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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. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Acute Mesenteric Ishemia
Types of Infectious diarrhea Shigella
DUKE criteria for endocarditis
The vital signs
2. 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
Missed Abortion
What should be done after CDAB's
Tx of CHF
Types of Infectious diarrhea Campylobacter
3. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Volvulus
Where to check pulses
EMTALA
Causes of 3rd trimester bleeding
4. 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
Emergency Severity Index
RCA
Pain scale for infants
STEMI vs Nstemi
5. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
GIB work up
Viral Gastroenteritis
Aortic Dissection definition - risks and S/S
6. 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
Incomplete abortion
Incidence of AMI
Emergency Severity Index
Kidney Stones
7. 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
SBO
Inferior leads
Cardiac Enzymes
Pain scale for infants
8. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
ED treatment for Ectopic Pregnancy
Acute Coronary syndrome
Urosepsis
Pain scale for infants
9. 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
Ovarian Torsion
Pericarditis
ED treatment of a Miscarriage
10. 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
Hypertensive Emergency
Acute Mesenteric Ishemia
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Abdominal Aortic Aneurysm
11. 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
Placenta Previa
Testicular Torsion
Types of Infectious diarrhea E coli
Common Presentation of GIB
12. 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
Ovarian Torsion
ED work up for cholecystitis
Symptoms of Ruptured ovarian cysts
Define Acute Cholecystitis
13. V1-V2 Right Posterior Descending Artery
Placenta Previa
Posterior
When is Rho GAM used
EKG changes
14. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Tx of Unstable Angina
Breathing
Anteroseptal leads and Anterior
DUKE criteria for endocarditis
15. 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
How to assess Airway
Common risk factors for LGIB
SBO
Inferior leads
16. 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)
EMTALA
Divertriculitis
When is Rho GAM used
Appendicitis
17. 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
Common risk factors for UGIB
Ovarian Cysts
Where to check pulses
Placental Abruption
18. 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
Define Acute Cholecystitis
GIB work up
ED workup of kidney stones
Types of Infectious diarrhea Shigella
19. 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
ED treatment of a Miscarriage
Testicular Torsion
Missed Abortion
Advanced airway techniques
20. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Ovarian Torsion
What to do with weak/thready pulses
EKG changes
Triage
21. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
When is Rho GAM used
Common Presentation of GIB
Placenta Previa
ED treatment for Ectopic Pregnancy
22. 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
CHF
Divertriculitis
Chlamydia
Incidence of AMI
23. 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
Acute Mesenteric Ishemia
How to assess Airway
Hypertensive Emergency
Tx of Unstable Angina
24. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Testicular Torsion
CHF
The vital signs
Incarcerated vs strangulated hernias
25. 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
Miscarriage
Dx of Aortic dissection
Supplemental O2
UTI
26. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Types of Infectious diarrhea Shigella
Tachycardia
Aortic Dissection definition - risks and S/S
Cardiac Tamponade
27. Old age - chronic anticoagulation - divertriculosis
Define Biliary colic
Incarcerated vs strangulated hernias
Common risk factors for LGIB
When to do a pelvic exam
28. 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
Types of Infectious diarrhea - Salmonella
Urosepsis
What to do with weak/thready pulses
Tachycardia
29. 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
What is a large bore IV?
Hypertensive Emergency
Tx of CHF
Genital Herpes
30. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of Infectious diarrhea Campylobacter
What to do with weak/thready pulses
What should be done after CDAB's
What is a large bore IV?
31. II - III - aVF - Means RCA involved
Common risk factors for UGIB
Additional cardiac Tests
Inferior leads
Dx of Aortic dissection
32. 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
The vital signs
Pancreatitis work up
How to assess Airway
Tx of Unstable Angina
33. 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
Pericarditis
Acute Mesenteric Ishemia
ED Tx of GIB
Incidence of AMI
34. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
CHF
When are Beta Blockers contraindicated
EMTALA
Ovarian Torsion
35. 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
Appendicitis
Kidney Stones
Acute Mesenteric Ishemia
36. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
CHF
Common Presentation of GIB
Inferior leads
Types of Infectious diarrhea - Salmonella
37. 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
ED Tx of GIB
Define Biliary colic
Emergency Severity Index
38. 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
Incarcerated vs strangulated hernias
Supplemental O2
RCA
39. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Gonorrhea
Ranson's criteria
Inferior leads
Types of Infectious diarrhea E coli
40. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
When are Beta Blockers contraindicated
Tx of Unstable Angina
Advanced airway techniques
Gonorrhea
41. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Anteroseptal leads and Anterior
Types of Infectious diarrhea Yersinia
Genital Herpes
Cardiac Tamponade
42. 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
Types of Infectious diarrhea Yersinia
Endocarditis
Types of Infectious diarrhea Campylobacter
Contraindications for thrombolytics
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
Incarcerated vs strangulated hernias
Causes of 3rd trimester bleeding
Incidence of AMI
Tx of CHF
44. 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
LBO - Large bowel obstruction
ED workup of kidney stones
How to assess Airway
Cardiac Enzymes
45. 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
Types of GI bleeds
Incomplete abortion
LBO - Large bowel obstruction
Pancreatitis work up
46. 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
Tx of Unstable Angina
Ascending Cholangitis
Incidence of AMI
EKG changes
47. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Appendicitis
Types of GI bleeds
Urosepsis
Anteroseptal leads and Anterior
48. 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 assess Airway
How to monitor CDAB
ED Tx of GIB
Types of Infectious diarrhea Shigella
49. 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
Types of Infectious diarrhea Shigella
How to assess Airway
Ovarian Torsion
Ovarian Cysts
50. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Acute Coronary syndrome
Chlamydia
DUKE criteria for endocarditis