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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. Old age - chronic anticoagulation - divertriculosis
Incomplete abortion
GIB work up
Common risk factors for LGIB
Dx of Aortic dissection
2. 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
Tx of Unstable Angina
Types of Infectious diarrhea - Salmonella
Supplemental O2
Kidney Stones
3. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Posterior
Common risk factors for UGIB
Urosepsis
Contraindications for thrombolytics
4. 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
Posterior
Pericarditis
Stable vs. Unstable Ectopic Pregnancy
ED workup of kidney stones
5. 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
Incomplete abortion
Pericarditis
ED workup of kidney stones
Posterior
6. 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
What to do with weak/thready pulses
Advanced airway techniques
Incomplete abortion
Endocarditis
7. 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
Causes of 3rd trimester bleeding
Triage
ED treatment for Ectopic Pregnancy
8. 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
Appendicitis
Testicular Torsion
Early miscarriage (20 weeks)
9. 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 Ectopic Pregnancy
ED Tx of GIB
Contraindications for thrombolytics
What to do with weak/thready pulses
10. V1-V2 Right Posterior Descending Artery
Posterior
Endocarditis
Viral Gastroenteritis
Causes of 3rd trimester bleeding
11. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Anteroseptal leads and Anterior
Tachycardia
Define Biliary colic
Incarcerated vs strangulated hernias
12. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
GIB work up
Stable vs. Unstable Ectopic Pregnancy
Types of Infectious diarrhea E coli
Cardiac Enzymes
13. 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
What should be done after CDAB's
Incidence of AMI
Cardiac Tamponade
Placental Abruption
14. 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
What to do with weak/thready pulses
EKG changes
Common risk factors for LGIB
Tx of CHF
15. 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)
Early miscarriage (20 weeks)
When is Rho GAM used
Acute Mesenteric Ishemia
Triage
16. 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
Gonorrhea
ED Tx of GIB
Advanced airway techniques
Where to check pulses
17. 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 Arterial occlusion - to lower extremities
What should be done after CDAB's
Placenta Previa
Acute Coronary syndrome
18. 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
Syphillis
Volvulus
Pain scale for infants
Placental Abruption
19. 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
ED workup of kidney stones
Breathing
Stable vs unstable angina`
Appendicitis work up
20. 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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21. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
EKG changes
Bradycardia
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea Campylobacter
22. 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
Breathing
Pancreatitis work up
Tachycardia
Divertriculitis
23. 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:
Symptoms of Ruptured ovarian cysts
LCA
Ovarian Torsion
Defibrillation
24. 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)
Pericarditis
Incidence of AMI
EKG changes
Causes of 3rd trimester bleeding
25. 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
How to assess Airway
Define Biliary colic
DUKE criteria for endocarditis
Chlamydia
26. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
What should be done after CDAB's
Aortic Dissection definition - risks and S/S
CHF
Inferior leads
27. 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
Abdominal Aortic Aneurysm
Ascending Cholangitis
EMTALA
28. 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
Genital Herpes
Other major arteries
Miscarriage
Early miscarriage (20 weeks)
29. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Defibrillation
Common Presentation of GIB
Early miscarriage (20 weeks)
Ovarian Cysts
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 Tx of GIB
Ectopic Pregnancy
Early miscarriage (20 weeks)
Aortic Dissection definition - risks and S/S
31. 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
Ranson's criteria
Causes of 3rd trimester bleeding
How to monitor CDAB
Common risk factors for UGIB
32. 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
Syphillis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Contraindications for thrombolytics
33. 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
Divertriculitis
ED treatment for Ectopic Pregnancy
Dx of Aortic dissection
Cardiac Enzymes
34. 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
Causes of 3rd trimester bleeding
Viral Gastroenteritis
CHF
Types of GI bleeds
35. 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
EMTALA
Contraindications for thrombolytics
LBO - Large bowel obstruction
Tx of CHF
36. 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
Tx of Unstable Angina
Defibrillation
Hypertensive Emergency
Volvulus
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
Pericarditis
Additional cardiac Tests
Volvulus
Other major arteries
38. 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
Acute Mesenteric Ishemia
Missed Abortion
Types of Infectious diarrhea E coli
EKG changes
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
Genital Herpes
When to do a pelvic exam
Testicular Torsion
40. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Emergency Severity Index
Genital Herpes
Volvulus
41. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Early miscarriage (20 weeks)
Tachycardia
ED Tx of GIB
Pain scale for infants
42. 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? -
Stable vs. Unstable Ectopic Pregnancy
ED workup of kidney stones
Tx of Unstable Angina
Advanced airway techniques
43. 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
Pericarditis
Syphillis
DUKE criteria for endocarditis
STEMI vs Nstemi
44. 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
Tachycardia
Divertriculitis
DUKE criteria for endocarditis
Causes of 3rd trimester bleeding
45. Left coronary artery (short and branches quickly)
DUKE criteria for endocarditis
Stable vs unstable angina`
LCA
Hypertensive Emergency
46. 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 -
Placental Abruption
Acute Coronary syndrome
Define Acute Cholecystitis
Viral Gastroenteritis
47. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
What is a large bore IV?
Types of Infectious diarrhea Shigella
LCA
Miscarriage
48. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Ranson's criteria
Cardiac Tamponade
Dx of Aortic dissection
Tx of Unstable Angina
49. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Acute Coronary syndrome
Types of Infectious diarrhea Campylobacter
Causes of 3rd trimester bleeding
Pain scale for infants
50. 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
ED work up for cholecystitis
EMTALA
Common risk factors for UGIB