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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. 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
Additional cardiac Tests
Define Acute Cholecystitis
Genital Herpes
Stable vs. Unstable Ectopic Pregnancy
2. 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
How to monitor CDAB
Common risk factors for LGIB
Ectopic Pregnancy
Incomplete abortion
3. 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
How to assess Airway
Appendicitis work up
Pancreatitis work up
4. 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
Tachycardia
Stable vs unstable angina`
Types of GI bleeds
Posterior
5. 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
Common risk factors for UGIB
Types of GI bleeds
DUKE criteria for endocarditis
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
Urosepsis
Supplemental O2
What to do with weak/thready pulses
Kidney Stones
7. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Tx of Unstable Angina
What to do with weak/thready pulses
When are Beta Blockers contraindicated
Acute Mesenteric Ishemia
8. 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 -
Placental Abruption
Define Acute Cholecystitis
Contraindications for thrombolytics
EMTALA
9. 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
When to do a pelvic exam
Ovarian Torsion
Gonorrhea
Types of Infectious diarrhea Campylobacter
10. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Lateral Leads
Urosepsis
Types of Infectious diarrhea Campylobacter
ED Tx of GIB
11. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
What should be done after CDAB's
Types of Infectious diarrhea Campylobacter
EMTALA
RCA
12. 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
LCA
Common risk factors for UGIB
Tachycardia
ED treatment of a Miscarriage
13. 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
STEMI vs Nstemi
EKG changes
Cardiac Enzymes
Ranson's criteria
14. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
When to do a pelvic exam
ED treatment for Ectopic Pregnancy
Tx of CHF
How to monitor CDAB
15. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Urosepsis
Supplemental O2
SBO
Common Presentation of GIB
16. 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
Appendicitis work up
Emergency Severity Index
Supplemental O2
ED workup of kidney stones
17. 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)
Testicular Torsion
Missed Abortion
EKG changes
Additional cardiac Tests
18. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
Anteroseptal leads and Anterior
Stable vs unstable angina`
Tachycardia
19. 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
Ranson's criteria
Divertriculitis
Bradycardia
ED Tx of GIB
20. 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:
EKG changes
Types of Infectious diarrhea - Salmonella
Types of GI bleeds
Ovarian Torsion
21. 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
Tx of Unstable Angina
ED treatment for Ectopic Pregnancy
Anteroseptal leads and Anterior
Chlamydia
22. 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
Acute Mesenteric Ishemia
Aortic Dissection definition - risks and S/S
Defibrillation
Types of Infectious diarrhea E coli
23. 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
Cardiac Tamponade
Syphillis
Lateral Leads
Acute Coronary syndrome
24. Left coronary artery (short and branches quickly)
LCA
Stable vs. Unstable Ectopic Pregnancy
Viral Gastroenteritis
Common Presentation of GIB
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
ED workup of kidney stones
Missed Abortion
Volvulus
Aortic Dissection definition - risks and S/S
26. 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
Inferior leads
Early miscarriage (20 weeks)
GIB work up
Types of Infectious diarrhea E coli
27. 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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28. 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
Symptoms of Ruptured ovarian cysts
Ranson's criteria
Hypertensive Emergency
Pancreatitis work up
29. 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
Ovarian Cysts
Posterior
What to do with weak/thready pulses
Initial steps in stabilizing a patient
30. 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
Miscarriage
Dx of Aortic dissection
Causes of 3rd trimester bleeding
Common risk factors for LGIB
31. 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
Hypertensive Emergency
How to monitor CDAB
Ovarian Torsion
Endocarditis
32. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Pancreatitis work up
Stable vs unstable angina`
Viral Gastroenteritis
33. 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`
Testicular Torsion
Appendicitis work up
DUKE criteria for endocarditis
34. 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
Appendicitis work up
How to assess Airway
CHF
Incidence of AMI
35. 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
Where to check pulses
EKG changes
Acute Coronary syndrome
ED Tx of GIB
36. 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
Contraindications for thrombolytics
Abdominal Aortic Aneurysm
Common Presentation of GIB
Endocarditis
37. 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
Cardiac Tamponade
How to assess Airway
SBO
Divertriculitis
38. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Stable vs. Unstable Ectopic Pregnancy
Lateral Leads
Syphillis
39. 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
Acute Mesenteric Ishemia
LCA
Breathing
Emergency Severity Index
40. 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
ED treatment for Ectopic Pregnancy
Symptoms of Ruptured ovarian cysts
Initial steps in stabilizing a patient
Cardiac Enzymes
41. 'trier' - to separate - sift or select based on priority of condition
Kidney Stones
Triage
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis
42. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Acute Mesenteric Ishemia
Types of Infectious diarrhea Campylobacter
Causes of 3rd trimester bleeding
Common risk factors for UGIB
43. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea E coli
CHF
Initial steps in stabilizing a patient
44. 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
Aortic Dissection definition - risks and S/S
Posterior
EMTALA
Ranson's criteria
45. 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
How to monitor CDAB
Viral Gastroenteritis
Pancreatitis work up
RCA
46. 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
Contraindications for thrombolytics
When is Rho GAM used
Pancreatitis work up
When to do a pelvic exam
47. 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
RCA
Ovarian Cysts
Testicular Torsion
Abdominal Aortic Aneurysm
48. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Tx of Unstable Angina
Define Biliary colic
ED Tx of GIB
Types of Infectious diarrhea - Salmonella
49. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
Genital Herpes
Testicular Torsion
Lateral Leads
50. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Endocarditis
Types of Infectious diarrhea - Salmonella
EMTALA