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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. 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
Early miscarriage (20 weeks)
What should be done after CDAB's
Common risk factors for LGIB
What is a large bore IV?
2. 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
Ovarian Cysts
Endocarditis
EKG changes
Ranson's criteria
3. 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
Initial steps in stabilizing a patient
DUKE criteria for endocarditis
Types of Infectious diarrhea - Salmonella
4. Leads I - aVL - V4-V6 - Left circumflex artery
CHF
RCA
Lateral Leads
Breathing
5. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Dx of Aortic dissection
Types of GI bleeds
Types of Infectious diarrhea Shigella
Pericarditis
6. 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
Placental Abruption
Lateral Leads
Define Acute Cholecystitis
What should be done after CDAB's
7. 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
ED treatment of a Miscarriage
EMTALA
Volvulus
Acute Coronary syndrome
8. 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
ED treatment of a Miscarriage
Define Acute Cholecystitis
Incidence of AMI
Appendicitis work up
9. 'trier' - to separate - sift or select based on priority of condition
Ascending Cholangitis
Cardiac Tamponade
Triage
Gonorrhea
10. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Chlamydia
Tachycardia
UTI
Types of Infectious diarrhea E coli
11. 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
Breathing
Incomplete abortion
Hypertensive Emergency
Ascending Cholangitis
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
Ectopic Pregnancy
Common Presentation of GIB
Placenta Previa
Genital Herpes
13. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
What to do with weak/thready pulses
LCA
How to monitor CDAB
ED treatment for Ectopic Pregnancy
14. 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
Incarcerated vs strangulated hernias
Supplemental O2
LBO - Large bowel obstruction
Viral Gastroenteritis
15. 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
Defibrillation
Urosepsis
Common Presentation of GIB
16. 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
Acute Arterial occlusion - to lower extremities
Initial steps in stabilizing a patient
17. 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
EMTALA
Ovarian Torsion
Urosepsis
18. Left coronary artery (short and branches quickly)
LCA
GIB work up
Ovarian Torsion
SBO
19. 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
Acute Arterial occlusion - to lower extremities
Anteroseptal leads and Anterior
ED work up for cholecystitis
Tx of Unstable Angina
20. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Types of Infectious diarrhea E coli
LBO - Large bowel obstruction
Contraindications for thrombolytics
Anteroseptal leads and Anterior
21. 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
22. 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)
ED Tx of GIB
Pancreatitis work up
EKG changes
Acute Arterial occlusion - to lower extremities
23. Old age - chronic anticoagulation - divertriculosis
ED treatment for Ectopic Pregnancy
What is a large bore IV?
Lateral Leads
Common risk factors for LGIB
24. 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
Abdominal Aortic Aneurysm
EKG changes
How to assess Airway
Initial steps in stabilizing a patient
25. 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
Breathing
EKG changes
Missed Abortion
ED work up for cholecystitis
26. 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
UTI
Tx of CHF
Acute Mesenteric Ishemia
ED treatment of a Miscarriage
27. 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
When are Beta Blockers contraindicated
ED workup of kidney stones
Triage
Stable vs. Unstable Ectopic Pregnancy
28. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Emergency Severity Index
Acute Mesenteric Ishemia
Cardiac Tamponade
Types of Infectious diarrhea Yersinia
29. 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
Viral Gastroenteritis
Define Biliary colic
Aortic Dissection definition - risks and S/S
Supplemental O2
30. 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
Gonorrhea
When are Beta Blockers contraindicated
Dx of Aortic dissection
ED treatment of a Miscarriage
31. 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
Ovarian Cysts
Incomplete abortion
Tx of Unstable Angina
Syphillis
32. 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? -
Acute Mesenteric Ishemia
Inferior leads
ED workup of kidney stones
Tx of Unstable Angina
33. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Endocarditis
Initial steps in stabilizing a patient
Miscarriage
Placenta Previa
34. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
EMTALA
LBO - Large bowel obstruction
DUKE criteria for endocarditis
Tx of CHF
35. 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
Gonorrhea
CHF
LCA
Define Acute Cholecystitis
36. 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
How to monitor CDAB
Common risk factors for UGIB
What should be done after CDAB's
Missed Abortion
37. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Placenta Previa
Abdominal Aortic Aneurysm
Anteroseptal leads and Anterior
Other major arteries
38. 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)
Types of Infectious diarrhea Yersinia
Types of GI bleeds
Appendicitis work up
DUKE criteria for endocarditis
39. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Types of Infectious diarrhea E coli
When to do a pelvic exam
DUKE criteria for endocarditis
Cardiac Tamponade
40. 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
Posterior
Chlamydia
Contraindications for thrombolytics
Ascending Cholangitis
41. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Ascending Cholangitis
Causes of 3rd trimester bleeding
Defibrillation
Tx of Unstable Angina
42. 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:
Pain scale for infants
ED Tx of GIB
UTI
Ovarian Torsion
43. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Stable vs unstable angina`
ED workup of kidney stones
CHF
Triage
44. 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
SBO
What is a large bore IV?
Tx of CHF
Genital Herpes
45. 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
ED treatment for Ectopic Pregnancy
What should be done after CDAB's
ED workup of kidney stones
Cardiac Enzymes
46. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Pancreatitis work up
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Genital Herpes
Divertriculitis
47. 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
Other major arteries
Cardiac Tamponade
Inferior leads
Divertriculitis
48. Testis twists on a spermatic cord - restore blood flow in 6 hours or may have infertility - common at puberty and in 1 year olds - High risk - Bell Clapper Deformity (tunica vaginalis isterts high on the spermatic cord) - horizontal lie spermatic cor
Testicular Torsion
Anteroseptal leads and Anterior
Viral Gastroenteritis
Breathing
49. 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)
Ovarian Cysts
When to do a pelvic exam
DUKE criteria for endocarditis
STEMI vs Nstemi
50. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
ED work up for cholecystitis
Define Acute Cholecystitis
Genital Herpes