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Test your basic knowledge |
Emergency Medicine
Start Test
Study First
Subjects
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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. 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
Viral Gastroenteritis
Placental Abruption
Miscarriage
How to monitor CDAB
2. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
EKG changes
Tx of Unstable Angina
Pain scale for infants
Types of Infectious diarrhea Campylobacter
3. 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
Aortic Dissection definition - risks and S/S
Stable vs unstable angina`
Contraindications for thrombolytics
Symptoms of Ruptured ovarian cysts
4. 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
Initial steps in stabilizing a patient
Additional cardiac Tests
Dx of Aortic dissection
Cardiac Enzymes
5. 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
Common Presentation of GIB
Ectopic Pregnancy
SBO
STEMI vs Nstemi
6. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Contraindications for thrombolytics
Types of Infectious diarrhea Yersinia
Defibrillation
When are Beta Blockers contraindicated
7. 16-18 Gauge
What is a large bore IV?
Pain scale for infants
Placental Abruption
Tx of Unstable Angina
8. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Placental Abruption
Urosepsis
Volvulus
Appendicitis
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
Incidence of AMI
Tx of Unstable Angina
Testicular Torsion
LBO - Large bowel obstruction
10. 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)
Tx of Unstable Angina
When is Rho GAM used
CHF
Cardiac Tamponade
11. 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
Anteroseptal leads and Anterior
Supplemental O2
What is a large bore IV?
Initial steps in stabilizing a patient
12. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Define Biliary colic
LBO - Large bowel obstruction
Stable vs. Unstable Ectopic Pregnancy
Types of Infectious diarrhea Shigella
13. II - III - aVF - Means RCA involved
Initial steps in stabilizing a patient
Testicular Torsion
ED work up for cholecystitis
Inferior leads
14. 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
Acute Coronary syndrome
Stable vs. Unstable Ectopic Pregnancy
LCA
LBO - Large bowel obstruction
15. 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
When to do a pelvic exam
Other major arteries
Gonorrhea
16. 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
What should be done after CDAB's
UTI
Pancreatitis work up
Incidence of AMI
17. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What to do with weak/thready pulses
EMTALA
The vital signs
Initial steps in stabilizing a patient
18. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
What should be done after CDAB's
Lateral Leads
Other major arteries
Ovarian Cysts
19. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Types of Infectious diarrhea Yersinia
Emergency Severity Index
Appendicitis
Causes of 3rd trimester bleeding
20. 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
How to monitor CDAB
Ranson's criteria
STEMI vs Nstemi
Missed Abortion
21. 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
CHF
Volvulus
Genital Herpes
Types of Infectious diarrhea Campylobacter
22. 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
When to do a pelvic exam
ED workup of kidney stones
Urosepsis
What is a large bore IV?
23. 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
Aortic Dissection definition - risks and S/S
Appendicitis
Advanced airway techniques
Endocarditis
24. 'trier' - to separate - sift or select based on priority of condition
Ovarian Cysts
Triage
Types of Infectious diarrhea - Salmonella
LBO - Large bowel obstruction
25. 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
Where to check pulses
Testicular Torsion
SBO
Cardiac Tamponade
26. 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
Types of Infectious diarrhea Yersinia
Viral Gastroenteritis
Common Presentation of GIB
Syphillis
27. 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
Triage
Aortic Dissection definition - risks and S/S
28. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Anteroseptal leads and Anterior
Divertriculitis
ED treatment of a Miscarriage
29. 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
Emergency Severity Index
Tachycardia
Types of GI bleeds
Other major arteries
30. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
DUKE criteria for endocarditis
Viral Gastroenteritis
Other major arteries
31. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Aortic Dissection definition - risks and S/S
CHF
Tachycardia
32. 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
Urosepsis
Other major arteries
LBO - Large bowel obstruction
GIB work up
33. 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
Other major arteries
Cardiac Enzymes
Incarcerated vs strangulated hernias
Placenta Previa
34. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
LBO - Large bowel obstruction
Defibrillation
ED treatment for Ectopic Pregnancy
Hypertensive Emergency
35. 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
Volvulus
Acute Arterial occlusion - to lower extremities
Tachycardia
Types of Infectious diarrhea Shigella
36. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Supplemental O2
What should be done after CDAB's
Common risk factors for UGIB
Types of Infectious diarrhea Shigella
37. 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
Ectopic Pregnancy
Stable vs unstable angina`
Anteroseptal leads and Anterior
Breathing
38. 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
Aortic Dissection definition - risks and S/S
ED Tx of GIB
Abdominal Aortic Aneurysm
39. Old age - chronic anticoagulation - divertriculosis
Causes of 3rd trimester bleeding
Testicular Torsion
Gonorrhea
Common risk factors for LGIB
40. 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
Supplemental O2
LBO - Large bowel obstruction
Pericarditis
Types of Infectious diarrhea E coli
41. Left coronary artery (short and branches quickly)
LCA
Incomplete abortion
When are Beta Blockers contraindicated
Symptoms of Ruptured ovarian cysts
42. 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
ED workup of kidney stones
Acute Mesenteric Ishemia
Ectopic Pregnancy
Pancreatitis work up
43. ABC's - IV - O2 - cardiac monitor - Diuretics - Lasix - Lasix naive patients start at 20 mg IV - chronic users start at 40 mg IV - Morphine - Nitro if pain - Pressors prn
Posterior
Cardiac Tamponade
Tx of CHF
Symptoms of Ruptured ovarian cysts
44. 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
Stable vs. Unstable Ectopic Pregnancy
Chlamydia
What to do with weak/thready pulses
Common risk factors for UGIB
45. 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
Define Acute Cholecystitis
ED Tx of GIB
Ascending Cholangitis
GIB work up
46. 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
Cardiac Tamponade
Missed Abortion
SBO
Acute Arterial occlusion - to lower extremities
47. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
DUKE criteria for endocarditis
Ovarian Cysts
Genital Herpes
How to monitor CDAB
48. 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
ED work up for cholecystitis
DUKE criteria for endocarditis
UTI
EKG changes
49. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
Common risk factors for UGIB
Additional cardiac Tests
The vital signs
50. 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)
Define Biliary colic
EKG changes
Tachycardia
Causes of 3rd trimester bleeding