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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. 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
ED treatment of a Miscarriage
Missed Abortion
Types of GI bleeds
Hypertensive Emergency
2. 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
Genital Herpes
When is Rho GAM used
UTI
3. 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
Acute Mesenteric Ishemia
Appendicitis
Kidney Stones
Incomplete abortion
4. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Initial steps in stabilizing a patient
Types of GI bleeds
RCA
Urosepsis
5. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Tachycardia
Contraindications for thrombolytics
Supplemental O2
6. 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
DUKE criteria for endocarditis
Placenta Previa
Types of GI bleeds
Common Presentation of GIB
7. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Define Biliary colic
What should be done after CDAB's
Cardiac Enzymes
8. 16-18 Gauge
Placenta Previa
Types of Infectious diarrhea - Salmonella
Incarcerated vs strangulated hernias
What is a large bore IV?
9. 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
Abdominal Aortic Aneurysm
Stable vs unstable angina`
Testicular Torsion
How to monitor CDAB
10. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Lateral Leads
What to do with weak/thready pulses
Breathing
Types of Infectious diarrhea Campylobacter
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
Types of Infectious diarrhea Yersinia
Viral Gastroenteritis
Pancreatitis work up
Endocarditis
12. 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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13. 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
When is Rho GAM used
Pericarditis
Acute Mesenteric Ishemia
Other major arteries
14. 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
Tx of Unstable Angina
Genital Herpes
Types of Infectious diarrhea Campylobacter
Common Presentation of GIB
15. 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
Hypertensive Emergency
UTI
Acute Coronary syndrome
Common risk factors for LGIB
16. 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
Stable vs unstable angina`
Bradycardia
Pancreatitis work up
17. 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
Incidence of AMI
Common risk factors for LGIB
How to assess Airway
Tx of CHF
18. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Shigella
Types of Infectious diarrhea - Salmonella
Incidence of AMI
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
19. 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
Common risk factors for LGIB
Where to check pulses
Gonorrhea
Types of Infectious diarrhea - Salmonella
20. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Acute Mesenteric Ishemia
Common risk factors for UGIB
Pain scale for infants
What to do with weak/thready pulses
21. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Common risk factors for UGIB
STEMI vs Nstemi
ED treatment for Ectopic Pregnancy
Ovarian Cysts
22. 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
The vital signs
Syphillis
Incarcerated vs strangulated hernias
Missed Abortion
23. 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
Cardiac Enzymes
Acute Arterial occlusion - to lower extremities
EMTALA
24. 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)
Acute Coronary syndrome
Miscarriage
Appendicitis work up
Viral Gastroenteritis
25. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Causes of 3rd trimester bleeding
Miscarriage
Acute Mesenteric Ishemia
SBO
26. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
How to assess Airway
CHF
27. 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
STEMI vs Nstemi
Early miscarriage (20 weeks)
How to monitor CDAB
28. 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)
When is Rho GAM used
Inferior leads
Emergency Severity Index
ED Tx of GIB
29. 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
ED Tx of GIB
Divertriculitis
Urosepsis
Anteroseptal leads and Anterior
30. Risk Factors: PID - Mirena IUD - tubal surgery - pelvic surgery - endometriosis - IVF -DES exposure S/S - R or L adnexal tenderness - R shoulder pain could be referred pain from intraabdominal hemorrhage (gallbladder - liver also) - Workup -CBC - C
ED work up for cholecystitis
Ectopic Pregnancy
Inferior leads
Abdominal Aortic Aneurysm
31. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Inferior leads
Supplemental O2
Common Presentation of GIB
Symptoms of Ruptured ovarian cysts
32. 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
Types of GI bleeds
Syphillis
EKG changes
ED Tx of GIB
33. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Genital Herpes
Anteroseptal leads and Anterior
Endocarditis
Appendicitis
34. 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
Pancreatitis work up
Placental Abruption
Acute Mesenteric Ishemia
Chlamydia
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
Syphillis
Hypertensive Emergency
Testicular Torsion
Defibrillation
36. 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
Define Acute Cholecystitis
Types of Infectious diarrhea - Salmonella
Tachycardia
GIB work up
37. 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)
EMTALA
Bradycardia
Inferior leads
Incidence of AMI
38. 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
Lateral Leads
Early miscarriage (20 weeks)
Tachycardia
Abdominal Aortic Aneurysm
39. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
EKG changes
Pain scale for infants
Types of Infectious diarrhea Shigella
Types of Infectious diarrhea E coli
40. V1-V2 Right Posterior Descending Artery
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Campylobacter
Posterior
Placental Abruption
41. 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
SBO
Ovarian Cysts
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Placental Abruption
42. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Types of Infectious diarrhea - Salmonella
Types of Infectious diarrhea Yersinia
Viral Gastroenteritis
43. Check Vital Signs
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44. 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
RCA
LCA
What should be done after CDAB's
Ascending Cholangitis
45. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
STEMI vs Nstemi
Ascending Cholangitis
Appendicitis work up
Incarcerated vs strangulated hernias
46. 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
Contraindications for thrombolytics
Early miscarriage (20 weeks)
Types of Infectious diarrhea E coli
Advanced airway techniques
47. 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
Kidney Stones
Ovarian Cysts
Symptoms of Ruptured ovarian cysts
GIB work up
48. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
When are Beta Blockers contraindicated
Types of Infectious diarrhea Yersinia
Placental Abruption
Appendicitis work up
49. 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
SBO
Types of Infectious diarrhea - Salmonella
Viral Gastroenteritis
50. 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
Types of GI bleeds
Causes of 3rd trimester bleeding
Common Presentation of GIB