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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. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
Acute Arterial occlusion - to lower extremities
Hypertensive Emergency
Testicular Torsion
2. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Tx of CHF
Types of Infectious diarrhea Shigella
SBO
3. II - III - aVF - Means RCA involved
Incidence of AMI
Incomplete abortion
Posterior
Inferior leads
4. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
How to monitor CDAB
GIB work up
Common risk factors for UGIB
Stable vs. Unstable Ectopic Pregnancy
5. 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
EMTALA
Ectopic Pregnancy
ED treatment of a Miscarriage
6. 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
Viral Gastroenteritis
ED treatment of a Miscarriage
ED Tx of GIB
Kidney Stones
7. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Genital Herpes
Stable vs. Unstable Ectopic Pregnancy
Causes of 3rd trimester bleeding
Gonorrhea
8. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Bradycardia
Emergency Severity Index
Cardiac Tamponade
Breathing
9. 'trier' - to separate - sift or select based on priority of condition
Initial steps in stabilizing a patient
Stable vs unstable angina`
Triage
Causes of 3rd trimester bleeding
10. 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
Cardiac Enzymes
When to do a pelvic exam
ED Tx of GIB
EKG changes
11. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis
Pancreatitis work up
DUKE criteria for endocarditis
12. 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
Ranson's criteria
Contraindications for thrombolytics
Chlamydia
Abdominal Aortic Aneurysm
13. 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 -
Kidney Stones
Causes of 3rd trimester bleeding
Advanced airway techniques
Placental Abruption
14. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Ovarian Cysts
Causes of 3rd trimester bleeding
15. 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)
Chlamydia
Stable vs. Unstable Ectopic Pregnancy
Appendicitis work up
Symptoms of Ruptured ovarian cysts
16. CXR - may see cardiomegaly - consolidation or effusions - Echo - look at wall motion - anuersysm - pericardial effusion - LV thrombus - Stress EcHO - CT Angiogram for Pulmonary Embolism!!!! (need good kidneys for dye) - can also do a spiral CT
Additional cardiac Tests
Placenta Previa
Gonorrhea
Tachycardia
17. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
ED treatment for Ectopic Pregnancy
Cardiac Enzymes
Pericarditis
18. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
SBO
Common risk factors for LGIB
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
What is a large bore IV?
19. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Abdominal Aortic Aneurysm
Tx of Unstable Angina
Urosepsis
Divertriculitis
20. 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? -
Causes of 3rd trimester bleeding
Advanced airway techniques
Initial steps in stabilizing a patient
Tx of Unstable Angina
21. S/S - PAIN OUT OF PROPORTION TO ABDOMINAL EXAM - benign compared to pain - At risk patients: elderly - vasculopaths - patients with afib - patients in cardiogenic shock/cardiopulm bypass or on high dose pressors - most occur in SMA (ie intracardiac e
Common risk factors for LGIB
ED treatment for Ectopic Pregnancy
Pericarditis
Acute Mesenteric Ishemia
22. 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
Anteroseptal leads and Anterior
Testicular Torsion
Common Presentation of GIB
Common risk factors for LGIB
23. 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
Placental Abruption
Dx of Aortic dissection
Incidence of AMI
Gonorrhea
24. 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
Genital Herpes
Pericarditis
Missed Abortion
Appendicitis
25. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Viral Gastroenteritis
Volvulus
Urosepsis
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)
Abdominal Aortic Aneurysm
When is Rho GAM used
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
CHF
27. 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`
Ovarian Torsion
LCA
Types of GI bleeds
28. 16-18 Gauge
What is a large bore IV?
Types of Infectious diarrhea - Salmonella
Common Presentation of GIB
Acute Arterial occlusion - to lower extremities
29. 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
Tx of CHF
Types of Infectious diarrhea Shigella
CHF
Inferior leads
30. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
Define Biliary colic
EKG changes
Placenta Previa
31. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Cardiac Enzymes
Common risk factors for LGIB
Types of Infectious diarrhea E coli
Advanced airway techniques
32. 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
Cardiac Tamponade
Anteroseptal leads and Anterior
ED Tx of GIB
Symptoms of Ruptured ovarian cysts
33. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Incidence of AMI
ED treatment for Ectopic Pregnancy
What to do with weak/thready pulses
Stable vs unstable angina`
34. 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
ED treatment of a Miscarriage
Common Presentation of GIB
Symptoms of Ruptured ovarian cysts
35. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Types of Infectious diarrhea E coli
Appendicitis
The vital signs
Common Presentation of GIB
36. 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
Where to check pulses
UTI
Types of Infectious diarrhea Yersinia
Types of GI bleeds
37. 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
Define Acute Cholecystitis
CHF
Divertriculitis
LBO - Large bowel obstruction
38. 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
What should be done after CDAB's
Lateral Leads
Acute Coronary syndrome
ED workup of kidney stones
39. 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
Stable vs unstable angina`
What should be done after CDAB's
Emergency Severity Index
40. 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
Emergency Severity Index
Ectopic Pregnancy
Aortic Dissection definition - risks and S/S
Contraindications for thrombolytics
41. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Early miscarriage (20 weeks)
Incidence of AMI
Genital Herpes
When are Beta Blockers contraindicated
42. 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
Divertriculitis
UTI
Early miscarriage (20 weeks)
When are Beta Blockers contraindicated
43. 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
Divertriculitis
UTI
Types of Infectious diarrhea Yersinia
Placenta Previa
44. 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
Urosepsis
Genital Herpes
Lateral Leads
Incidence of AMI
45. 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
What is a large bore IV?
RCA
Hypertensive Emergency
Endocarditis
46. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
Where to check pulses
ED workup of kidney stones
Lateral Leads
47. Leads I - aVL - V4-V6 - Left circumflex artery
Placental Abruption
EMTALA
Types of GI bleeds
Lateral Leads
48. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
When are Beta Blockers contraindicated
Miscarriage
When to do a pelvic exam
Pain scale for infants
49. 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
Cardiac Enzymes
ED work up for cholecystitis
GIB work up
Dx of Aortic dissection
50. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Early miscarriage (20 weeks)
Aortic Dissection definition - risks and S/S
The vital signs
Cardiac Enzymes