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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. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Acute Coronary syndrome
Kidney Stones
Pain scale for infants
Causes of 3rd trimester bleeding
2. 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
Syphillis
ED work up for cholecystitis
Aortic Dissection definition - risks and S/S
ED treatment of a Miscarriage
3. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
ED treatment of a Miscarriage
RCA
Pericarditis
Types of Infectious diarrhea Shigella
4. Check Vital Signs
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5. 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
SBO
Advanced airway techniques
LBO - Large bowel obstruction
How to assess Airway
6. 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
Dx of Aortic dissection
ED treatment for Ectopic Pregnancy
Supplemental O2
Cardiac Tamponade
7. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Kidney Stones
Types of Infectious diarrhea E coli
ED work up for cholecystitis
Types of GI bleeds
8. Left coronary artery (short and branches quickly)
LCA
CHF
Inferior leads
Incomplete abortion
9. 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
The vital signs
Early miscarriage (20 weeks)
Cardiac Enzymes
Urosepsis
10. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Tx of CHF
Placental Abruption
When are Beta Blockers contraindicated
Ovarian Cysts
11. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
RCA
Ovarian Cysts
Define Acute Cholecystitis
When to do a pelvic exam
12. 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
Other major arteries
Symptoms of Ruptured ovarian cysts
Stable vs unstable angina`
ED Tx of GIB
13. 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
Types of Infectious diarrhea Yersinia
Stable vs unstable angina`
Appendicitis work up
Tachycardia
14. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Placenta Previa
Syphillis
Common Presentation of GIB
CHF
15. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Appendicitis
Pain scale for infants
Acute Arterial occlusion - to lower extremities
16. 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
Additional cardiac Tests
Missed Abortion
Appendicitis
17. Categorize based on severity: 1 to 5 1 - most severe: cyanotic/not breathing - unreseponsive or not talking 2 - MI (life threatening but talking) 3- appendicitis/ abdomino pelvic pain 4- ankle swelling - broken leg 5- suture removal Things you ca
ED treatment for Ectopic Pregnancy
Contraindications for thrombolytics
Emergency Severity Index
Anteroseptal leads and Anterior
18. 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)
Defibrillation
Acute Coronary syndrome
Tx of Unstable Angina
How to monitor CDAB
19. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Stable vs unstable angina`
When are Beta Blockers contraindicated
ED treatment for Ectopic Pregnancy
When is Rho GAM used
20. V1-V2 Right Posterior Descending Artery
STEMI vs Nstemi
Posterior
ED work up for cholecystitis
RCA
21. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Contraindications for thrombolytics
RCA
When is Rho GAM used
Cardiac Tamponade
22. 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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23. 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
Initial steps in stabilizing a patient
ED workup of kidney stones
Posterior
Acute Coronary syndrome
24. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Appendicitis work up
Acute Arterial occlusion - to lower extremities
Types of GI bleeds
Divertriculitis
25. 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
Divertriculitis
Acute Coronary syndrome
Stable vs. Unstable Ectopic Pregnancy
How to monitor CDAB
26. 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
Bradycardia
Initial steps in stabilizing a patient
Common Presentation of GIB
Appendicitis work up
27. 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
Appendicitis
Breathing
ED Tx of GIB
Types of GI bleeds
28. Old age - chronic anticoagulation - divertriculosis
Stable vs unstable angina`
DUKE criteria for endocarditis
Common risk factors for LGIB
What should be done after CDAB's
29. Leads I - aVL - V4-V6 - Left circumflex artery
Abdominal Aortic Aneurysm
DUKE criteria for endocarditis
Lateral Leads
Urosepsis
30. 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
Triage
Ovarian Torsion
Testicular Torsion
31. 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
Stable vs. Unstable Ectopic Pregnancy
LBO - Large bowel obstruction
Pancreatitis work up
Initial steps in stabilizing a patient
32. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Pain scale for infants
Volvulus
Ectopic Pregnancy
Ovarian Cysts
33. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Other major arteries
Dx of Aortic dissection
Miscarriage
STEMI vs Nstemi
34. 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
Define Biliary colic
Types of Infectious diarrhea Yersinia
ED workup of kidney stones
Hypertensive Emergency
35. 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
Breathing
How to monitor CDAB
UTI
Supplemental O2
36. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Volvulus
Abdominal Aortic Aneurysm
The vital signs
Defibrillation
37. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Initial steps in stabilizing a patient
Kidney Stones
Appendicitis
38. 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
Ovarian Torsion
EKG changes
Gonorrhea
How to monitor CDAB
39. 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
LCA
Missed Abortion
Tachycardia
Acute Arterial occlusion - to lower extremities
40. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Additional cardiac Tests
RCA
Ascending Cholangitis
Hypertensive Emergency
41. 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
Kidney Stones
Where to check pulses
Chlamydia
42. 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
Gonorrhea
Chlamydia
Ascending Cholangitis
Appendicitis
43. 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
EKG changes
Gonorrhea
GIB work up
The vital signs
44. Sigmoid - volvulus: High risk patients: chronic constipation - elderly and debilitated patients - Dx: plain film - Tx: decompress with rectal tube - Cecal volvulus - see congenital hypermobile cecum. also dx with plain films
Ovarian Torsion
Gonorrhea
Ranson's criteria
Volvulus
45. 16-18 Gauge
Causes of 3rd trimester bleeding
Types of GI bleeds
What is a large bore IV?
Aortic Dissection definition - risks and S/S
46. 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
Missed Abortion
SBO
Contraindications for thrombolytics
47. 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
Pain scale for infants
Viral Gastroenteritis
Additional cardiac Tests
Placenta Previa
48. 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)
Lateral Leads
Appendicitis work up
Viral Gastroenteritis
Inferior leads
49. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Initial steps in stabilizing a patient
Anteroseptal leads and Anterior
Pain scale for infants
Missed Abortion
50. 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 -
The vital signs
Placental Abruption
Types of Infectious diarrhea Campylobacter
When to do a pelvic exam