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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.
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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. 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
Gonorrhea
LCA
Genital Herpes
Emergency Severity Index
2. 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
ED Tx of GIB
Ovarian Cysts
Cardiac Tamponade
Inferior leads
3. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Define Biliary colic
Other major arteries
Types of Infectious diarrhea Yersinia
Ovarian Cysts
4. Check Vital Signs
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5. 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
Gonorrhea
The vital signs
Chlamydia
Stable vs unstable angina`
6. 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
What is a large bore IV?
Where to check pulses
Stable vs unstable angina`
Miscarriage
7. 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
Contraindications for thrombolytics
Incidence of AMI
Divertriculitis
Common risk factors for UGIB
8. 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
Hypertensive Emergency
Additional cardiac Tests
Contraindications for thrombolytics
Incomplete abortion
9. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
How to assess Airway
Stable vs. Unstable Ectopic Pregnancy
What is a large bore IV?
The vital signs
10. 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
Pericarditis
DUKE criteria for endocarditis
Posterior
Supplemental O2
11. 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)
Appendicitis work up
Types of Infectious diarrhea Campylobacter
When is Rho GAM used
Volvulus
12. 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
Where to check pulses
Placental Abruption
GIB work up
Causes of 3rd trimester bleeding
13. 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
Ovarian Torsion
ED treatment for Ectopic Pregnancy
Common risk factors for UGIB
Syphillis
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
Types of Infectious diarrhea E coli
Bradycardia
Anteroseptal leads and Anterior
Divertriculitis
15. 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
Appendicitis work up
GIB work up
Tachycardia
16. 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)
Aortic Dissection definition - risks and S/S
Incarcerated vs strangulated hernias
Defibrillation
CHF
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)
Other major arteries
Stable vs unstable angina`
Bradycardia
Incidence of AMI
18. 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
Other major arteries
SBO
Symptoms of Ruptured ovarian cysts
Urosepsis
19. 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
RCA
When is Rho GAM used
Endocarditis
Other major arteries
20. 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
Syphillis
When are Beta Blockers contraindicated
Emergency Severity Index
When is Rho GAM used
21. 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
Stable vs. Unstable Ectopic Pregnancy
DUKE criteria for endocarditis
Pain scale for infants
Initial steps in stabilizing a patient
22. 'trier' - to separate - sift or select based on priority of condition
Lateral Leads
ED treatment of a Miscarriage
Triage
Viral Gastroenteritis
23. Old age - chronic anticoagulation - divertriculosis
Appendicitis work up
Abdominal Aortic Aneurysm
Common risk factors for LGIB
Viral Gastroenteritis
24. II - III - aVF - Means RCA involved
Inferior leads
ED treatment of a Miscarriage
Ovarian Cysts
Tachycardia
25. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Inferior leads
How to assess Airway
Anteroseptal leads and Anterior
Types of Infectious diarrhea - Salmonella
26. 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
ED treatment for Ectopic Pregnancy
SBO
Initial steps in stabilizing a patient
Gonorrhea
27. 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
Define Acute Cholecystitis
Cardiac Enzymes
When are Beta Blockers contraindicated
Divertriculitis
28. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
EMTALA
Incomplete abortion
Acute Arterial occlusion - to lower extremities
Placental Abruption
29. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Abdominal Aortic Aneurysm
RCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea Shigella
30. 16-18 Gauge
Supplemental O2
Types of Infectious diarrhea Yersinia
What is a large bore IV?
Tachycardia
31. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
GIB work up
What is a large bore IV?
Hypertensive Emergency
32. 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
Other major arteries
Miscarriage
Types of GI bleeds
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
Abdominal Aortic Aneurysm
Types of GI bleeds
Types of Infectious diarrhea Shigella
When is Rho GAM used
34. 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
Genital Herpes
How to assess Airway
Ovarian Torsion
Where to check pulses
35. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Divertriculitis
Hypertensive Emergency
CHF
Cardiac Tamponade
36. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Types of Infectious diarrhea E coli
Define Acute Cholecystitis
Appendicitis
CHF
37. 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
ED treatment for Ectopic Pregnancy
Appendicitis work up
ED treatment of a Miscarriage
The vital signs
38. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
The vital signs
LBO - Large bowel obstruction
Ovarian Cysts
Hypertensive Emergency
39. 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 GI bleeds
Additional cardiac Tests
Cardiac Enzymes
Tx of Unstable Angina
40. 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
Ectopic Pregnancy
Early miscarriage (20 weeks)
Ranson's criteria
Placental Abruption
41. 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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42. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Initial steps in stabilizing a patient
RCA
Stable vs unstable angina`
Incarcerated vs strangulated hernias
43. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
The vital signs
LBO - Large bowel obstruction
Advanced airway techniques
Placental Abruption
44. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Common risk factors for UGIB
Syphillis
What should be done after CDAB's
Urosepsis
45. 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 should be done after CDAB's
ED work up for cholecystitis
Acute Coronary syndrome
DUKE criteria for endocarditis
46. 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
Incidence of AMI
UTI
Viral Gastroenteritis
How to assess Airway
47. 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)
Define Acute Cholecystitis
Stable vs unstable angina`
Appendicitis work up
Pain scale for infants
48. 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
Gonorrhea
Early miscarriage (20 weeks)
Bradycardia
49. 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
ED work up for cholecystitis
Bradycardia
Symptoms of Ruptured ovarian cysts
Pericarditis
50. V1-V2 Right Posterior Descending Artery
Types of GI bleeds
Lateral Leads
Define Biliary colic
Posterior
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