A 12-year-old boy cuts his hand on a soda can. He has a 5-cm laceration on the palmar aspect of his hand that will require suturing. The emergency department physician injects 1% lidocaine into the wound after careful cleansing with Betadine. The mechanism of action of lidocaine blocks which of the following modalities?

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Question 1 of 5

A 12-year-old boy cuts his hand on a soda can. He has a 5-cm laceration on the palmar aspect of his hand that will require suturing. The emergency department physician injects 1% lidocaine into the wound after careful cleansing with Betadine. The mechanism of action of lidocaine blocks which of the following modalities?

Correct Answer: B

Rationale: Lidocaine blocks sodium channels in peripheral nerves, inhibiting nerve conduction and thus peripheral nervous activity, providing local anesthesia.

Question 2 of 5

A 23-year-old G1P0 woman at 34 weeks gestation presents to the labor and delivery floor with contractions. The contractions are intense and occurring regularly every 3 min. The physician wants to slow down the contractions and try to delay labor until betamethasone can be given. What medication would be most appropriate?

Correct Answer: D

Rationale: Ritodrine, a β2-agonist, is a tocolytic that relaxes uterine smooth muscle, slowing contractions to delay preterm labor, allowing time for betamethasone to mature fetal lungs.

Question 3 of 5

The pain of a 57-year-old man with metastatic colorectal cancer to liver, bone, and brain is an inpatient on the oncology service. He is managed with a morphine pump. However, he has become tolerant to morphine. Which of the following might be indicated to ameliorate his pain?

Correct Answer: C

Rationale: Fentanyl, a potent opioid, is often used in morphine-tolerant cancer patients via transdermal or IV routes, providing strong analgesia for severe pain.

Question 4 of 5

A 67-year-old woman presents to the emergency department after seizure-like activity. This is her first seizure and a CT scan of her head is performed. The CT scan shows numerous calcified and uncalcified cysts throughout her brain. Her husband does report that they went to a cookout that had a pig roast. What is the most appropriate treatment?

Correct Answer: D

Rationale: Praziquantel treats neurocysticercosis (Taenia solium from undercooked pork), causing cyst death, often with steroids to manage inflammation from dying larvae.

Question 5 of 5

A 32-year-old G2P1001 woman at 36 weeks gestation presents to the emergency room with a high fever. The fever started 2 days ago and has progressively worsened. It has been associated with chills, nausea, vomiting, and full body aches. The resident suggests starting trimethoprim-sulfamethoxazole as part of the empiric coverage of her infection until blood cultures return. What side effect would be a contraindication to starting trimethoprim-sulfamethoxazole in a pregnant woman?

Correct Answer: D

Rationale: Trimethoprim-sulfamethoxazole in late pregnancy risks kernicterus in the fetus by displacing bilirubin from albumin, contraindicated near term.

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