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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. 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
When are Beta Blockers contraindicated
How to assess Airway
Viral Gastroenteritis
What is a large bore IV?
2. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Urosepsis
Common risk factors for UGIB
Incarcerated vs strangulated hernias
ED treatment for Ectopic Pregnancy
3. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
ED treatment for Ectopic Pregnancy
EKG changes
Common Presentation of GIB
Miscarriage
4. 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
Ovarian Cysts
ED Tx of GIB
Ectopic Pregnancy
Gonorrhea
5. 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
Tx of Unstable Angina
Placental Abruption
EKG changes
6. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Stable vs. Unstable Ectopic Pregnancy
LCA
Common Presentation of GIB
The vital signs
7. Inflammation of the pericardial sac with or without effusion - S/S: sharp - pleuritic chest pain that's worse when laying down - pericardial friction rub on exam - ST elevations in ALL leads!!! - depressed PR intervals
Incomplete abortion
Breathing
Pericarditis
Stable vs. Unstable Ectopic Pregnancy
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
Initial steps in stabilizing a patient
Define Acute Cholecystitis
Ectopic Pregnancy
Volvulus
9. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
What is a large bore IV?
Kidney Stones
Stable vs unstable angina`
Types of Infectious diarrhea Shigella
10. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
ED treatment of a Miscarriage
Placental Abruption
Appendicitis
Incidence of AMI
11. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Placental Abruption
ED treatment of a Miscarriage
Ranson's criteria
ED treatment for Ectopic Pregnancy
12. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Define Biliary colic
Cardiac Tamponade
Other major arteries
ED treatment of a Miscarriage
13. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
LCA
Abdominal Aortic Aneurysm
Stable vs unstable angina`
14. Old age - chronic anticoagulation - divertriculosis
Supplemental O2
Common risk factors for LGIB
Pericarditis
Define Acute Cholecystitis
15. 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
What is a large bore IV?
ED work up for cholecystitis
Tx of CHF
Triage
16. 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 work up
Breathing
Stable vs unstable angina`
Lateral Leads
17. 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
Common risk factors for LGIB
Define Acute Cholecystitis
Types of GI bleeds
Missed Abortion
18. 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
RCA
The vital signs
Types of Infectious diarrhea E coli
Genital Herpes
19. 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
Ranson's criteria
Volvulus
Advanced airway techniques
How to monitor CDAB
20. 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
When to do a pelvic exam
DUKE criteria for endocarditis
Tachycardia
Define Acute Cholecystitis
21. 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
What is a large bore IV?
How to assess Airway
Missed Abortion
Ectopic Pregnancy
22. 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
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea - Salmonella
Aortic Dissection definition - risks and S/S
What to do with weak/thready pulses
23. 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
Ovarian Cysts
Incomplete abortion
How to monitor CDAB
Urosepsis
24. 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 -
Pericarditis
GIB work up
Placental Abruption
ED treatment for Ectopic Pregnancy
25. 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
Placenta Previa
What should be done after CDAB's
Initial steps in stabilizing a patient
ED work up for cholecystitis
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)
When is Rho GAM used
Volvulus
How to assess Airway
SBO
27. 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
Acute Mesenteric Ishemia
ED work up for cholecystitis
Contraindications for thrombolytics
ED treatment of a Miscarriage
28. 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
CHF
Pancreatitis work up
Volvulus
What should be done after CDAB's
29. 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
Tachycardia
Other major arteries
Incomplete abortion
30. 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? -
Initial steps in stabilizing a patient
What should be done after CDAB's
Tx of Unstable Angina
Breathing
31. 'trier' - to separate - sift or select based on priority of condition
Triage
EMTALA
Appendicitis
Divertriculitis
32. Check Vital Signs
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33. 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
Tx of Unstable Angina
Miscarriage
Define Acute Cholecystitis
Aortic Dissection definition - risks and S/S
34. 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
Stable vs unstable angina`
Contraindications for thrombolytics
Testicular Torsion
Advanced airway techniques
35. 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
GIB work up
Miscarriage
Contraindications for thrombolytics
Where to check pulses
36. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Common risk factors for UGIB
Types of Infectious diarrhea Shigella
When is Rho GAM used
37. 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)
Other major arteries
Common risk factors for LGIB
Bradycardia
LBO - Large bowel obstruction
38. 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
Kidney Stones
Testicular Torsion
Other major arteries
Endocarditis
39. 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
Breathing
Lateral Leads
How to monitor CDAB
UTI
40. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Additional cardiac Tests
Incidence of AMI
Causes of 3rd trimester bleeding
Cardiac Enzymes
41. 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)
Appendicitis work up
Types of Infectious diarrhea E coli
Incidence of AMI
EKG changes
42. 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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43. 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?
ED treatment for Ectopic Pregnancy
Other major arteries
Incidence of AMI
44. 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)
Pain scale for infants
Ranson's criteria
Defibrillation
Bradycardia
45. 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
Chlamydia
Placental Abruption
Anteroseptal leads and Anterior
46. 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
Viral Gastroenteritis
Supplemental O2
Anteroseptal leads and Anterior
47. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Abdominal Aortic Aneurysm
Dx of Aortic dissection
Miscarriage
Stable vs. Unstable Ectopic Pregnancy
48. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
Syphillis
Placenta Previa
Contraindications for thrombolytics
49. 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
Aortic Dissection definition - risks and S/S
Types of Infectious diarrhea Shigella
Breathing
Contraindications for thrombolytics
50. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Campylobacter
Appendicitis