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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. 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
When to do a pelvic exam
Genital Herpes
Cardiac Enzymes
ED workup of kidney stones
2. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Chlamydia
ED workup of kidney stones
Supplemental O2
3. 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)
Hypertensive Emergency
Appendicitis work up
When are Beta Blockers contraindicated
Triage
4. 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
Stable vs unstable angina`
Types of Infectious diarrhea Shigella
Contraindications for thrombolytics
Inferior leads
5. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Gonorrhea
Pericarditis
The vital signs
Early miscarriage (20 weeks)
6. 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
ED Tx of GIB
GIB work up
Volvulus
7. 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
ED treatment for Ectopic Pregnancy
Testicular Torsion
EMTALA
Acute Arterial occlusion - to lower extremities
8. 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
ED workup of kidney stones
Where to check pulses
Types of Infectious diarrhea E coli
Volvulus
9. 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
Ectopic Pregnancy
Ovarian Cysts
Incidence of AMI
UTI
10. 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)
Additional cardiac Tests
Bradycardia
Types of Infectious diarrhea E coli
EKG changes
11. 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
Ovarian Torsion
ED treatment of a Miscarriage
Pain scale for infants
Urosepsis
12. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Stable vs unstable angina`
Syphillis
13. 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
Kidney Stones
ED treatment for Ectopic Pregnancy
Emergency Severity Index
14. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Aortic Dissection definition - risks and S/S
Where to check pulses
Viral Gastroenteritis
Cardiac Tamponade
15. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Anteroseptal leads and Anterior
What should be done after CDAB's
Advanced airway techniques
Defibrillation
16. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
Acute Mesenteric Ishemia
Acute Arterial occlusion - to lower extremities
Viral Gastroenteritis
17. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Define Acute Cholecystitis
Tx of CHF
Incomplete abortion
Ovarian Cysts
18. 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
Ranson's criteria
Contraindications for thrombolytics
Types of GI bleeds
Cardiac Tamponade
19. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
ED treatment for Ectopic Pregnancy
Tx of Unstable Angina
Define Biliary colic
Gonorrhea
20. 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
Types of Infectious diarrhea E coli
Hypertensive Emergency
How to assess Airway
21. 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
Ectopic Pregnancy
Triage
Bradycardia
Breathing
22. 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
Miscarriage
Stable vs unstable angina`
SBO
Stable vs. Unstable Ectopic Pregnancy
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
How to monitor CDAB
Urosepsis
ED work up for cholecystitis
Viral Gastroenteritis
24. 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
Tx of Unstable Angina
EMTALA
Ascending Cholangitis
25. 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
Define Biliary colic
Dx of Aortic dissection
EKG changes
26. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Appendicitis work up
Initial steps in stabilizing a patient
Hypertensive Emergency
Pain scale for infants
27. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Acute Coronary syndrome
Ascending Cholangitis
Cardiac Tamponade
Define Biliary colic
28. V1-V2 Right Posterior Descending Artery
Chlamydia
Pericarditis
When is Rho GAM used
Posterior
29. 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
Breathing
Ovarian Cysts
Pancreatitis work up
30. 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
ED treatment of a Miscarriage
Triage
Endocarditis
31. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Posterior
What to do with weak/thready pulses
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea Yersinia
32. 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
Chlamydia
Cardiac Tamponade
Early miscarriage (20 weeks)
GIB work up
33. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
RCA
Tachycardia
Dx of Aortic dissection
34. 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
Bradycardia
Symptoms of Ruptured ovarian cysts
Define Acute Cholecystitis
Types of Infectious diarrhea Shigella
35. 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 Tx of GIB
Ranson's criteria
Ectopic Pregnancy
36. 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 -
Genital Herpes
Initial steps in stabilizing a patient
Placental Abruption
Incidence of AMI
37. Check Vital Signs
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38. 16-18 Gauge
Hypertensive Emergency
Miscarriage
What is a large bore IV?
Additional cardiac Tests
39. Left coronary artery (short and branches quickly)
Gonorrhea
LCA
SBO
Placenta Previa
40. 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
Endocarditis
Where to check pulses
Common risk factors for LGIB
Abdominal Aortic Aneurysm
41. 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
EKG changes
Testicular Torsion
Pericarditis
Ectopic Pregnancy
42. 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
Cardiac Enzymes
When to do a pelvic exam
Tachycardia
Endocarditis
43. 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? -
Bradycardia
ED workup of kidney stones
Tx of Unstable Angina
CHF
44. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Supplemental O2
How to assess Airway
Hypertensive Emergency
45. 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
What is a large bore IV?
Early miscarriage (20 weeks)
Where to check pulses
46. II - III - aVF - Means RCA involved
Inferior leads
Ascending Cholangitis
ED treatment for Ectopic Pregnancy
Posterior
47. 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
Genital Herpes
Breathing
Ovarian Torsion
Aortic Dissection definition - risks and S/S
48. 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
Placental Abruption
Ranson's criteria
How to assess Airway
EMTALA
49. Leads I - aVL - V4-V6 - Left circumflex artery
Cardiac Enzymes
Define Acute Cholecystitis
Lateral Leads
Ranson's criteria
50. 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
What to do with weak/thready pulses
Other major arteries
Triage