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8/6 CorePendium Board Review

Authored by Ashley Mogul Wyman

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8/6 CorePendium Board Review
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14 questions

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1.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

A 65-year-old man presents with hematemesis and hypotension. He is pale and diaphoretic. What is the most appropriate initial step in management?

Start proton pump inhibitor

Perform nasogastric lavage

Insert a large-bore nasogastric tube

Initiate two large-bore IVs and begin resuscitation

2.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Which of the following features most strongly suggests an upper GI source of bleeding?

Bright red blood per rectum

Hematochezia with normal BUN

Melena with elevated BUN:Cr ratio

Abdominal cramping and tenesmus

3.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

A 58-year-old male with cirrhosis presents with hematemesis and altered mental status. BP is 80/60 mmHg. What is the next best treatment step?

Immediate endoscopy

Initiate antibiotics, octreotide, and fluid resuscitation

Place a Sengstaken-Blakemore tube

Administer NSAIDs for portal hypertension

4.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

A 72-year-old woman with known diverticulosis presents with painless bright red blood per rectum. Her vitals are normal. What is the most appropriate next step?

Emergent colonoscopy

CT angiography

Rectal exam and supportive care with observation

Surgical consultation for urgent colectomy

5.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Which of the following interventions is indicated prior to endoscopy in an unstable patient with upper GI bleeding?

Broad-spectrum antibiotics only

Anticoagulation reversal if applicable

Nasogastric lavage to clear the stomach

Platelet transfusion regardless of count

6.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

A 45-year-old man presents with rectal pain and a tender perianal mass. On exam, he has a thrombosed external hemorrhoid. What is the most appropriate initial management?

Emergent surgical referral

Rubber band ligation in the ED

Warm sitz baths and topical analgesia

Excision with elliptical incision if within 72 hours of onset

7.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Which of the following is most characteristic of internal hemorrhoids?

Sharp pain with defecation

Visible perianal mass

Painless rectal bleeding during bowel movements

Foul-smelling discharge from the rectum

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