Night Shift in the Emergency Department Online Trivia | Sci / Tech

Quiz Answer Key and Fun Facts

1. Our first patient was assaulted by his loan shark. The doctor informs him that he has a fracture of his patella. What is the more common term for the patella?

Answer: Knee cap

The patella is commonly known as the kneecap. It is a roughly triangular shaped bone that covers the front portion of the knee joint. In addition to helping protect the joint, it also helps the quadricep (or thigh muscle) extend (or straighten out) the leg. Babies are not born with fully formed kneecaps.

They are born with a smaller kneecap made of cartilage that eventually turns into bone by around the age of five.

2. A mother brings in a crying baby at midnight. Mom says that her child has been crying all night long. After a thorough examination, the baby is diagnosed with acute pharyngitis. Mom freaks out because she doesn't know what that means. What does the term pharyngitis mean?

Answer: Sore throat

The pharynx is part of the respiratory and digestive system. It is the portion of the throat located behind the mouth and below the nasal cavity and above the esophagus and larynx (or voice box). The suffix "-itis" means inflammation, so pharyngitis is inflammation of the back of the throat.

It is usually caused by a virus, but may also be caused by a bacteria, streptococcus, when it is called "strep throat" and treated with antibiotics.

3. A man comes in after a late night bar fight. After his radiological studies (or X-rays) have been completed, the doctor tells him that he has an acute fracture of his orbit. What has he broken?

Answer: Eye socket

The orbit is not formed by just one bone, but is a cavity made at the junction of seven separate bones. This cavity supports and protects the eyeball and the associated structures, such as muscles, blood vessels and nerves. These injuries are usually due to blunt injuries to the face. One, often avoidable, way to fracture your orbit is for your face to hit the steering wheel or dashboard during a motor vehicle collision. Use of your seat belt, along with airbag deployment, can help prevent this particular injury.

4. Another man staggers in from the bar fight. After an examination and a chest X-ray, the physician informs the patient that he has a pneumothorax. He looks at you breathlessly and asks "What is that?". What do you tell him?

Answer: A collapsed lung

A pneumothorax results from the entry of air into the space between the outside of the lung and the inside of the chest wall. This area is usually a vacuum and that helps to keep your lungs expanded. Once air is allowed to enter, your lung "deflates".

This usually occurs from a penetrating chest wound, such as a stabbing, or a rib fracture. A pneumothorax can also spontaneously form under certain conditions such as advanced Chronic Obstructive Pulmonary Disease, also known as COPD.

5. Your next patient is someone that was in a motor vehicle collision. Luckily, his only injury is a fractured clavicle. What body part is that?

Answer: Collar bone

The clavicle lies horizontally above the first rib. Its purpose is to act as a strut to help support and stabilize the scapula (or shoulder blade) so the arm can have a wide range of motion. It also protects blood vessels and nerves that exit the chest on their way to the arm.

It is usually fractured when someone falls horizontally onto their shoulder, on an outstretched arm or from direct trauma.

6. One last person from the barroom brawl comes in. After X-rays, he is told that he has a fracture of one of his metacarpals. Where is his metacarpal?

Answer: Hand

Most people have ten metacarpals, five in each hand. They are the bones that connect the carpals (or wrist bones) to the phalanges (or fingers). There are similar bones in the feet that are called metatarsals. A common way to injure these bones is to hit something hard, such as a wall or someone's head.

A fracture of the fifth metacarpal (or the one in your small finger) is called a boxer's fracture. Even though it's called a boxer's fracture, people trained in boxing rarely get this injury.

This is an injury that is usually seen in someone that hasn't been trained in the proper way to throw a punch.

7. One rather sick looking older man comes in complaining about his skin being an odd yellow color. After a thorough examination and evaluation of his laboratory tests, he is diagnosed with hepatitis. Which organ should he be worried about?

Answer: Liver

Hepatitis is caused by inflammation of the liver. It can lead to jaundice, which is yellowing of the skin and eyes, due to the liver not filtering out toxins efficiently enough. It can be caused by a variety of things, such as viruses, certain autoimmune conditions, alcohol or drug abuse. Worldwide, the most common cause is viral hepatitis, followed by alcoholic hepatitis.

The prognosis for hepatitis depends on its cause.

8. A basketball player comes in complaining of pain since injuring himself in that night's game. He is eventually told that he has a strained a ligament that attaches to his lateral malleolus. What has he injured?

Answer: His ankle

He has sprained his ankle. A common way to sprain an ankle is to jump and land on the outside edge of your foot and "twist" it, or step in a hole and "twist" it. The lateral malleolus is the name of end of the fibula that is on the outside (or lateral) of the ankle. Three separate ligaments connect the foot to the lateral malleolus and these help to give the foot a wide range of motion.

The term "sprain" means a partial tear or disruption of a ligament.

9. Late into our shift a man comes, seemingly very drunk. He says that he has been drinking all night and now he hurts. After a physical examination and evaluation of his laboratory and radiologic studies, we tell him that he has acute alcoholic gastritis. Which body part has he harmed?

Answer: His stomach

"Gastro" refers to the stomach and "itis" means inflammation, so he has inflammation of the lining of his stomach caused by excessive alcohol ingestion. Gastritis can be caused by many things including some drugs, infections, alcohol, Crohn's disease, along with many other things.

It is a very common condition and it is usually benign and self limiting. Symptoms include nausea, vomiting, belching, bloating and pain in the upper central part of the abdomen.

10. The last patient is definitely the sickest one. A nurse comes over and hands the doctor a copy of his electrocardiograph (ECG or EKG). The physician goes in and tells the patient that he is having an acute myocardial infarction. What has he had that makes him so sick?

Answer: A heart attack

The EKG (or ECG) shows a tracing of the electrical activity in his heart. The myocardium (or heart muscle) has had an infarction, which is an interruption of the blood flow. The patient needs to have the blockage that is causing the infarction treated before the area of the heart becomes ischemic, meaning it dies to a lack of oxygen.

Source: Author Ctvega

This quiz was reviewed by FunTrivia editor rossian before going online.
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Night Shift in the Emergency Department Quiz

Crazy things happen during the night shift in the Emergency Department (ED). The ED physician will give you the diagnosis. See if you can translate the medical term into more commonly understood terms.

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