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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. 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)
When are Beta Blockers contraindicated
DUKE criteria for endocarditis
Appendicitis work up
LBO - Large bowel obstruction
2. 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
What is a large bore IV?
Pericarditis
Tx of CHF
Placenta Previa
3. 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
Dx of Aortic dissection
How to assess Airway
Cardiac Enzymes
What is a large bore IV?
4. 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
Other major arteries
Types of Infectious diarrhea E coli
Define Biliary colic
5. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Types of Infectious diarrhea E coli
Pancreatitis work up
When are Beta Blockers contraindicated
Additional cardiac Tests
6. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Pain scale for infants
Gonorrhea
Contraindications for thrombolytics
Miscarriage
7. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
ED treatment of a Miscarriage
Advanced airway techniques
How to assess Airway
Urosepsis
8. 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
Supplemental O2
ED workup of kidney stones
ED Tx of GIB
DUKE criteria for endocarditis
9. 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
Defibrillation
Hypertensive Emergency
LCA
What should be done after CDAB's
10. 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
Cardiac Tamponade
Testicular Torsion
Incomplete abortion
Advanced airway techniques
11. 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
Urosepsis
Incomplete abortion
Inferior leads
Ovarian Torsion
12. 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
GIB work up
How to assess Airway
Contraindications for thrombolytics
Causes of 3rd trimester bleeding
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
Kidney Stones
Aortic Dissection definition - risks and S/S
Define Acute Cholecystitis
Divertriculitis
14. 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)
How to assess Airway
EKG changes
Types of GI bleeds
Contraindications for thrombolytics
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
Tachycardia
Acute Mesenteric Ishemia
Types of GI bleeds
Gonorrhea
16. 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)
Additional cardiac Tests
Cardiac Tamponade
Chlamydia
Bradycardia
17. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Placenta Previa
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Contraindications for thrombolytics
Types of Infectious diarrhea Shigella
18. 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
Cardiac Enzymes
ED treatment for Ectopic Pregnancy
Lateral Leads
Appendicitis
19. 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
Endocarditis
Kidney Stones
ED work up for cholecystitis
20. 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
Incarcerated vs strangulated hernias
Placental Abruption
Where to check pulses
Stable vs. Unstable Ectopic Pregnancy
21. 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
ED work up for cholecystitis
DUKE criteria for endocarditis
Genital Herpes
Anteroseptal leads and Anterior
22. 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
Volvulus
Placenta Previa
Bradycardia
23. 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
Common risk factors for UGIB
LCA
Incidence of AMI
24. 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
Viral Gastroenteritis
Posterior
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
How to assess Airway
25. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
CHF
Tx of Unstable Angina
Define Biliary colic
Types of Infectious diarrhea Yersinia
26. 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
Viral Gastroenteritis
What to do with weak/thready pulses
Appendicitis work up
EMTALA
27. 16-18 Gauge
Types of Infectious diarrhea E coli
Bradycardia
Acute Coronary syndrome
What is a large bore IV?
28. 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
Where to check pulses
Pancreatitis work up
Acute Coronary syndrome
29. 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
Types of Infectious diarrhea Yersinia
Pancreatitis work up
Acute Coronary syndrome
Symptoms of Ruptured ovarian cysts
30. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Contraindications for thrombolytics
Cardiac Tamponade
Syphillis
Incarcerated vs strangulated hernias
31. 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
Cardiac Enzymes
Triage
Initial steps in stabilizing a patient
32. 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
Types of GI bleeds
Bradycardia
Acute Coronary syndrome
Types of Infectious diarrhea Shigella
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
Placenta Previa
UTI
Advanced airway techniques
DUKE criteria for endocarditis
34. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common risk factors for LGIB
Types of GI bleeds
Tx of Unstable Angina
Common Presentation of GIB
35. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
CHF
ED treatment for Ectopic Pregnancy
Bradycardia
Gonorrhea
36. 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
When to do a pelvic exam
LBO - Large bowel obstruction
Ectopic Pregnancy
Endocarditis
37. 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
Supplemental O2
Gonorrhea
When is Rho GAM used
38. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Kidney Stones
Urosepsis
Acute Mesenteric Ishemia
Common risk factors for LGIB
39. 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
Viral Gastroenteritis
Incomplete abortion
EMTALA
Define Biliary colic
40. 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
Placental Abruption
Pancreatitis work up
Ascending Cholangitis
How to monitor CDAB
41. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Early miscarriage (20 weeks)
STEMI vs Nstemi
EMTALA
Volvulus
42. 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
LBO - Large bowel obstruction
ED Tx of GIB
Symptoms of Ruptured ovarian cysts
43. 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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44. 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
Advanced airway techniques
Contraindications for thrombolytics
When are Beta Blockers contraindicated
Cardiac Tamponade
45. 'trier' - to separate - sift or select based on priority of condition
STEMI vs Nstemi
When are Beta Blockers contraindicated
Triage
Incomplete abortion
46. Abnormal dilatation of the arterial wall - most common in abdominal area below renal arteries - risk factors; atherosclerosis - age - HTN - smoking - connective tissue dz - fam hx - hyperlipidemia - DM - S/S : often ASYMPTOMATIC - dull abd or back pa
SBO
Volvulus
ED Tx of GIB
Abdominal Aortic Aneurysm
47. 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
Tachycardia
Incidence of AMI
Common risk factors for UGIB
Viral Gastroenteritis
48. 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
Define Biliary colic
Common risk factors for UGIB
How to monitor CDAB
Stable vs. Unstable Ectopic Pregnancy
49. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Acute Coronary syndrome
Miscarriage
Tx of Unstable Angina
Anteroseptal leads and Anterior
50. 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
Bradycardia
Emergency Severity Index
ED treatment for Ectopic Pregnancy
Define Biliary colic