EM Board and Inservice Review

by Bob Stuntz

One of the things you will be seeing in the upcoming weeks and months is the addition of board/inservice exam review content.  I will be making some board review podcasts, and will also be posting some questions here on the blog.  My hope is for interaction, so feel free to answer questions, post questions, and interact.  

One disclaimer: all questions that I post on the blog are ones that I made up.  I will not be posting questions from any books, nor do these questions come directly from the Emergency Medicine Boards.  My goal is to emphasize what I found to be important points in my studying and review, as well as conceptual approaches to studying for the exam.  I will not be posting anything that is not free public knowledge about the exams already.  Do not expect insider information.  Since I am making these up, do not expect them to necessarily be board level quality.  Basically, I’m not doing anything against the rules!

First question:

A 65 year old make with a history of hypertension and a 50 pack year history of smoking presents s/p syncope and abdominal pain.  On exam, his HR is 110/min, BP 82/40, RR 16, and Pox 98% on RA.  You note abdominal tenderness in the midline, and a palpable pulsitile abdominal mass on exam.  What is your next step in the management of this patient?

A.  Arteriogram

B.  CT scan of the abdomen and pelvis with IV contrast

C.  MRI of the abdomen

D.  Point of care ultrasound of the abdomen