Emergency Medicine Q&A , Third Edition . Edited by Joseph Lex, MD . Boston, MA : McGraw-Hill Companies , 2009 ; 347 pp; $64.95 (softcover ).

In this third edition of Emergency Medicine Q&A: Pearls of Wisdom, the reader will find more than 800 multiple-choice questions. Each question is followed with the correct answer and an explanation of the relevant material. This text is intended to prepare residents and practicing emergency physicians for certification, recertification, or the annual in-training exam. The majority of questions are formatted similarly to those on the emergency medicine written board exam.

This review text is divided into 21 chapters covering all areas of the core content of emergency medicine. The format allows the reader to identify areas of weakness for further study, reinforces comprehensive understanding in areas of competence, and allows the student to assess his or her clinical judgment. This edition added a chapter on the administrative aspects of emergency medicine, prehospital care, and ethics, as well as an expanded chapter on medical imaging with high-quality black and white reproductions of chest radiographs, computed tomography scans, and ultrasound images.

In general, the questions are well written, the explanations are well organized, and they adequately clarify the clinical material supporting the subject matter. There are, however, a small number of questions in several of the sections that are not relevant to the practice of emergency medicine, geared more to the underlying science. These questions are not representative of what is currently on the in-training exam or the board exam. Most of the sections, such as systemic infections, abdominal and gastrointestinal, neurology, thoracic and respiratory, and pediatrics, are truly excellent with challenging and relevant questions and very-well-written answer explanations. The imaging chapter integrated the visual images into the questions in a very informative way, and the quality of the images is surprisingly good.

This study text meets its objective in focusing on the core content of emergency medicine and in testing the reader’s comprehension and judgment across the continuum of emergency care. It could be improved by removing questions that are not clinically focused or not in standard board format. In addition, expanding the immunologic section and including a chapter on special populations, such as transplant recipients and their potential complications, would enhance its value substantially. There are no rhythm or electrocardiogram interpretations in this text, and incorporation of this media would further increase its value to the student preparing for the boards or recertification, as there are most certainly rhythm interpretations on those exams. Overall, with the abundance of questions and concentration of information in the answer explanations, Emergency Medicine Q&A provides a rapid and effective review and is an excellent choice for refreshing knowledge for residents in training and physicians in practice.