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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. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Emergency Severity Index
Initial steps in stabilizing a patient
Types of Infectious diarrhea - Salmonella
CHF
2. 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
Aortic Dissection definition - risks and S/S
Tx of Unstable Angina
GIB work up
Initial steps in stabilizing a patient
3. 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
Acute Mesenteric Ishemia
Miscarriage
EMTALA
4. 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)
Acute Mesenteric Ishemia
Advanced airway techniques
Chlamydia
Bradycardia
5. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Testicular Torsion
Chlamydia
ED treatment for Ectopic Pregnancy
Inferior leads
6. 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)
Placental Abruption
Define Acute Cholecystitis
Appendicitis work up
Bradycardia
7. 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
Aortic Dissection definition - risks and S/S
UTI
What to do with weak/thready pulses
Ectopic Pregnancy
8. II - III - aVF - Means RCA involved
Types of Infectious diarrhea Yersinia
When to do a pelvic exam
LBO - Large bowel obstruction
Inferior leads
9. 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
Abdominal Aortic Aneurysm
Causes of 3rd trimester bleeding
Dx of Aortic dissection
Advanced airway techniques
10. 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
Other major arteries
STEMI vs Nstemi
ED Tx of GIB
Stable vs. Unstable Ectopic Pregnancy
11. 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
Supplemental O2
Pancreatitis work up
Tachycardia
Placenta Previa
12. 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
Acute Coronary syndrome
Breathing
Define Acute Cholecystitis
Ranson's criteria
13. 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)
Additional cardiac Tests
Syphillis
Missed Abortion
Defibrillation
14. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
The vital signs
Lateral Leads
Pain scale for infants
ED treatment of a Miscarriage
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
Types of Infectious diarrhea - Salmonella
Missed Abortion
RCA
ED treatment of a Miscarriage
16. 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
Syphillis
Anteroseptal leads and Anterior
Dx of Aortic dissection
Define Acute Cholecystitis
17. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
EKG changes
When to do a pelvic exam
Common Presentation of GIB
Miscarriage
18. 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
Breathing
Miscarriage
Viral Gastroenteritis
ED workup of kidney stones
19. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
LCA
Symptoms of Ruptured ovarian cysts
Common risk factors for LGIB
Causes of 3rd trimester bleeding
20. Look for ST elevation in at least 2 contiguous lead (at least 1mm) - may see a new LBBB - Reciprocal changes - T wave inversion (end of the infarct or old) - Q waves (old infarct)
EKG changes
Pericarditis
Advanced airway techniques
Anteroseptal leads and Anterior
21. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Kidney Stones
STEMI vs Nstemi
Triage
EMTALA
22. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Ovarian Torsion
When are Beta Blockers contraindicated
Where to check pulses
Types of Infectious diarrhea Campylobacter
23. 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
What to do with weak/thready pulses
Early miscarriage (20 weeks)
Advanced airway techniques
24. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Ranson's criteria
Incarcerated vs strangulated hernias
Chlamydia
UTI
25. 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
Chlamydia
Hypertensive Emergency
Symptoms of Ruptured ovarian cysts
Anteroseptal leads and Anterior
26. 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
The vital signs
Define Acute Cholecystitis
GIB work up
Ascending Cholangitis
27. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Types of Infectious diarrhea Shigella
Advanced airway techniques
Aortic Dissection definition - risks and S/S
Acute Coronary syndrome
28. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Advanced airway techniques
Abdominal Aortic Aneurysm
Genital Herpes
29. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Ovarian Cysts
Common Presentation of GIB
When is Rho GAM used
SBO
30. 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)
Stable vs unstable angina`
Appendicitis
When is Rho GAM used
Advanced airway techniques
31. 16-18 Gauge
Types of Infectious diarrhea Yersinia
Tx of Unstable Angina
What is a large bore IV?
Ranson's criteria
32. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Gonorrhea
Inferior leads
Ovarian Cysts
RCA
33. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Kidney Stones
LBO - Large bowel obstruction
Appendicitis work up
Types of Infectious diarrhea Campylobacter
34. 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
Where to check pulses
How to assess Airway
Pericarditis
Causes of 3rd trimester bleeding
35. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Triage
Ranson's criteria
Acute Coronary syndrome
Define Biliary colic
36. 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
ED work up for cholecystitis
How to monitor CDAB
Types of Infectious diarrhea - Salmonella
Chlamydia
37. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Inferior leads
The vital signs
Hypertensive Emergency
How to monitor CDAB
38. 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
ED workup of kidney stones
Ovarian Cysts
GIB work up
Chlamydia
39. 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
Stable vs. Unstable Ectopic Pregnancy
Causes of 3rd trimester bleeding
Acute Coronary syndrome
Syphillis
40. 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 -
Types of Infectious diarrhea Campylobacter
Posterior
Placental Abruption
Common risk factors for LGIB
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. 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
When to do a pelvic exam
Stable vs unstable angina`
Emergency Severity Index
Additional cardiac Tests
43. 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)
What to do with weak/thready pulses
ED workup of kidney stones
Incarcerated vs strangulated hernias
DUKE criteria for endocarditis
44. 'trier' - to separate - sift or select based on priority of condition
Defibrillation
RCA
Triage
ED treatment for Ectopic Pregnancy
45. 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:
Incidence of AMI
Anteroseptal leads and Anterior
Triage
Ovarian Torsion
46. 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
Contraindications for thrombolytics
Miscarriage
Triage
47. 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
EKG changes
Contraindications for thrombolytics
ED treatment for Ectopic Pregnancy
Miscarriage
48. 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
Incidence of AMI
Types of Infectious diarrhea E coli
Cardiac Tamponade
Anteroseptal leads and Anterior
49. 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
Acute Arterial occlusion - to lower extremities
Hypertensive Emergency
Ovarian Torsion
Common Presentation of GIB
50. 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
Appendicitis work up
Missed Abortion
Urosepsis
Additional cardiac Tests