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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. 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
Testicular Torsion
Contraindications for thrombolytics
Acute Coronary syndrome
Define Acute Cholecystitis
2. 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)
Anteroseptal leads and Anterior
When is Rho GAM used
What is a large bore IV?
SBO
3. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Define Biliary colic
CHF
The vital signs
Volvulus
4. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Lateral Leads
Aortic Dissection definition - risks and S/S
Dx of Aortic dissection
Causes of 3rd trimester bleeding
5. 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
SBO
Anteroseptal leads and Anterior
Breathing
6. 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
Defibrillation
Ascending Cholangitis
When to do a pelvic exam
Types of Infectious diarrhea Yersinia
7. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Dx of Aortic dissection
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Yersinia
ED treatment for Ectopic Pregnancy
8. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
EKG changes
Placental Abruption
LBO - Large bowel obstruction
Volvulus
9. 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
Acute Mesenteric Ishemia
Tx of CHF
Pericarditis
Incarcerated vs strangulated hernias
10. Leads I - aVL - V4-V6 - Left circumflex artery
STEMI vs Nstemi
UTI
Lateral Leads
Missed Abortion
11. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Acute Mesenteric Ishemia
RCA
Ascending Cholangitis
Placental Abruption
12. 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
Genital Herpes
Abdominal Aortic Aneurysm
Initial steps in stabilizing a patient
Cardiac Enzymes
13. Active internal bleeding - hx hemorrhagic stroke/TIA in the past year - Intracranial tumor - AV malformation or aneurysm - suspected aortic dissection or tamponade - Severe bleeding disorder - Head trauma - Intracranial procedure
Tx of Unstable Angina
Pericarditis
Contraindications for thrombolytics
Incidence of AMI
14. Check Vital Signs
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15. 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
Cardiac Enzymes
What to do with weak/thready pulses
EMTALA
16. 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
The vital signs
Types of Infectious diarrhea Yersinia
Kidney Stones
Ovarian Torsion
17. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Contraindications for thrombolytics
Acute Coronary syndrome
Incarcerated vs strangulated hernias
Types of GI bleeds
18. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
SBO
Tx of CHF
Acute Coronary syndrome
When to do a pelvic exam
19. 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
The vital signs
Cardiac Enzymes
Anteroseptal leads and Anterior
Other major arteries
20. 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
Cardiac Enzymes
Lateral Leads
Acute Arterial occlusion - to lower extremities
21. 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
Supplemental O2
Symptoms of Ruptured ovarian cysts
DUKE criteria for endocarditis
UTI
22. 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
Anteroseptal leads and Anterior
Early miscarriage (20 weeks)
Appendicitis
23. 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
Urosepsis
RCA
Symptoms of Ruptured ovarian cysts
Endocarditis
24. 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
When is Rho GAM used
Placenta Previa
Ovarian Torsion
Missed Abortion
25. 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
ED workup of kidney stones
What to do with weak/thready pulses
CHF
Triage
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
Stable vs. Unstable Ectopic Pregnancy
STEMI vs Nstemi
Acute Mesenteric Ishemia
Types of Infectious diarrhea Campylobacter
27. 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
Contraindications for thrombolytics
Incomplete abortion
Placenta Previa
Testicular Torsion
28. 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
Causes of 3rd trimester bleeding
Aortic Dissection definition - risks and S/S
Lateral Leads
29. 16-18 Gauge
Urosepsis
When is Rho GAM used
Triage
What is a large bore IV?
30. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Placental Abruption
Pain scale for infants
Types of Infectious diarrhea Shigella
EKG changes
31. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
CHF
Hypertensive Emergency
Common Presentation of GIB
32. 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
ED work up for cholecystitis
Syphillis
EMTALA
Types of GI bleeds
33. 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
Ascending Cholangitis
Chlamydia
Viral Gastroenteritis
Contraindications for thrombolytics
34. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
What is a large bore IV?
Contraindications for thrombolytics
Miscarriage
Genital Herpes
35. 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
Types of Infectious diarrhea Yersinia
SBO
Abdominal Aortic Aneurysm
Common risk factors for LGIB
36. 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
Stable vs unstable angina`
RCA
Anteroseptal leads and Anterior
37. 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
Initial steps in stabilizing a patient
Additional cardiac Tests
Incomplete abortion
Breathing
38. 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
Acute Arterial occlusion - to lower extremities
ED Tx of GIB
Triage
ED workup of kidney stones
39. 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
Abdominal Aortic Aneurysm
Breathing
Advanced airway techniques
40. 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
Volvulus
Genital Herpes
Ranson's criteria
ED treatment for Ectopic Pregnancy
41. 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)
The vital signs
Volvulus
Tx of CHF
42. 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
Acute Mesenteric Ishemia
Supplemental O2
Pericarditis
Where to check pulses
43. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
DUKE criteria for endocarditis
ED treatment of a Miscarriage
Acute Arterial occlusion - to lower extremities
When are Beta Blockers contraindicated
44. 'trier' - to separate - sift or select based on priority of condition
Common Presentation of GIB
Triage
Appendicitis
When is Rho GAM used
45. 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)
Bradycardia
Ranson's criteria
ED Tx of GIB
Acute Arterial occlusion - to lower extremities
46. 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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47. Old age - chronic anticoagulation - divertriculosis
UTI
EMTALA
GIB work up
Common risk factors for LGIB
48. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
The vital signs
Define Biliary colic
Where to check pulses
Miscarriage
49. 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
Posterior
Pain scale for infants
Initial steps in stabilizing a patient
Tachycardia
50. 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
RCA
The vital signs
Symptoms of Ruptured ovarian cysts
Syphillis