Emergency Medicine – MCCQE1 High-Yield Notes

Emergency Medicine in the MCCQE1 tests your ability to recognize and manage life-threatening conditions quickly. Questions focus on resuscitation, acute presentations, and triage decisions.

🔑 Key Topics for MCCQE1

• Basic Life Support (BLS): chest compressions 100-120/min, ratio 30:2
• ACLS: VF/VT → defibrillation, PEA/asystole → CPR + epinephrine
• Anaphylaxis: epinephrine IM (0.5mg thigh) first, then antihistamines and steroids
• Acute MI: aspirin + heparin + nitrates, urgent PCI if STEMI
• Stroke: CT head first (exclude hemorrhage), tPA if ischemic within 4.5 hours
• Status epilepticus: lorazepam → phenytoin/levetiracetam → intubation
• Hypertensive emergency: end-organ damage, IV labetalol or nicardipine
• DKA: fluids first → then insulin drip → correct potassium
• Hyperosmolar hyperglycemic state: very high glucose, no ketones, aggressive fluids
• Acute severe asthma: salbutamol + ipratropium, IV steroids, MgSO4 if severe
• Tension pneumothorax: tracheal deviation, absent breath sounds, needle decompression
• Cardiac tamponade: Beck's triad (hypotension, JVD, muffled heart sounds), pericardiocentesis
• Shock types: hypovolemic, distributive, cardiogenic, obstructive – fluids vs pressors
• Head trauma: GCS assessment, CT criteria (Canadian CT Head Rule)
• Burns: rule of nines, Parkland formula for fluid resuscitation

⚠️ High-Yield Clinical Pearls

• Anaphylaxis: Epinephrine is the ONLY life-saving drug – give it FIRST
• Tension PTX: Clinical diagnosis – do NOT wait for imaging, needle decompress NOW
• DKA: Correct potassium BEFORE starting insulin if K <3.5 mEq/L
• Status epilepticus: After 5 min of seizure = status – start treatment immediately
• Stroke: Time is brain – CT then tPA decision within 60 min of arrival
• Cardiac tamponade: Pulsus paradoxus >10mmHg – echo confirms

📊 Quick Reference Table

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