A 38 year-old male presented with mild and occasional SOB for the past

1.A 23 year-old male requested acupuncture for neck pain. Palpation of the neck muscles revealed a single, non-painful nodule on the left anterior side of the neck. There was no nodule on the right side. There was no lymphadenopathy in any other area. Which action would you take? 选项： A:timely (1 week) referral to primary care physician B:call 911 for emergency transport C:semi-urgent (next day) referral to primary care physician D:urgent (same hour) referral to primary care physician

2.A 30 year-old male requested acupuncture treatment for pain. Prior to the appointment he ate lunch and had a hot dog, potato chips, and a soda. During the interview he complained of his skin itching and feeling hot. He began developing red welts. He remembered having a similar episode last year after eating lobster that required him going to an ED. The patient then developed an itchy throat with his lips beginning to swell but did not have SOB. He did not have any medications to self-administer. His wife was asked to take him to the nearest ED. Which condition does the patient have? 选项： A:anaphylactic shock B:food poisoning C:urticaria D:COPD

3.A 1-year-old boy present to the emergency department with a barking cough and stridor. He is treated with dexamethasone and his respiratory symptoms improve. He has had multiple previous similar emergency department attendances requiring steroids. His weight is 21kg.Which is MOST likely to be an effective strategy in managing his weight? 选项： A: Ban steroid use B: Inform public health C: Refer to general outpatient clinic for detailed assessment D: Refer to respiratory E: Take a dietary history and give advice before discharge from the emergency department

4.You attend a trauma call in the emergency department. The patient is a 32-year-old male who has been stabbed in the left side of the chest, just below the fifth rib. You suspect that the patient has cardiac tamponade.Which of the following signs would be consistent with the diagnosis of cardiac tamponade?Select one answer only 选项： A: A 'globular' cardiac outline on chest X-ray (CXR) B: Charcofs triad C: Collapsed neck veins D: Hypertension E: Prominent heart sounds

5.A male patient is brought to the emergency department(ED) following ingestion of an unknown substance. He is found to have an elevated temperature, hot and flushed skin, dilated pupils, and tachycardia. Of the following, which would most likely cause these findings?选项： A:Propranolol ; B:Methylphenidate ; C:Prazosin ; D:Guanethidine ; E:Atropine

6.A 75-year-old heavy smoker of 40 cigarettes per day is admitted to the Emergency Department He has a past history of hypertension and atrial fibrillation. Over the past few months he has suffered a chronic cough and has lost approximately 2 stone (about 12 5 kg) in weight. He has been I increasingly drowsy over the past few days and his relatives were unable to rouse him this morning. On examination he has a GCS of 6 and you notice that he has been incontinent of urine and faeces.What diagnosis fits with this clinical picture? 选项： A: Cerebral meningioma B: Embolic stroke C: Glioblastoma multiforme D: Metastatic carcinoma with cerebral metastases E: Subarachnoid haemorrhage

7.A 2-year-old boy has been doing well despite his diagnosis of tetralogy of Fallot. He presented to an outside ER a few days ago with a complaint of an acute febrile illness for which he was started on a “pink antibiotic.” His mother reports that for the past 12 hours or so he has had a headache and is more lethargic than normal. On your examination he seems to have a severe headache, nystagmus眼球震颤, and ataxia运动失调. Which of the following would be the most appropriate first test to order?选项： A:Urine drug screen; B:Blood culture; C:Lumbar puncture; D:CT or MRI of the brain

8.A 19-year-old man with learning difficulties presents to the Emergency Department with sudden blurring of his vision in the left eye. He lives in a community house with other individuals with learning difficulties He has a past history of a deep vein thrombosis some 3 years ago, downward lens dislocation in the right eye and severe myopia in the left eye On examination he has a BMI of 19 kg/m2 and a blood pressure of 135/78 mmHg. You notice that he seems abnormally tall, particularly with respect to his arm and leg length, and he has a livedo-type appearance to his skin. He has hypotonia on neurological examination.Investigations:Which one of the following is the most likely diagnosis? 选项： A: Homocystinuria B: Ehlers-Danlos syndrome C:Marfan syndrome D: Maple syrup urine disease E: Fragile X syndrome

9.A．He has had a heart attack because of smoking.B．He has serious lung disease.C．He is c 选项：A．He has had a heart attack because of smoking.B．He has serious lung disease.C．He is coughing because of too much smoking.D．He will go to see a doctor about his coughing.

10.Which of the following time-frame is considered a semi-urgent referral? 选项： A:calling 911 B:making the referral within several days to two weeks C:making the referral within the same to several days D:making an immediate referral to an emergency room

11.______ a little more time to think, he might have acted much better. 选项：If he took|If he had taken|Has he taken|Should he take

12.______ a little more time to think, he might have acted much better. 选项：A、If he took B、If he had taken C、Has he taken D、Should he take

13.A 45 years old female patient complains of recurrent dizziness for 2 years which aggravated yesterday. She has a past history of hypertension for 3 years and she has been taking anti-hypertensives intermittently. Physical examination shows blood pressure is 160/100mmHg, heart rate is 76 beats/min, with a regular heart rhythm.The resident wants to know whether her her dizziness is associated with the patient's blood pressure.The best way to question the patient is 选项：A、“Did you measure your blood pressure when you are feeling dizzy?"B、" Is your blood pressure higher than normal when you are: feeling dizzy?"C、" Do you feel dizzy when your blood pressure is high?"D、"Is your blood pressure lower than normal when you are felling dizzy?"E、" You didn't take anti-hypertensives yesterday, did you?"

14. Bob knew deep in his heart that he had been living a criminal life and he had hoped that his friend Jimmy would have done much better.

15. Bob knew deep in his heart that he had been living a criminal life and he had hoped that his friend Jimmy would have done much better.

16. The man who had once talked too much about his work with his families finallySucceeded in his business because 选项： A: he stopped complaining of his misfortunes B: he stopped talking about what his family members were not really interested in C: he chose to keep silent and refused to talk to his mother and aunt D: he got a better position which offered a better salary

17.He would have finished his college education, but he__to quit and find a iob to support his family 选项： A:had had B:has C: had D: would have

18.A teenage boy came to the clinic with his parents because of a cold he got two weeks ago. He still has copious coughing with profuse phlegm. He also had a fever and chills, a headache, and chest congestion but no sweating. His tongue has a white coating and the pulse is slippery. What is the most likely diagnosis for this patient? 选项： A:Contraction of wind cold with phlegm congestion B:Phlegm heat invading the lung C:Chronic lung deficiency D:Lung deficiency caused by Kidney deficiency

19.He would have finished his college education, but he_to quit and find a job toSupport his family. 选项： A: had had B: has C: had D: would have

20. The man who had once talked too much about his work with his families finally succeeded in his Business because ____. 选项： A:he stopped complaining of his misfortunes B:he stopped talking about what his family members were not really interested in C:he chose to keep silent and refused to talk to his mother and aunt D:he got a better position which offered a better salary

21.The man who had once talked too much about his work with his families finally succeeded in his business because _ . 选项： A: he chose to keep silent and refused to talk to his mother and aunt B:he stopped complaining of his misfortunes C: he stopped talking about what his family members were not really interested in D: he got a better position which offered a better salary

22. The man who had once talked too much about his work with his families finally succeeded in his business because ____. 选项： A: he stopped complaining of his misfortunes B: he stopped talking about what his family members were not really interested in C: he chose to keep silent and refused to talk to his mother and aunt D: he got a better position which offered a better salary

23.Bob knew deep in his heart that he had been living a criminal life and he had hoped that his friend Jimmy would have done much better.（）选项： A:对 B:错

24.Bob knew deep in his heart that he had been living a criminal life and he had hoped that his friend Jim would have done much better. ( ) 选项： A:对 B:错