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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. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Dx of Aortic dissection
EMTALA
CHF
Miscarriage
2. 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
Appendicitis work up
Testicular Torsion
Aortic Dissection definition - risks and S/S
Bradycardia
3. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Stable vs unstable angina`
Advanced airway techniques
What should be done after CDAB's
Incarcerated vs strangulated hernias
4. 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
Syphillis
Additional cardiac Tests
Ectopic Pregnancy
Early miscarriage (20 weeks)
5. 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
Gonorrhea
ED work up for cholecystitis
Cardiac Tamponade
Placenta Previa
6. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
Acute Mesenteric Ishemia
When is Rho GAM used
Kidney Stones
7. 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
Appendicitis work up
Syphillis
Common Presentation of GIB
Endocarditis
8. 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
Additional cardiac Tests
Causes of 3rd trimester bleeding
Urosepsis
9. 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
Common Presentation of GIB
GIB work up
Ranson's criteria
Ectopic Pregnancy
10. 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
DUKE criteria for endocarditis
Incarcerated vs strangulated hernias
Initial steps in stabilizing a patient
Anteroseptal leads and Anterior
11. Troponin T or I - mores specific for heart. Tropoinin I stays elevated for 7-10 days - Troponin T stays elevated for 10-14 days - CK - MB: - peaks 20 hours after AMI (specific to cardiac muscle) - CPK - measures muscle breakdown so nonspecific
ED treatment of a Miscarriage
Abdominal Aortic Aneurysm
How to assess Airway
Cardiac Enzymes
12. 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
Pain scale for infants
LCA
Appendicitis work up
Symptoms of Ruptured ovarian cysts
13. 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
Pericarditis
Placental Abruption
Genital Herpes
Define Biliary colic
14. 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
Chlamydia
Types of GI bleeds
Gonorrhea
ED Tx of GIB
15. IVF with crystalloids - RhoGAM for Rh Negative - Abx if sepsis or suspect retained POC - D and C if retained POC's - F/you with OB GYN in 48 hours - monitor HCG is trending down - Return for worsening sxs
When to do a pelvic exam
ED treatment of a Miscarriage
Stable vs. Unstable Ectopic Pregnancy
Additional cardiac Tests
16. 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 -
Placental Abruption
Where to check pulses
Incidence of AMI
Incarcerated vs strangulated hernias
17. BRADYCARDIA - due to depressed SA node act or delayed conduction - excessive beta blockers - HR < 50 BPM - Tx: Atropine - Pacing ready / defibrillator prn - treat underlying cause (electrolyte imbalance - drugs - hypothermia)
Pancreatitis work up
Pain scale for infants
Dx of Aortic dissection
Bradycardia
18. 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
Incomplete abortion
Types of Infectious diarrhea Yersinia
ED work up for cholecystitis
Viral Gastroenteritis
19. 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
Define Acute Cholecystitis
Appendicitis
Appendicitis work up
Viral Gastroenteritis
20. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Abdominal Aortic Aneurysm
Types of Infectious diarrhea E coli
Ectopic Pregnancy
Ascending Cholangitis
21. 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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22. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
Ectopic Pregnancy
Chlamydia
Incidence of AMI
23. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Types of GI bleeds
Pancreatitis work up
What to do with weak/thready pulses
24. II - III - aVF - Means RCA involved
What should be done after CDAB's
EKG changes
Inferior leads
Pancreatitis work up
25. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Other major arteries
What should be done after CDAB's
Appendicitis work up
RCA
26. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Placenta Previa
Incidence of AMI
ED treatment of a Miscarriage
27. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Divertriculitis
Abdominal Aortic Aneurysm
Tx of CHF
28. 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
Anteroseptal leads and Anterior
Pericarditis
Syphillis
What should be done after CDAB's
29. 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
Advanced airway techniques
Acute Arterial occlusion - to lower extremities
Abdominal Aortic Aneurysm
Common risk factors for UGIB
30. 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
Bradycardia
When to do a pelvic exam
How to assess Airway
ED work up for cholecystitis
31. Check Vital Signs
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32. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Types of GI bleeds
Hypertensive Emergency
Common Presentation of GIB
Define Biliary colic
33. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Genital Herpes
Abdominal Aortic Aneurysm
Tx of CHF
Types of Infectious diarrhea Campylobacter
34. 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
Pericarditis
Posterior
Breathing
Tx of Unstable Angina
35. 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
Additional cardiac Tests
Acute Arterial occlusion - to lower extremities
Appendicitis
Viral Gastroenteritis
36. 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
Stable vs unstable angina`
Viral Gastroenteritis
Dx of Aortic dissection
Ectopic Pregnancy
37. 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
ED Tx of GIB
Supplemental O2
Common risk factors for UGIB
38. 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
Pericarditis
ED workup of kidney stones
Anteroseptal leads and Anterior
Hypertensive Emergency
39. 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
Acute Arterial occlusion - to lower extremities
Acute Coronary syndrome
Kidney Stones
Incidence of AMI
40. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Emergency Severity Index
Ovarian Cysts
Divertriculitis
41. 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
What is a large bore IV?
ED treatment for Ectopic Pregnancy
Where to check pulses
Acute Coronary syndrome
42. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
EMTALA
Missed Abortion
STEMI vs Nstemi
When are Beta Blockers contraindicated
43. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
UTI
When are Beta Blockers contraindicated
Pericarditis
How to monitor CDAB
44. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Causes of 3rd trimester bleeding
Define Biliary colic
LCA
What should be done after CDAB's
45. 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
Viral Gastroenteritis
STEMI vs Nstemi
EMTALA
Tx of Unstable Angina
46. Renal colic - due to passing of a stone thru the ureter (don't cause pain in the kidney - asymptomatic) - pain due to ureteral spasm and obstruction of urine M: F - 3: 1 prevalence - Stones smaller than 5 mm have 90% chance of passing alone
Kidney Stones
Common Presentation of GIB
Initial steps in stabilizing a patient
Stable vs. Unstable Ectopic Pregnancy
47. 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
Stable vs unstable angina`
Incarcerated vs strangulated hernias
Lateral Leads
Chlamydia
48. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
ED workup of kidney stones
Types of Infectious diarrhea Campylobacter
Cardiac Tamponade
Cardiac Enzymes
49. 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
Defibrillation
Aortic Dissection definition - risks and S/S
Ectopic Pregnancy
Early miscarriage (20 weeks)
50. Leads I - aVL - V4-V6 - Left circumflex artery
SBO
LBO - Large bowel obstruction
Lateral Leads
Cardiac Tamponade