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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.
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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. 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
EMTALA
SBO
Ascending Cholangitis
2. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Advanced airway techniques
Cardiac Tamponade
Types of Infectious diarrhea Yersinia
Urosepsis
3. 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
Volvulus
Hypertensive Emergency
LBO - Large bowel obstruction
How to assess Airway
4. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
Types of Infectious diarrhea - Salmonella
Define Biliary colic
Endocarditis
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
Tx of CHF
Missed Abortion
Supplemental O2
Incidence of AMI
6. 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
Tachycardia
Appendicitis
Posterior
Other major arteries
7. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Urosepsis
Chlamydia
Initial steps in stabilizing a patient
8. 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
Syphillis
LCA
Initial steps in stabilizing a patient
Cardiac Enzymes
9. 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
Appendicitis
Urosepsis
Gonorrhea
ED Tx of GIB
10. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Miscarriage
Types of Infectious diarrhea Yersinia
ED treatment for Ectopic Pregnancy
11. 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
Miscarriage
GIB work up
Emergency Severity Index
Syphillis
12. 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
Cardiac Enzymes
When are Beta Blockers contraindicated
Tachycardia
EMTALA
13. 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
Incomplete abortion
Where to check pulses
Define Acute Cholecystitis
Triage
14. 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
Tx of Unstable Angina
Chlamydia
ED workup of kidney stones
15. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
Viral Gastroenteritis
Appendicitis
Advanced airway techniques
16. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Missed Abortion
Types of Infectious diarrhea E coli
ED treatment of a Miscarriage
Types of Infectious diarrhea Yersinia
17. Leads I - aVL - V4-V6 - Left circumflex artery
Contraindications for thrombolytics
Acute Arterial occlusion - to lower extremities
Lateral Leads
What to do with weak/thready pulses
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
Testicular Torsion
Pericarditis
Anteroseptal leads and Anterior
Hypertensive Emergency
19. 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
Stable vs unstable angina`
Ranson's criteria
Define Acute Cholecystitis
20. 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)
Inferior leads
Bradycardia
Causes of 3rd trimester bleeding
Common risk factors for LGIB
21. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
ED treatment for Ectopic Pregnancy
Ascending Cholangitis
Incidence of AMI
22. 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
Appendicitis
Incomplete abortion
Placenta Previa
Ascending Cholangitis
23. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Tx of CHF
RCA
Symptoms of Ruptured ovarian cysts
24. 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
Initial steps in stabilizing a patient
Early miscarriage (20 weeks)
Types of GI bleeds
Dx of Aortic dissection
25. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Divertriculitis
Syphillis
ED treatment for Ectopic Pregnancy
Defibrillation
26. 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)
How to assess Airway
When to do a pelvic exam
When is Rho GAM used
Common risk factors for UGIB
27. 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
Kidney Stones
Acute Coronary syndrome
Gonorrhea
Tx of CHF
28. 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
Early miscarriage (20 weeks)
Pancreatitis work up
GIB work up
Advanced airway techniques
29. 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
Bradycardia
Inferior leads
Chlamydia
Volvulus
30. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Common Presentation of GIB
Kidney Stones
Appendicitis
Define Acute Cholecystitis
31. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
EMTALA
Genital Herpes
Contraindications for thrombolytics
Causes of 3rd trimester bleeding
32. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Common risk factors for UGIB
ED work up for cholecystitis
Types of Infectious diarrhea Campylobacter
Types of Infectious diarrhea Shigella
33. 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
Urosepsis
Types of Infectious diarrhea Shigella
Dx of Aortic dissection
34. 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
Define Biliary colic
When to do a pelvic exam
Cardiac Tamponade
Placenta Previa
35. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
UTI
Common risk factors for UGIB
Pancreatitis work up
LBO - Large bowel obstruction
36. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Aortic Dissection definition - risks and S/S
Cardiac Tamponade
Acute Mesenteric Ishemia
Causes of 3rd trimester bleeding
37. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
ED treatment for Ectopic Pregnancy
Initial steps in stabilizing a patient
What to do with weak/thready pulses
Tx of Unstable Angina
38. 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
Common risk factors for LGIB
Placenta Previa
How to monitor CDAB
39. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Gonorrhea
RCA
EMTALA
When to do a pelvic exam
40. 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)
Incomplete abortion
Posterior
Appendicitis work up
GIB work up
41. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
GIB work up
Placenta Previa
When are Beta Blockers contraindicated
Common risk factors for LGIB
42. 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
Define Acute Cholecystitis
Cardiac Tamponade
Missed Abortion
Types of Infectious diarrhea Yersinia
43. V1-V2 Right Posterior Descending Artery
SBO
Placental Abruption
How to monitor CDAB
Posterior
44. 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
Pericarditis
Aortic Dissection definition - risks and S/S
Inferior leads
Kidney Stones
45. 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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46. 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
Pancreatitis work up
How to assess Airway
Stable vs unstable angina`
Ovarian Torsion
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 -
Placental Abruption
Types of Infectious diarrhea - Salmonella
Types of GI bleeds
EMTALA
48. 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
Incomplete abortion
What to do with weak/thready pulses
ED treatment of a Miscarriage
What is a large bore IV?
49. 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
Placental Abruption
ED treatment for Ectopic Pregnancy
Advanced airway techniques
Pancreatitis work up
50. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
ED work up for cholecystitis
Testicular Torsion
Urosepsis
Common Presentation of GIB
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