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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. 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
Defibrillation
Incomplete abortion
ED Tx of GIB
Ascending Cholangitis
2. 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
Acute Coronary syndrome
Defibrillation
How to monitor CDAB
Bradycardia
3. Leads I - aVL - V4-V6 - Left circumflex artery
Chlamydia
Genital Herpes
Lateral Leads
Acute Coronary syndrome
4. 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
Appendicitis
How to assess Airway
Chlamydia
Tx of CHF
5. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Miscarriage
How to monitor CDAB
ED workup of kidney stones
Types of Infectious diarrhea E coli
6. 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
Stable vs unstable angina`
Early miscarriage (20 weeks)
Cardiac Tamponade
Types of Infectious diarrhea Yersinia
7. 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
Missed Abortion
CHF
Tachycardia
Inferior leads
8. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Kidney Stones
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Ovarian Cysts
Causes of 3rd trimester bleeding
9. 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
LBO - Large bowel obstruction
Stable vs unstable angina`
Acute Arterial occlusion - to lower extremities
Common Presentation of GIB
10. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
RCA
Pain scale for infants
How to monitor CDAB
Cardiac Tamponade
11. 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
Acute Mesenteric Ishemia
The vital signs
ED work up for cholecystitis
Posterior
12. 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
When are Beta Blockers contraindicated
When to do a pelvic exam
Aortic Dissection definition - risks and S/S
13. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Incidence of AMI
Abdominal Aortic Aneurysm
UTI
14. 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
When are Beta Blockers contraindicated
Missed Abortion
Pancreatitis work up
Symptoms of Ruptured ovarian cysts
15. Check Vital Signs
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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
Emergency Severity Index
Early miscarriage (20 weeks)
RCA
Define Acute Cholecystitis
17. 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
Gonorrhea
RCA
Dx of Aortic dissection
Appendicitis work up
18. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Other major arteries
Supplemental O2
Contraindications for thrombolytics
19. 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
Ectopic Pregnancy
ED Tx of GIB
Types of Infectious diarrhea Campylobacter
RCA
20. 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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21. 'trier' - to separate - sift or select based on priority of condition
SBO
Triage
Contraindications for thrombolytics
Appendicitis work up
22. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Ectopic Pregnancy
When are Beta Blockers contraindicated
Pain scale for infants
23. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Divertriculitis
Genital Herpes
Types of Infectious diarrhea Shigella
Placental Abruption
24. 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)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
DUKE criteria for endocarditis
Emergency Severity Index
Pericarditis
25. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Acute Mesenteric Ishemia
ED work up for cholecystitis
ED treatment for Ectopic Pregnancy
STEMI vs Nstemi
26. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Pancreatitis work up
How to assess Airway
When are Beta Blockers contraindicated
27. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Common risk factors for UGIB
Appendicitis
Contraindications for thrombolytics
Cardiac Tamponade
28. 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)
Urosepsis
Common risk factors for UGIB
Bradycardia
ED treatment for Ectopic Pregnancy
29. 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:
Common risk factors for LGIB
Syphillis
Ovarian Torsion
RCA
30. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Anteroseptal leads and Anterior
ED treatment for Ectopic Pregnancy
Hypertensive Emergency
Types of Infectious diarrhea - Salmonella
31. 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
Divertriculitis
When is Rho GAM used
Supplemental O2
Volvulus
32. 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
What should be done after CDAB's
Types of GI bleeds
Bradycardia
Cardiac Enzymes
33. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
Appendicitis work up
Stable vs unstable angina`
Common risk factors for UGIB
34. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Emergency Severity Index
Incarcerated vs strangulated hernias
Volvulus
Common Presentation of GIB
35. V1-V2 Right Posterior Descending Artery
Types of Infectious diarrhea E coli
Stable vs unstable angina`
Breathing
Posterior
36. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Campylobacter
Advanced airway techniques
Types of Infectious diarrhea Yersinia
37. 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
Anteroseptal leads and Anterior
Dx of Aortic dissection
Types of Infectious diarrhea E coli
Contraindications for thrombolytics
38. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Volvulus
Types of Infectious diarrhea Shigella
Appendicitis
Gonorrhea
39. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
What to do with weak/thready pulses
Types of Infectious diarrhea E coli
Tachycardia
Define Biliary colic
40. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
ED treatment for Ectopic Pregnancy
Acute Arterial occlusion - to lower extremities
Divertriculitis
Contraindications for thrombolytics
41. 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? -
Pancreatitis work up
Tx of Unstable Angina
Types of Infectious diarrhea - Salmonella
UTI
42. 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
Additional cardiac Tests
Common Presentation of GIB
Ectopic Pregnancy
Stable vs. Unstable Ectopic Pregnancy
43. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
How to monitor CDAB
Triage
Miscarriage
Incarcerated vs strangulated hernias
44. 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
Causes of 3rd trimester bleeding
Acute Coronary syndrome
Ascending Cholangitis
Contraindications for thrombolytics
45. Left coronary artery (short and branches quickly)
Tachycardia
LCA
Acute Mesenteric Ishemia
Posterior
46. 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
Tx of Unstable Angina
How to assess Airway
Common Presentation of GIB
EMTALA
47. 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
Tx of CHF
Triage
ED treatment of a Miscarriage
How to monitor CDAB
48. 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
Define Acute Cholecystitis
Ovarian Cysts
Gonorrhea
Where to check pulses
49. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
ED treatment for Ectopic Pregnancy
Emergency Severity Index
Causes of 3rd trimester bleeding
Incomplete abortion
50. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
RCA
Inferior leads
When to do a pelvic exam
Kidney Stones