular D Visual Correct Answer: Vestibular In the US, what is a common cause of imbalance due to peripheral disease? Correct Answer: Diabetic distal peripheral polyneuropathy An elderly man complains of dizziness upon standing. He denies being dizzy once he has stood for 5 minutes, and also denies being dizzy when supine or seated. He denies associated chest pain, palpitations, or dyspnea. Which of the following tests should first be performed during the evaluation of this positional dizziness? A Chest radiograph B Head-up tilt-table testing C Orthostatic vital signs D Transesophageal echocardiography Correct Answer: C orthostatic vital signs List some medications whose side effects can cause symptoms of orthostasis? Correct Answer: Antiparkinsonian drugs, antiadrenergics, anticholinergics, antidepressants, antiarrhythmics, antipsychotics, diuretics, narcotics and sedatives. Orthostatic hypotension diagnostic criteria Correct Answer: Decrease in systolic blood pressure ≥ 20 Decrease in diastolic blood pressure ≥ 10 Inadequate physiologic response to postural changes *rhythm strip showing SVT* A 1-year-old boy presents with the rhythm seen above. Physical exam is unremarkable except for tachycardia. Which of the following vagal maneuvers is the most effective to treat this rhythm? A Apply external ocular pressure B Apply ice to the face C Blow on the patient's face with a straw D Perform carotid massage Correct Answer: B apply ice to the face It is important that when performing this maneuver that you do not occlude the nose or mouth, and apply the ice only over the patient's forehead, eyes, and bridge of the nose for 10-15 seconds. Adenosine, an AV-nodal blocking agent, ca

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