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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. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Ascending Cholangitis
Abdominal Aortic Aneurysm
Volvulus
Anteroseptal leads and Anterior
2. 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
Syphillis
Emergency Severity Index
Divertriculitis
Other major arteries
3. 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
EMTALA
Ovarian Torsion
Tx of Unstable Angina
Acute Coronary syndrome
4. 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
Types of Infectious diarrhea Shigella
What is a large bore IV?
Placenta Previa
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
Initial steps in stabilizing a patient
Triage
Lateral Leads
SBO
6. 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
STEMI vs Nstemi
SBO
Anteroseptal leads and Anterior
7. 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
Placental Abruption
DUKE criteria for endocarditis
Common risk factors for LGIB
ED work up for cholecystitis
8. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Tx of CHF
Posterior
What is a large bore IV?
Incarcerated vs strangulated hernias
9. 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)
Placenta Previa
Bradycardia
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea - Salmonella
10. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Common risk factors for LGIB
Additional cardiac Tests
Symptoms of Ruptured ovarian cysts
When are Beta Blockers contraindicated
11. 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
Aortic Dissection definition - risks and S/S
Additional cardiac Tests
Ectopic Pregnancy
Tx of CHF
12. 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
Lateral Leads
SBO
Ectopic Pregnancy
Pericarditis
13. 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
Tx of CHF
Placenta Previa
How to monitor CDAB
Types of Infectious diarrhea Shigella
14. Left coronary artery (short and branches quickly)
Genital Herpes
LCA
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
15. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Acute Arterial occlusion - to lower extremities
Appendicitis
Types of Infectious diarrhea - Salmonella
Stable vs. Unstable Ectopic Pregnancy
16. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
What should be done after CDAB's
Define Biliary colic
Acute Arterial occlusion - to lower extremities
Chlamydia
17. Old age - chronic anticoagulation - divertriculosis
Early miscarriage (20 weeks)
Endocarditis
Common risk factors for LGIB
Causes of 3rd trimester bleeding
18. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
What is a large bore IV?
CHF
Cardiac Tamponade
Kidney Stones
19. 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
How to monitor CDAB
Symptoms of Ruptured ovarian cysts
LBO - Large bowel obstruction
Incarcerated vs strangulated hernias
20. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
SBO
Incomplete abortion
Tx of Unstable Angina
Common risk factors for UGIB
21. 16-18 Gauge
Acute Mesenteric Ishemia
LCA
Breathing
What is a large bore IV?
22. 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
Aortic Dissection definition - risks and S/S
ED treatment of a Miscarriage
Emergency Severity Index
23. 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
Symptoms of Ruptured ovarian cysts
Aortic Dissection definition - risks and S/S
EKG changes
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)
DUKE criteria for endocarditis
LCA
Appendicitis
GIB work up
25. 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
ED treatment of a Miscarriage
Define Biliary colic
How to monitor CDAB
26. 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
What is a large bore IV?
Syphillis
Triage
Incidence of AMI
27. 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
Advanced airway techniques
Aortic Dissection definition - risks and S/S
Ranson's criteria
Abdominal Aortic Aneurysm
28. 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
Acute Mesenteric Ishemia
Abdominal Aortic Aneurysm
Common Presentation of GIB
Aortic Dissection definition - risks and S/S
29. 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
Tx of Unstable Angina
LBO - Large bowel obstruction
ED treatment for Ectopic Pregnancy
UTI
30. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Acute Mesenteric Ishemia
Common Presentation of GIB
Types of Infectious diarrhea Campylobacter
Define Biliary colic
31. 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)
Abdominal Aortic Aneurysm
When are Beta Blockers contraindicated
Defibrillation
Endocarditis
32. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Endocarditis
ED treatment of a Miscarriage
Chlamydia
Miscarriage
33. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Cardiac Enzymes
ED treatment for Ectopic Pregnancy
Contraindications for thrombolytics
Urosepsis
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
Hypertensive Emergency
Types of Infectious diarrhea Yersinia
Gonorrhea
Triage
35. 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
Chlamydia
When are Beta Blockers contraindicated
Missed Abortion
Pancreatitis work up
36. 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
Breathing
Emergency Severity Index
Stable vs unstable angina`
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
Kidney Stones
Placental Abruption
The vital signs
Other major arteries
38. 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
Tx of CHF
When is Rho GAM used
What to do with weak/thready pulses
Where to check pulses
39. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Endocarditis
UTI
Define Biliary colic
Pericarditis
40. 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
Urosepsis
Breathing
Causes of 3rd trimester bleeding
Define Acute Cholecystitis
41. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
ED treatment for Ectopic Pregnancy
Contraindications for thrombolytics
LBO - Large bowel obstruction
Placental Abruption
42. 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
Common Presentation of GIB
Endocarditis
Pericarditis
Ovarian Torsion
43. 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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44. 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)
Pain scale for infants
Appendicitis work up
Acute Mesenteric Ishemia
Where to check pulses
45. 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
Incomplete abortion
Dx of Aortic dissection
Types of Infectious diarrhea Shigella
Stable vs. Unstable Ectopic Pregnancy
46. 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
Ascending Cholangitis
When to do a pelvic exam
Common Presentation of GIB
Define Biliary colic
47. 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
Anteroseptal leads and Anterior
Acute Arterial occlusion - to lower extremities
Placenta Previa
Initial steps in stabilizing a patient
48. 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
Pain scale for infants
ED work up for cholecystitis
Anteroseptal leads and Anterior
Initial steps in stabilizing a patient
49. 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
Types of GI bleeds
ED treatment of a Miscarriage
Initial steps in stabilizing a patient
50. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Define Acute Cholecystitis
Stable vs. Unstable Ectopic Pregnancy
Causes of 3rd trimester bleeding
Viral Gastroenteritis