1
MCGRAW-HILL EMERGENCY MEDICINE EXAM REVIEW
(TINTINALLI'S) EXAM LATEST UPDATE -2025/2026- 100+
QUESTIONS AND VERIFIED ANSWERS ALL THE BEST
Which of the following is the BEST answer regarding medication for back pain and
sciatica?
A
Cyclobenzaprine (Flexeril) is an appropriate long-term medication for chronic back
pain.
B
NSAIDs are an appropriate long-term treatment for chronic low back pain in
patients at low risk of side effects.
C
Opioids are appropriate long-term agents to use for chronic back pain.
D
, 2
Steroids are an effective and long-lasting treatment for acute sciatica.
E
Tricyclic antidepressants are NOT appropriate long-term medications for use in
chronic back pain.
The correct answer is E. Paralysis
Explanation:
Paralysis and anesthesia are late findings of ischemic injury that portend loss of
limb viability. An adequate collateral blood supply may mask signs of ischemia in a
severely diseased artery. Pain can be the sole and earliest symptom of ischemia in
a patient with underlying peripheral vascular disease. Peripheral nerves and
muscles are very sensitive to ischemia, which causes early findings of hypesthesia,
hyperesthesia, and muscle weakness. Skin changes associated with complete
arterial obstruction include pallor, cyanosis, petechiae or blisters, and decreased
temperature. Ultimately, skin and fat necrosis ensue.
Cardiovascular Disorders
The correct answer is D. Acute myocardial infarction (AMI)
Explanation:
, 3
Cardiogenic shock is mostly commonly due to extensive MI with suppressed
myocardial contractility. Pump failure is the underlying factor in most causes of
cardiogenic shock (Table 54-2). Hypoperfusion, with or without hypotension, is
the unifying feature of cardiogenic shock, regardless of etiology. During an AMI,
several mechanical complications can precipitate cardiogenic shock, including
acute myocardial regurgitation due to papillary muscle rupture, ventricular septal
defect (VSD), and free-wall rupture. Mechanical complications cause one-fourth of
the cardiogenic shock following AMI. Right ventricular infarction can also cause
cardiogenic shock due to loss of preload. Cardiac contractility can also be severely
depressed due to sepsis, myocarditis, myocardial contusion, and cardiomyopathy.
Mechanical obstruction to forward blood flow can also lead to cardiogenic shock,
including aortic stenosis, HCM, mitral stenosis, left atrial myxoma, and pericardial
tamponade. Regurgitation of LV output due to chordal rupture or aortic
insufficiency can cause profound cardiogenic shock.
85% of users answered correctly.
What is the MOST common cause of cardiogenic shock?
A
Acute aortic insufficiency
B
Aortic stenosis
, 4
C
Hypertrophic cardiomyopathy
D
Acute myocardial infarction (AMI)
E
Pericardial tamponade
The correct answer is A. Chronic pain is more common in elderly patients.
Explanation:
Chronic pain is more common in elderly patients and the most common site of
chronic pain is the back. Complete pain relief is an unrealistic goal for chronic pain
patients who present to the emergency department. Chronic pain patients who
present to the emergency department may be best helped by referral to a pain
clinic or specialists; hospital admission is seldom indicated.
Which is TRUE about chronic pain?
MCGRAW-HILL EMERGENCY MEDICINE EXAM REVIEW
(TINTINALLI'S) EXAM LATEST UPDATE -2025/2026- 100+
QUESTIONS AND VERIFIED ANSWERS ALL THE BEST
Which of the following is the BEST answer regarding medication for back pain and
sciatica?
A
Cyclobenzaprine (Flexeril) is an appropriate long-term medication for chronic back
pain.
B
NSAIDs are an appropriate long-term treatment for chronic low back pain in
patients at low risk of side effects.
C
Opioids are appropriate long-term agents to use for chronic back pain.
D
, 2
Steroids are an effective and long-lasting treatment for acute sciatica.
E
Tricyclic antidepressants are NOT appropriate long-term medications for use in
chronic back pain.
The correct answer is E. Paralysis
Explanation:
Paralysis and anesthesia are late findings of ischemic injury that portend loss of
limb viability. An adequate collateral blood supply may mask signs of ischemia in a
severely diseased artery. Pain can be the sole and earliest symptom of ischemia in
a patient with underlying peripheral vascular disease. Peripheral nerves and
muscles are very sensitive to ischemia, which causes early findings of hypesthesia,
hyperesthesia, and muscle weakness. Skin changes associated with complete
arterial obstruction include pallor, cyanosis, petechiae or blisters, and decreased
temperature. Ultimately, skin and fat necrosis ensue.
Cardiovascular Disorders
The correct answer is D. Acute myocardial infarction (AMI)
Explanation:
, 3
Cardiogenic shock is mostly commonly due to extensive MI with suppressed
myocardial contractility. Pump failure is the underlying factor in most causes of
cardiogenic shock (Table 54-2). Hypoperfusion, with or without hypotension, is
the unifying feature of cardiogenic shock, regardless of etiology. During an AMI,
several mechanical complications can precipitate cardiogenic shock, including
acute myocardial regurgitation due to papillary muscle rupture, ventricular septal
defect (VSD), and free-wall rupture. Mechanical complications cause one-fourth of
the cardiogenic shock following AMI. Right ventricular infarction can also cause
cardiogenic shock due to loss of preload. Cardiac contractility can also be severely
depressed due to sepsis, myocarditis, myocardial contusion, and cardiomyopathy.
Mechanical obstruction to forward blood flow can also lead to cardiogenic shock,
including aortic stenosis, HCM, mitral stenosis, left atrial myxoma, and pericardial
tamponade. Regurgitation of LV output due to chordal rupture or aortic
insufficiency can cause profound cardiogenic shock.
85% of users answered correctly.
What is the MOST common cause of cardiogenic shock?
A
Acute aortic insufficiency
B
Aortic stenosis
, 4
C
Hypertrophic cardiomyopathy
D
Acute myocardial infarction (AMI)
E
Pericardial tamponade
The correct answer is A. Chronic pain is more common in elderly patients.
Explanation:
Chronic pain is more common in elderly patients and the most common site of
chronic pain is the back. Complete pain relief is an unrealistic goal for chronic pain
patients who present to the emergency department. Chronic pain patients who
present to the emergency department may be best helped by referral to a pain
clinic or specialists; hospital admission is seldom indicated.
Which is TRUE about chronic pain?
