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Test your basic knowledge |
Emergency Medicine
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Study First
Subjects
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health-sciences
,
emergency-medicine
Instructions:
Answer 50 questions in 15 minutes.
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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. ABC's - IV - O2 - cardiac monitor - Diuretics - Lasix - Lasix naive patients start at 20 mg IV - chronic users start at 40 mg IV - Morphine - Nitro if pain - Pressors prn
Tx of CHF
Posterior
ED workup of kidney stones
Triage
2. Charcot's Triad - Fever - Jaundice - RUQ pain - bacteria enters the biliary tract thru Sphincter of Oddi - Increase risk after sphincterotomy - cholecochal surgery or biliary stent Dx: with ERCP - endoscopic retrograde cholangiopancreatography
Pancreatitis work up
Ascending Cholangitis
Initial steps in stabilizing a patient
ED work up for cholecystitis
3. 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
Ovarian Cysts
Aortic Dissection definition - risks and S/S
Pericarditis
Tachycardia
4. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Endocarditis
Placenta Previa
Types of Infectious diarrhea Shigella
The vital signs
5. 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
Emergency Severity Index
Ranson's criteria
Gonorrhea
Types of Infectious diarrhea Shigella
6. leading caUse of death inUS - Includes angina (stable and unstable) and MI (STEMI vs NSTEMI) - risk factors: HTN - Hyperlipidemia - smoking - DM - fam hx under age 55 - advanced age - males and postmenopausal females - Patho: atherosclerosis of arter
Contraindications for thrombolytics
Acute Coronary syndrome
Additional cardiac Tests
Hypertensive Emergency
7. Most due to E coli - Lower UTI - bladder and /or urethra - Upper UTI: bladder - urethra and kidneys (so ureters to) S/S: dysuria - urgency and frequency - may be asymptomatic in prego - elderly and immunosuppressed - may see confusion or AMS Tx: Uri
Acute Arterial occlusion - to lower extremities
SBO
ED treatment for Ectopic Pregnancy
UTI
8. Old age - chronic anticoagulation - divertriculosis
LCA
When to do a pelvic exam
Where to check pulses
Common risk factors for LGIB
9. Causes: Alcohol - gallstones - high triglycerides - hypercalcemia - drugs - mumps - trauma Tx: CBC - chem 7 - LFT's - amylase - lipase - EKG Ultrasound CT scan IVF - IVF - IVF!!! NPO Pain control - anti emetics
Ovarian Torsion
Pancreatitis work up
Posterior
Acute Mesenteric Ishemia
10. 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
RCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Aortic Dissection definition - risks and S/S
Syphillis
11. Accounts for 20% o all 3rd trimester bleeding - Placenta overlaps with the cervix near the os (complete - partial - vaginal -low lying) - S/s: bright red vaginal bleeding - painless - NO NOT PERFORM VAGINAL DIGITAL EXAM - risk factors: prior c sect
Placenta Previa
Supplemental O2
ED Tx of GIB
Incomplete abortion
12. 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)
Inferior leads
Defibrillation
Tachycardia
Dx of Aortic dissection
13. 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
Acute Arterial occlusion - to lower extremities
Pericarditis
Define Biliary colic
14. Infection/bacterial overgrowth of particles in divertricula - risk factors: old age - low fiber diet - chronic constipation - - Mostly occurs in sigmoid colon - Dx: CBC - chem 7 - LFT's - Lipase/Amylase - UA - HCG - Abd CT scan - Can do KUb if suspe
RCA
Missed Abortion
Acute Arterial occlusion - to lower extremities
Divertriculitis
15. Cysts rupture and cause pelvic bleeding --> peritonitis --> hypotension --> shock S/S: unilateral sharp - lower abd pain - work up: IVF w. crystalloids - - O2 prn - CBC - chem 7 - HCG - UA - ABO/Rh - PT/PTT - Pelvic ultrasound with color doppler fl
Tx of Unstable Angina
Anteroseptal leads and Anterior
GIB work up
Symptoms of Ruptured ovarian cysts
16. Often a complicaiton of a patient with ACS (often s/p AMI) - HR > 100 BPM - Dx: Look for P waves to see a fib vs a flutter - Tx: Adenosine to slow heart for diagnostic purposes - always check TSH - classifications: narrow complex vs wide complex - re
Stable vs. Unstable Ectopic Pregnancy
Tachycardia
Bradycardia
Additional cardiac Tests
17. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Stable vs unstable angina`
Bradycardia
Appendicitis
EMTALA
18. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Common risk factors for UGIB
Stable vs unstable angina`
ED work up for cholecystitis
19. Due to HSV-1 S/S: painful vesicles after 1-2 weeks of exposure - HA - fever - dysuria - myalgias. First outbreak lasts 2-3 weeks - likely to recur DxL PCR from vesicular fluid Tx: Acyclovir 400 mg po TID x 2 weeks or Valacyclovir x 10 days. Most pat
Viral Gastroenteritis
Define Biliary colic
GIB work up
Genital Herpes
20. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Divertriculitis
Endocarditis
Genital Herpes
Common risk factors for UGIB
21. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
GIB work up
LBO - Large bowel obstruction
Pancreatitis work up
22. 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
Anteroseptal leads and Anterior
Pericarditis
Supplemental O2
Advanced airway techniques
23. V1-V2 Right Posterior Descending Artery
Viral Gastroenteritis
Posterior
Divertriculitis
Other major arteries
24. CXR - may see cardiomegaly - consolidation or effusions - Echo - look at wall motion - anuersysm - pericardial effusion - LV thrombus - Stress EcHO - CT Angiogram for Pulmonary Embolism!!!! (need good kidneys for dye) - can also do a spiral CT
Types of Infectious diarrhea Campylobacter
Causes of 3rd trimester bleeding
LCA
Additional cardiac Tests
25. S/S - PAIN OUT OF PROPORTION TO ABDOMINAL EXAM - benign compared to pain - At risk patients: elderly - vasculopaths - patients with afib - patients in cardiogenic shock/cardiopulm bypass or on high dose pressors - most occur in SMA (ie intracardiac e
Acute Mesenteric Ishemia
Gonorrhea
GIB work up
Breathing
26. 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
Advanced airway techniques
Chlamydia
Contraindications for thrombolytics
Cardiac Enzymes
27. CDAB - Circulation (rapid CPR to reestablish circulation) - Defibrillaiton - Airway - Breathing - the main goal is to restore effective oxygenation -ventilation and circulation until return of spontaneous circulation or ACLS
Pericarditis
Lateral Leads
Initial steps in stabilizing a patient
Ovarian Torsion
28. Common STI - similar presentation as Gonorrhea - may have pus when milking urethra - Common caUse of infertility - Dx: PCR of urine - fluorescent antibody testing - cervical or urethral culture swab - Tx: Asithromycin 1 g po x 1 or Doxy x 7 days (at
Bradycardia
CHF
ED workup of kidney stones
Chlamydia
29. Check Vital Signs
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30. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Kidney Stones
ED treatment of a Miscarriage
Where to check pulses
31. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Inferior leads
Ascending Cholangitis
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Yersinia
32. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
DUKE criteria for endocarditis
The vital signs
Anteroseptal leads and Anterior
RCA
33. 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
ED workup of kidney stones
Placenta Previa
Abdominal Aortic Aneurysm
Advanced airway techniques
34. 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
Supplemental O2
Acute Arterial occlusion - to lower extremities
What is a large bore IV?
EMTALA
35. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Other major arteries
Missed Abortion
Incidence of AMI
What to do with weak/thready pulses
36. 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
Pain scale for infants
Ovarian Torsion
Where to check pulses
Ectopic Pregnancy
37. 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)
Pericarditis
Abdominal Aortic Aneurysm
How to monitor CDAB
Appendicitis work up
38. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
When is Rho GAM used
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis work up
Urosepsis
39. 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
Pancreatitis work up
ED workup of kidney stones
ED Tx of GIB
How to assess Airway
40. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
Define Biliary colic
What should be done after CDAB's
Ovarian Cysts
41. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of Infectious diarrhea Campylobacter
Define Acute Cholecystitis
ED treatment for Ectopic Pregnancy
Types of Infectious diarrhea - Salmonella
42. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
Breathing
Additional cardiac Tests
Define Acute Cholecystitis
43. Ovary torsion causes venous and arterial obstruction leading to ischemia and obstruction - At risk: long fallopian tubes - pregnancy - enlarged ovaries - ovarian tumors - tubal surgery - large ovarian cysts **anything that enlarges the ovary! - S/S:
Placenta Previa
Missed Abortion
Ovarian Torsion
Appendicitis
44. Given to any woman that is Rh Negative who is HCG positive and has any vaginal bleeding during pregnancy - to Rh Negative patients (prevent formation of anti Rh antibodies - against baby)
Tx of Unstable Angina
When is Rho GAM used
Gonorrhea
Where to check pulses
45. Reassess circulation: compression - check cardiac rhythm - pulse - give meds to help Bp or rhythm prn - Monitor Oxygen and IV - DDx -goalis to find and treat reversible causes
Divertriculitis
Types of Infectious diarrhea Shigella
How to monitor CDAB
Dx of Aortic dissection
46. 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? -
Pancreatitis work up
Tx of Unstable Angina
Urosepsis
Stable vs. Unstable Ectopic Pregnancy
47. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Appendicitis
Placental Abruption
Early miscarriage (20 weeks)
Types of Infectious diarrhea E coli
48. 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)
Gonorrhea
EKG changes
DUKE criteria for endocarditis
Ovarian Torsion
49. 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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50. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
Tachycardia
Hypertensive Emergency
Types of GI bleeds