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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. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Stable vs unstable angina`
Acute Mesenteric Ishemia
Common Presentation of GIB
The vital signs
2. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Shigella
Anteroseptal leads and Anterior
Emergency Severity Index
3. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
Ascending Cholangitis
ED treatment for Ectopic Pregnancy
Additional cardiac Tests
4. 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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5. 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
Cardiac Enzymes
Tachycardia
Contraindications for thrombolytics
Ectopic Pregnancy
6. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Define Biliary colic
GIB work up
EKG changes
7. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Incomplete abortion
Inferior leads
Common Presentation of GIB
Gonorrhea
8. Leads I - aVL - V4-V6 - Left circumflex artery
Acute Arterial occlusion - to lower extremities
Lateral Leads
When are Beta Blockers contraindicated
Types of Infectious diarrhea Yersinia
9. 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
Define Biliary colic
Other major arteries
Acute Coronary syndrome
Additional cardiac Tests
10. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Endocarditis
Ectopic Pregnancy
Appendicitis
Initial steps in stabilizing a patient
11. 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
Tachycardia
Placenta Previa
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
ED workup of kidney stones
12. 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
ED work up for cholecystitis
The vital signs
Pain scale for infants
Dx of Aortic dissection
13. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Incomplete abortion
Pain scale for infants
Defibrillation
14. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Genital Herpes
Ovarian Torsion
LBO - Large bowel obstruction
Ranson's criteria
15. 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)
Miscarriage
EMTALA
When is Rho GAM used
Anteroseptal leads and Anterior
16. 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
Tx of CHF
Incomplete abortion
Ranson's criteria
Incidence of AMI
17. V1-V2 Right Posterior Descending Artery
Posterior
Types of Infectious diarrhea - Salmonella
UTI
What should be done after CDAB's
18. 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
Hypertensive Emergency
EMTALA
Cardiac Enzymes
What should be done after CDAB's
19. 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
Appendicitis work up
Types of Infectious diarrhea - Salmonella
UTI
Tx of Unstable Angina
20. 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
Initial steps in stabilizing a patient
EMTALA
Viral Gastroenteritis
LCA
21. 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
Acute Mesenteric Ishemia
LBO - Large bowel obstruction
22. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of GI bleeds
How to monitor CDAB
Types of Infectious diarrhea Campylobacter
CHF
23. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
LBO - Large bowel obstruction
Types of Infectious diarrhea E coli
Volvulus
Breathing
24. 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)
ED treatment for Ectopic Pregnancy
RCA
What to do with weak/thready pulses
EKG changes
25. 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
Syphillis
Divertriculitis
Stable vs. Unstable Ectopic Pregnancy
Cardiac Tamponade
26. 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
What should be done after CDAB's
Endocarditis
Testicular Torsion
Urosepsis
27. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Other major arteries
Anteroseptal leads and Anterior
Acute Arterial occlusion - to lower extremities
When is Rho GAM used
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)
Viral Gastroenteritis
Pancreatitis work up
LCA
Appendicitis work up
29. Old age - chronic anticoagulation - divertriculosis
Incarcerated vs strangulated hernias
Common risk factors for LGIB
SBO
LBO - Large bowel obstruction
30. 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
Contraindications for thrombolytics
Pericarditis
Incarcerated vs strangulated hernias
31. 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
Miscarriage
Testicular Torsion
GIB work up
ED work up for cholecystitis
32. 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:
UTI
Ovarian Torsion
Missed Abortion
Tx of Unstable Angina
33. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Miscarriage
RCA
Types of Infectious diarrhea E coli
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
Initial steps in stabilizing a patient
Chlamydia
Breathing
Acute Arterial occlusion - to lower extremities
35. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Other major arteries
Define Biliary colic
Common Presentation of GIB
Emergency Severity Index
36. 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
ED Tx of GIB
Where to check pulses
Tachycardia
GIB work up
37. 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
ED treatment of a Miscarriage
Stable vs unstable angina`
Abdominal Aortic Aneurysm
Cardiac Tamponade
38. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Symptoms of Ruptured ovarian cysts
Testicular Torsion
Initial steps in stabilizing a patient
39. 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
EKG changes
Appendicitis work up
Placental Abruption
Ascending Cholangitis
40. 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)
Common risk factors for UGIB
Incarcerated vs strangulated hernias
Emergency Severity Index
41. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
Triage
Additional cardiac Tests
Acute Mesenteric Ishemia
42. 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
ED treatment of a Miscarriage
Miscarriage
How to assess Airway
The vital signs
43. 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
Other major arteries
GIB work up
ED Tx of GIB
44. 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
When are Beta Blockers contraindicated
Cardiac Enzymes
Divertriculitis
Define Biliary colic
45. 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
Stable vs. Unstable Ectopic Pregnancy
Syphillis
When to do a pelvic exam
Types of GI bleeds
46. 'trier' - to separate - sift or select based on priority of condition
Appendicitis work up
Triage
Symptoms of Ruptured ovarian cysts
EKG changes
47. 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 -
Breathing
CHF
Placental Abruption
LBO - Large bowel obstruction
48. S/S - PAIN OUT OF PROPORTION TO ABDOMINAL EXAM - benign compared to pain - At risk patients: elderly - vasculopaths - patients with afib - patients in cardiogenic shock/cardiopulm bypass or on high dose pressors - most occur in SMA (ie intracardiac e
Incidence of AMI
Chlamydia
Acute Mesenteric Ishemia
Ovarian Cysts
49. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Dx of Aortic dissection
Incidence of AMI
Endocarditis
Types of Infectious diarrhea - Salmonella
50. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
EKG changes
ED work up for cholecystitis
Pericarditis
Pain scale for infants