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Test your basic knowledge |
Emergency Medicine
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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. 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)
Supplemental O2
Aortic Dissection definition - risks and S/S
Appendicitis work up
Contraindications for thrombolytics
2. 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? -
Types of Infectious diarrhea Shigella
Incomplete abortion
Tx of Unstable Angina
Incidence of AMI
3. 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
EMTALA
Stable vs unstable angina`
ED workup of kidney stones
Supplemental O2
4. 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:
Ovarian Torsion
When are Beta Blockers contraindicated
Viral Gastroenteritis
Posterior
5. 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
Supplemental O2
Ectopic Pregnancy
Defibrillation
Emergency Severity Index
6. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
How to monitor CDAB
Bradycardia
Types of Infectious diarrhea Campylobacter
GIB work up
7. 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
LBO - Large bowel obstruction
What should be done after CDAB's
Divertriculitis
Define Acute Cholecystitis
8. 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
Emergency Severity Index
Symptoms of Ruptured ovarian cysts
Defibrillation
Stable vs. Unstable Ectopic Pregnancy
9. 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
Stable vs. Unstable Ectopic Pregnancy
Endocarditis
Placenta Previa
When are Beta Blockers contraindicated
10. 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
Viral Gastroenteritis
What to do with weak/thready pulses
Types of Infectious diarrhea Shigella
RCA
11. 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
GIB work up
Gonorrhea
How to monitor CDAB
12. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
SBO
Appendicitis
How to assess Airway
Endocarditis
13. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
ED treatment of a Miscarriage
Cardiac Enzymes
Define Biliary colic
Appendicitis work up
14. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
EMTALA
Tx of Unstable Angina
Anteroseptal leads and Anterior
What to do with weak/thready pulses
15. 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
Aortic Dissection definition - risks and S/S
DUKE criteria for endocarditis
Breathing
Acute Arterial occlusion - to lower extremities
16. 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
Types of Infectious diarrhea Campylobacter
Acute Arterial occlusion - to lower extremities
CHF
Pancreatitis work up
17. 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
What to do with weak/thready pulses
ED treatment of a Miscarriage
Missed Abortion
EKG changes
18. 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
Incomplete abortion
STEMI vs Nstemi
Kidney Stones
Stable vs unstable angina`
19. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
GIB work up
CHF
Volvulus
Endocarditis
20. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
Appendicitis
Types of Infectious diarrhea - Salmonella
How to assess Airway
21. 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
Divertriculitis
Kidney Stones
What to do with weak/thready pulses
Aortic Dissection definition - risks and S/S
22. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
How to assess Airway
Types of Infectious diarrhea E coli
Incomplete abortion
23. 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
Testicular Torsion
Initial steps in stabilizing a patient
Define Biliary colic
Supplemental O2
24. V1-V2 Right Posterior Descending Artery
Placental Abruption
How to monitor CDAB
Posterior
Causes of 3rd trimester bleeding
25. 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
Emergency Severity Index
How to monitor CDAB
Lateral Leads
Dx of Aortic dissection
26. 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
Early miscarriage (20 weeks)
Anteroseptal leads and Anterior
Causes of 3rd trimester bleeding
What is a large bore IV?
27. 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
Bradycardia
Common Presentation of GIB
Early miscarriage (20 weeks)
Tachycardia
28. 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)
DUKE criteria for endocarditis
Gonorrhea
Types of Infectious diarrhea Campylobacter
Hypertensive Emergency
29. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
What to do with weak/thready pulses
Common risk factors for LGIB
Acute Arterial occlusion - to lower extremities
LCA
30. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Placental Abruption
Types of Infectious diarrhea - Salmonella
Causes of 3rd trimester bleeding
Placenta Previa
31. 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
Acute Mesenteric Ishemia
Types of Infectious diarrhea E coli
ED Tx of GIB
Appendicitis work up
32. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea Shigella
Bradycardia
STEMI vs Nstemi
33. 16-18 Gauge
Ascending Cholangitis
ED treatment of a Miscarriage
What is a large bore IV?
Appendicitis
34. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ectopic Pregnancy
Pain scale for infants
Where to check pulses
Ovarian Cysts
35. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea - Salmonella
RCA
UTI
36. 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
RCA
Types of GI bleeds
Ovarian Torsion
When to do a pelvic exam
37. 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
Cardiac Enzymes
CHF
ED workup of kidney stones
Incarcerated vs strangulated hernias
38. 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)
Bradycardia
Stable vs unstable angina`
Hypertensive Emergency
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
39. 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
Miscarriage
Hypertensive Emergency
Triage
Pain scale for infants
40. 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
When to do a pelvic exam
Stable vs unstable angina`
How to monitor CDAB
Ascending Cholangitis
41. 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
Genital Herpes
Defibrillation
Volvulus
ED Tx of GIB
42. Leads I - aVL - V4-V6 - Left circumflex artery
Types of Infectious diarrhea Yersinia
Lateral Leads
ED Tx of GIB
Posterior
43. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Supplemental O2
LBO - Large bowel obstruction
Pain scale for infants
Dx of Aortic dissection
44. 'trier' - to separate - sift or select based on priority of condition
Triage
When is Rho GAM used
Syphillis
Contraindications for thrombolytics
45. 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
UTI
Testicular Torsion
Other major arteries
GIB work up
46. Check Vital Signs
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47. 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)
Missed Abortion
Placenta Previa
When is Rho GAM used
Types of Infectious diarrhea E coli
48. 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
Anteroseptal leads and Anterior
Initial steps in stabilizing a patient
ED workup of kidney stones
When is Rho GAM used
49. 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
Acute Arterial occlusion - to lower extremities
Advanced airway techniques
Urosepsis
50. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
SBO
GIB work up
Posterior
Miscarriage