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PAEA EMERGENCY MEDICINE EOR EXAM WITH VERIFIED QUESTIONS AND DETAILED ANSWERS|| ALREADY GRADED A+|| LATEST UPDATE 2026

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PAEA EMERGENCY MEDICINE EOR EXAM WITH VERIFIED QUESTIONS AND DETAILED ANSWERS|| ALREADY GRADED A+|| LATEST UPDATE 2026 what is the difference in pathophysiology between central and nephrogenic diabetes insipidus? both result in what s/sx's? - ANSWER--central: ADH (vasopressin) deficiency (d/t idiopathic MC, autoimmune to posterior pituitary, head trauma, brain/pituitary tumor, infection, sarcoid granuloma) -nephrogenic: renal insensitivity to ADH (d/t drugs: *lithium*, amphotericin B, demeclocycline, *hypercalcemia*, *hypokalemia*) -s/sx's: polyuria (up to 20L/d), polydipsia (to maintain H2O balance), nocturia, if severe/dec H2O intake may have hypernatremia, large amounts of dilute urine (200 & low specific gravity), hypotension, dehydration what is the tx for central and nephrogenic diabetes insipidus? if symptomatic type of fluid to give? - ANSWER--central tx: *desmopressin* (DDAVP) (synthetic ADH), carbemazepine (anticonvulsant that increases ADH), chlorpropamide -nephrogenic tx: Na+/protein restriction (*low solute diet*) decreases urine output, *HCTZ* (causes mild hypovolemia, promoting water retention), indomethacin -symptomatic tx: hypotonic fluid (oral pure water preferred, D5W, 1/2NS) what is released to increase blood Ca2+ (via inc bone resorption & inc GI/kidney absorption)? what is released to decrease blood Ca2+ (via inc bone mineralization & dec GI/kidney absorption)? - ANSWER--hypocalcemia triggers and inc in *PTH* (increases osteoclastic activity & renal absorption) & *vitD/calcitriol* (increases GI absorption) to inc blood Ca2+ -hypercalcemia triggers and inc in *calcitonin* (tone down Ca2+) to dec blood Ca2+ what is the most common type of hyperparathyroidism? MC cause? is Ca2+ inc or dec? clinical manifestations? tx? - ANSWER--primary hyperparathyroidism -MC (80%) parathyroid adenoma, (15% parathyroid hyperplasia/enlargement, others: *lithium*, *thiazides*, MEN I (pituitary tumor, pancreatic tumor), MEN IIa (pheochromocytoma, medullary thyroid cancer); (MEN = multiple endocrine neoplasia) -Ca2+ is *increased*, phosphate will be dec -s/sx: of hypercalcemia (kidney stones, bone pain, abdominal groans/constipation, psychic moans, dec DTRs), shortened QT interval on EKG -tx: parathyroidectomy what is the tx for acute bacterial endocarditis? subacute endocarditis? IVDA? prosthetic valve endocarditis? - ANSWER--acute/s. aureus: nafcillin + gentamicin -subacute/s. viridans: PCN OR ampicillin + gentamicin -IVDA/MRSA: vancomycin -prosthetic/staph epi: vancomycin + gentamicin + rifampin all ~4-6 weeks when is antibiotic endocarditis prophylaxis indicated? what is the abx of choice? - ANSWER-1. prosthetic valves/prosthetic materials in heart 2. h/o endocarditis 3. congenital heart dz 4. dental procedures (involving manipulation of gums, roots of teeth, oral mucosa perforation) 5. respiratory (surgery on respiratory mucosa, rigid bronchoscopy) 6. procedures involving infected skin/msk tissue tx w/ *ampicillin* 2g 30-60min before procedures or *clindamycin* 600mg if PCN allergic what are the causes of acute pericarditis? - ANSWER--idiopathic (likely post viral) -viral (coxsackie, hepB, CMV) -post MI -autoimmune (SLE, RA) what antiemetics can be given for gastroenteritis? what are some S/Es? - ANSWER--*blocks serotonin receptors peripherally & centrally* (ondansetron, granisetron, dolasetron) -*blocks CNS dopamine receptors D1/D2* (prochlorperazine/Compazine, promethazine/Phenergan, metoclopramide/Reglan) -S/Es: QT prolongation, constipation, drowsiness, extrapyramidal sx's (rigidity, bradykinesia, tremor, akathisia), parkinonianism

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PAEA EMERGENCY MEDICINE EOR EXAM
WITH VERIFIED QUESTIONS AND DETAILED
ANSWERS|| ALREADY GRADED A+|| LATEST
UPDATE 2026




what is the difference in pathophysiology between central and nephrogenic
diabetes insipidus? both result in what s/sx's? - ANSWER--central: ADH
(vasopressin) deficiency (d/t idiopathic MC, autoimmune to posterior pituitary,
head trauma, brain/pituitary tumor, infection, sarcoid granuloma)
-nephrogenic: renal insensitivity to ADH (d/t drugs: *lithium*, amphotericin B,
demeclocycline, *hypercalcemia*, *hypokalemia*)
-s/sx's: polyuria (up to 20L/d), polydipsia (to maintain H2O balance), nocturia,
if severe/dec H2O intake may have hypernatremia, large amounts of dilute urine
(<200 & low specific gravity), hypotension, dehydration


what is the tx for central and nephrogenic diabetes insipidus? if symptomatic
type of fluid to give? - ANSWER--central tx: *desmopressin* (DDAVP)
(synthetic ADH), carbemazepine (anticonvulsant that increases ADH),
chlorpropamide
-nephrogenic tx: Na+/protein restriction (*low solute diet*) decreases urine
output, *HCTZ* (causes mild hypovolemia, promoting water retention),
indomethacin
-symptomatic tx: hypotonic fluid (oral pure water preferred, D5W, 1/2NS)


what is released to increase blood Ca2+ (via inc bone resorption & inc
GI/kidney absorption)? what is released to decrease blood Ca2+ (via inc bone
mineralization & dec GI/kidney absorption)? - ANSWER--hypocalcemia
triggers and inc in *PTH* (increases osteoclastic activity & renal absorption) &
*vitD/calcitriol* (increases GI absorption) to inc blood Ca2+

,-hypercalcemia triggers and inc in *calcitonin* (tone down Ca2+) to dec blood
Ca2+


what is the most common type of hyperparathyroidism? MC cause? is Ca2+ inc
or dec? clinical manifestations? tx? - ANSWER--primary hyperparathyroidism
-MC (80%) parathyroid adenoma, (15% parathyroid hyperplasia/enlargement,
others: *lithium*, *thiazides*, MEN I (pituitary tumor, pancreatic tumor), MEN
IIa (pheochromocytoma, medullary thyroid cancer); (MEN = multiple endocrine
neoplasia)
-Ca2+ is *increased*, phosphate will be dec
-s/sx: of hypercalcemia (kidney stones, bone pain, abdominal
groans/constipation, psychic moans, dec DTRs), shortened QT interval on EKG
-tx: parathyroidectomy


what is the tx for acute bacterial endocarditis? subacute endocarditis? IVDA?
prosthetic valve endocarditis? - ANSWER--acute/s. aureus: nafcillin +
gentamicin
-subacute/s. viridans: PCN OR ampicillin + gentamicin
-IVDA/MRSA: vancomycin
-prosthetic/staph epi: vancomycin + gentamicin + rifampin


all ~4-6 weeks


when is antibiotic endocarditis prophylaxis indicated? what is the abx of
choice? - ANSWER-1. prosthetic valves/prosthetic materials in heart
2. h/o endocarditis
3. congenital heart dz
4. dental procedures (involving manipulation of gums, roots of teeth, oral
mucosa perforation)
5. respiratory (surgery on respiratory mucosa, rigid bronchoscopy)
6. procedures involving infected skin/msk tissue

,tx w/ *ampicillin* 2g 30-60min before procedures or *clindamycin* 600mg if
PCN allergic


what are the causes of acute pericarditis? - ANSWER--idiopathic (likely post-
viral)
-viral (coxsackie, hepB, CMV)
-post MI
-autoimmune (SLE, RA)
what antiemetics can be given for gastroenteritis? what are some S/Es? -
ANSWER--*blocks serotonin receptors peripherally & centrally* (ondansetron,
granisetron, dolasetron)
-*blocks CNS dopamine receptors D1/D2* (prochlorperazine/Compazine,
promethazine/Phenergan, metoclopramide/Reglan)
-S/Es: QT prolongation, constipation, drowsiness, extrapyramidal sx's (rigidity,
bradykinesia, tremor, akathisia), parkinonianism


which of the following is noninvasive vs invasive infectious gastroenteritis?
1. vomiting, watery, voluminous (involves small intestine), no fecal WBCs or
blood
2. high fever, + blood/fecal leukocytes, not as voluminous (involves large
intestine), mucus - ANSWER-1. noninvasive (enterotoxin) infectious
gastroenteritis
2. invasive infectious gastroenteritis


what are the causes of noninvasive vs invasive infectious diarrhea? - ANSWER-
-noninvasive: viral, s. aureus, b. cereus, v. cholera, enterotoxigenic e. coli
-invasive: enterhemorrhagic e. coli, shigella, salmonella, yersinia,
campylobacter

, what type of noninvasive infectious diarrhea (vomiting, voluminous, watery, -
fecal/blood leukocytes) is caused by eating contaminated dairy products,
mayonnaise, meats, eggs and is self-limiting? - ANSWER-s. aureus
-can tx w/ anti-motility agent like immodium, anti-inflammatory pepto bismol,
and antiemetic


what type of noninvasive infectious diarrhea (vomiting, voluminous, watery, -
fecal/blood leukocytes) is MC caused by contaminated *fried rice* and is self-
limiting? - ANSWER-bacillus cereus
-can tx w/ anti-motility agent like immodium, anti-inflammatory pepto bismol,
and antiemetic


Dx? noninvasive diarrhea, copious watery diarrhea, *"rice water stools"* grey,
w/o fecal odor/blood/pus, rapid dehydration, transmitted via contaminated food
(seafood) & water and usually occurs in outbreaks during poor sanitation &
overcrowding conditions in other countries; tx? - ANSWER-dx: vibrio cholerae
tx: fluid replacement is mainstay of tx, but if severe can give *tetracyclines*,
FQs or macrolides to shorten length of disease


what is the MC cause of traveler's diarrhea- a type of noninvasive infectious
diarrhea (vomiting, voluminous, watery, - fecal/blood leukocytes) from
unpeeled fruits and *unsanitary drinking water/ice*? tx? - ANSWER-
enterotoxigenic e. coli
tx: fluids, bismuth, if severe *FQ*, bactrim, azithromycin


what type of noninvasive infectious diarrhea (vomiting, voluminous, watery, -
fecal/blood leukocytes) is usually iatrogenic following a course of abx (esp
clindamycin) or chemotherapy and has very high leukocytosis, is aka
pseudomembranous colitis, and can result in bowel perf and toxic mega colon?
tx? - ANSWER-dx: clostridium difficile
tx: *po metronidazole* 1st line, *vancomycin* 2nd line unless severe dz vanc is
1st line

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