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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. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Appendicitis work up
Ranson's criteria
Kidney Stones
The vital signs
2. 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
Appendicitis
Supplemental O2
UTI
Incidence of AMI
3. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Dx of Aortic dissection
Contraindications for thrombolytics
The vital signs
RCA
4. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
DUKE criteria for endocarditis
Bradycardia
Genital Herpes
Cardiac Tamponade
5. 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
Gonorrhea
EMTALA
What should be done after CDAB's
Causes of 3rd trimester bleeding
6. 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
Define Acute Cholecystitis
Posterior
Incomplete abortion
ED treatment of a Miscarriage
7. 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
Lateral Leads
CHF
ED workup of kidney stones
LBO - Large bowel obstruction
8. 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
SBO
Incarcerated vs strangulated hernias
Aortic Dissection definition - risks and S/S
Kidney Stones
9. 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)
Incidence of AMI
Causes of 3rd trimester bleeding
When is Rho GAM used
Symptoms of Ruptured ovarian cysts
10. II - III - aVF - Means RCA involved
Ovarian Cysts
CHF
Inferior leads
ED treatment of a Miscarriage
11. 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
Causes of 3rd trimester bleeding
Ascending Cholangitis
Types of Infectious diarrhea Campylobacter
Kidney Stones
12. 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
Ovarian Torsion
ED work up for cholecystitis
Types of GI bleeds
Define Acute Cholecystitis
13. 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
What is a large bore IV?
Chlamydia
SBO
Divertriculitis
14. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of GI bleeds
Types of Infectious diarrhea Yersinia
Divertriculitis
Kidney Stones
15. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
ED treatment of a Miscarriage
Genital Herpes
Ectopic Pregnancy
Types of Infectious diarrhea - Salmonella
16. Left coronary artery (short and branches quickly)
LCA
Pain scale for infants
GIB work up
Types of Infectious diarrhea E coli
17. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Cardiac Enzymes
Types of Infectious diarrhea E coli
Acute Arterial occlusion - to lower extremities
Inferior leads
18. 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
Additional cardiac Tests
Triage
Emergency Severity Index
Acute Arterial occlusion - to lower extremities
19. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
When are Beta Blockers contraindicated
Common Presentation of GIB
Early miscarriage (20 weeks)
ED treatment for Ectopic Pregnancy
20. V1-V2 Right Posterior Descending Artery
Posterior
Contraindications for thrombolytics
Incarcerated vs strangulated hernias
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
21. 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
Abdominal Aortic Aneurysm
UTI
Appendicitis
Ovarian Torsion
22. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
ED workup of kidney stones
Miscarriage
Types of Infectious diarrhea Shigella
Common risk factors for LGIB
23. 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
Pericarditis
Initial steps in stabilizing a patient
Causes of 3rd trimester bleeding
Incomplete abortion
24. 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
ED treatment for Ectopic Pregnancy
Emergency Severity Index
How to monitor CDAB
25. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Advanced airway techniques
STEMI vs Nstemi
Pain scale for infants
Early miscarriage (20 weeks)
26. 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
ED Tx of GIB
Acute Mesenteric Ishemia
Bradycardia
27. 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
Defibrillation
Dx of Aortic dissection
Incidence of AMI
Tachycardia
28. 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
Gonorrhea
Other major arteries
Pancreatitis work up
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
29. 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
Hypertensive Emergency
Define Acute Cholecystitis
How to assess Airway
30. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Triage
The vital signs
Types of Infectious diarrhea Yersinia
Urosepsis
31. 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
Stable vs. Unstable Ectopic Pregnancy
Pancreatitis work up
Posterior
Kidney Stones
32. 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)
LCA
EKG changes
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea Shigella
33. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Early miscarriage (20 weeks)
SBO
Causes of 3rd trimester bleeding
Posterior
34. 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
Define Biliary colic
Pancreatitis work up
Emergency Severity Index
Where to check pulses
35. 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
Placenta Previa
Posterior
ED Tx of GIB
Types of GI bleeds
36. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
The vital signs
Ectopic Pregnancy
Gonorrhea
37. 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
Bradycardia
Acute Coronary syndrome
Breathing
Other major arteries
38. 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
Common risk factors for UGIB
GIB work up
Endocarditis
How to monitor CDAB
39. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Ovarian Torsion
Supplemental O2
CHF
Advanced airway techniques
40. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Acute Coronary syndrome
Causes of 3rd trimester bleeding
Anteroseptal leads and Anterior
ED workup of kidney stones
41. 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
Placenta Previa
Types of Infectious diarrhea E coli
Placental Abruption
How to assess Airway
42. 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
Miscarriage
When is Rho GAM used
Dx of Aortic dissection
Anteroseptal leads and Anterior
43. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Bradycardia
Syphillis
Pain scale for infants
Hypertensive Emergency
44. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Pancreatitis work up
What to do with weak/thready pulses
Common risk factors for UGIB
When are Beta Blockers contraindicated
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
Volvulus
Pain scale for infants
Causes of 3rd trimester bleeding
Miscarriage
46. 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
Missed Abortion
Stable vs unstable angina`
Acute Coronary syndrome
Breathing
47. 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
Tx of CHF
Types of Infectious diarrhea Shigella
Kidney Stones
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
48. 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
ED work up for cholecystitis
Viral Gastroenteritis
RCA
49. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Other major arteries
Incidence of AMI
Ovarian Cysts
Kidney Stones
50. 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
Advanced airway techniques
The vital signs
Incarcerated vs strangulated hernias
Cardiac Enzymes