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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. 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
Types of Infectious diarrhea E coli
When to do a pelvic exam
Pancreatitis work up
Cardiac Enzymes
2. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
ED Tx of GIB
Causes of 3rd trimester bleeding
Posterior
Common Presentation of GIB
3. No bleeding - no fetal cardiac activity - uterus small - os closed - retained fetal tissue - Tx: D and C - Can have sepsis due to retained tissue/ fetus. Treat with IV abx (ampicillin and gentamycin) - Can give Misoprostol and cytotec (to dilate cerv
Emergency Severity Index
What should be done after CDAB's
Common risk factors for LGIB
Missed Abortion
4. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
SBO
Define Biliary colic
Posterior
When are Beta Blockers contraindicated
5. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Types of Infectious diarrhea Shigella
What to do with weak/thready pulses
When is Rho GAM used
6. 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)
Posterior
Defibrillation
Anteroseptal leads and Anterior
Ovarian Cysts
7. 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
When is Rho GAM used
Define Acute Cholecystitis
EKG changes
8. 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
Abdominal Aortic Aneurysm
Appendicitis
Hypertensive Emergency
Types of GI bleeds
9. 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
Advanced airway techniques
Incarcerated vs strangulated hernias
Chlamydia
Acute Coronary syndrome
10. 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
Types of Infectious diarrhea Yersinia
Cardiac Tamponade
Tx of Unstable Angina
11. 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
Where to check pulses
ED Tx of GIB
GIB work up
When are Beta Blockers contraindicated
12. 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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13. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Genital Herpes
Causes of 3rd trimester bleeding
Cardiac Enzymes
ED treatment of a Miscarriage
14. II - III - aVF - Means RCA involved
Incidence of AMI
Inferior leads
How to assess Airway
SBO
15. 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
ED work up for cholecystitis
Common Presentation of GIB
Gonorrhea
Common risk factors for UGIB
16. 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
Abdominal Aortic Aneurysm
Contraindications for thrombolytics
Stable vs. Unstable Ectopic Pregnancy
Endocarditis
17. 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
GIB work up
Types of Infectious diarrhea Yersinia
Incomplete abortion
Types of Infectious diarrhea Shigella
18. 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
Ovarian Cysts
Bradycardia
LBO - Large bowel obstruction
19. 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
Aortic Dissection definition - risks and S/S
Anteroseptal leads and Anterior
Causes of 3rd trimester bleeding
SBO
20. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Types of Infectious diarrhea Yersinia
Common risk factors for LGIB
LBO - Large bowel obstruction
21. 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
Causes of 3rd trimester bleeding
Aortic Dissection definition - risks and S/S
Ranson's criteria
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
22. 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
Incidence of AMI
Types of GI bleeds
Viral Gastroenteritis
Tx of Unstable Angina
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? -
Stable vs unstable angina`
LCA
Tx of Unstable Angina
Tachycardia
24. 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
Other major arteries
Genital Herpes
Types of Infectious diarrhea Shigella
Gonorrhea
25. 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)
DUKE criteria for endocarditis
Types of Infectious diarrhea Yersinia
Defibrillation
Early miscarriage (20 weeks)
26. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
When are Beta Blockers contraindicated
Stable vs. Unstable Ectopic Pregnancy
Cardiac Tamponade
27. 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
Breathing
Aortic Dissection definition - risks and S/S
ED Tx of GIB
Chlamydia
28. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Breathing
Acute Arterial occlusion - to lower extremities
Stable vs. Unstable Ectopic Pregnancy
Defibrillation
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
Acute Mesenteric Ishemia
Tx of Unstable Angina
STEMI vs Nstemi
How to assess Airway
30. 16-18 Gauge
What is a large bore IV?
Define Biliary colic
Ovarian Cysts
RCA
31. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Acute Arterial occlusion - to lower extremities
Initial steps in stabilizing a patient
Pain scale for infants
32. 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
Stable vs unstable angina`
Where to check pulses
Inferior leads
Triage
33. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
What is a large bore IV?
Define Biliary colic
Acute Coronary syndrome
Ranson's criteria
34. Old age - chronic anticoagulation - divertriculosis
ED work up for cholecystitis
Breathing
Common risk factors for LGIB
Pericarditis
35. 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
Cardiac Tamponade
Symptoms of Ruptured ovarian cysts
Stable vs unstable angina`
Additional cardiac Tests
36. 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
Common risk factors for LGIB
Testicular Torsion
Supplemental O2
37. 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
Triage
Pericarditis
Initial steps in stabilizing a patient
GIB work up
38. 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
Urosepsis
When is Rho GAM used
Incarcerated vs strangulated hernias
Emergency Severity Index
39. 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)
LCA
When is Rho GAM used
Types of Infectious diarrhea - Salmonella
What to do with weak/thready pulses
40. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Abdominal Aortic Aneurysm
Types of Infectious diarrhea Shigella
Anteroseptal leads and Anterior
The vital signs
41. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Appendicitis
Placental Abruption
Incarcerated vs strangulated hernias
42. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Breathing
Incidence of AMI
Anteroseptal leads and Anterior
What should be done after CDAB's
43. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Early miscarriage (20 weeks)
Types of Infectious diarrhea - Salmonella
Ranson's criteria
LCA
44. 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
Types of Infectious diarrhea Campylobacter
Divertriculitis
Anteroseptal leads and Anterior
ED treatment for Ectopic Pregnancy
45. 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
Posterior
ED Tx of GIB
Types of Infectious diarrhea E coli
Bradycardia
46. 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
Types of Infectious diarrhea Shigella
Early miscarriage (20 weeks)
Pancreatitis work up
When is Rho GAM used
47. 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
Pericarditis
Ovarian Cysts
Placental Abruption
Inferior leads
48. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Incidence of AMI
Acute Mesenteric Ishemia
Types of Infectious diarrhea E coli
UTI
49. 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
Types of Infectious diarrhea Shigella
Lateral Leads
Chlamydia
RCA
50. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
What should be done after CDAB's
When are Beta Blockers contraindicated
Ovarian Torsion