Instruction: A 10-month-old boy was brought to the emergency room by his parents because he was agitated and had altered consciousness. The mother said that the boy had been vomiting and having diarrhea since the previous night. He vomited every time he ate, so he had not taken anything for nearly half a day. Physical examination revealed that the boy was very lethargic and had dry mucous membranes. A bedside rapid blood glucose test revealed that his blood glucose level was 35 mg/dL. Which of the following is the most appropriate treatment for this child?

Input: (A) Intravenous injection of 1 ml of 50% glucose solution per kg of body weight. (B) Intravenous injection of 10 ml of 5% glucose solution per kg of body weight. (C) Intravenous injection of 5 ml of 10% glucose solution per kg of body weight. (D) Intravenous injection of 2 ml of 25% glucose solution per kg of body weight. (E)Observe vital signs, wait until the blood sugar report from the formal laboratory comes out, and then deal with it according to the blood sugar level.

Output: C


Instruction: A 16-year-old male patient was sent to the emergency room. He was confused, sweating all over and his clothes were wet. The electrocardiogram monitor showed a heart rate of 180 beats/minute, blood pressure of 220/110 mmHg, pupil size of both sides was 8 mm, and light reflex was not obvious. Which of the following drugs could be poisoning?

Input: (A)Lithium. (B)Meperidine. (C)Organophosphates. (D)Amphetamine. (E)Antihistamine.

Output: D


Instruction: 20 A 6-year-old female was brought to the hospital by her mother. She complained of shortness of breath and abdominal pain. She was thirsty and urinated a lot recently. Her blood pressure was 92/60 mmHg, heart rate was 120 beats/min, respiration was 32 breaths/min, body temperature was 35.2℃, white blood cell count was 6800/mm³, hemoglobin was 13.2 g/dL, platelets were 182000/mm³, glucose was 520 mg/dL, and blood ketone was (+). Which of the following statements about the possible symptoms and signs of this patient is incorrect?

Input: (A) The patient may have Kussmaul breathing. (B) The patient may have fruity breath. (C) The patient is very likely to have Chvostek or Trousseau sign. (D) If the patient is found to have symptoms of headache, nausea and drowsiness during treatment, the possibility of cerebral edema should be considered. (E) Low body temperature is mainly caused by peripheral vascular dilation.

Output: C


Instruction: A healthy male weighing 70 kg loses about 1800 ml of blood due to trauma. Which of the following statements about his physiological manifestations is correct?

Input: (A) The patient's pulse pressure will increase, blood pressure is normal, and heart rate is normal. (B) The patient's pulse pressure will be normal or slightly decreased, blood pressure is normal, and heart rate is accelerated (> 100 beats/minute). (C) The patient's pulse pressure will decrease, blood pressure is decreased, and heart rate is accelerated (> 120 beats/minute). (D) The patient's pulse pressure will increase, blood pressure will decrease, and heart rate will increase (> 120 beats/minute). (E) The patient's pulse pressure will increase, blood pressure will be normal, and heart rate will increase (> 100 beats/minute).

Output: C


Instruction: A 25-year-old female, currently 28 weeks pregnant, fell down the stairs and injured her right waist and went to the emergency department. The patient's vital signs are normal and stable, with no abdominal pain, uterine contractions, ruptured membranes, or vaginal bleeding. What is the most appropriate next step?

Input: (A) Arrange an ultrasound examination. If no abnormality is found, discharge the patient to his home for observation. (B) Arrange an abdominal CT scan. (C) Discharge the patient to his home for observation, provide health education, and arrange outpatient follow-up. (D) Hospitalization for observation for at least 48 hours. (E) Extracorporeal tocodynamometric monitoring for at least 4 hours.

Output: E


Instruction: A 25-year-old woman goes to the emergency department with right lower abdominal pain. Which of the following statements is incorrect?

Input: (A) Women of childbearing age who are suspected of acute appendicitis should undergo a pregnancy test. (B) It is challenging to diagnose acute appendicitis in women of childbearing age because other gynecological and obstetric diseases can easily be misdiagnosed as acute appendicitis. (C) If the pregnancy test is positive, then ectopic pregnancy can be diagnosed, and the diagnosis of acute appendicitis can be ruled out. (D) If there is vaginal discharge and tenderness of the cervix, it is more likely to be pelvic inflammation rather than acute appendicitis. (E) If there is migration of pain and the tenderness is concentrated in the right lower abdomen, it is more likely to be acute appendicitis rather than pelvic inflammation.

Output: C


Instruction: A 26-year-old female patient went to the emergency room because of difficulty breathing. She felt more labored breathing 3 days ago, and the situation became more serious day by day. She also found that she had become weak recently, her hands were too weak to comb her hair, and she had double vision when she looked at things. The above symptoms are milder when getting up in the morning and become more severe in the evening. What is the most likely diagnosis?

Input: (A)Guillain-Barre syndrome。 (B)Cervical cord myelopathy。 (C)Myasthenia gravis。 (D)Duchenne muscular dystrophy。 (E)Amyotrophic lateral sclerosis。

Output: C


Instruction: The 3-year-old girl was rescued by rescue technicians at the fire scene and sent to the emergency room for treatment. The girl's GCS: E3M5V4, shortness of breath, extensive burns on the face, chest and abdomen, hoarse voice, blood pressure 110/45 mmHg, heart rate 120 beats/minute, temperature 36.5 °C, respiration 32 times/minute, SpO₂ 87%, emergency intubation and ventilator required, regarding respiratory measures, which of the following statements is wrong?

Input: (A) It is best to choose an endotracheal tube without a cuff. (B) Measure the carboxyhemoglobin concentration in the blood and consider hyperbaric oxygen therapy. (C) For auxiliary drugs used for intubation, succinylcholine is the first choice for muscle relaxants. (D) Sedatives for intubation should be used, such as midazolam. (E) If intubation is not smooth, tracheostomy should be avoided as much as possible.

Output: C


Instruction: A 30-year-old male patient was sent to the emergency department by ambulance. He complained that he had just been in a car accident and had been hit in the chest. He now felt chest tightness and difficulty breathing. His blood pressure was 98/62 mmHg, heart rate was 120 beats/min, and respiratory rate was 26 beats/minute, body temperature 37.2℃. Which of the following statements about possible symptoms and signs of this patient is incorrect?

Input: (A) Beck triad manifestations of pericardial tamponade include distended cervical veins, hypotension, and muffled heart sounds. (B) Pericardial tamponade may present with Kussmaul signs, where the cervical vein will dilate further when the patient exhales deeply. (C) If the patient has a Hamman sign, the possibility of pneumomediastinum should be considered. (D) If physical examination reveals a puncture wound in the midline of the right clavicle, heart injury should be included in the differential diagnosis. (E) Traumatic aortic rupture may show esophageal deviation from the fourth thoracic vertebra on chest X-ray. The right side of the spinous process is larger than 1-2 cm.

Output: B


Instruction: A 34-year-old female was brought to the emergency room by ambulance due to shortness of breath. The patient was 8 weeks pregnant, with a blood pressure of 70/40 mmHg, respiratory rate of 32 breaths/minute, and heart rate of 130 beats/minute. According to her family, the patient recently came to the clinic to get medicine for a cold. After taking the first dose, she began to complain of dizziness, shortness of breath, and obvious facial swelling 20 minutes later. Breath sounds were bilateral wheezing. Which of the following treatments is more correct?

Input: (A) Give oxygen, epinephrine 0.3 mg IM, diphenhydramine 20 mg IV, methylprednisolone 125 mg IV, 1000 ml of saline solution, rapid infusion. (B) Give oxygen, diphenhydramine 20 mg IV, methylprednisolone 125 mg IV, 1000 ml of saline solution, rapid infusion. (C) Give oxygen, methylprednisolone 125 mg IV, 1000 ml of saline solution, rapid infusion. (D) Give oxygen, diphenhydramine 20 mg IV, 1000 ml of saline solution, rapid infusion. (E) Give oxygen, 1000 ml of saline solution, rapid infusion.

Output: A


Instruction: A 34-year-old male came to the emergency room with confusion and shortness of breath. His temperature was 36.4 ℃, blood pressure was 86/50 mmHg, heart rate was 110 beats/min, and respiration was 30 breaths/min. Arterial blood gas analysis showed pH: 7.10, PCO₂: 20 mmHg, PO₂: 96 mmHg, HCO₃⁻: 8 mEq/L, blood Na⁺: 145 mEq/L, K⁺: 2.7 mEq/L, Cl⁻: 105 mEq/L. Which of the following statements is incorrect?

Input: (A) The patient may have cyanide poisoning. (B) The patient may have iron poisoning. (C) The patient may have been poisoned by metformin. (D) The patient may have been poisoned by methanol. (E) The patient may have been poisoned by isopropyl alcohol.

Output: E


Instruction: A 35-year-old woman who was 24 weeks pregnant and weighed 65 kg was hit in the abdomen by a bicycle on the sidewalk. When she was taken to the emergency room by ambulance, her temperature was 36.7℃, her respiratory rate was 23 times/minute, her heart rate was 110 times/minute, and her blood pressure was 120/80 mmHg. The patient complained of severe lower abdominal pain and felt contractions. Physical examination revealed lower abdominal tenderness but no rebound tenderness combined with a small amount of vaginal bleeding. Which of the following statements about this pregnant woman is incorrect?

Input: (A) The pregnant woman does not know her own blood type, but it is known that the blood type of her husband is type O Rh(-). Therefore, no matter what the mother's blood type is, she does not need to be given Rh⁰D immune globulin. (B) The most common cause of fetal death caused by trauma is maternal death, and the second most common is placenta previa. (C) Tocolytic drugs may affect the initial trauma assessment. (D) Although the pregnant woman's blood pressure is still within the normal range, her bleeding volume may still exceed 1500 ml. (E) If the mother's heart stops beating after emergency treatment, emergency cesarean section can be considered.

Output: B


Instruction: A 36-year-old male has his right hand exposed to hydrofluoric acid. Which of the following statements is correct?

Input: (A) In case of severe burns, calcium gluconate can be infused through the upstream artery. (B) Calcium chloride solution can be injected for infiltration therapy. (C) Pain and redness of the skin will not occur after 6 hours. (D) If blisters appear on the affected area, it is not recommended to break the blisters to avoid infection. (E) Attention should be paid to hypocalcemia and hypokalemia, which may cause arrhythmia.

Output: A


Instruction: A 4-day-old female baby was sent to the emergency room because of bloody stools and persistent abdominal distension. CT scan revealed pneumatosis intestinalis, suspected to be necrotizing enterocolitis. Regarding necrotizing enterocolitis, which of the following statements is incorrect?

Input: (A) Premature and low-weight newborns are more susceptible. (B) Maternal cocaine use is a risk factor for necrotizing enteritis in full-term infants. (C) If diagnosed too late, it may lead to intestinal perforation and septic shock. (D) Laboratory diagnosis is not specific for necrotizing enteritis. (E) Regardless of whether there is intestinal perforation, patients with necrotizing enteritis require surgical treatment.

Output: E


Instruction: 45 A 6-year-old female with a history of rheumatoid arthritis came to the emergency room because she suddenly felt an electric shock on her back when she bent her neck during morning exercises. Physical examination showed no abnormalities, and the muscle strength on both sides was equal. Which step is the most appropriate next?

Input: (A) Immediately inject methylprednisolone 30 mg/kg intravenously. (B) Urgently perform a cervical spine CT scan. (C) Tell the patient that more activity can reduce this abnormal sensation. (D) Immediately inject a large amount of physiological saline intravenously. (E) Draw blood to check the inflammation status.

Output: B


Instruction: A 45-year-old male fell from a height of about 3 meters to the ground at a building construction site. Witnesses found that the patient had landed on his head. The patient lost consciousness briefly and woke up to forget that he had an accident. When he was taken to the emergency room by ambulance, his body temperature was 36.7℃, his breathing was 16 times/minute, his heart rate was 102 times/minute, and his blood pressure was 120/67 mmHg. The patient complained of weakness in his limbs and abnormal sensation. Which of the following statements about the patient's possible spinal cord injury is incorrect?

Input: (A) Anterior cord syndrome is usually caused by neck flexion, and only proprioception and vibration are retained below the injured area. (B) Central cord syndrome is more likely to occur in young people, and the weakness in the lower limbs is greater than that in the upper limbs. (C) Brown-Sequard syndrome is characterized by weakness on the same side, loss of proprioception on the same side, and loss of pain and temperature sensation on the opposite side. (D) The prognosis of Cauda equina syndrome is better, mainly because the injured nerves are peripheral nerves and have a chance of regeneration. (E) If the nerve damage is confirmed to be at the C5 position, it is necessary to consider intubation in advance to prevent respiratory failure.

Output: B


Instruction: A 45-year-old patient with cirrhosis was hospitalized due to fever and abdominal distension. Physical examination revealed ascites, and there was tenderness and rebound pain in the abdomen. Ascites examination showed that the white blood cell count in it was 1000/mm³, Among them, multinucleated spheres account for 90%. Which of the following statements about spontaneous bacterial peritonitis is incorrect?

Input: (A) The third-generation antibiotic of choice is cephalosporin. (B) If the protein concentration in the ascitic fluid is greater than 1 g/dL, the chance of spontaneous peritonitis increases. (C) The most common bacteria are Gram-negative bacteria, such as Escherichia coli. (D) If the multinucleated spheres in the ascitic fluid are greater than 250/mm³, the diagnosis can be confirmed and antibiotic treatment can be started. (E) The use of prophylactic antibiotics for high-risk patients with ascites can reduce the incidence of spontaneous bacterial peritonitis.

Output: B


Instruction: 5 A 6-year-old girl has many papules the size of half a grain of rice all over her body (especially her trunk). Some of these papules are blister-like and have obvious erythema, while others are small scabs. She also had a fever two or three days ago. Which of the following diagnoses is most likely?

Input: (A) Measles. (B) Chickenpox. (C) Pityriasis rosea. (D) Eczema. (E) Staphylococcal scalded skin syndrome.

Output: B


Instruction: A 5-year-old girl, weighing 20 kg, suffered from diabetic ketoacidosis, presented with lethargy and rapid breathing. She was brought to the emergency room by her family. Her blood pressure was 70/40 mmHg, heart rate was 120 beats/min, and blood glucose was 420 mg/dL. The emergency physician assessed that she was 10% dehydrated. Which of the following statements about her treatment and prognosis is incorrect?

Input: (A) Prioritize instillation of 200-400 ml of 0.9% saline solution to restore the capillary refilling time to normal. (B) If the child's consciousness improves and the perfusion is adequate after a single infusion of 400 ml of 0.9% saline, the infusion should not exceed 1.5 times the maintenance infusion volume within 48 hours. (C) Before giving 0.9% saline infusion, give an immediate regular insulin 2 units IV bolus and a continuous hourly regular insulin 2 units intravenous infusion. (D) If hyponatremia cannot be stabilized after blood sugar is corrected, it is one of the risk factors for cerebral edema. (E) Bicarbonate supplementation is usually not necessary.

Output: C


Instruction: A 56-year-old man is brought to the emergency room with a fever of 39.2°C for 1 day. The patient also has headache, general fatigue, nausea and vomiting. The doctor performs a lumbar puncture. Which of the following results of cerebrospinal fluid analysis does not match the manifestation of bacterial meningitis?

Input: (A) Sugar 80 mg/dL. (B) White blood cell count 1500/mm³. (C) White blood cell classification 85% neutrophils. (D) Open pressure 350 mmH2O. (E) Protein (total protein) 250 mg/dL.

Output: A


Instruction: A 56-year-old male construction worker from the flooded area in southern Taiwan went to the emergency room for about 3 days because of fever, headache, vomiting, loss of appetite, fatigue, and body aches. He had a history of diabetes and kidney disease. When he arrived at the hospital, his temperature was 39.2 °C, his heart rate was 120 beats/min, his respiratory rate was 22 breaths/min, and his blood pressure was 105/60 mmHg. Physical examination showed no conjunctival congestion, no jaundice, and no rash. Which of the following is a possible diagnosis?

Input: (A) Q fever. (B) dengue fever. (C) leptospirosis. (D) melioidosis. (E) All of the above.

Output: E


Instruction: A 60-year-old male patient was sent to the emergency room because of fever, chills, and altered consciousness for one day. The patient had a history of hypertension, diabetes, and bedridden due to stroke. On arrival, his temperature was 39.3 °C, heart rate was 116 beats/min, respiratory rate was 24 breaths/min, and blood pressure was 75/40 mmHg. Physical examination revealed a stiff neck, no jaundice, a soft abdomen, and no bedsores. White blood cell count was 16800/mm³, Segment 78%, Band 10%, Lactate 5.2 mmol/L. Which of the following treatments is wrong?

Input: (A) First, assess whether the airway is open, whether the breathing and ventilation are appropriate, and whether intubation should be performed. (B) Central venous lines must be established quickly to monitor central venous pressure and central venous oxygen saturation. (C) Dopamine or norepinephrine should be administered intravenously immediately. (D) Broad-acting antibiotics should be administered within 1 hour. (E) Possible sites of infection should be identified within 6 hours and source control should be performed.

Output: C


Instruction: A 70-year-old male patient who had just undergone coronary artery bypass surgery was discharged from the hospital 3 days ago. The patient was sent back to the emergency room because he could not sleep at night, talked a lot, and had confused behavior. His laboratory test results were normal, his wounds were not infected, and his neurological examination did not show any focal neurological symptoms, but his mental status examination revealed severe intellectual disability. His family members said that the patient had shown signs of intellectual degeneration several years ago, did not remember his family, and had gone out on his own before, but he would not have confused behavior. Which of the following actions is the least appropriate?

Input: (A) Consider a head CT scan. (B) Ask the patient to avoid sleeping during the day as much as possible. (C) Further follow-up examinations should be performed. (D) Consider giving him antipsychotic drugs. (E) He should be transferred to a psychiatric ward for inpatient treatment immediately.

Output: E


Instruction: 72 A 6-year-old male patient came to the emergency room with abdominal distension and shortness of breath. Physical examination showed distended cervical veins and shifting dullness in the abdomen. The results of ascites examination showed a white blood cell count of 280/mm³, 40% of which were polynuclear cells. The albumin in the ascites was 1.3 g/dL and the triglyceride was 300 mg/dL; the albumin in the blood was 2.6 g/dL. What is the most likely cause of his ascites?

Input: (A) Peritoneal tuberculosis. (B) Bacterial peritonitis. (C) Disseminated intraabdominal cancer. (D) Congestive heart failure. (E) Chylous ascites.

Output: D


Instruction: A vehicle carrying isotopes accidentally overturned. When the ambulance arrived, it was found that the radioactive isotope material had leaked. There was 1 A patient suspected of being contaminated by isotopes was sent to the emergency department of a hospital. Which of the following statements about emergency response is incorrect?

Input: (A) A decontamination area should be set up in the emergency room, and traffic control should be implemented to guide the patient to the decontamination area for treatment. (B) Workers in the decontamination area should wear waterproof full-body protective clothing, double-layer surgical latex gloves, and surgical masks for the mouth and nose. (C) Necessary emergency medical treatment (such as pressure to stop bleeding) should be performed before decontamination. (D) After the patient arrives at the decontamination area, he or she should take off his or her clothes and rinse the whole body vigorously with plenty of clean water. (E) Contaminated skin without wounds should not be scrubbed vigorously.

Output: D


Instruction: Which of the following is incorrect about the treatment of deep vein thrombosis (DVT)?

Input: (A) If there is no obvious contraindication to the medication, low molecular weight heparin can be used for initial treatment. (B) For patients with renal dysfunction (creatinine > 2 mg/dL), low molecular weight heparin can still be used, but the dose needs to be adjusted. (C) While using heparin, oral anticoagulant warfarin can be started. (D) For pregnant women, due to the obvious teratogenicity of low molecular weight heparin, only oral warfarin can be used. (E) If DVT is induced by tumor, lifelong use of anticoagulants is recommended.

Output: D


Instruction: Which of the following symptoms is most helpful in distinguishing anticholinergic toxicity from sympathomimetic toxicity?

Input: (A) Rapid heart rate. (B) Dry skin. (C) Confusion. (D) Dilated pupils. (E) Increased temperature.

Output: B


Instruction: Which of the following statements about hyperpotassium is incorrect?

Input: (A) Leukocytosis may lead to pseudohyperkalemia. (B) Calcium chloride should be given to severe cases of hyperpotassium. (C) Hyperkalemia may occur when insulin is used to treat hyperglycemia. (D) Kayexalate may not be effective for patients who have undergone colon resection. (E) Inhaled albuterol can treat hyperkalemia.

Output: C


Instruction: Which of the following statements about right ventricular myocardial infarction is incorrect?

Input: (A) Most of them are caused by lesions in the right coronary artery, so they are often combined with left ventricular inferior wall myocardial infarction in clinical practice. (B) The ST wave rise of V4R on the right electrocardiogram is its special change, but it may not always appear. (C) The clinical manifestations are often combined with low blood pressure and severe pulmonary edema. (D) Treatment can be achieved by infusion to increase left ventricular preload, and appropriate cardiotonic drugs can be considered. (E) If symptoms occur within 12 hours, primary percutaneous coronary intervention should be considered.

Output: C


Instruction: Which of the following statements about acute pulmonary embolism is incorrect?

Input: (A) Chest x-ray may show areas of oligoemia (Westermark's sign). (B) EKG may show sinus tachycardia, right bundle branch block, or an S1Q3T3 pattern. (C) Echocardiography may show right atrial, right ventricular, or main pulmonary artery enlargement with tricuspid regurgitation. (D) D-dimer is highly specific and, if elevated, almost always confirms the diagnosis. (E) If severe hypoxia or shock occurs, thrombolytic therapy should be considered and surgical referral should be sought.

Output: D


Instruction: Mr. Chen developed high fever, cough and shortness of breath on the third day of bed rest after a stroke. A chest X-ray confirmed pneumonia. Which of the following statements about aspiration pneumonia is incorrect?

Input: (A) Recent studies have found that the main pathogens of aspiration pneumonia are anaerobic bacteria. (B) Rapid sequence intubation is one of the risk factors for aspiration pneumonia. (C) The typical X-ray distribution of aspiration pneumonia in bedridden patients is the posterior segments of the upper lobe and the superior segments of the lower lobe. (D) The peak of the inflammatory response caused by pulmonary aspiration occurs between 4 and 6 hours. (E) In healthy young people with pulmonary aspiration, if the amount of aspiration is small and there are no obvious symptoms, antibiotics do not necessarily need to be used.

Output: A


Instruction: Which of the following statements about ventricular tachycardia (VT) and supraventricular tachycardia (SVT) is incorrect?

Input: (A) If VT or SVT with aberrancy cannot be distinguished clinically, both should be treated as VT. (B) If atrioventricular dissociation is found on the electrocardiogram, it should be treated as VT. (C) If the patient's condition is stable, adenosine can be considered to distinguish the two. (D) When Wolff-Parkinson-White (WPW) syndrome is accompanied by atrial fibrillation, β-blockers and calcium channel blockers should not be given. Digoxin can be used for treatment. (E) WPW syndrome is accompanied by narrow QRS tachycardia adenosine is not an absolute contraindication for use in patients with traumatic intubation.

Output: D


Instruction: Which of the following statements is incorrect about the choice of drugs to be used for rapid sequence intubation in trauma patients?

Input: (A) Fentanyl is used for patients with hypotension. (B) Ketamine is used for patients with brain trauma. (C) Lidocaine is used for patients with head trauma before intubation. (D) Rocuronium is used for patients with crush injuries. (E) Succinylcholine is used for patients with suspected brain trauma.

Output: B


Instruction: In a regional hospital near a disaster site, when the number of patients exceeds the hospital's capacity, a second triage is required. Which of the following methods is more appropriate?

Input: (A) No need for second triage. (B) JumpSTART (simple triage and rapid treatment). (C) PTT (pediatric triage tape). (D) SAVE (secondary assessment of victim endpoint). (E) START (simple triage and rapid treatment).

Output: D


Instruction: Which of the following descriptions of carbon monoxide (CO) poisoning is incorrect?

Input: (A) Hemoglobin's ability to bind carbon monoxide is 230-270 times that of oxygen, while myosin's ability to bind carbon monoxide is 20-25 times that of oxygen. (B) If the patient is exposed to moderate or severe carbon monoxide, pulse oximetry, carboxyhemoglobin (COHb), CK-MB and troponin-I, electrolytes, lactate and chest X-ray should be performed. (C) Pulse oximetry can be used to assess whether the blood oxygen concentration of patients with carbon monoxide poisoning is adequate. (D) If the patient has only mild symptoms, no unconsciousness, no cardiopulmonary symptoms, is conscious and cooperative, routine COHb testing and electrocardiogram examinations should still be performed to identify hidden cardiac hypoxia. (E) Carbon monoxide poisoning may cause lesions in the basal ganglia or hypothalamus, resulting in interval CO syndrome.

Output: C


Instruction: Which of the following is incorrect about the clinical features and related treatments of bradycardia?

Input: (A) In patients with TypeⅡ second-degree atrioventricular (AV) block myocardial infarction, anterior wall myocardial infarction is common and can easily progress to complete AV block. (B) For severe poor blood perfusion, transcutaneous pacing (TCP) and atropine should be used first. Dopamine and epinephrine should not be used at the same time. (C) TCP should be used for unstable patients who have failed to respond to atropine or whose intravenous infusion has not been given. (D) For patients with third-degree AV block with poor blood perfusion, TCP is more effective than atropine. (E) Isoproterenol is not the first choice for the treatment of symptomatic bradycardia.

Output: B


Instruction: Which of the following statements about intussusception in children is incorrect?

Input: (A) It can be caused by Meckel diverticulum, intestinal polyps, lymphoma, or foreign bodies. (B) It can be treated with barium enema, and after successful reduction, the child can be discharged home immediately. (C) The most common age is about three months to six years old, and the male to female ratio is about 4:1. (D) The common symptom is intermittent abdominal pain, and the appearance of currant jelly stool is a late manifestation. (E) The most common type is ileocolic intussusception.

Output: B


Instruction: Which of the following statements about the straight leg raising test is not included?

Input: (A) A positive straight leg raise test indicates that the nerve root is compressed. (B) The straight leg raise test only reproduces low back pain and posterior thigh pain, which is not enough to constitute a positive result of the test. (C) The patient lies on his back, extends his knee, and passively raises the affected lower limb. Sciatica radiates to below the knee joint within 70°, which is called a positive straight leg raise test on the same side. (D) The contralateral straight leg raise test has a higher specificity for diagnosing nerve root compression caused by intervertebral disc herniation. (E) The contralateral straight leg raise test has a higher sensitivity for diagnosing nerve root compression caused by intervertebral disc herniation.

Output: E


Instruction: Which of the following statements about protective gear for toxic and chemical disasters is correct?

Input: (A) Class A protective gear includes a self-contained air cylinder plus a full-body splashproof chemical protective suit. (B) Class B protective gear can protect personnel working in an oxygen-deficient environment. (C) Class C protective gear includes an N95 mask plus a full-body splashproof chemical protective suit. (D) Class B protective gear is what general medical personnel should wear when providing medical treatment to chemical disaster patients. (E) A fire suit plus a self-contained air cylinder is equivalent to Class B protective gear.

Output: B


Instruction: Which of the following statements about the concept of using a nasogastric tube to treat gastrointestinal bleeding is correct?

Input: (A) Patients suspected of lower gastrointestinal bleeding do not need a nasogastric tube. (B) Nasogastric tube placement is likely to cause varicose vein bleeding in patients and should be avoided if possible. (C) Bright red blood in the stool from the anus must be from the lower gastrointestinal tract. (D) Upper gastrointestinal bleeding cannot be ruled out even if the drainage from the nasogastric tube is normal. (E) In the case of upper gastrointestinal bleeding, the nasogastric tube should be flushed with ice water because evidence-based medicine shows that hypothermia can help stop bleeding.

Output: D


Instruction: Which of the following statements about high-altitude syndromes is incorrect?

Input: (A) Ginkgo biloba may be used to prevent acute mountain sickness. (B) The main treatment for acute mountain sickness is immediate descent and oxygen administration, along with oral acetazolamide 125 mg twice a day. (C) High-altitude pulmonary edema is a very serious complication and should be treated with oxygen and oral nifedipine. (D) If headache and vomiting occur when climbing a mountain quickly, acute mountain sickness should be highly suspected. (E) The pathogenesis of high-altitude syndrome may be low pressure and low blood oxygen in the mountains, which cause cerebral vasoconstriction, thereby reducing cerebral blood flow and finally causing high-altitude cerebral edema.

Output: E


Instruction: Which of the following descriptions of electric injury is incorrect?

Input: (A) When injured by AC electric shock, if the current reaches 18-30 milliamperes (mA), respiratory depression may occur. (B) When injured by AC current, if the current reaches 70 mA or more, it may cause ventricular fibrillation. (C) When injured by high-voltage AC current (600-70,000 volts), the first rhythm of cardiac arrest is more likely to be ventricular fibrillation. (D) When injured by lightning, the first rhythm of cardiac arrest is more likely to be asystole. (E) High-voltage electric shock is more likely to cause myosinuria and renal failure than lightning shock.

Output: C


Instruction: Which of the following statements about the indications for head computed tomography in mild traumatic brain injury (TBI) is incorrect?

Input: (A) Symptoms of amnesia. (B) Local neurological abnormalities. (C) Confusion or seizure. (D) Dizziness and nausea. (E) History of abnormal coagulation function.

Output: D


Instruction: Which of the following descriptions of diving emergencies is correct?

Input: (A) Generally speaking, recreational divers who carry a tank of pure oxygen on their backs when diving are statistically more likely to develop diving emergencies, such as decompression sickness, when diving multiple times a day than when diving once a day. (B) If you feel joint pain after diving and go to the hospital emergency room, and the X-ray examination shows no joint fractures or lesions, you may have type II decompression sickness. The most important treatment at this time is hyperbaric oxygen therapy. (C) If you conduct a single recreational dive per day, you should wait at least 12 hours after the last dive before flying. If you conduct multiple dives per day with unlimited depth, it is best to wait 24 hours after the last dive before flying. (D) Type I decompression sickness is more serious than type II and can easily cause damage to the spinal cord and brain. (E) The pathogenesis of decompression sickness is mainly due to the accumulation of oxygen in the tissues and vascular system, causing blockage and inflammatory reactions.

Output: C


Instruction: Which of the following statements about heatstroke is correct?

Input: (A) The typical definition of heat stroke is a core body temperature above 39°C, central nervous system dysfunction and no sweating (anhidrosis). (B) Heat stroke often causes liver damage, and liver enzymes may increase, which can help differentiate between heat stroke and heat exhaustion. (C) Heat stroke patients usually develop high blood potassium in the early stages and low blood potassium in the late stages. (D) Heat stroke can be treated by rapid cooling with ice water. (E) The clinical symptoms, signs and treatments of exercise and non-exertional heat stroke are different. The higher the body temperature, the higher the mortality rate caused by heat stroke.

Output: B、D


Instruction: Which of the examination data for pleural effusion best supports empyema diagnosis?

Input: (A) The ratio of total protein concentration between pleural effusion and serum is 0.6. (B) The ratio of lactate dehydrogenase concentration between pleural effusion and serum is 0.4. (C) The pH of pleural effusion is 6.5. (D) The white blood cell count of pleural effusion is 10000/mm³. (E) The red blood cell count of pleural effusion is 100000/mm³.

Output: C


Instruction: The symptoms of child abuse are sometimes confused with other diseases. Regarding the situation of non-child abuse, which of the following statements is incorrect?

Input: (A)Burns may be caused by accidents, most of which are caused by hot water splashing. They should not have strange shapes like cigarette burns. (B)Mongolian spots are purple spots similar to bruises. The difference from ordinary bruises is that Mongolian spots will change color (purple, green, blue, brown) over time. (C)Bruise of young children or school-age children that is not caused by child abuse usually appears on bone protrusions, such as the calves and forehead, and most of them are unilateral. (D)Neonatal fractures that are not caused by child abuse often occur in the clavicle and humerus. (E)Osteogenesis imperfecta is caused by a genetic defect and is often mistaken for child abuse.

Output: B


Instruction: Which of the following is the least likely to occur in an acute myocardial infarction complicated by severe pulmonary edema?

Input: (A) A large area of ST-wave-band elevation myocardial infarction on the anterior wall of the left ventricle. (B) A large area of non-ST-wave-band elevation myocardial infarction. (C) A myocardial infarction on the inferior wall of the left ventricle complicated by a right ventricular infarction. (D) A myocardial infarction on the anterior wall of the left ventricle complicated by rupture of the chordae tendineae or mastoid muscles of the mitral valve. (E) A rupture of the ventricular septum caused by an infarction of the anterior wall and septum of the left ventricle.

Output: C


Instruction: For the following suspected victims of violence, in addition to medical care, treatment, and reporting, emergency physicians are also required to examine the injuries and issue various special diagnosis certificates. However, if you are only an emergency physician, which type of victims of violence can you not diagnose and issue special diagnosis certificates?

Input: (A) Victims of domestic violence. (B) Abused children. (C) Elderly people who have been abused or subjected to domestic violence. (D) Victims of sexual violence. (E) None of the above.

Output: D


Instruction: A fire broke out on campus and you are the first person to arrive at the scene. According to the START (simple triage and rapid treatment) process, which of the following injuries are classified as yellow?

Input: (A) 22-year-old female, rapid breathing, black carbon particles attached to mouth and nose, unconscious. (B) 21-year-old female, left thigh fracture, normal breathing and pulse, conscious. (C) 18-year-old female, panicked, running around, crying and shouting that classmates were still in the classroom, right hand slightly burned. (D) 25-year-old female, no breathing, large facial burns. (E) 40-year-old female, breathing 25 times per minute, capillary refill time 3 seconds.

Output: B


Instruction: According to the definition of mental illness as revised in July 2007, mental illness refers to abnormal mental states such as thinking, emotions, perception, cognition, and behavior, which cause impairment in the ability to adapt to life and require medical treatment and care. Which of the following is not included in its scope?

Input: (A) Mental illness. (B) Neurosis. (C) Alcohol addiction. (D) Drug addiction. (E) Antisocial personality disorder.

Output: E


Instruction: The patient is using oxygen at a concentration (FiO2) of 60%, and his PaO2 is 280 mmHg and PaCO2 is 40 mmHg. What is the estimated alveolar-arterial oxygen difference (Aa DO2) of the patient in mmHg?

Input: (A)50 (B)100 (C)150 (D)200 (E)250

Output: B


Instruction: The patient has erythematous macules, papules, and vesicular rashes on the trunk and limbs. Many of the rashes are target-shaped. The patient also has oral ulcers and red and swollen conjunctivae. Which of the following diagnoses is most likely?

Input: (A)Stevens-Johnson syndrome. (B)bullous pemphigoid. (C)pustular psoriasis. (D)pemphigus vulgaris. (E)dermatitis herpertiformis.

Output: A


Instruction: Patients with ischemic stroke have different clinical symptoms depending on the area of the brain affected. Which of the following statements is incorrect?

Input: (A) Cerebellar infarction often causes sudden inability to stand or walk, but no abnormalities in the brain nerves occur. (B) Middle cerebral artery infarction causes weakness in the contralateral limbs (the upper limbs are more serious than the lower limbs) and numbness. (C) Anterior cerebral artery infarction causes weakness in the contralateral limbs (the lower limbs are more serious than the upper limbs) and mild sensory loss. (D) Posterior cerebral artery infarction causes symptoms such as dizziness, vertigo, diplopia and movement disorders. (E) Basal artery infarction can cause severe limb paralysis, coma and locked-in syndrome. In patients with locked-in syndrome, all muscles in the body are paralyzed except for the eyes, which can move upward.

Output: A


Instruction: Which of the following is incorrect about the common location of avascular necrosis after fracture?

Input: (A) Scaphoid fracture. (B) Femoral head fracture. (C) Femoral neck fracture. (D) Patella fracture. (E) Talus neck fracture Hawkins classification type II and III.

Output: D


Instruction: Which of the following is the most common cause of intestinal obstruction in pregnant women?

Input: (A) Intussusception. (B) Cecal volvulus. (C) Sigmoid volvulus. (D) Sigmoid tumor. (E) Sigmoid bezoars.

Output: B


Instruction: Which of the following statements about end-tidal CO2 is incorrect?

Input: (A) In patients with COPD, this value is more different from PaCO2. (B) During CPR, this value will increase before the patient's pulse is restored. (C) After sodium bicarbonate is injected, this value will increase temporarily. (D) If the endotracheal tube is accidentally inserted into the esophagus during intubation, this value will be low. (E) In normal people, the value is approximately equal to PaCO2 but slightly higher.

Output: E


Instruction: Which of the following statements about hypertensive emergencies is incorrect?

Input: (A) Hypertensive encephalopathy is caused by blood pressure exceeding the upper limit of cerebral vascular self-regulation, resulting in cerebral hyperperfusion and loss of the integrity of the blood-brain barrier, resulting in cerebral edema and severe cerebral vasoconstriction. (B) The treatment of hypertensive encephalopathy should try to lower blood pressure to around 110/70 mmHg with drugs. (C) The choice of drug can achieve a faster blood pressure lowering effect by intravenous infusion of nitroprusside. (D) Angiotensin-converting enzyme inhibitor should be avoided in patients with poor renal function and pregnant women. (E) If the patient has aortic detachment, β-blocker should be used concurrently with intravenous infusion of nitroprusside to avoid reflex tachycardia.

Output: B


Instruction: Which of the following statements about the characteristics of neurogenic shock is incorrect?

Input: (A) Slow heartbeat. (B) Dry and warm skin. (C) Decreased blood pressure. (D) Warm limbs. (E) Narrowing of pulse pressure.

Output: E


Instruction: Which of the following statements about testicular torsion is incorrect?

Input: (A) Testicular torsion not only occurs after strenuous activities, but may also occur during sleep. (B) Testicular torsion occurs (C) Doppler ultrasound can be used to confirm the diagnosis, which can show decreased blood flow on the affected side. (D) In the case of right-sided testicular torsion, manual repositioning of the affected testicle can be considered before surgery. The method is to stand in front of the patient's feet and twist the right testicle 540 degrees in a clockwise direction. (E) In the case of testicular torsion, the pain will not vary in degree with changes in the patient's posture.

Output: D


Instruction: Which of the following is incorrect about the diagnosis and treatment of sigmoid volvulus?

Input: (A) Colonoscopy can reveal a spiral sphincter-like twist in the colon mucosa. (B) A typical feature of a barium enema study is a bird's beak. (C) CT diagnosis is highly accurate and most diagnoses require CT. (D) If the intestine is healthy and not necrotic, endoscopic decompression can be used and the intestine can twist on its own (self-detorsion). (E) About 60% of cases will relapse. It is recommended to electively resection the excess sigmoid colon after the acute phase is relieved.

Output: C


Instruction: Which of the following statements about pneumonia caused by pathogens is incorrect?

Input: (A)Mycoplasma pneumoniae can cause gastrointestinal symptoms. (B)Pneumococcus is still the most common pathogen. (C)Staphylococcus aureus is more common in patients with chronic lung disease. (D)Streptococcus pneumoniae is more common in the elderly and children under 2 years old. (E)Klebsiella can form pulmonary cavitation and lobar infiltration.

Output: A


Instruction: Regarding the management of the oral anticoagulant warfarin, which of the following is more appropriate?

Input: (A)International normalized ratio(INR)2-3, continue to monitor activated partial thromboplastin time. (B)INR ＜5, no obvious bleeding, suspend the use of warfarin until the INR returns to the normal range. (C) INR 5-9, no obvious bleeding, transfuse fresh frozen plasma. (D) INR > 9, no obvious bleeding, repeated intravenous injection of vitamin K1. (E) INR > 20, no obvious bleeding, suspend the use of warfarin.

Output: B


Instruction: Which of the following statements about central and peripheral vertigo is incorrect?

Input: (A) Peripheral vertigo generally lasts for a shorter time, while central symptoms may last for weeks to months. (B) Generally speaking, the symptoms of peripheral vertigo are more affected by head posture, while those of central vertigo are less affected. (C) Symptoms of peripheral vertigo are usually milder, while those of central vertigo are more severe. (D) Nystagmus is usually unidirectional in peripheral vertigo, but may be horizontal, circular, or vertical in central vertigo. (E) Peripheral vertigo is not associated with other neurological symptoms, but central vertigo may be associated with other neurological symptoms.

Output: C


Instruction: Which of the following statements about pericardial effusion is incorrect?

Input: (A)Possible causes include pericarditis, hypothyroidism, cancer, uremia, ventricular rupture, and trauma. (B)Typical clinical signs are low blood pressure, venous distension, and distant, muffled heart sounds. If these signs are absent, acute pericardial effusion can be ruled out. (C)If a patient with acute chest pain suddenly faints and his blood pressure suddenly becomes unmeasurable, and a moderate amount of pericardial effusion is found on bedside ultrasound, myocardial infarction with myocardial rupture or aortic detachment should be considered. (D)If the blood pressure is low, the first treatment should be intravenous infusion to increase the pressure of the right heart and overcome the pressure of the pericardial effusion. (E) If pericardial tamponade has occurred and needle aspiration fails to drain the effusion, surgical pericardiotomy should be considered.

Output: B


Instruction: Which of the following is incorrect about the diagnosis of aortic detachment?

Input: (A) Not all patients present with the classic symptom of chest pain that moves to the back. (B) Older patients with hypertension are often associated with atherosclerotic lesions in the aorta. If the patient is young, Marfan syndrome should be considered. (C) During physical examination, attention should be paid to whether the pulse strength of the four limbs is symmetrical. If it is not certain whether it is symmetrical, the blood pressure of the four limbs can be further measured to determine the difference between the left and right sides. (D) If a diastolic murmur is heard above the right side of the sternum during auscultation during physical examination, the aorta should be considered to be separated to the base of the aorta, resulting in aortic insufficiency. (E) Chest X-ray examination is the most important basis for judgment. If the thoracic longitudinal diaphragmatic cavity is not enlarged or widened, aortic separation can be ruled out.

Output: E


Instruction: Which of the following is not an indication for urgent thoracotomy for traumatic hemothorax?

Input: (A) The chest tube drainage volume is greater than 1500 ml at a time. (B) The chest tube drainage volume is greater than 200 ml per hour and lasts for more than 3 hours. (C) The patient continues to have shock symptoms after intravenous transfusion therapy, and bleeding from other sites has been ruled out. (D) The patient's chest X-ray is combined with a large pneumothorax and tracheal deviation can be seen. (E) The patient's follow-up chest X-ray shows a significant increase in the amount of hemothorax, and the patient does not respond well to intravenous therapy.

Output: D


Instruction: Which of the following statements is correct about the primary assessment of trauma patients and their corresponding treatment?

Input: (A) Protection of the airway includes opening the airway to make it unobstructed. If a foreign body is seen, it should be removed. There is no need to consider cervical spine fixation. (B) Patients who are conscious should be given an oropharyngeal airway to prevent tongue collapse. (C) If the patient has symptoms of tension pneumothorax, needle decompression should be performed immediately without waiting. (D) If the patient has symptoms of pericardial tamponade, treatment should be given during the secondary assessment after the primary assessment. (E) For patients with poor circulation, a central venous catheter should be established first to provide infusion. If infusion is not possible, two large-bore catheters should be used for intravenous infusion.

Output: C


Instruction: Which of the following is not included in the timing of transarterial embolization treatment?

Input: (A) Upper limb fracture combined with vascular injury. (B) Blunt abdominal contusion, unstable blood pressure, CT scan revealed extensive liver parenchymal damage, combined with contrast agent extravasation. (C) Blunt abdominal contusion, stable blood pressure, CT scan revealed contrast agent extravasation in the spleen. (D) Kidney injury with continuous bleeding and hematuria, the hematoma is limited to the perirenal space, and the collecting system is not damaged. (E) Patient with pelvic fracture, very unstable blood pressure, and local hematoma rapidly expanding.

Output: A


Instruction: Which of the following statements about the incident command system is correct?

Input: (A) The command structure can be divided into five major functions, including command, safety, execution, planning and logistics. (B) The recommended ratio of supervisors to subordinates is 1:8. (C) In addition to ensuring the safety of disaster rescuers and disaster victims, the safety officer must also release relevant information to the media on a regular basis. (D) It is not the task of the logistics department to make records of injuries or damage. (E) The commander must have a very professional understanding of all disasters, otherwise he cannot serve as a commander.

Output: D


Instruction: Which of the following statements about the management of viral croup in children is incorrect?

Input: (A) If the patient has idiopathic hypertrophic subaortic stenosis, monitor monitoring is required when the safety of L-epinephrine is of concern. (B) Patients receiving epinephrine nebulization should be observed in the emergency room for at least 3 hours after treatment. (C) Patients receiving epinephrine nebulization should also receive steroid treatment. (D) Oral dexamethasone is not recommended for the treatment of croup. (E) If the patient's overall appearance is relaxed and he or she only makes stridor sounds when he or she cries excitedly, epinephrine nebulization treatment is not necessary.

Output: D


Instruction: Which of the following statements about lung abscess is incorrect?

Input: (A) Pulmonary abscesses caused by anaerobic bacteria often contain more than one species of bacteria. (B) Pulmonary abscesses are mainly treated with surgery, and early resection can effectively shorten the course of antibiotics. (C) It is more likely to occur in the basal segments of the lower lung lobes. (D) Patients who are prone to pulmonary aspiration are also prone to pulmonary abscesses. (E) About 1/3 of patients with pulmonary ulcers will develop pleural effusion (empyema).

Output: B


Instruction: Which of the following statements about the diagnosis and treatment of acute pancreatitis is incorrect?

Input: (A)Amylase rises quickly and has a short half-life, so its sensitivity decreases after 36 hours. (B)Amylase and lipase levels have nothing to do with the severity of the disease. (C)After amylase returns to normal, elevated lipase levels can persist for several days. (D)If the Ranson score is ≥ 3 points, or APACHE II is ≥ 8 points, it indicates severe acute pancreatitis and a poor prognosis. (E)Abdominal CT can be used to assess severity. If the CT is normal, the diagnosis of acute pancreatitis can be ruled out.

Output: E


Instruction: Which of the following statements about acute gout is incorrect?

Input: (A)It is a crystal-induced synovitis. (B) Drugs that can induce gout include aspirin, diuretics, and cyclosporine. (C) High serum uric acid levels are a prerequisite for the diagnosis of gout. (D) Nonsteroidal anti-inflammatory drugs are the first choice for the treatment of acute gout. (E) Intravenous colchicine is not recommended for the treatment of gout, as its serious side effects include bone marrow suppression.

Output: C


Instruction: Which of the following is more appropriate in the management of an acute transfusion reaction?

Input: (A) If urticaria occurs during a blood transfusion, no more transfusions should be given. (B) If a fever occurs during a blood transfusion, it must be a reaction to the transfusion and not caused by an infection. (C) In the event of acute intravascular hemolysis, blood transfusions must not be continued. (D) Because transfusion reactions are unpredictable, blood transfusions should be given as quickly as possible from the beginning. (E) If fever occurs during transfusion, it can be treated with diphenhydramine only.

Output: C


Instruction: Which of the following statements is correct about rapid visual deterioration?

Input: (A) Central retinal artery occlusion is usually accompanied by eye pain. (B) If optic neuritis is suspected, oral steroids should be given. (C) Acute angle-closure glaucoma often causes a constricted pupil that is unresponsive to light. (D) Fundus examination reveals cherry-red spots, which are characteristic of central retinal vein occlusion. (E) If the worsening vision is due to temporal artery inflammation, the vision in the other eye may also worsen over a few days to weeks.

Output: E


Instruction: Which of the following statements about asthma in pregnant women is incorrect?

Input: (A) About one-third of asthma patients will have worsening symptoms during pregnancy. (B) Peak expiratory flow values do not change much during pregnancy and can be used to assess the severity of the disease and guide treatment. (C) In acute attacks, inhaled beta-adrenergic receptor agonists are the main treatment option. (D) The treatment prognosis of well-controlled asthma is the same as that of general patients and will not increase the risk to the fetus. (E) Pregnant women can use inhaled steroid preparations, but oral steroid drugs should not be used.

Output: E


Instruction: Which of the following statements about the treatment of asthma is incorrect?

Input: (A) Beta-adrenergic receptor agonists can cause bronchodilation. (B) Theophylline It is the first-line drug for the treatment of acute asthma. (C) Giving steroid treatment within 1 hour of hospitalization can reduce the rate of hospitalization. (D) Intravenous injection of magnesium sulfate can treat acute severe asthma. (E) The anti-inflammatory effect of steroids appears 4-8 hours after treatment.

Output: B


Instruction: Which of the following statements about alcohol withdrawal syndrome is incorrect?

Input: (A) Symptoms appear 6-24 hours after stopping drinking. (B) Symptoms may last about 2-7 days. (C) Visual and auditory hallucinations will occur. (D) Blood pressure rises and the heart rate becomes faster. (E) Changes in consciousness are mainly drowsiness.

Output: E


Instruction: Which of the following statements about common pesticide poisoning is incorrect?

Input: (A) If a patient drinks an unknown pesticide and develops oral mucosal ulcers 1-2 days later, paraquat poisoning should be considered. (B) Carbamate poisoning rarely causes seizures because it cannot pass through the blood-brain barrier. (C) Pyrethrin acts on the sodium ion channels on the nerve cell membrane, repeatedly stimulating them and eventually causing conduction disorders. (D) The toxicity of glyphosate is mainly related to the surfactant it contains. (E) Paraquat poisoning can be removed by hemodialysis in the early stages.

Output: E


Instruction: Which of the following statements about eyeball rupture is incorrect?

Input: (A)BB bullets, firecracker debris, or small pieces of wood thrown by lawn mowers may penetrate the eyeball. (B)Common manifestations of eyeball rupture include shallow anterior chamber, blood accumulation, irregular pupil shape, and significant deterioration of vision. (C)When eyeball rupture is suspected, intraocular pressure should be measured. (D)When eyeball rupture is suspected, tetanus toxoid or immunoglobulin should be injected, and antibiotics should be injected intravenously. (E)When a foreign body is suspected to have penetrated the eyeball, Water's view or orbital CT should be performed.

Output: C


Instruction: For patients with minor head trauma, which of the following does not meet the Canadian CT head rule's recommendation for CT?

Input: (A) A 75-year-old man was riding a bicycle and tripped over a rock on the road and fell and hit his head. He had a 4-cm laceration on his scalp. He was conscious and his GCS was 15. (B) A 22-year-old college student was hit on the head while playing volleyball. There was no obvious hematoma on his scalp. He was conscious and his GCS was 15. He now feels dizzy but has not vomited. (C) A 2-year-old child rolled down the stairs (about 60 cm high). There was no obvious hematoma on his scalp. He vomited 5 times at home before coming to the emergency room and is now more sleepy. (D) A 45-year-old male drunkenly fell off his motorcycle. He was not wearing a helmet. He was conscious, GCS 15, and had a distinct raccoon eye in his right eye. (E) A 33-year-old female motorcycle passenger, wearing a helmet, was hit by a truck at 80 km/h and flew out. She had multiple abrasions all over her body. She was conscious, GCS 15.

Output: B


Instruction: Which of the following statements is correct about the treatment of lithium salt poisoning?

Input: (A) Forced diuresis can be used to increase the excretion of lithium salt. (B) If the patient has seizures, phenytoin can be used for treatment. (C) In case of acute poisoning, if hemodialysis is required, acetate dialysate is more effective. (D) The use of continuous dialysis is less likely to cause the problem of lithium salt concentration rebound. (E) Perform gastric lavage and use activated carbon to assist adsorption.

Output: D


Instruction: Which of the following statements about alcohol withdrawal is incorrect?

Input: (A)Patients with alcohol withdrawal often experience sweating, unsteady gait (ataxia) and hallucinations. (B)Symptoms of alcohol withdrawal are not related to the type of alcohol consumed. (C)Symptoms of alcohol withdrawal can be divided into four stages: autonomic hyperactivity, hallucination, dyskinesia and global confusion. (D)After stopping drinking, symptoms usually return within 24 hours. Symptoms of sweating, palpitations and hallucinations may occur within hours. (E) Treatment is mainly supportive therapy.

Output: C


Instruction: A 25-year-old tall and thin male was admitted to the emergency room because of sudden chest pain while fighting monsters in an online game. The patient reported no external injuries and no history of other diseases. He occasionally smoked. Which of the following statements about this patient is incorrect?

Input: (A) Mitral valve prolapse may be accompanied by symptoms of dizziness, hyperventilation, anxiety, and palpitations. (B) Expiratory chest X-ray is much more sensitive than inspiratory chest X-ray in diagnosing pneumothorax and can provide a better assessment of lung parenchyma. (C) Based on clinical judgment, an electrocardiogram should still be performed if necessary to rule out acute coronary heart disease. (D) Pneumonia may also cause chest pain, usually accompanied by fever and cough. Rales may be heard during physical examination, and chest X-ray can help confirm the diagnosis. (E) Clinical symptoms and signs combined with chest X-ray cannot completely rule out aortic detachment. Further imaging examinations are required if necessary.

Output: B


Instruction: An 86-year-old man was sent to the emergency room by his family due to fever. According to the nurse, the patient often choked when eating recently. He has a history of Alzheimer's disease and hypertension. He usually lives at home and has not been to the hospital in the past two months. After examination, you found rales in the right lung and infiltration in the right lower lobe of the chest X-ray. Which of the following statements is incorrect when you want to treat a patient with a single antibiotic?

Input: (A)Clindamycin. (B)Ceftriaxone. (C)Ceftazidime. (D)Levofloxacin. (E)Piperacillin-tazobactam.

Output: A


Instruction: Which of the following statements about spontaneous pneumothorax is incorrect?

Input: (A)The most common cause in the neonatal age group is respiratory distress syndrome. (B)The most common cause in the 20 to 40 age group is rupture of subpleural bleb in the apex. (C) In patients over 40 years of age, the most common cause of secondary spontaneous pneumothorax is lung tumor. (D) Deep sulcus sign can sometimes be seen on chest X-ray. (E) Giving the patient 3-4 L/min of oxygen can increase pleural air absorption by 3 to 4 times.

Output: C


Instruction: One afternoon, a 50-year-old woman was sent to the emergency room. Her family said that the patient had a history of asthma. In the morning, she drank a soup made from asthma-curing herbs that she had picked in the mountains yesterday. In the afternoon, she began to talk nonsense and her whole body felt dry and hot. The patient's vital signs when she arrived at the emergency room were as follows: temperature 38.5℃, respiration 19 times/min, heart rate 120 beats/min, blood pressure 152/80 mmHg, confusion, restlessness, E2V2M5. Which treatment is the least appropriate for this patient?

Input: (A) Give the patient adequate infusion and appropriate monitoring. (B) Give the patient physical restraints, but not for too long. (C) Give the patient a sedative, such as lorazepam or phenothiazines. (D) If the patient's electrocardiogram shows a widened QRS, consider using sodium bicarbonate. (E) Consider using physostigmine to treat the patient.

Output: C


Instruction: Which of the following statements about antidotes for poisoning treatment is incorrect?

Input: (A) Atropine is an antidote for organophosphate poisoning and should be used regardless of the presence of bradycardia, increased bronchial secretions, or spasms. (B) Dimercaprol (BAL) is an antidote for arsenic, mercury, or lead poisoning. Its side effects are nephrotoxic, causing nausea, vomiting, and urticaria. (C) Pralidoxime (PAM) is an antidote for organophosphate poisoning and is not used for carbamate poisoning. (D) Hypoglycemia caused by sulfonylurea poisoning can be treated with octreotide. (E) Calcium ions (CaCl2 or Ca gluconate) are used for poisoning by hydrofluoric acid, calcium ion blockers, oxalate, etc., but not for digitalis poisoning.

Output: A


Instruction: There is a 25-year-old male with a history of bipolar disorder. He has had diarrhea for 4 days due to gastroenteritis. He was taken to the emergency room by his family because of drowsiness and slurred speech. The medicine bag brought by the family contained lithium, valproate sodium and estazolam. Which of the following statements is incorrect?

Input: (A) If the patient's blood lithium concentration is 4 meq/L, hemodialysis should be used to remove the lithium, and repeated dialysis is often required. (B) If the patient has seizures, phenytoin should be used for treatment. (C) The blood concentrations of lithium, valproic acid, and benzodiazepine should be checked. (D) The patient should be asked about polyuria, which will help to diagnose lithium poisoning. (E) The patient should be given adequate fluid therapy, and normal saline is the preferred fluid.

Output: B


Instruction: A 21-year-old male presented to the emergency department with sudden onset of right-sided chest pain. A chest X-ray revealed a 10% pneumothorax on the right side. Which of the following statements is incorrect?

Input: (A) The patient should be observed for at least 6 hours and then X-rayed. If there is no change in the X-ray, the patient can be discharged and scheduled for an outpatient appointment in 24 hours. (B) The air in the pleural cavity is absorbed at a rate of 1-2% per day. The use of oxygen 3-4 L/min can increase the absorption rate by about 4 times. (C) If this is the first attack, the possible subsequent recurrence rate is about 30%. (D) Both the use of a catheter for suction and the placement of a small-caliber chest tube are acceptable treatment strategies. (E) If catheter suction is used, the suction volume should be greater than 10 liters, there may be continuous air leakage.

Output: E


Instruction: A 3.5-year-old girl was brought to the emergency room by her family, complaining of fever and cold symptoms for five days. Physical examination revealed that the girl had stridor and stiff neck. The trauma station measured O2 saturation of 96%, and determined the trauma level to be level three. The girl seemed anxious and could still use sentences fluently, but was unwilling to lie down for examination. Which of the following treatments is more appropriate?

Input: (A) Immediately intramuscular injection of steroid dexamethasone 0.6mg/kg. (B) Intramuscular injection of epinephrine. (C) Lateral neck X-ray. (D) Immediately give her an IV drip and replenish the infusion. (E)Immediately place an endotracheal tube to maintain airway patency.

Output: C


Instruction: Which of the following statements about gastrointestinal bleeding is incorrect?

Input: (A)Proton-Pump inhibitor (PPI) can reduce the rebleeding rate of hemorrhagic gastric ulcers and reduce the need for blood transfusion and surgery. (B)Sengstaken-Blakemore tube (SB tube) is no longer recommended for the treatment of varicose vein bleeding due to too many complications. (C)Nasogastric tube placement can be considered for upper gastrointestinal bleeding, even for suspected esophageal varicose vein bleeding. (D)Angiography can be used as a diagnostic tool, but it can only be detected when the bleeding rate exceeds 0.5~2.0 ml/min. (E) The most common cause of lower gastrointestinal bleeding is hemorrhoidal bleeding, followed by angiodysplasia and diverticular disease.

Output: B


Instruction: Which of the following statements about emphysematous cholecystitis is incorrect?

Input: (A) Emphysematous cholecystitis occurs in about 1% of patients with acute cholecystitis. (B) 30% of patients with emphysematous cholecystitis do not have gallstones. (C) Abdominal tomographic scan is recommended to confirm emphysematous cholecystitis. (D) Emphysematous cholecystitis has a higher mortality rate than general acute cholecystitis. (E) Emphysematous cholecystitis is mostly caused by a single microbial infection.

Output: E


Instruction: Which of the following statements about complications of acute pancreatitis is incorrect?

Input: (A) Acute respiratory distress syndrome (ARDS). (B) Pericardiac effusion. (C) Portal vein thrombosis. (D) Sudden visual loss (Purtscher's retinopathy). (E) Hypercalcemia.

Output: E


Instruction: Common risk factors for acalculous cholecystitis do not include:

Input: (A) Multiple trauma (B) Young obese women. (C) Bacterial infection of the gall bladder. (D) Gallbladder torsion. (E) A patient with severe burns and scalds.

Output: B


Instruction: A 60-year-old male with a medical history of hypertension and diabetes was sent to the emergency room because of acute chest pain extending to the back. When he sought medical attention, his blood pressure was 220/110 mmHg, his heart rate was 98 beats/min, and his respiratory rate was 20 breaths/min. Chest X-ray showed mediastinum widening, and the electrocardiogram showed left ventricular hypertrophy. Regarding the diagnosis and clinical treatment of this patient, which of the following is incorrect?

Input: (A) Clinically, aortic dissection should be strongly suspected, and a CT examination should be arranged immediately. (B) Pulse deficit is helpful in diagnosis but has only 15-30% sensitivity. (C) Chest X-rays of patients with aortic detachment have 63-88% abnormal changes. (D) Aortic detachment sometimes involves the coronary arteries, most commonly the right coronary artery, which can cause inferior or posterior wall infarction. (E) Regarding blood pressure control in this patient, nitroprusside alone may be considered.

Output: E


Instruction: The patient has red maculopapular and vesicular rashes on the trunk and limbs, many of which are target-shaped rashes. He also has oral ulcers and conjunctival erythema. Which of the following diagnoses is most likely:

Input: (A) Stevens-Johnson syndrome. (B) Bullous pemphigoid. (C) Pustular psoriasis. (D) Pemphigus vulgaris. (E) Dermatitis herpertiformis.

Output: A


Instruction: A 56-year-old female presents to the emergency department with unconsciousness. During screening, her temperature is 39.4℃, BP: 130/80 mmHg, heart rate 100 beats/min, respiration 16 breaths/min, and peripheral blood oxygen concentration (SpO2) is 98%. Many small hemorrhages (petechiae) are found on the skin. The white blood cells in the blood are: 10,000/mm³, hemoglobin: 8.5 g/dL, platelets 10,000/mm³, PT and PTT are normal, and schistocytes are found in the blood smear. Creatinine: 4.5 mg/dL. Which of the following statements is correct?

Input: (A) Platelets should be given immediately to avoid spontaneous bleeding. (B) Bone marrow aspiration and biopsy should be arranged. (C) The patient has disseminated intravascular coagulation. (D) Administration of fresh frozen plasma is an effective treatment. (E) Splenectomy is an effective treatment.

Output: D


Instruction: Which of the following symptoms can most confidently identify the patient as having peripheral vertigo?

Input: (A) Tinnitus and hearing loss. (B) Dysphagia. (C) Sudden onset. (D) Nystagmus of uncertain direction. (E) Visual fixation does not affect nystagmus.

Output: A


Instruction: Which of the following best describes testicular torsion?

Input: (A) Pain is relieved by changes in posture. (B) The testicle is horizontal when standing. (C) The pain is mild and not noticeable at first. (D) The pain is limited to the scrotum. (E) The cremasteric reflex is normal.

Output: B


Instruction: A 29-year-old male receiving methadone treatment was shot in the left chest and was taken to the emergency room by his family. He was breathing more than 30 times per minute, and a weak pulse could be felt in the carotid artery. He was agitated. Physical examination revealed cold sweat all over the body, distended carotid veins, no breath sounds in the left chest, and tympanic sound on percussion. The bullet hole was at the intersection of the 6th intercostal space on the left and the midclavicular line. Which of the following treatments is most appropriate?

Input: (A) Give an endotracheal tube. tube) while protecting the cervical spine. (B) Perform abdominal ultrasound (FAST) examination to check whether there is bleeding in the abdomen. (C) Place a chest tube directly through the bullet hole for rapid drainage. (D) Rapidly administer 2 liters of fluid. (E) Insert a 14-gauge empty needle in the left midclavicular line and second intercostal space to reduce pressure.

Output: E


Instruction: A 21-year-old male was riding a motorcycle and collided with a small passenger car. When he arrived at the hospital, he had a right scoliosis and head injury, was unconscious, had obvious contusions on the chest and upper abdomen, and had weak breath sounds on the left chest. His blood pressure was 90/50 mmHg and his heart rate was 140/min. Which of the following treatment sequences is most appropriate? 1. Endotracheal tube tube) insertion. 2. CT of the brain. 3. Rapid infusion of 2 liters. 4. Abdominal ultrasound (FAST). 5. Left thoracic tube insertion (tube thoracostomy).

Input: (A)1->2->3->4->5. (B)1->3->5->4->2. (C)1->3->4->5->2. (D)5->1->3->2->4. (E)5->1->3->4->2.

Output: B


Instruction: A 50-year-old female fell from the 3rd floor and was sent to the emergency room. The patient was conscious and her vital signs were stable, but she had obvious pain in her lower back and paralysis of her lower limbs. Chest and abdominal X-rays revealed T12 fracture dislocation. Which of the following statements is wrong in the first-line assessment and treatment?

Input: (A) Immediately perform a physical examination to check for anus tone. (B) Arrange surgical reduction of dislocation as soon as possible. (C) Neurogenic shock presents with hypotension and tachycardia. (D) Consider the use of methylprednisolone. (E) Arrange a spine computer tomography examination immediately.

Output: C


Instruction: Which of the following descriptions is correct about diaphragmatic injury?

Input: (A) Emergency surgery is usually not required unless blood pressure drops. (B) It is usually more common on the right side than on the left. (C) It is more common in puncture wounds of the chest and abdomen. (D) The main threat to vital signs is hemorrhagic shock. (E) For smaller diaphragmatic injuries, the diagnosis rate of CT scan is very high.

Output: C


Instruction: In recent years, Taiwan has successively held two large-scale events, the World Games and the Deaflympics. Which of the following statements about emergency medical care for mass gatherings is incorrect?

Input: (A) Definition: For the same purpose, the number of people gathered in a certain place exceeds 1,000. (B) The incidence of medical needs generated by sports gatherings is 0.12-17 / 1000 people. (C) The incidence of cardiac arrest at sports gatherings is 3-40 / 1000000 people. (D) Combines three major fields: emergency medicine, public health, and public safety. (E) Proper emergency medical planning is required.

Output: C


Instruction: Which of the following statements about our country's medical guidance system and medical guidance physicians is wrong?

Input: (A) Municipal and county (city) fire authorities should designate medical guidance physicians and establish a medical guidance system. (B) Responsible for the education, training, supervision, and assessment of emergency rescue technicians at all levels. (C) Establish quality indicators for rescue technicians at all levels and implement quality monitoring. (D) Approve the rescue record form of senior rescue technicians performing emergency rescue in accordance with the pre-established medical process. (E) The qualifications of medical supervisors are determined by the central fire department.

Output: E


Instruction: Regarding the composition and tasks of the Regional Emergency Medical Response Center under the Emergency Medical Rescue Act, which of the following statements is incorrect?

Input: (A) There are currently 6 Regional Emergency Response Centers in the country. (B) They can be entrusted to medical institutions to handle their operations. (C) When emergency hospitals transfer critically ill patients, they must assist in bed allocation and patient tracking. (D) They must regularly conduct annual major disaster emergency medical drills. (E) They must have a grasp of emergency medical information and resource status in the region.

Output: C


Instruction: Which of the following is not a common abnormal manifestation in patients with myxedema?

Input: (A) Hypernatremia and water retention. (B) Hypoventilation and hypoxia. (C) Hypothermia. (D) Bradycardia. (E) Confusion, even lethargy or coma.

Output: A


Instruction: Which of the following is incorrect about the treatment of jellyfish stings?

Input: (A) Do not use fresh water for flushing, as it will stimulate the release of toxins from the remaining stinging cells in the skin. (B) 5% acetic acid is the first choice for reducing the activity of stinging cells. (C) Tetanus vaccination is required. (D) Prophylactic antibiotic use is not recommended. (E) Even if there are no systemic symptoms, the patient still needs to be observed for 8 hours to avoid delayed reactions.

Output: E


Instruction: 25 A 65-year-old male presents to the emergency department with a punch to the right eye. Physical examination reveals that the right eye cannot look up and has diplopia. He is suspected of having an orbital blow out fracture. What other physical examination findings would you expect, excluding the following?

Input: (A) Abnormal sensation of the right anterior cheek. (B) Enophthalmos. (C) Subcutaneous edema around the orbit. (D) Subconjunctival hemorrhage. (E) Cerebrospinal fluid rhinorrhea.

Output: E


Instruction: A 65-year-old postmenopausal woman with no past systemic illness had a normal CBC on physical examination six months ago. In the past three days, she has gradually developed pale complexion and shortness of breath after exercise, but has no other discomfort. Her CBC is as follows: Hb 8.6 gm/dL, MCV 80 fL, white blood cell count 9950/mm³, normal classification, platelet 145000/mm³, which of the following tests is most helpful for diagnosis?

Input: (A) Urine test. (B) Liver function test. (C) Kidney function test. (D) Stool test. (E) Bone marrow test.

Output: D


Instruction: A 78-year-old female patient has suffered from diabetes for 40 years and has poor blood sugar control. She came to the emergency department complaining that she had a ruptured wound on her right foot for two weeks, and the redness and swelling of the affected area gradually expanded. The infectious disease physician's clinical diagnosis was limb-threatening cellulitis. Please ask: In addition to surgical treatment, which of the following intravenous antibiotics is the least appropriate?

Input: (A)Ampicillin-sulbactam. (B)Aztreonam + clindamycin. (C)Cefoxitin. (D)Extended-spectrum fluroquinolone. (E)Piperacillin-tazobactam.

Output: D


Instruction: A 32-year-old male complains of weakness in his limbs, clear consciousness, proximal weakness compared to distal weakness, abnormal eye movement, poor pupillary light reflex, and normal sensation and reflex in his limbs. Which of the following diagnoses is most appropriate?

Input: (A) Botulism. (B) Myasthemia gravis. (C) Acute intermittent porphyria. (D) Lead poisoning. (E) Guillain-Barré syndrome.

Output: B


Instruction: Which of the following is incorrect about Guillain-Barré syndrome(GBS)?

Input: (A) It is the most common acute systemic neuropathy. Patients usually have a history of viral infection, such as gastroenteritis. (B) It mainly affects the motor nerves, manifested as asymmetric limb weakness, usually affecting the lower limbs first and then the upper limbs. (C) The most obvious neurological examination result is the absence of deep tendon reflex. (D) Although patients may have some complaints of abnormal sensation, neurological examination shows that the sensory nerves are normal. (E) The occurrence of Guillain-Barré syndrome is related to acute campylobacter jejuni infection.

Output: B


Instruction: A 34-year-old female, who received gonadotropin treatment at an infertility clinic a week ago, gradually developed shortness of breath, abdominal pain combined with nausea and vomiting, and increased abdominal circumference and weight in recent days. On the day of consultation, her urine output decreased significantly. Which of the following statements is incorrect?

Input: (A) About a quarter of patients who use gonadotropin to stimulate ovulation will develop mild symptoms, and less than 2% will develop severe symptoms like the above. (B) Continuous blood oxygen monitoring and electrocardiogram monitoring are required. (C) A detailed abdominal examination, especially deep palpation and pelvic examination, is required to identify serious lesions at an early stage. (D) Laboratory tests include electrolytes, renal function, complete blood count (CBC), coagulation function, and blood preparation. (E) Serious complications include pleural or peritoneal effusion, renal failure, ovarian torsion or cyst rupture, and adult respiratory distress syndrome.

Output: C


Instruction: Which of the following statements is incorrect in the treatment of hemorrhagic shock in children?

Input: (A) Give 20 ml/kg of Ringer's lactate first. (B) If blood pressure is still unstable, Ringer's lactate can be given one or two times. (C) If blood pressure is still unstable, 20 ml/kg of packed RBC can be given. (D) When intravenous drip cannot be established, venous cutdown or intraosseous injection can be performed. (E) Urine volume and urine specific gravity can provide important information on whether fluid is sufficient during emergency treatment.

Output: C


Instruction: A 90 A year-old female was sent to the emergency room with fever. This patient has lived in a nursing home for a long time and has a history of dementia and diabetes. She has not been to the hospital in the past month. After your examination, you suspected that it was pneumonia. Which of the following statements about the pathogen of this patient's pneumonia is correct?

Input: (A) Mycoplasma pneumoniae and Legionella are common pathogens of pneumonia in these patients living in nursing homes. (B) Because these patients have less opportunities to go out and contact with people, they are not easily infected by influenza viruses. (C) If nursing home patients get pneumonia, the most common pathogen is Pseudomonas aeruginosa. (D) Giving influenza vaccines to these elderly people in nursing homes can achieve an 80% effectiveness in preventing postinfluenzal pneumonia. (E) The most common bacteria is Streptococcus pneumoniae, gram-negative bacilli and Haemophilius influenzae.

Output: E


Instruction: A 55-year-old male patient with long-term alcohol addiction was brought to the emergency room by his family. He complained of cough and fever for two weeks, weight loss and night sweats. Blood tests showed elevated white blood cell counts and inflammatory indexes. Chest X-ray showed a 5-centimeter hole with air-fluid level lesions in the left lower lung. Which of the following statements is correct?

Input: (A) Pulmonary abscesses are mainly caused by aerobic bacteria in immunocompetent patients, while they are mainly caused by anaerobic bacteria in immunocompromised patients. (B) In terms of treatment, the failure rate of antibiotic treatment alone is too high, and postural drainage or bronchoscopic drainage should be used to accelerate recovery. (C) Possible factors for failure of medical treatment include large cavities, thick cavitary walls, pustules, and blockage. (D) Chest X-ray is a good basis for tracking clinical progress. (E) About 50% of patients ultimately require surgical treatment.

Output: C


Instruction: Which of the following statements is incorrect about the treatment of hydrofluoric acid (HF)?

Input: (A) Calcium gluconate solution up to 33% can be used for local soaking until the pain is reduced. (B) Calcium gluconate solution or calcium chloride solution can be used for local injection at the exposed area. (C) Calcium gluconate solution can be used for continuous arterial infusion or local intravenous infusion. (D) If HF is ingested, milk, calcium solution, magnesium gastric emulsion, calcium tablets or magnesium gastric emulsion tablets can be given to bind toxic fluoride ions. (E) If there are systemic symptoms, the main treatment is to correct hypocalcemia, which can be supplemented with calcium gluconate or calcium chloride according to the free calcium value in the blood.

Output: B


Instruction: Which of the following statements about methemoglobinemia is incorrect?

Input: (A) There are many factors that can cause methemoglobinemia, such as congenital factors or certain drugs, such as nitrates, lidocaine, acetaminophen, etc. (B) The patient will have cyanosis. When the pulse oxymeter is used to measure the blood oxygen concentration, it can be found that the blood oxygen concentration is low. (C) When the patient's blood contains more than 10% hemoglobin, it will appear chocolate-brown. (D) The oxyhemoglobin dissociation curve of such patients will shift to the left. (E) When patients with severe G6PD deficiency use methylene blue to treat hemoglobinemia, it may cause hemolytic anemia. Patients and their families should be fully informed before use.

Output: B


Instruction: Two patients who were unconscious while cleaning the spa sink were taken to the emergency room. According to the EMT personnel, the scene was filled with the smell of rotten eggs. Which of the following statements about these two patients is incorrect?

Input: (A) Both patients may have been poisoned by hydrogen sulfide (H2S). (B) Rescuers are advised to carry self-contained breathing apparatus. (C) At the scene of the incident, if the patient is not breathing, give the patient mouth-to-mouth artificial respiration. (D) As an antidote, consider giving the patient amyl nitrite inhalation and intravenous sodium nitrite. (E) Hyperbaric oxygen therapy may be considered for the patient.

Output: C


Instruction: A 35-year-old woman, depressed after an argument over her husband's affair, swallowed 50 tablets of extra-strength Tylenol brought back from the United States. Three hours later, she was found by a friend and sent to the emergency room. After a blood test, the acetaminophen concentration in her blood was 350 µg/mL 4 hours later. She complained of no discomfort and asked to go home. Which of the following statements is correct?

Input: (A) After explaining in detail the precautions after returning home and informing the patient to return to the emergency department if she feels any discomfort, the patient can be allowed to go home. (B) After observing the patient for 6 hours, if the patient still does not feel any discomfort, the patient can be allowed to go home. (C) Arrange the patient to be hospitalized for observation, because the symptoms caused by long-acting drugs may be delayed. (D) Arrange the patient to be admitted to a psychiatric ward to prevent the patient from committing suicide again. (E) Start treatment with N-acetylcysteine and arrange for the patient to be hospitalized.

Output: E


Instruction: Which of the following statements about chain snake bites is correct?

Input: (A) The wound is usually not swollen, but numb. (B) Kidney failure may occur very early. (C) The venom may cause skin ulcers if it is sprayed on the skin. (D) If not treated promptly, respiratory failure may cause death. (E) If the patient has a positive skin test for anti-chain snake antibodies, anti-chain snake antibody treatment should not be used.

Output: B


Instruction: Which of the following statements about the treatment of swallowed foreign bodies is incorrect?

Input: (A) If a child swallows a button-type battery and it gets stuck in the esophagus, it must be removed as soon as possible. Otherwise, it may cause esophageal rupture even in less than 6 hours. (B) If a child swallows a button-type battery and it has passed through the esophagus and there are no symptoms, there is no urgency and weekly X-ray follow-up examinations are sufficient. (C) If cocaine in a condom package is swallowed and gets stuck in the esophagus, a gastroenterologist should be seen as soon as possible for endoscopic removal. (D) If the swallowed sharp object is greater than 5 cm in length and greater than 2 cm in width, the chance of it passing through the stomach is very low. (E) If a child swallows a coin and it gets stuck in the esophagus, consider using a Foley scissor within 24 hours. catheter removed.

Output: C


Instruction: Which of the following statements is correct regarding the use of a nasogastric tube to treat gastrointestinal bleeding?

Input: (A) Patients suspected of lower gastrointestinal bleeding do not need a nasogastric tube. (B) The placement of a nasogastric tube is likely to cause varicose vein rupture and bleeding in patients, and should be avoided as much as possible. (C) If bright red blood is discharged from the anus, the source of bleeding must be in the lower gastrointestinal tract. (D) Upper gastrointestinal bleeding cannot be ruled out even if the drainage of the nasogastric tube is normal. (E) In the case of upper gastrointestinal bleeding, the nasogastric tube should be flushed with ice water because evidence-based medicine shows that hypothermia can help stop bleeding.

Output: D


Instruction: A 35-year-old male patient with chronic alcoholism presented to the emergency department with upper abdominal pain. His temperature was 37.8℃ and his heart rate was 120. bpm, blood pressure 100/70 mmHg, white blood cell count 13000/mm³, segment 80%, band 5%, AST 60 U/L, lipase 1800 U/L. Which of the following treatments is most important for this patient at present?

Input: (A) Administration of first or second generation of cephalosporins. (B) Fluid resuscitation. (C) Intravenous injection of gabexate mesilate (protease inhibitor). (D) Intravenous or intramuscular injection of morphine analgesics (narcotics). (E) Nasogastric drainage (NG tube drainage).

Output: B


Instruction: A 5-year-old boy reported that he swallowed 5 A child was found with a plastic toy coin the size of a dollar. When the child was brought to the emergency room, his parents said they did not witness the incident. The child's breathing was normal and he had no chest or abdominal pain. However, the child was unable to swallow saliva. Neck soft tissue, CXR and KUB examinations showed no obvious foreign objects or abnormalities. Which of the following treatments is most appropriate?

Input: (A)Chest computer tomography. (B)Endoscopic removal. (C)Foley catheter removal. (D)Intravenous glucagon administration. (E)Sublingually nifedipine use.

Output: B


Instruction: Intussusception is a common abdominal emergency in children. Which of the following statements is incorrect?

Input: (A)When the disease occurs, the child will have sudden acute abdominal pain. (B) Currant jelly stool is a typical symptom. (C) Ultrasound may reveal a crescent sign. (D) Barium enema is one of the diagnostic methods. (E) It is most likely to occur in ileal intussusception.

Output: C


Instruction: A 4-day-old female infant was sent to the emergency room because of bloody stools and persistent abdominal distension. CT scan revealed pneumatosis intestinalis, suspected to be necrotizing enterocolitis. Which of the following statements is incorrect?

Input: (A) The most susceptible groups are premature infants and low-weight newborns. (B) Maternal cocaine use is a risk factor for necrotizing enteritis in full-term infants. (C) If diagnosed too late, it may lead to intestinal perforation and septic shock. (D) Laboratory diagnosis is not specific for necrotizing enteritis. (E) Regardless of whether there is intestinal perforation, patients with necrotizing enteritis require surgical treatment.

Output: E


Instruction: Which of the following statements about Boerhaave's syndrome is incorrect?

Input: (A) Epileptic seizures can cause. (B) It often invades the distal esophagus. (C) Men drinking alcohol is a risk factor. (D) It often leads to right-sided pleural effusion. (E) The pathogenesis is a transient high pressure in the esophagus, which leads to rupture of the entire esophagus.

Output: D


Instruction: Which of the following statements about the use of adenosine is incorrect?

Input: (A) It can be used to stabilize WPW syndrome with narrow QRS complex regular tachycardia. (B) It can be used to stabilize supraventricular (C) For unstable supraventricular pulse, adenosine can be given once. (D) For stable wide QRS complex regular pulse (wide QRS complex regular tachycardia), adenosine can be given. (E) For unstable wide QRS complex regular pulse, adenosine can be given.

Output: E


Instruction: Which of the following statements is correct about diagnostic tools used to assist in the diagnosis of pulmonary embolism?

Input: (A) The presence of S1Q3T3 on the electrocardiogram can confirm the diagnosis of pulmonary embolism. (B) A normal D-Dimer value can completely rule out pulmonary embolism. (C) In the absence of oxygen (room air), an arterial gas analysis PaO2>80mmHg can completely rule out pulmonary embolism. (D) Patient shock will affect the diagnostic rate of pulmonary embolism by CT. (E) Ventilation-perfusion lung scan can provide an accurate diagnosis and is a standard emergency examination for pulmonary embolism.

Output: D


Instruction: A 65-year-old man was taken to the hospital emergency room by a passerby because of chest tightness. In the emergency room, the patient complained of squeezing pain in the chin and left shoulder. He had been in good health in the past and had no history of heart-related diseases. The only medication he was currently taking was Levitra (Vardenafil). The electrocardiogram showed ST-segment elevation, and the blood test report showed elevated troponin-I and CK-MB, with normal D-Dimer values. The emergency physician initially diagnosed it as acute coronary syndrome. Which of the following statements is correct for the next treatment?

Input: (A) Immediately give nitroglycerin (0.4mg sublingual tablet), and the maximum dose can be given three times (five minutes apart each time). (B) Unless there are contraindications such as hypotension, morphine (4 mg, IVP) should be routinely given to relieve chest tightness. (C) Even if the patient is allergic to aspirin, clopidogrel (300 mg) should be used instead. (D) ACE inhibitors should not be used in patients with normal LVEF (left ventricular ejection fraction). (E) For such patients, oxygen should be given.

Output: C


Instruction: Which of the following statements is correct regarding the first aid and corresponding drug treatment pairing for drug-induced cardiovascular toxicity?

Input: (A) Polymorphic ventricular tachycardia (VT) caused by antihistamines is treated with procainamide. (B) Ventricular dysrhythmias (VD) caused by tricyclic antidepressants are treated with sodium bicarbonate. (C) Hypertensive crisis (HH) caused by amphetamine is treated with propranolol. (D) Acute digitalis intoxication causes hyperkalemia leading to QRS widening, which is treated with calcium chloride. (E) In the case of acetylcholinesterase-inhibiting agents bradycardia caused by isoproterenol treatment.

Output: B


Instruction: A 45-year-old female with a history of breast cancer and lung metastasis collapsed after going to the toilet at home and was unconscious for about 2 minutes. When she arrived at the emergency room, she had chest tightness, pale face, cold sweats, and low blood pressure. Her electrocardiogram was as follows. Which of the following statements is incorrect?

Input: (A) The patient often has pulsus paradoxus. (B) It is cardiogenic shock, and water should be restricted. Do not use large amounts of infusion. (C) Ultrasound cardiography is a good diagnostic tool. (D) Emergency pericardiocentesis should be performed when necessary. (E) X-ray examination can reveal an enlarged heart image.

Output: B


Instruction: Which of the following is an indication for fibrinolytic therapy for acute pulmonary embolism?

Input: (A) A mismatch between the perfusion scan and ventilation scan. (B) Severe disturbance of consciousness. (C) S1Q3T3 on the electrocardiogram. (D) Acute chest pain occurs within 3 hours. (E) Hemodynamic instability and severe hypoxia.

Output: E


Instruction: A 50-year-old male with acute ST-segment elevation myocardial infarction was in the emergency room waiting to be sent to the cardiac catheterization room for examination. An intravenous infusion route had been established. He suddenly became unconscious, had no breathing or pulse, and the electrocardiogram monitor showed the following figure. Which of the following immediate emergency measures is the most correct?

Input: (A) Immediately provide artificial respiration or positive pressure oxygen. (B) Immediately provide epinephrine 1mg. (C) Immediately provide defibrillator once (chest compressions must be performed during the preparation of the defibrillator). (D) Perform a full 2 minutes (or 5 30:2 cycles of CPR) before defibrillator. (E) Perform endotracheal intubation first.

Output: C


Instruction: A 30-year-old male complained of a history of depression and was sent to the emergency room due to an overdose of tricyclic antidepressants. When he arrived at the hospital, his temperature was 37℃, his respiratory rate was 26 times/min, his blood pressure was 84/60 mmHg, and he was unconscious (coma index E3M5V2). The electrocardiogram monitor showed the following figure. Which emergency treatment has the highest priority?

Input: (A)Amiodarone. (B)Lidocaine. (C)Biphasic synchronized cardioversion 200 joules. (D)Biphasic defibrillation 150-200 joules. (E)Sodium bicarbonate.

Output: D


Instruction: In the case of acute myocardial infarction complicated by severe pulmonary edema, which of the following is least likely?

Input: (A)ST elevation myocardial infarction in a large area of the anterior wall of the left ventricle. (B)Non-ST elevation myocardial infarction with diffuse ST wave depression in multiple coronary artery basins. (C) Myocardial infarction of the inferior wall of the left ventricle complicated by right ventricular infarction. (D) Myocardial infarction of the anterior wall of the left ventricle complicated by chordae tendinae or papillary muscle rupture. (E) Infarction of the anterior wall of the left ventricle and septum leading to septal rupture.

Output: C