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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. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
CHF
Lateral Leads
EKG changes
2. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Aortic Dissection definition - risks and S/S
Ovarian Torsion
When is Rho GAM used
What to do with weak/thready pulses
3. 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
Aortic Dissection definition - risks and S/S
Emergency Severity Index
Types of GI bleeds
Incomplete abortion
4. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Defibrillation
Ectopic Pregnancy
What is a large bore IV?
LBO - Large bowel obstruction
5. 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
Aortic Dissection definition - risks and S/S
Types of GI bleeds
ED workup of kidney stones
Syphillis
6. 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
Ovarian Torsion
How to monitor CDAB
Tachycardia
STEMI vs Nstemi
7. 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
How to assess Airway
Endocarditis
Acute Coronary syndrome
Emergency Severity Index
8. 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
Advanced airway techniques
Divertriculitis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
9. 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
Tachycardia
ED Tx of GIB
Acute Arterial occlusion - to lower extremities
Ascending Cholangitis
10. 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
Divertriculitis
Where to check pulses
Incarcerated vs strangulated hernias
Placenta Previa
11. 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)
How to monitor CDAB
When is Rho GAM used
Divertriculitis
Syphillis
12. 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)
Bradycardia
Appendicitis work up
Miscarriage
How to monitor CDAB
13. 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
Pain scale for infants
Dx of Aortic dissection
Advanced airway techniques
Stable vs unstable angina`
14. 16-18 Gauge
Urosepsis
Aortic Dissection definition - risks and S/S
Other major arteries
What is a large bore IV?
15. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Urosepsis
Emergency Severity Index
EKG changes
Types of Infectious diarrhea E coli
16. Old age - chronic anticoagulation - divertriculosis
Stable vs unstable angina`
Common risk factors for LGIB
Define Acute Cholecystitis
Lateral Leads
17. 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
Hypertensive Emergency
Ovarian Torsion
Incidence of AMI
Pancreatitis work up
18. 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
How to monitor CDAB
Pericarditis
Acute Arterial occlusion - to lower extremities
Gonorrhea
19. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Breathing
Genital Herpes
Triage
20. 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)
EKG changes
Types of Infectious diarrhea Campylobacter
Acute Arterial occlusion - to lower extremities
When to do a pelvic exam
21. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Types of Infectious diarrhea - Salmonella
Acute Arterial occlusion - to lower extremities
The vital signs
Early miscarriage (20 weeks)
22. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
GIB work up
EKG changes
Ectopic Pregnancy
The vital signs
23. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Types of Infectious diarrhea Shigella
ED treatment for Ectopic Pregnancy
Kidney Stones
24. 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
When is Rho GAM used
Types of Infectious diarrhea Campylobacter
Divertriculitis
When are Beta Blockers contraindicated
25. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Advanced airway techniques
Divertriculitis
Define Acute Cholecystitis
26. 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
Hypertensive Emergency
Aortic Dissection definition - risks and S/S
Missed Abortion
GIB work up
27. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Ovarian Torsion
Types of GI bleeds
Incarcerated vs strangulated hernias
Syphillis
28. 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
Common Presentation of GIB
Testicular Torsion
UTI
Ascending Cholangitis
29. 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
Urosepsis
Abdominal Aortic Aneurysm
How to assess Airway
LBO - Large bowel obstruction
30. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Dx of Aortic dissection
Tx of Unstable Angina
Cardiac Enzymes
Causes of 3rd trimester bleeding
31. Left coronary artery (short and branches quickly)
Cardiac Tamponade
Define Biliary colic
Where to check pulses
LCA
32. 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
ED treatment of a Miscarriage
Types of Infectious diarrhea Yersinia
What is a large bore IV?
Acute Coronary syndrome
33. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Contraindications for thrombolytics
DUKE criteria for endocarditis
Placental Abruption
Common Presentation of GIB
34. 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
Volvulus
Define Biliary colic
Types of GI bleeds
Inferior leads
35. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Genital Herpes
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
EKG changes
Ovarian Cysts
36. 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:
Ovarian Torsion
ED work up for cholecystitis
DUKE criteria for endocarditis
Tachycardia
37. 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
The vital signs
UTI
Hypertensive Emergency
Additional cardiac Tests
38. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
Incarcerated vs strangulated hernias
Testicular Torsion
Triage
39. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Tx of Unstable Angina
Types of Infectious diarrhea - Salmonella
Define Biliary colic
Ovarian Cysts
40. 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
Genital Herpes
Volvulus
Endocarditis
Cardiac Enzymes
41. 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
What is a large bore IV?
Ectopic Pregnancy
Kidney Stones
Define Acute Cholecystitis
42. 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
UTI
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
EMTALA
Pericarditis
43. 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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44. 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
EMTALA
Dx of Aortic dissection
Bradycardia
What is a large bore IV?
45. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Incarcerated vs strangulated hernias
Anteroseptal leads and Anterior
Types of Infectious diarrhea Campylobacter
Emergency Severity Index
46. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
When is Rho GAM used
Tx of Unstable Angina
Common risk factors for UGIB
Acute Mesenteric Ishemia
47. 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
Chlamydia
Placental Abruption
Tachycardia
Incidence of AMI
48. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
LCA
Miscarriage
Breathing
Pancreatitis work up
49. 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
Abdominal Aortic Aneurysm
Acute Mesenteric Ishemia
Define Acute Cholecystitis
Incarcerated vs strangulated hernias
50. 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
Ectopic Pregnancy
Syphillis
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea Shigella