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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. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Tachycardia
Acute Mesenteric Ishemia
Kidney Stones
STEMI vs Nstemi
2. 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? -
Stable vs unstable angina`
Where to check pulses
Tx of Unstable Angina
Cardiac Enzymes
3. 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
Chlamydia
Cardiac Enzymes
Kidney Stones
ED treatment of a Miscarriage
4. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Inferior leads
Acute Arterial occlusion - to lower extremities
Define Biliary colic
Causes of 3rd trimester bleeding
5. 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
Volvulus
ED work up for cholecystitis
Ectopic Pregnancy
Miscarriage
6. 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
Common risk factors for LGIB
Divertriculitis
Posterior
7. 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
How to assess Airway
LCA
Contraindications for thrombolytics
Miscarriage
8. 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
Placenta Previa
What is a large bore IV?
Dx of Aortic dissection
Gonorrhea
9. 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
Define Biliary colic
How to monitor CDAB
Posterior
Bradycardia
10. 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
Breathing
GIB work up
Where to check pulses
Define Acute Cholecystitis
11. Check Vital Signs
12. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Appendicitis
Advanced airway techniques
CHF
Aortic Dissection definition - risks and S/S
13. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Incidence of AMI
Causes of 3rd trimester bleeding
Advanced airway techniques
Urosepsis
14. 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
Testicular Torsion
CHF
Acute Coronary syndrome
GIB work up
15. 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)
Advanced airway techniques
ED work up for cholecystitis
DUKE criteria for endocarditis
When is Rho GAM used
16. Gallbladder inflammation - often from prolonged obstruction of stones - Pain more severe than biliary coli - assoc w/ fever and lasts 6+ hours - Common bacteria: gram - - strep - anaerobes
Define Acute Cholecystitis
ED workup of kidney stones
LCA
Contraindications for thrombolytics
17. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Define Biliary colic
Gonorrhea
Types of Infectious diarrhea E coli
Tx of Unstable Angina
18. 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
ED workup of kidney stones
Hypertensive Emergency
Types of Infectious diarrhea Shigella
Gonorrhea
19. 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
Types of Infectious diarrhea Yersinia
How to assess Airway
Contraindications for thrombolytics
Acute Coronary syndrome
20. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Types of Infectious diarrhea E coli
Pain scale for infants
Common risk factors for UGIB
21. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Types of Infectious diarrhea E coli
Tx of CHF
When to do a pelvic exam
LCA
22. 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
Pancreatitis work up
Tx of CHF
Acute Mesenteric Ishemia
Syphillis
23. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Emergency Severity Index
Types of Infectious diarrhea E coli
What to do with weak/thready pulses
Inferior leads
24. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
Acute Mesenteric Ishemia
What should be done after CDAB's
What is a large bore IV?
25. 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
Acute Mesenteric Ishemia
Pancreatitis work up
SBO
Pain scale for infants
26. 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)
Missed Abortion
Appendicitis work up
Common Presentation of GIB
Acute Coronary syndrome
27. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Lateral Leads
LCA
Causes of 3rd trimester bleeding
UTI
28. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
ED treatment of a Miscarriage
The vital signs
DUKE criteria for endocarditis
What is a large bore IV?
29. 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
Hypertensive Emergency
Viral Gastroenteritis
Contraindications for thrombolytics
Ectopic Pregnancy
30. 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 workup of kidney stones
Causes of 3rd trimester bleeding
GIB work up
DUKE criteria for endocarditis
31. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Acute Arterial occlusion - to lower extremities
Symptoms of Ruptured ovarian cysts
ED workup of kidney stones
Placental Abruption
32. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea Campylobacter
Triage
33. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
The vital signs
Stable vs. Unstable Ectopic Pregnancy
LBO - Large bowel obstruction
Hypertensive Emergency
34. II - III - aVF - Means RCA involved
EKG changes
Inferior leads
Common risk factors for UGIB
EMTALA
35. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Aortic Dissection definition - risks and S/S
Anteroseptal leads and Anterior
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Kidney Stones
36. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Anteroseptal leads and Anterior
Appendicitis
Breathing
37. 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
Miscarriage
Causes of 3rd trimester bleeding
Breathing
When is Rho GAM used
38. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Tx of Unstable Angina
Pain scale for infants
RCA
Posterior
39. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Abdominal Aortic Aneurysm
Initial steps in stabilizing a patient
CHF
Types of Infectious diarrhea Shigella
40. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
What is a large bore IV?
Ectopic Pregnancy
Incomplete abortion
Common risk factors for UGIB
41. 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
Contraindications for thrombolytics
Placenta Previa
Syphillis
Tx of CHF
42. 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)
When is Rho GAM used
Appendicitis work up
Dx of Aortic dissection
STEMI vs Nstemi
43. 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
ED workup of kidney stones
Inferior leads
Hypertensive Emergency
Incomplete abortion
44. 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
Symptoms of Ruptured ovarian cysts
Advanced airway techniques
Appendicitis
Incidence of AMI
45. 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
Supplemental O2
Types of GI bleeds
Ranson's criteria
Volvulus
46. 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
Pain scale for infants
CHF
The vital signs
47. 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
Syphillis
Types of Infectious diarrhea - Salmonella
Bradycardia
Symptoms of Ruptured ovarian cysts
48. 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
Tachycardia
Genital Herpes
RCA
Supplemental O2
49. V1-V2 Right Posterior Descending Artery
Common Presentation of GIB
Endocarditis
Posterior
Where to check pulses
50. 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 Shigella
Lateral Leads
Pancreatitis work up
Causes of 3rd trimester bleeding