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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. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Gonorrhea
ED work up for cholecystitis
ED treatment for Ectopic Pregnancy
Common risk factors for UGIB
2. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Miscarriage
ED treatment for Ectopic Pregnancy
Types of Infectious diarrhea Shigella
Cardiac Tamponade
3. 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
Where to check pulses
Cardiac Tamponade
Gonorrhea
Appendicitis
4. 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
Ranson's criteria
Ascending Cholangitis
The vital signs
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
5. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
UTI
Chlamydia
ED Tx of GIB
6. 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
Emergency Severity Index
When to do a pelvic exam
Volvulus
7. 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
Early miscarriage (20 weeks)
ED treatment for Ectopic Pregnancy
Anteroseptal leads and Anterior
Abdominal Aortic Aneurysm
8. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
EKG changes
Anteroseptal leads and Anterior
Bradycardia
Triage
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
Acute Coronary syndrome
ED workup of kidney stones
RCA
Hypertensive Emergency
10. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Types of Infectious diarrhea Campylobacter
ED Tx of GIB
When are Beta Blockers contraindicated
Chlamydia
11. 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
SBO
Stable vs. Unstable Ectopic Pregnancy
What should be done after CDAB's
Stable vs unstable angina`
12. 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
Cardiac Enzymes
Stable vs. Unstable Ectopic Pregnancy
Ectopic Pregnancy
13. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Early miscarriage (20 weeks)
Common Presentation of GIB
Ovarian Torsion
When are Beta Blockers contraindicated
14. 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
Defibrillation
Types of Infectious diarrhea E coli
Incidence of AMI
Advanced airway techniques
15. 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:
Acute Coronary syndrome
Ovarian Torsion
Tx of Unstable Angina
How to assess Airway
16. 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
Early miscarriage (20 weeks)
Abdominal Aortic Aneurysm
GIB work up
STEMI vs Nstemi
17. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea - Salmonella
RCA
How to monitor CDAB
18. 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
Causes of 3rd trimester bleeding
Emergency Severity Index
Types of Infectious diarrhea E coli
Inferior leads
19. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
ED workup of kidney stones
When is Rho GAM used
Define Biliary colic
Ovarian Torsion
20. 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
Incarcerated vs strangulated hernias
Ovarian Torsion
Appendicitis work up
21. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Placenta Previa
Ovarian Cysts
Endocarditis
Where to check pulses
22. II - III - aVF - Means RCA involved
Emergency Severity Index
Ascending Cholangitis
LCA
Inferior leads
23. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of GI bleeds
Types of Infectious diarrhea - Salmonella
RCA
Anteroseptal leads and Anterior
24. 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
Common risk factors for LGIB
Missed Abortion
Cardiac Tamponade
25. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
EMTALA
Pericarditis
Acute Coronary syndrome
Urosepsis
26. 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
Abdominal Aortic Aneurysm
GIB work up
UTI
Pancreatitis work up
27. 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
Causes of 3rd trimester bleeding
Viral Gastroenteritis
Divertriculitis
Incidence of AMI
28. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Types of Infectious diarrhea Shigella
Acute Arterial occlusion - to lower extremities
Abdominal Aortic Aneurysm
Advanced airway techniques
29. 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
Genital Herpes
UTI
What should be done after CDAB's
30. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
When to do a pelvic exam
What to do with weak/thready pulses
Common risk factors for LGIB
What is a large bore IV?
31. 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
What is a large bore IV?
STEMI vs Nstemi
Tx of Unstable Angina
ED workup of kidney stones
32. 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
Appendicitis
The vital signs
Genital Herpes
Missed Abortion
33. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Additional cardiac Tests
Stable vs. Unstable Ectopic Pregnancy
Incarcerated vs strangulated hernias
Divertriculitis
34. 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
Acute Mesenteric Ishemia
Anteroseptal leads and Anterior
Pancreatitis work up
35. 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 should be done after CDAB's
Appendicitis
Inferior leads
Stable vs. Unstable Ectopic Pregnancy
36. 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
CHF
Chlamydia
Incidence of AMI
37. 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
Where to check pulses
DUKE criteria for endocarditis
Types of Infectious diarrhea Campylobacter
38. 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
Genital Herpes
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Stable vs unstable angina`
What should be done after CDAB's
39. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Pancreatitis work up
LBO - Large bowel obstruction
Common risk factors for UGIB
Types of Infectious diarrhea E coli
40. 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
How to assess Airway
Triage
Causes of 3rd trimester bleeding
41. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
What to do with weak/thready pulses
Cardiac Enzymes
Incidence of AMI
42. 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
Common risk factors for LGIB
Additional cardiac Tests
Volvulus
When is Rho GAM used
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
Syphillis
Inferior leads
Breathing
Aortic Dissection definition - risks and S/S
44. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
What should be done after CDAB's
Kidney Stones
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Define Acute Cholecystitis
45. 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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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
EKG changes
When are Beta Blockers contraindicated
Placenta Previa
Bradycardia
47. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea Campylobacter
Advanced airway techniques
Types of Infectious diarrhea Shigella
48. Left coronary artery (short and branches quickly)
LCA
Initial steps in stabilizing a patient
Posterior
Divertriculitis
49. 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
Other major arteries
Divertriculitis
Acute Mesenteric Ishemia
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)
Tachycardia
Symptoms of Ruptured ovarian cysts
Acute Coronary syndrome
DUKE criteria for endocarditis