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Test your basic knowledge |
Emergency Medicine
Start Test
Study First
Subjects
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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. 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
Incidence of AMI
Genital Herpes
Viral Gastroenteritis
Acute Arterial occlusion - to lower extremities
2. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Causes of 3rd trimester bleeding
How to monitor CDAB
Gonorrhea
Incarcerated vs strangulated hernias
3. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Pericarditis
Inferior leads
Cardiac Enzymes
Types of Infectious diarrhea Campylobacter
4. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Endocarditis
Incarcerated vs strangulated hernias
ED treatment for Ectopic Pregnancy
5. 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
Breathing
Genital Herpes
ED treatment of a Miscarriage
LCA
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
What should be done after CDAB's
Pain scale for infants
RCA
How to assess Airway
7. 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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8. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Missed Abortion
Aortic Dissection definition - risks and S/S
Tx of Unstable Angina
9. 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
EMTALA
Types of GI bleeds
What should be done after CDAB's
Endocarditis
10. 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
EKG changes
CHF
RCA
Incomplete abortion
11. 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
Acute Arterial occlusion - to lower extremities
What to do with weak/thready pulses
Types of Infectious diarrhea - Salmonella
Ascending Cholangitis
12. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
When is Rho GAM used
Causes of 3rd trimester bleeding
How to monitor CDAB
13. 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
GIB work up
Chlamydia
Placenta Previa
Abdominal Aortic Aneurysm
14. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Testicular Torsion
EKG changes
Define Biliary colic
Stable vs unstable angina`
15. 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
GIB work up
Early miscarriage (20 weeks)
Tachycardia
The vital signs
16. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Additional cardiac Tests
ED workup of kidney stones
CHF
17. V1-V2 Right Posterior Descending Artery
Dx of Aortic dissection
Posterior
What is a large bore IV?
Incomplete abortion
18. 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)
What is a large bore IV?
Pericarditis
Appendicitis work up
Anteroseptal leads and Anterior
19. 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? -
Tx of Unstable Angina
UTI
Supplemental O2
STEMI vs Nstemi
20. 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
ED Tx of GIB
Common risk factors for LGIB
Contraindications for thrombolytics
Supplemental O2
21. 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
Ascending Cholangitis
How to monitor CDAB
Cardiac Enzymes
Types of Infectious diarrhea Shigella
22. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Breathing
Types of GI bleeds
Divertriculitis
Miscarriage
23. 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:
Ovarian Torsion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
LBO - Large bowel obstruction
Emergency Severity Index
24. 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
Incidence of AMI
Additional cardiac Tests
Dx of Aortic dissection
Stable vs. Unstable Ectopic Pregnancy
25. 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
CHF
Kidney Stones
ED treatment for Ectopic Pregnancy
Symptoms of Ruptured ovarian cysts
26. 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
Breathing
Appendicitis
What to do with weak/thready pulses
Missed Abortion
27. 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
Cardiac Enzymes
What is a large bore IV?
Abdominal Aortic Aneurysm
Types of GI bleeds
28. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Dx of Aortic dissection
Common risk factors for UGIB
Symptoms of Ruptured ovarian cysts
Incarcerated vs strangulated hernias
29. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
ED work up for cholecystitis
Volvulus
Ascending Cholangitis
Ovarian Cysts
30. 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
Tx of CHF
Types of Infectious diarrhea - Salmonella
Acute Coronary syndrome
Defibrillation
31. 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
Anteroseptal leads and Anterior
Dx of Aortic dissection
Define Acute Cholecystitis
Early miscarriage (20 weeks)
32. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Types of Infectious diarrhea E coli
What to do with weak/thready pulses
Common Presentation of GIB
Ectopic Pregnancy
33. 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
Bradycardia
Incarcerated vs strangulated hernias
What to do with weak/thready pulses
34. 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 workup of kidney stones
Emergency Severity Index
Other major arteries
ED work up for cholecystitis
35. 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
Appendicitis
Where to check pulses
Causes of 3rd trimester bleeding
What to do with weak/thready pulses
36. 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
ED workup of kidney stones
Acute Coronary syndrome
Cardiac Enzymes
37. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Lateral Leads
How to assess Airway
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea E coli
38. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Tachycardia
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
What to do with weak/thready pulses
Incomplete abortion
39. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Genital Herpes
CHF
The vital signs
ED treatment for Ectopic Pregnancy
40. 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
Additional cardiac Tests
Tachycardia
Tx of CHF
Advanced airway techniques
41. 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
Lateral Leads
Breathing
ED work up for cholecystitis
Stable vs unstable angina`
42. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Aortic Dissection definition - risks and S/S
Volvulus
Advanced airway techniques
43. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Early miscarriage (20 weeks)
Types of GI bleeds
When to do a pelvic exam
How to assess Airway
44. 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
Tx of CHF
Posterior
Ectopic Pregnancy
What is a large bore IV?
45. 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
EMTALA
Acute Arterial occlusion - to lower extremities
Pancreatitis work up
46. 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
Pericarditis
Bradycardia
Pain scale for infants
Tx of Unstable Angina
47. 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
Appendicitis work up
Pain scale for infants
Pericarditis
Syphillis
48. 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
Define Biliary colic
CHF
Ectopic Pregnancy
Aortic Dissection definition - risks and S/S
49. 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
LBO - Large bowel obstruction
Miscarriage
Tx of CHF
Viral Gastroenteritis
50. 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
The vital signs
Types of Infectious diarrhea - Salmonella
Initial steps in stabilizing a patient
CHF