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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. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Advanced airway techniques
ED treatment for Ectopic Pregnancy
Define Acute Cholecystitis
Stable vs unstable angina`
2. 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 - Salmonella
Genital Herpes
Inferior leads
When are Beta Blockers contraindicated
3. 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
When is Rho GAM used
EMTALA
The vital signs
Supplemental O2
4. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Emergency Severity Index
ED Tx of GIB
Ascending Cholangitis
5. 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 -
Miscarriage
Placental Abruption
What to do with weak/thready pulses
Incidence of AMI
6. 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
Volvulus
Placental Abruption
Urosepsis
Dx of Aortic dissection
7. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Stable vs unstable angina`
What to do with weak/thready pulses
DUKE criteria for endocarditis
Ovarian Cysts
8. 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
Acute Mesenteric Ishemia
What is a large bore IV?
Early miscarriage (20 weeks)
Causes of 3rd trimester bleeding
9. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Stable vs unstable angina`
Stable vs. Unstable Ectopic Pregnancy
What should be done after CDAB's
Incarcerated vs strangulated hernias
10. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
When are Beta Blockers contraindicated
Incidence of AMI
Testicular Torsion
11. 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
Gonorrhea
Common Presentation of GIB
Aortic Dissection definition - risks and S/S
12. 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
Types of Infectious diarrhea E coli
CHF
Stable vs unstable angina`
Volvulus
13. 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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14. 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)
Bradycardia
Defibrillation
Causes of 3rd trimester bleeding
Stable vs unstable angina`
15. 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
Tx of CHF
Endocarditis
Ovarian Torsion
Acute Coronary syndrome
16. 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
Supplemental O2
ED workup of kidney stones
Common Presentation of GIB
Additional cardiac Tests
17. 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
Tachycardia
Volvulus
Pain scale for infants
Pericarditis
18. Leads I - aVL - V4-V6 - Left circumflex artery
Appendicitis
Lateral Leads
Types of Infectious diarrhea Campylobacter
Miscarriage
19. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Missed Abortion
Kidney Stones
Causes of 3rd trimester bleeding
CHF
20. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
CHF
The vital signs
Where to check pulses
Pain scale for infants
21. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
LBO - Large bowel obstruction
Acute Mesenteric Ishemia
Common Presentation of GIB
ED workup of kidney stones
22. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Miscarriage
Tx of Unstable Angina
Defibrillation
When to do a pelvic exam
23. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
What is a large bore IV?
ED workup of kidney stones
Types of GI bleeds
24. 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 Tx of GIB
Gonorrhea
SBO
Defibrillation
25. 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
Pancreatitis work up
Acute Coronary syndrome
Common risk factors for LGIB
Pain scale for infants
26. 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
How to assess Airway
Acute Mesenteric Ishemia
Advanced airway techniques
ED work up for cholecystitis
27. 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
Appendicitis work up
Types of Infectious diarrhea - Salmonella
Cardiac Enzymes
Types of GI bleeds
28. 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
EKG changes
Emergency Severity Index
Inferior leads
29. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Causes of 3rd trimester bleeding
Abdominal Aortic Aneurysm
Incidence of AMI
How to assess Airway
30. 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
Divertriculitis
Symptoms of Ruptured ovarian cysts
Tx of Unstable Angina
Chlamydia
31. Check Vital Signs
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32. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
What to do with weak/thready pulses
How to monitor CDAB
Other major arteries
33. 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
RCA
UTI
How to assess Airway
Stable vs. Unstable Ectopic Pregnancy
34. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
LBO - Large bowel obstruction
Breathing
Placental Abruption
Miscarriage
35. 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
How to assess Airway
Define Acute Cholecystitis
Testicular Torsion
Types of Infectious diarrhea - Salmonella
36. 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
Appendicitis
How to assess Airway
Breathing
37. 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`
DUKE criteria for endocarditis
When is Rho GAM used
GIB work up
38. 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
What to do with weak/thready pulses
RCA
Posterior
Stable vs. Unstable Ectopic Pregnancy
39. 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
Common risk factors for LGIB
Define Acute Cholecystitis
Chlamydia
Initial steps in stabilizing a patient
40. 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
Additional cardiac Tests
Hypertensive Emergency
Viral Gastroenteritis
Where to check pulses
41. Prolonged/ more severe angina that doens't resolve with rest - 50% triggered by event: stress - exercise - surgery - illness - More common in early am - substernal pain elephant in chest - crushing - heavy +/- radiation to left arm - jaw - neck - may
Incidence of AMI
Appendicitis
Additional cardiac Tests
Miscarriage
42. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Initial steps in stabilizing a patient
LBO - Large bowel obstruction
Incidence of AMI
Advanced airway techniques
43. 'trier' - to separate - sift or select based on priority of condition
Ascending Cholangitis
Cardiac Tamponade
Triage
GIB work up
44. 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
Miscarriage
Tachycardia
Types of Infectious diarrhea Shigella
Inferior leads
45. 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
Tx of Unstable Angina
Define Biliary colic
ED workup of kidney stones
GIB work up
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
Missed Abortion
Gonorrhea
Placenta Previa
Types of Infectious diarrhea - Salmonella
47. 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
Viral Gastroenteritis
Divertriculitis
ED workup of kidney stones
Pancreatitis work up
48. 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
Pancreatitis work up
Appendicitis
Symptoms of Ruptured ovarian cysts
Tx of CHF
49. 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:
Types of Infectious diarrhea Campylobacter
Appendicitis
Define Biliary colic
Ovarian Torsion
50. 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
What to do with weak/thready pulses
Early miscarriage (20 weeks)
GIB work up
Supplemental O2