SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
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. IV fluids - monitor Bp - EKG prn - CBC - chem 7 - LFT's - Lipase - UA - HCG - Ultrasound of gallbladder - Surgical cx - CCY in 24-48 hours - Broad spectrum Abx (Unasyn or Levaquin) - Pain control (morphine or dilaudid) - don't use Toradol (NSAID) - N
ED work up for cholecystitis
Ascending Cholangitis
Types of Infectious diarrhea Shigella
Chlamydia
2. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Stable vs. Unstable Ectopic Pregnancy
ED treatment for Ectopic Pregnancy
Acute Coronary syndrome
Placental Abruption
3. 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
What to do with weak/thready pulses
EMTALA
Stable vs. Unstable Ectopic Pregnancy
Genital Herpes
4. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Contraindications for thrombolytics
SBO
The vital signs
Causes of 3rd trimester bleeding
5. 'trier' - to separate - sift or select based on priority of condition
Urosepsis
Symptoms of Ruptured ovarian cysts
Triage
ED workup of kidney stones
6. 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
What should be done after CDAB's
Contraindications for thrombolytics
Incidence of AMI
Define Acute Cholecystitis
7. 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
ED treatment of a Miscarriage
Causes of 3rd trimester bleeding
Placenta Previa
Hypertensive Emergency
8. 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
Pancreatitis work up
Tx of CHF
How to assess Airway
Symptoms of Ruptured ovarian cysts
9. 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
Defibrillation
Cardiac Enzymes
Tachycardia
Viral Gastroenteritis
10. 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
STEMI vs Nstemi
Early miscarriage (20 weeks)
SBO
Types of GI bleeds
11. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Common risk factors for LGIB
Tx of CHF
Causes of 3rd trimester bleeding
Appendicitis
12. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Gonorrhea
Types of Infectious diarrhea E coli
Causes of 3rd trimester bleeding
Testicular Torsion
13. 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)
When is Rho GAM used
ED Tx of GIB
DUKE criteria for endocarditis
Aortic Dissection definition - risks and S/S
14. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Ovarian Cysts
Stable vs. Unstable Ectopic Pregnancy
Types of Infectious diarrhea E coli
Causes of 3rd trimester bleeding
15. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Pain scale for infants
Chlamydia
Advanced airway techniques
Incidence of AMI
16. 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:
Types of Infectious diarrhea - Salmonella
Placental Abruption
Ovarian Torsion
Types of Infectious diarrhea E coli
17. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
What to do with weak/thready pulses
What should be done after CDAB's
Define Biliary colic
18. 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
What should be done after CDAB's
Stable vs unstable angina`
UTI
Additional cardiac Tests
19. Check Vital Signs
20. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Tx of Unstable Angina
Ovarian Cysts
Types of GI bleeds
Contraindications for thrombolytics
21. 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)
Cardiac Enzymes
Appendicitis work up
Ascending Cholangitis
Stable vs. Unstable Ectopic Pregnancy
22. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Aortic Dissection definition - risks and S/S
The vital signs
Urosepsis
EKG changes
23. 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
Breathing
ED workup of kidney stones
Aortic Dissection definition - risks and S/S
EKG changes
24. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Common risk factors for LGIB
EMTALA
LBO - Large bowel obstruction
Cardiac Enzymes
25. 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
Stable vs. Unstable Ectopic Pregnancy
Define Biliary colic
Types of GI bleeds
26. Rectal exam for EVERYONE with belly pain - EKG (don't want to r/o MI) - Labs: CBC - chem 7 - PTT - blood type and screen/cross (in case need blood transfusion) - H Pylori: Rapid urease test or IgG / IgM - Endoscopy for UGIB (can be done in ED) - Colo
GIB work up
Types of Infectious diarrhea Shigella
Lateral Leads
When is Rho GAM used
27. 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
28. Left coronary artery (short and branches quickly)
LCA
Other major arteries
Appendicitis work up
Testicular Torsion
29. 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
How to monitor CDAB
Types of Infectious diarrhea - Salmonella
Common risk factors for LGIB
Abdominal Aortic Aneurysm
30. 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
Miscarriage
When is Rho GAM used
Types of Infectious diarrhea Yersinia
31. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
What is a large bore IV?
How to assess Airway
Syphillis
Types of Infectious diarrhea Yersinia
32. Rare STI - increaseing now - due to AIDs - S/S - rash or chancre - serologic testing of blood or CSF - TxL Benzathine penicillin or Doxy x 2 weeks
Syphillis
Viral Gastroenteritis
ED Tx of GIB
Cardiac Tamponade
33. School/work outbreak - Common viruses: rotavirus - norwalk - adenovirus - astrovirus - last 24 to 48 hours - ALWAYS DX as VOMITING AND DIARRHEA - never use the term viral gastroenteritis (CYA medicine) Tx: CBC - chem 7 - LFT's - lIpase - UA - general
What to do with weak/thready pulses
Viral Gastroenteritis
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea Campylobacter
34. 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? -
Tx of Unstable Angina
Inferior leads
ED treatment for Ectopic Pregnancy
ED Tx of GIB
35. 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
Ectopic Pregnancy
Incomplete abortion
Tx of CHF
Acute Coronary syndrome
36. IVF w crystalloid CBC - chem 7 - LFT's - lipase - UA - urine cx - HCG - Abdominal/pelvis CT with NO CONTRAST (if suspect a stone) - Ultrasound is an alternative - will show hydronephrosis - Pain control - Dilaudid 1 mg IV - Toradol 30 mg IV (caution
UTI
How to monitor CDAB
ED workup of kidney stones
Posterior
37. Bp diffrence between R and L arms: > 20 difference in systolic or > 15 mm Hg difference in diastolic - Aortography - gold standard - CT scan with contrast - EKG - CXR - widended mediastinum - obliteraiton of aortic knowb - tracheal deviation - L hemo
Dx of Aortic dissection
Stable vs unstable angina`
ED treatment of a Miscarriage
Genital Herpes
38. 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
Contraindications for thrombolytics
EMTALA
Defibrillation
DUKE criteria for endocarditis
39. 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)
Missed Abortion
Common risk factors for UGIB
Defibrillation
Bradycardia
40. II - III - aVF - Means RCA involved
Defibrillation
What should be done after CDAB's
Inferior leads
Divertriculitis
41. Due to chromosomal abnormalities - check Rubella a) Threatened abortion if - 1st trimester vag bleed - < 20 weeks GA - os closed - membranes intact - some cramping. Tx - pelvic rest - bed rest - close OB GYN f/you b) Inevitable abortion - if < 20 wee
Bradycardia
Chlamydia
Early miscarriage (20 weeks)
Genital Herpes
42. 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
Missed Abortion
Posterior
Divertriculitis
Tx of CHF
43. Premature separation of the implanted placenta - S/S: abdominal pain - dark vaginal bleeding -hypertonic and tender uterus - fetal distress - may see signs of shock without visible bleeding if intrauterine bleeding Risk factors: HTN - pelvic trauma -
Lateral Leads
Placental Abruption
Supplemental O2
Additional cardiac Tests
44. 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
Placental Abruption
Symptoms of Ruptured ovarian cysts
Breathing
Endocarditis
45. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
LCA
UTI
Miscarriage
Anteroseptal leads and Anterior
46. 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)
Advanced airway techniques
Incidence of AMI
When is Rho GAM used
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
47. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Cardiac Tamponade
ED Tx of GIB
When to do a pelvic exam
Bradycardia
48. Elevated Bp with signs of end organ damage to brain - eyes - heart or kidney. - Organ damage risk increases when diastolic Bp > 115-130 - HTN urgency if see high Bp but no signs of organ damage yet - Get a head CT ASAP!! Symptoms: Head: HA - confusio
ED workup of kidney stones
Hypertensive Emergency
Cardiac Enzymes
How to monitor CDAB
49. 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
Types of GI bleeds
What should be done after CDAB's
Genital Herpes
EMTALA
50. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Initial steps in stabilizing a patient
EMTALA
Pain scale for infants
Kidney Stones