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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. 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
Hypertensive Emergency
Common risk factors for UGIB
Cardiac Enzymes
Endocarditis
2. II - III - aVF - Means RCA involved
Ectopic Pregnancy
Posterior
Early miscarriage (20 weeks)
Inferior leads
3. 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
Types of Infectious diarrhea E coli
Kidney Stones
Initial steps in stabilizing a patient
Aortic Dissection definition - risks and S/S
4. Leads I - aVL - V4-V6 - Left circumflex artery
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Lateral Leads
Where to check pulses
Ascending Cholangitis
5. 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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6. 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
Missed Abortion
How to assess Airway
Common Presentation of GIB
Types of Infectious diarrhea E coli
7. 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
Cardiac Enzymes
DUKE criteria for endocarditis
Incomplete abortion
Stable vs unstable angina`
8. 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
Cardiac Enzymes
Abdominal Aortic Aneurysm
When is Rho GAM used
Kidney Stones
9. 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
Divertriculitis
Anteroseptal leads and Anterior
Volvulus
Where to check pulses
10. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Triage
Anteroseptal leads and Anterior
Ovarian Torsion
Common risk factors for UGIB
11. 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
Viral Gastroenteritis
Acute Arterial occlusion - to lower extremities
RCA
12. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Breathing
ED treatment for Ectopic Pregnancy
Anteroseptal leads and Anterior
Causes of 3rd trimester bleeding
13. 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
Stable vs. Unstable Ectopic Pregnancy
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Pancreatitis work up
14. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
SBO
UTI
Types of Infectious diarrhea E coli
Appendicitis
15. 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
Endocarditis
What should be done after CDAB's
Posterior
16. 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
Other major arteries
Bradycardia
ED workup of kidney stones
Emergency Severity Index
17. 'trier' - to separate - sift or select based on priority of condition
Missed Abortion
Triage
Types of Infectious diarrhea Shigella
Miscarriage
18. 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
STEMI vs Nstemi
What to do with weak/thready pulses
Types of Infectious diarrhea Campylobacter
19. 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)
Endocarditis
Acute Arterial occlusion - to lower extremities
ED work up for cholecystitis
Defibrillation
20. 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
Define Biliary colic
CHF
Where to check pulses
Supplemental O2
21. 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
EKG changes
SBO
Ovarian Torsion
Genital Herpes
22. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Ovarian Cysts
Pain scale for infants
Aortic Dissection definition - risks and S/S
ED work up for cholecystitis
23. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Cardiac Enzymes
Ovarian Cysts
Bradycardia
What to do with weak/thready pulses
24. 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)
When to do a pelvic exam
Acute Mesenteric Ishemia
Common risk factors for UGIB
When is Rho GAM used
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
UTI
LCA
Volvulus
Acute Arterial occlusion - to lower extremities
26. 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
Placental Abruption
Types of GI bleeds
Common risk factors for UGIB
Appendicitis work up
27. V1-V2 Right Posterior Descending Artery
ED Tx of GIB
Missed Abortion
Posterior
Pericarditis
28. 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
Types of Infectious diarrhea Yersinia
Aortic Dissection definition - risks and S/S
Incomplete abortion
Types of Infectious diarrhea E coli
29. 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
Early miscarriage (20 weeks)
Acute Arterial occlusion - to lower extremities
What is a large bore IV?
Common risk factors for UGIB
30. 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
Appendicitis
Advanced airway techniques
Initial steps in stabilizing a patient
Defibrillation
31. 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
Ranson's criteria
Define Acute Cholecystitis
Posterior
Pancreatitis work up
32. 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
Symptoms of Ruptured ovarian cysts
Ectopic Pregnancy
LBO - Large bowel obstruction
Endocarditis
33. 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
Gonorrhea
Types of Infectious diarrhea E coli
Bradycardia
Acute Arterial occlusion - to lower extremities
34. 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
Endocarditis
Supplemental O2
Acute Mesenteric Ishemia
ED work up for cholecystitis
35. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Early miscarriage (20 weeks)
STEMI vs Nstemi
Emergency Severity Index
LCA
36. 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
Advanced airway techniques
Missed Abortion
Additional cardiac Tests
Dx of Aortic dissection
37. 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
SBO
Syphillis
Tx of CHF
Stable vs unstable angina`
38. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Chlamydia
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis
Pancreatitis work up
39. 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
Divertriculitis
EKG changes
ED work up for cholecystitis
Placenta Previa
40. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Types of Infectious diarrhea E coli
EMTALA
CHF
Defibrillation
41. 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
ED Tx of GIB
Viral Gastroenteritis
Bradycardia
Acute Mesenteric Ishemia
42. 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
Ranson's criteria
UTI
Stable vs unstable angina`
Incidence of AMI
43. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
ED Tx of GIB
Abdominal Aortic Aneurysm
Symptoms of Ruptured ovarian cysts
44. 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
Common risk factors for UGIB
Acute Coronary syndrome
Pain scale for infants
45. Sigmoid - volvulus: High risk patients: chronic constipation - elderly and debilitated patients - Dx: plain film - Tx: decompress with rectal tube - Cecal volvulus - see congenital hypermobile cecum. also dx with plain films
Define Acute Cholecystitis
What to do with weak/thready pulses
Volvulus
Inferior leads
46. 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
Ascending Cholangitis
Testicular Torsion
SBO
47. Left coronary artery (short and branches quickly)
LBO - Large bowel obstruction
Pain scale for infants
LCA
When to do a pelvic exam
48. 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
Appendicitis
Viral Gastroenteritis
GIB work up
Early miscarriage (20 weeks)
49. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
What should be done after CDAB's
Kidney Stones
Common risk factors for UGIB
Types of Infectious diarrhea Shigella
50. 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
Ascending Cholangitis
Common risk factors for UGIB
ED treatment of a Miscarriage