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Test your basic knowledge |
Emergency Medicine
Start Test
Study First
Subjects
:
health-sciences
,
emergency-medicine
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Inflammation of the pericardial sac with or without effusion - S/S: sharp - pleuritic chest pain that's worse when laying down - pericardial friction rub on exam - ST elevations in ALL leads!!! - depressed PR intervals
Tx of CHF
Pericarditis
Genital Herpes
LCA
2. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
EKG changes
Define Biliary colic
Breathing
Cardiac Enzymes
3. HEAD TILT-CHIN LIFT: assess if airway is obstructed vs. open - look for foreign body - vomit - blood. - JAW THRUST - if C-spine injury suspected - 30 compressions for every 2 breaths - Give one breath every 5-6 sections (don't over-ventilate the pat
Acute Coronary syndrome
How to assess Airway
Pancreatitis work up
Endocarditis
4. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
Ectopic Pregnancy
Divertriculitis
RCA
5. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Common risk factors for UGIB
Ovarian Torsion
RCA
Miscarriage
6. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
What is a large bore IV?
Appendicitis work up
Incarcerated vs strangulated hernias
Where to check pulses
7. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Pancreatitis work up
When to do a pelvic exam
Tachycardia
What should be done after CDAB's
8. Sigmoid - volvulus: High risk patients: chronic constipation - elderly and debilitated patients - Dx: plain film - Tx: decompress with rectal tube - Cecal volvulus - see congenital hypermobile cecum. also dx with plain films
Volvulus
DUKE criteria for endocarditis
Gonorrhea
Kidney Stones
9. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
CHF
How to assess Airway
When are Beta Blockers contraindicated
Incidence of AMI
10. Gallbladder inflammation - often from prolonged obstruction of stones - Pain more severe than biliary coli - assoc w/ fever and lasts 6+ hours - Common bacteria: gram - - strep - anaerobes
Viral Gastroenteritis
Define Acute Cholecystitis
Chlamydia
How to monitor CDAB
11. Emergency Medical Treatment and Active Labor Act - hospitals are obligated to screen/treat a patient in the ER regardless of insurance - if a emergency medical condition exists - they must stabilize the patient before transferring or d/c the patient
Volvulus
Define Biliary colic
EMTALA
Syphillis
12. Stable - NOT ruptured - vitals stable - no drop in H/H - no pain or tenderness Tx - with Methotrexate per OB GYN - inhibits folate so cells stop multiplying (used in RA and cancers) Don't use Methotrexate if fetal HR identified - Unstable - RUPTURED
Divertriculitis
Tachycardia
Stable vs. Unstable Ectopic Pregnancy
Cardiac Enzymes
13. Shock to electrically terminate abnormal heart rate and restart. - The earlier a fibrillating heart is defibrillated - the more successful (survival drops by 10% with each minute)
EKG changes
Genital Herpes
Defibrillation
DUKE criteria for endocarditis
14. MONA - morphine - oxygen - nitroglycerin (sublingual or IV) -Aspirin 325 mg (consider Integrilin in high risk patients) - Beta Blocker (metoprolol) - decrease streght of heart contractility within first hour - Cardiology cx --> PCI vs surgery prn? -
Missed Abortion
Placenta Previa
Posterior
Tx of Unstable Angina
15. Major criteria (2 each) - Positive blood cultures - Positive echo - Mass or abscess pressent Minor criteria - fevers - IVDU - roth spot (retinal hemorrhage) - Janeway lesions (nails) - Ostlers nodes (painful raised lesions on hands and feet)
Pancreatitis work up
DUKE criteria for endocarditis
Causes of 3rd trimester bleeding
EMTALA
16. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Defibrillation
Types of Infectious diarrhea Yersinia
Types of GI bleeds
Syphillis
17. Bilateral carotid and femoral pulses = most reliable - No pulse - start CPR immediately (2 minutes fast and hard and then swhich out)- Never stop doing CPR until pulse is present (CPR while defibrillator is charging - stop for electric discharge - an
LBO - Large bowel obstruction
How to assess Airway
Where to check pulses
Volvulus
18. Main cause - hernias and adhesions. Other causes: CA - IBD - bezoar - gallstones - intussusception - Ascaris worm if travel - - Diagnostic Tests = KUB --> look or air/ fluid - levels and dilated loops of bowel - also CT scan Labs: CBC - chem 7 - LF
SBO
Tx of CHF
Stable vs. Unstable Ectopic Pregnancy
Miscarriage
19. O2 and monitor sats - 2 large bore IV's (min 18G) - w/ Normal saline orLR -Blood transfusion prn - give PRBC - 1 unit of PRBC raises Hcrt 3 points - goal is HCRT > 30 - Hold coumadin if INR 5 or less OR reverse with Vit K or Free Frozen plasma if INR
Define Acute Cholecystitis
RCA
ED Tx of GIB
Ectopic Pregnancy
20. Def: Defect in the intimal layer of the aorta allows for blood to enter space between vascular layers - Risk actors: age - HTN - Connective tissue dz (marphans) - bicuspid aortic valve - coarctation of the aorta - inflam dz of aorta - atherosclerosi
How to assess Airway
Aortic Dissection definition - risks and S/S
When are Beta Blockers contraindicated
ED workup of kidney stones
21. Pay attention to resp rate - breathing pattern (normal vs. agonic breaths) - O2 sats - goal is > 94% - Chest rise/tidal volume - Waveform Capnography: measures CO2 input and output. Best measure for assessing ventilation - Bag-valve-mask helps patie
UTI
Hypertensive Emergency
Breathing
When is Rho GAM used
22. Stable - predictible pattern of chest pain w/ exertion or stress. Relieved by rest or Nitro. Lasts 15 sec to 15 min UNSTABLE - any change in character or time of the angina - ANGINA AT REST - NEW ONSET - ANGINA MORE FREQUENT OR SEVERE. - Unstable a
Placenta Previa
Miscarriage
Emergency Severity Index
Stable vs unstable angina`
23. At presentation: Age > 55 - WBC > 16 K - Glucose > 200 - LDH > 350 - AST > 250 At 48 hours - fall in HCT > 10 - increase in BUN > 5 - Ca < 8 - PaO2 < 60 - fluid deficit > 6 L
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24. Leads I - aVL - V4-V6 - Left circumflex artery
Syphillis
Lateral Leads
Volvulus
Chlamydia
25. IVF - fill the tank - CBC - chem 7 - LFT's - Lipase - UA - HCG for females - surgery cx - Abd CT scan for adults - ultrasound for kids or to r/o ovarian pathology in females - NPO - Pain control - Pre op Antibiotics (Levo - Flagyl or Unasyn)
Placental Abruption
Ascending Cholangitis
Appendicitis work up
Ectopic Pregnancy
26. V1-V2 Right Posterior Descending Artery
Posterior
Inferior leads
Tx of Unstable Angina
Ovarian Torsion
27. Active internal bleeding - hx hemorrhagic stroke/TIA in the past year - Intracranial tumor - AV malformation or aneurysm - suspected aortic dissection or tamponade - Severe bleeding disorder - Head trauma - Intracranial procedure
Genital Herpes
Contraindications for thrombolytics
Incidence of AMI
Triage
28. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Defibrillation
Volvulus
Kidney Stones
29. All cardiac arrest patients get 100% O2 - Room air= 21% - Nasal cannula O2 - raises FiO2 by 2-3% per liter. Normally give 1-6 Liters/minute - Non-rebreather mask --> you are receiving 100% O2
When are Beta Blockers contraindicated
Supplemental O2
LCA
Initial steps in stabilizing a patient
30. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Ectopic Pregnancy
Common risk factors for LGIB
Other major arteries
31. Categorize based on severity: 1 to 5 1 - most severe: cyanotic/not breathing - unreseponsive or not talking 2 - MI (life threatening but talking) 3- appendicitis/ abdomino pelvic pain 4- ankle swelling - broken leg 5- suture removal Things you ca
Emergency Severity Index
Gonorrhea
LCA
Symptoms of Ruptured ovarian cysts
32. Testis twists on a spermatic cord - restore blood flow in 6 hours or may have infertility - common at puberty and in 1 year olds - High risk - Bell Clapper Deformity (tunica vaginalis isterts high on the spermatic cord) - horizontal lie spermatic cor
Testicular Torsion
CHF
Missed Abortion
Incarcerated vs strangulated hernias
33. U GIB - ** DARK STOOLS - above the ligament of Treitz: Esophageal varices - Dieulafoy lesion - PUD - Mallory Weiss Tear - LGIB: ** BRight red blood - below lig of Treitz AVM (Atrio-venous malformation) -Divertriculitis - Meckel's divertriculum - colo
Stable vs. Unstable Ectopic Pregnancy
Ectopic Pregnancy
Types of GI bleeds
Contraindications for thrombolytics
34. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
How to assess Airway
Define Acute Cholecystitis
Incidence of AMI
Causes of 3rd trimester bleeding
35. Abnormal dilatation of the arterial wall - most common in abdominal area below renal arteries - risk factors; atherosclerosis - age - HTN - smoking - connective tissue dz - fam hx - hyperlipidemia - DM - S/S : often ASYMPTOMATIC - dull abd or back pa
Types of Infectious diarrhea - Salmonella
Abdominal Aortic Aneurysm
Types of Infectious diarrhea Campylobacter
What to do with weak/thready pulses
36. Infection of endocardium and/or heart valves due to Strep bacteria (viridans or aureus) and HACEK species - Risk factors: IVDU - structural heart abomality - prosthetic valve - rheumatic heart dz - HIV Tx: IV antibioticx x 4 weeks
Endocarditis
Urosepsis
Types of GI bleeds
Symptoms of Ruptured ovarian cysts
37. No bleeding - no fetal cardiac activity - uterus small - os closed - retained fetal tissue - Tx: D and C - Can have sepsis due to retained tissue/ fetus. Treat with IV abx (ampicillin and gentamycin) - Can give Misoprostol and cytotec (to dilate cerv
LCA
CHF
Missed Abortion
Initial steps in stabilizing a patient
38. Same as Early miscarriage - os open - bleeding - but some POC's (prod of conception) expelled. TX: D & C Complete AB: same as miscariage - but OS closed and all POC's expelled
Additional cardiac Tests
Cardiac Tamponade
Ascending Cholangitis
Incomplete abortion
39. Old age - chronic anticoagulation - divertriculosis
CHF
When is Rho GAM used
Initial steps in stabilizing a patient
Common risk factors for LGIB
40. Look for ST elevation in at least 2 contiguous lead (at least 1mm) - may see a new LBBB - Reciprocal changes - T wave inversion (end of the infarct or old) - Q waves (old infarct)
Pain scale for infants
Posterior
EKG changes
Defibrillation
41. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
Types of GI bleeds
STEMI vs Nstemi
Acute Arterial occlusion - to lower extremities
42. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Pancreatitis work up
Other major arteries
Acute Mesenteric Ishemia
Genital Herpes
43. Risk Factors: PID - Mirena IUD - tubal surgery - pelvic surgery - endometriosis - IVF -DES exposure S/S - R or L adnexal tenderness - R shoulder pain could be referred pain from intraabdominal hemorrhage (gallbladder - liver also) - Workup -CBC - C
EKG changes
Ectopic Pregnancy
Symptoms of Ruptured ovarian cysts
How to assess Airway
44. Check Vital Signs
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45. Common STI- S/S: skin pustules - fever - monarticular septic arthritis. - may be asymptomatic in females - or cervicitis - PID Males: epididimytis - urethritis - prostatitis Dx: cervical or urethral culture swab Tx: Ceftriaxone IM x 1or Cefixime 4
Incidence of AMI
Ascending Cholangitis
EMTALA
Gonorrhea
46. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Types of Infectious diarrhea Campylobacter
Miscarriage
EKG changes
47. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Acute Mesenteric Ishemia
Early miscarriage (20 weeks)
What to do with weak/thready pulses
Anteroseptal leads and Anterior
48. Prolonged/ more severe angina that doens't resolve with rest - 50% triggered by event: stress - exercise - surgery - illness - More common in early am - substernal pain elephant in chest - crushing - heavy +/- radiation to left arm - jaw - neck - may
Defibrillation
ED workup of kidney stones
Cardiac Tamponade
Incidence of AMI
49. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Types of GI bleeds
When are Beta Blockers contraindicated
Types of Infectious diarrhea E coli
Common Presentation of GIB
50. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Emergency Severity Index
Anteroseptal leads and Anterior
STEMI vs Nstemi
How to assess Airway