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Test your basic knowledge |
Emergency Medicine
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Subjects
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health-sciences
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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. 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)
Defibrillation
Tx of Unstable Angina
Acute Arterial occlusion - to lower extremities
Ectopic Pregnancy
2. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Ovarian Torsion
Pancreatitis work up
Types of Infectious diarrhea - Salmonella
Types of Infectious diarrhea E coli
3. 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
EMTALA
Define Acute Cholecystitis
Testicular Torsion
Endocarditis
4. 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
Incarcerated vs strangulated hernias
Supplemental O2
Appendicitis work up
Common Presentation of GIB
5. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Define Biliary colic
Anteroseptal leads and Anterior
ED Tx of GIB
Abdominal Aortic Aneurysm
6. 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 -
Abdominal Aortic Aneurysm
Cardiac Tamponade
Placental Abruption
Gonorrhea
7. 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
When are Beta Blockers contraindicated
Symptoms of Ruptured ovarian cysts
Divertriculitis
Common risk factors for UGIB
8. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
Urosepsis
EKG changes
Common risk factors for LGIB
9. 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
Placenta Previa
Additional cardiac Tests
Types of Infectious diarrhea Campylobacter
10. 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
LBO - Large bowel obstruction
Supplemental O2
Types of Infectious diarrhea - Salmonella
ED workup of kidney stones
11. 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
Advanced airway techniques
Tachycardia
Appendicitis work up
Other major arteries
12. 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
EKG changes
Define Biliary colic
What should be done after CDAB's
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
What should be done after CDAB's
Appendicitis
Syphillis
14. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
When is Rho GAM used
Acute Mesenteric Ishemia
ED work up for cholecystitis
Types of Infectious diarrhea Shigella
15. 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
Define Biliary colic
Syphillis
Volvulus
EMTALA
16. Old age - chronic anticoagulation - divertriculosis
Types of GI bleeds
Pain scale for infants
Incarcerated vs strangulated hernias
Common risk factors for LGIB
17. Check Vital Signs
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18. 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 E coli
Divertriculitis
UTI
Pancreatitis work up
19. 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
EMTALA
Chlamydia
Tx of Unstable Angina
20. No bleeding - no fetal cardiac activity - uterus small - os closed - retained fetal tissue - Tx: D and C - Can have sepsis due to retained tissue/ fetus. Treat with IV abx (ampicillin and gentamycin) - Can give Misoprostol and cytotec (to dilate cerv
Tachycardia
What should be done after CDAB's
Genital Herpes
Missed Abortion
21. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Acute Arterial occlusion - to lower extremities
Abdominal Aortic Aneurysm
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
RCA
22. 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
Initial steps in stabilizing a patient
ED treatment of a Miscarriage
Supplemental O2
23. 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
Early miscarriage (20 weeks)
Placenta Previa
Divertriculitis
Stable vs unstable angina`
24. 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
Endocarditis
Additional cardiac Tests
Incidence of AMI
How to monitor CDAB
25. 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
Testicular Torsion
How to assess Airway
Cardiac Enzymes
26. 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
When is Rho GAM used
Types of Infectious diarrhea Campylobacter
Incidence of AMI
27. 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
Initial steps in stabilizing a patient
Causes of 3rd trimester bleeding
Syphillis
Aortic Dissection definition - risks and S/S
28. 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)
Genital Herpes
Tx of CHF
Appendicitis work up
Viral Gastroenteritis
29. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Abdominal Aortic Aneurysm
Tx of Unstable Angina
ED treatment for Ectopic Pregnancy
30. 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
Placental Abruption
LCA
Tx of Unstable Angina
31. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Incidence of AMI
Define Biliary colic
Types of Infectious diarrhea Shigella
Common risk factors for UGIB
32. 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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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
Volvulus
Types of GI bleeds
How to monitor CDAB
Chlamydia
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
Types of Infectious diarrhea Campylobacter
EMTALA
Gonorrhea
Genital Herpes
35. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
CHF
Ovarian Torsion
LBO - Large bowel obstruction
Incidence of AMI
36. 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
Additional cardiac Tests
Genital Herpes
ED work up for cholecystitis
Common Presentation of GIB
37. 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
Bradycardia
Lateral Leads
Pain scale for infants
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
Missed Abortion
Causes of 3rd trimester bleeding
Where to check pulses
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
Volvulus
Other major arteries
Acute Arterial occlusion - to lower extremities
Hypertensive Emergency
40. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
ED work up for cholecystitis
Incidence of AMI
Advanced airway techniques
The vital signs
41. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Symptoms of Ruptured ovarian cysts
Incarcerated vs strangulated hernias
Missed Abortion
42. 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
LBO - Large bowel obstruction
Early miscarriage (20 weeks)
Pancreatitis work up
Causes of 3rd trimester bleeding
43. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Tachycardia
Other major arteries
Lateral Leads
The vital signs
44. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Bradycardia
Common risk factors for LGIB
Pericarditis
45. 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)
DUKE criteria for endocarditis
When to do a pelvic exam
Bradycardia
UTI
46. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What to do with weak/thready pulses
Other major arteries
Cardiac Enzymes
Define Biliary colic
47. Left coronary artery (short and branches quickly)
How to assess Airway
Breathing
The vital signs
LCA
48. 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
Types of Infectious diarrhea E coli
Viral Gastroenteritis
Early miscarriage (20 weeks)
Common Presentation of GIB
49. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
How to assess Airway
Genital Herpes
Cardiac Tamponade
UTI
50. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Cardiac Tamponade
Emergency Severity Index
Types of Infectious diarrhea E coli
Advanced airway techniques