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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. 16-18 Gauge
DUKE criteria for endocarditis
Syphillis
Lateral Leads
What is a large bore IV?
2. 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
EMTALA
Hypertensive Emergency
Ectopic Pregnancy
Tx of Unstable Angina
3. 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
Viral Gastroenteritis
Common risk factors for UGIB
Lateral Leads
4. 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
LBO - Large bowel obstruction
UTI
Syphillis
Placenta Previa
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
Miscarriage
Additional cardiac Tests
EMTALA
Common risk factors for UGIB
6. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
DUKE criteria for endocarditis
Types of Infectious diarrhea Yersinia
Viral Gastroenteritis
Appendicitis work up
7. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of Infectious diarrhea Campylobacter
Acute Arterial occlusion - to lower extremities
Define Acute Cholecystitis
Abdominal Aortic Aneurysm
8. 'trier' - to separate - sift or select based on priority of condition
Emergency Severity Index
Breathing
Triage
Other major arteries
9. 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
Viral Gastroenteritis
Additional cardiac Tests
Pancreatitis work up
Triage
10. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Pancreatitis work up
LCA
Tx of Unstable Angina
11. 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
Define Acute Cholecystitis
Ovarian Torsion
How to monitor CDAB
Endocarditis
12. Check Vital Signs
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13. 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)
Defibrillation
Advanced airway techniques
Posterior
Volvulus
14. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Acute Mesenteric Ishemia
Types of Infectious diarrhea Shigella
What is a large bore IV?
Anteroseptal leads and Anterior
15. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Initial steps in stabilizing a patient
SBO
ED Tx of GIB
Types of Infectious diarrhea E coli
16. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
RCA
What is a large bore IV?
GIB work up
STEMI vs Nstemi
17. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
RCA
Contraindications for thrombolytics
When is Rho GAM used
ED treatment for Ectopic Pregnancy
18. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
ED workup of kidney stones
Anteroseptal leads and Anterior
Chlamydia
Ovarian Cysts
19. 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:
ED treatment for Ectopic Pregnancy
Ovarian Torsion
Types of Infectious diarrhea Campylobacter
Endocarditis
20. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Syphillis
GIB work up
When are Beta Blockers contraindicated
Pericarditis
21. 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
Ranson's criteria
What should be done after CDAB's
Placental Abruption
ED Tx of GIB
22. 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
Syphillis
Types of Infectious diarrhea Campylobacter
Dx of Aortic dissection
Other major arteries
23. 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
Other major arteries
Incomplete abortion
ED treatment for Ectopic Pregnancy
Types of GI bleeds
24. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Divertriculitis
Advanced airway techniques
Types of Infectious diarrhea E coli
EKG changes
25. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Contraindications for thrombolytics
Causes of 3rd trimester bleeding
Types of Infectious diarrhea E coli
Common risk factors for UGIB
26. 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
Acute Arterial occlusion - to lower extremities
Early miscarriage (20 weeks)
Define Acute Cholecystitis
27. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Where to check pulses
Supplemental O2
Miscarriage
Incarcerated vs strangulated hernias
28. 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
Kidney Stones
Chlamydia
LBO - Large bowel obstruction
Common risk factors for UGIB
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
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea Shigella
What should be done after CDAB's
Emergency Severity Index
30. 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)
Anteroseptal leads and Anterior
Tx of Unstable Angina
EKG changes
Breathing
31. 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
Acute Mesenteric Ishemia
ED workup of kidney stones
Early miscarriage (20 weeks)
32. 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)
Hypertensive Emergency
Define Biliary colic
When is Rho GAM used
CHF
33. 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
Hypertensive Emergency
Contraindications for thrombolytics
Pain scale for infants
Miscarriage
34. 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)
Where to check pulses
Ascending Cholangitis
Bradycardia
UTI
35. 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
Testicular Torsion
Ascending Cholangitis
Tachycardia
Cardiac Tamponade
36. IVF with crystalloids - RhoGAM for Rh Negative - Abx if sepsis or suspect retained POC - D and C if retained POC's - F/you with OB GYN in 48 hours - monitor HCG is trending down - Return for worsening sxs
ED treatment of a Miscarriage
What should be done after CDAB's
LBO - Large bowel obstruction
Anteroseptal leads and Anterior
37. 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
Symptoms of Ruptured ovarian cysts
Inferior leads
Define Acute Cholecystitis
DUKE criteria for endocarditis
38. 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
LBO - Large bowel obstruction
Placenta Previa
Define Acute Cholecystitis
39. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Cardiac Enzymes
Acute Arterial occlusion - to lower extremities
Hypertensive Emergency
CHF
40. 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
Triage
Types of Infectious diarrhea E coli
Ectopic Pregnancy
41. 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)
Initial steps in stabilizing a patient
What should be done after CDAB's
Appendicitis work up
Kidney Stones
42. Left coronary artery (short and branches quickly)
LCA
The vital signs
Kidney Stones
Supplemental O2
43. 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
Ovarian Torsion
Supplemental O2
Ovarian Cysts
44. 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
Incomplete abortion
What to do with weak/thready pulses
Stable vs unstable angina`
45. 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
Stable vs. Unstable Ectopic Pregnancy
Missed Abortion
Types of Infectious diarrhea - Salmonella
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
46. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Cardiac Enzymes
RCA
STEMI vs Nstemi
LBO - Large bowel obstruction
47. 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
Ranson's criteria
Define Acute Cholecystitis
Ectopic Pregnancy
Defibrillation
48. 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
ED workup of kidney stones
EMTALA
Contraindications for thrombolytics
49. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Aortic Dissection definition - risks and S/S
Types of Infectious diarrhea E coli
Cardiac Tamponade
LCA
50. 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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