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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. 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
ED workup of kidney stones
Cardiac Tamponade
Incomplete abortion
2. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
What to do with weak/thready pulses
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Bradycardia
3. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Acute Arterial occlusion - to lower extremities
Inferior leads
Types of GI bleeds
Types of Infectious diarrhea Campylobacter
4. 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
Common risk factors for UGIB
Define Acute Cholecystitis
Divertriculitis
What is a large bore IV?
5. 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
RCA
Common Presentation of GIB
Ascending Cholangitis
Volvulus
6. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Urosepsis
Types of Infectious diarrhea E coli
Where to check pulses
Emergency Severity Index
7. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Pancreatitis work up
What to do with weak/thready pulses
Causes of 3rd trimester bleeding
8. 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
EMTALA
RCA
ED work up for cholecystitis
Lateral Leads
9. 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
Types of GI bleeds
GIB work up
Viral Gastroenteritis
10. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
GIB work up
Defibrillation
Endocarditis
11. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
CHF
Anteroseptal leads and Anterior
The vital signs
Stable vs unstable angina`
12. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Ranson's criteria
Testicular Torsion
Common Presentation of GIB
13. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Pericarditis
Common risk factors for UGIB
Lateral Leads
How to monitor CDAB
14. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Pericarditis
RCA
Syphillis
How to assess Airway
15. 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)
Syphillis
Supplemental O2
Tachycardia
When is Rho GAM used
16. Check Vital Signs
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17. 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
Ovarian Cysts
Divertriculitis
Placenta Previa
How to assess Airway
18. 16-18 Gauge
Cardiac Enzymes
Early miscarriage (20 weeks)
Appendicitis
What is a large bore IV?
19. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Shigella
CHF
Testicular Torsion
Types of Infectious diarrhea Yersinia
20. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Hypertensive Emergency
When to do a pelvic exam
When is Rho GAM used
Gonorrhea
21. 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
Stable vs unstable angina`
Contraindications for thrombolytics
How to monitor CDAB
Acute Mesenteric Ishemia
22. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Viral Gastroenteritis
Acute Arterial occlusion - to lower extremities
Kidney Stones
Endocarditis
23. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Additional cardiac Tests
Lateral Leads
What to do with weak/thready pulses
Types of Infectious diarrhea Shigella
24. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Cardiac Enzymes
Divertriculitis
Ovarian Cysts
DUKE criteria for endocarditis
25. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Causes of 3rd trimester bleeding
Anteroseptal leads and Anterior
CHF
Volvulus
26. 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
Endocarditis
Kidney Stones
Stable vs unstable angina`
Where to check pulses
27. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Placental Abruption
Initial steps in stabilizing a patient
ED treatment of a Miscarriage
The vital signs
28. 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
What is a large bore IV?
ED work up for cholecystitis
Hypertensive Emergency
29. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Tachycardia
Pain scale for infants
Common risk factors for UGIB
STEMI vs Nstemi
30. 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:
ED work up for cholecystitis
Acute Coronary syndrome
Common risk factors for UGIB
Ovarian Torsion
31. 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
Early miscarriage (20 weeks)
Ranson's criteria
Hypertensive Emergency
Triage
32. 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
Common risk factors for LGIB
Pain scale for infants
Placenta Previa
Supplemental O2
33. 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
Endocarditis
Types of Infectious diarrhea Shigella
Bradycardia
Pericarditis
34. 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
Divertriculitis
Gonorrhea
ED Tx of GIB
GIB work up
35. 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
ED workup of kidney stones
Placenta Previa
GIB work up
36. 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
SBO
When is Rho GAM used
Divertriculitis
Aortic Dissection definition - risks and S/S
37. 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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38. 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
Incarcerated vs strangulated hernias
Ectopic Pregnancy
ED Tx of GIB
ED treatment of a Miscarriage
39. 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
Incomplete abortion
Incarcerated vs strangulated hernias
Ovarian Cysts
Volvulus
40. 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
Kidney Stones
Pancreatitis work up
Tx of CHF
Anteroseptal leads and Anterior
41. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Ranson's criteria
Common risk factors for UGIB
Miscarriage
The vital signs
42. 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
Additional cardiac Tests
Ectopic Pregnancy
Emergency Severity Index
Volvulus
43. 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
LBO - Large bowel obstruction
Symptoms of Ruptured ovarian cysts
Other major arteries
Ranson's criteria
44. 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
Stable vs. Unstable Ectopic Pregnancy
Where to check pulses
How to monitor CDAB
Volvulus
45. 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
ED work up for cholecystitis
Genital Herpes
ED workup of kidney stones
EMTALA
46. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Incarcerated vs strangulated hernias
Bradycardia
What is a large bore IV?
Appendicitis
47. 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)
When is Rho GAM used
ED workup of kidney stones
Hypertensive Emergency
DUKE criteria for endocarditis
48. 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 GI bleeds
Cardiac Enzymes
Urosepsis
49. 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
The vital signs
Dx of Aortic dissection
Additional cardiac Tests
Tachycardia
50. 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
Types of Infectious diarrhea Yersinia
Endocarditis
Advanced airway techniques
Abdominal Aortic Aneurysm