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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. 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
EKG changes
Endocarditis
Stable vs. Unstable Ectopic Pregnancy
ED workup of kidney stones
2. 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)
STEMI vs Nstemi
Dx of Aortic dissection
When are Beta Blockers contraindicated
Bradycardia
3. 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
Viral Gastroenteritis
Initial steps in stabilizing a patient
Aortic Dissection definition - risks and S/S
Ranson's criteria
4. 16-18 Gauge
What is a large bore IV?
Gonorrhea
Common risk factors for UGIB
UTI
5. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incidence of AMI
Incarcerated vs strangulated hernias
What should be done after CDAB's
DUKE criteria for endocarditis
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
Missed Abortion
How to monitor CDAB
Incomplete abortion
Triage
7. 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
Urosepsis
Ascending Cholangitis
Incarcerated vs strangulated hernias
Endocarditis
8. 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
DUKE criteria for endocarditis
Cardiac Enzymes
Symptoms of Ruptured ovarian cysts
Types of GI bleeds
9. 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
RCA
Types of GI bleeds
Cardiac Tamponade
Testicular Torsion
10. 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
Ovarian Cysts
Triage
Define Biliary colic
ED workup of kidney stones
11. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
RCA
Supplemental O2
Pancreatitis work up
12. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Dx of Aortic dissection
Anteroseptal leads and Anterior
Ovarian Cysts
Types of Infectious diarrhea Yersinia
13. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Other major arteries
Gonorrhea
The vital signs
14. 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 Tx of GIB
ED treatment of a Miscarriage
Other major arteries
Incarcerated vs strangulated hernias
15. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Advanced airway techniques
Cardiac Enzymes
Miscarriage
16. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Viral Gastroenteritis
When to do a pelvic exam
Pancreatitis work up
Emergency Severity Index
17. 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
Define Acute Cholecystitis
Lateral Leads
Types of Infectious diarrhea Campylobacter
Additional cardiac Tests
18. 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 -
Syphillis
DUKE criteria for endocarditis
Placental Abruption
Contraindications for thrombolytics
19. 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
Placenta Previa
Incomplete abortion
Ranson's criteria
Cardiac Tamponade
20. 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
Aortic Dissection definition - risks and S/S
Cardiac Enzymes
Advanced airway techniques
Appendicitis work up
21. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
When to do a pelvic exam
Appendicitis
Causes of 3rd trimester bleeding
Contraindications for thrombolytics
22. V1-V2 Right Posterior Descending Artery
LCA
When is Rho GAM used
Posterior
Aortic Dissection definition - risks and S/S
23. 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
Placenta Previa
Ranson's criteria
Tachycardia
24. 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
Pancreatitis work up
Ranson's criteria
Triage
Dx of Aortic dissection
25. 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
Ovarian Cysts
Appendicitis work up
SBO
Pericarditis
26. IVF - fill the tank - CBC - chem 7 - LFT's - Lipase - UA - HCG for females - surgery cx - Abd CT scan for adults - ultrasound for kids or to r/o ovarian pathology in females - NPO - Pain control - Pre op Antibiotics (Levo - Flagyl or Unasyn)
Appendicitis work up
Abdominal Aortic Aneurysm
Anteroseptal leads and Anterior
Where to check pulses
27. 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
Miscarriage
GIB work up
Anteroseptal leads and Anterior
Where to check pulses
28. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
ED Tx of GIB
When to do a pelvic exam
ED workup of kidney stones
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
Types of Infectious diarrhea Shigella
Genital Herpes
Where to check pulses
Chlamydia
30. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
What should be done after CDAB's
STEMI vs Nstemi
Incidence of AMI
ED work up for cholecystitis
31. 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
RCA
Chlamydia
Contraindications for thrombolytics
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
32. 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
Lateral Leads
Hypertensive Emergency
Cardiac Tamponade
Dx of Aortic dissection
33. 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)
Acute Arterial occlusion - to lower extremities
Defibrillation
STEMI vs Nstemi
Where to check pulses
34. 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
Volvulus
EMTALA
ED treatment for Ectopic Pregnancy
Symptoms of Ruptured ovarian cysts
35. 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
Incarcerated vs strangulated hernias
Advanced airway techniques
Supplemental O2
Types of Infectious diarrhea - Salmonella
36. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
ED treatment of a Miscarriage
Types of Infectious diarrhea E coli
Missed Abortion
Gonorrhea
37. 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
Ectopic Pregnancy
Tachycardia
Acute Arterial occlusion - to lower extremities
Lateral Leads
38. 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
LCA
Ovarian Cysts
Acute Mesenteric Ishemia
GIB work up
39. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Types of GI bleeds
Ectopic Pregnancy
SBO
Advanced airway techniques
40. 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
EKG changes
Missed Abortion
GIB work up
Volvulus
41. Old age - chronic anticoagulation - divertriculosis
When is Rho GAM used
Common risk factors for LGIB
SBO
Syphillis
42. 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)
Where to check pulses
EKG changes
Urosepsis
Gonorrhea
43. 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
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea E coli
How to assess Airway
When are Beta Blockers contraindicated
44. Check Vital Signs
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45. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
UTI
Kidney Stones
Types of Infectious diarrhea Campylobacter
Urosepsis
46. 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
Ovarian Torsion
Stable vs unstable angina`
Placenta Previa
What should be done after CDAB's
47. 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
Define Acute Cholecystitis
The vital signs
Missed Abortion
Endocarditis
48. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Genital Herpes
RCA
Hypertensive Emergency
Ranson's criteria
49. 'trier' - to separate - sift or select based on priority of condition
Lateral Leads
Anteroseptal leads and Anterior
Pericarditis
Triage
50. 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
Advanced airway techniques
Cardiac Enzymes
Pain scale for infants
Breathing