I know it's jarring to see something so unfamiliar pop up on a test, but I'll venture a guess and say that the point of the question was probably to see if you could apply what you know to a novel situation, not to see if you had memorized when and what IV cocaine is used for. E.g.
step 1-recall properties of cocaine (blocks reuptake of catecholamines and dopamine, vasoconstricts, blocks sodium channels and peripheral nerve conduction i.e. same mechanism as lidocaine)
step 2- apply what you know about cocaine to clinical situation at hand
step 3- ???
step 4- profit!
I had plenty of WTF questions too and I took my exam prior to the July 27th question pool change. My WTF questions were often like this; you have to take what you know and do the best you can with it to think through a weird situation you've never seen before. The WTF questions make you feel like you didn't do so well because you aren't 100% sure that you got all the answers right. All I can say is trust your practice tests.
As for other WTF questions, I too had weirdo public health/quality improvement questions...I had questions that seemed so vague and I was down to eliminating answer choices rather than knowing the diagnosis right off the bat in many instances. You feel like you're relying more on your intuition on step 2 and because of that, you feel less confident. This feeling is not unique to people who took the test after July 27th. Uworld and MTB/etc don't fully capture the content of what you actually see on test day; they never have and they never will.
