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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. 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
Types of Infectious diarrhea Shigella
Ovarian Cysts
Volvulus
2. 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
Chlamydia
Missed Abortion
Common risk factors for LGIB
Types of Infectious diarrhea - Salmonella
3. 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
SBO
Pericarditis
Pain scale for infants
Syphillis
4. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Breathing
ED treatment of a Miscarriage
Lateral Leads
Types of Infectious diarrhea E coli
5. 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
UTI
Ectopic Pregnancy
Emergency Severity Index
Dx of Aortic dissection
6. Check Vital Signs
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7. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
ED workup of kidney stones
Bradycardia
SBO
8. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Incomplete abortion
UTI
Other major arteries
When is Rho GAM used
9. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Cardiac Enzymes
Ovarian Cysts
GIB work up
Ectopic Pregnancy
10. 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
Common risk factors for LGIB
Anteroseptal leads and Anterior
Cardiac Tamponade
Incidence of AMI
11. 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
ED work up for cholecystitis
Tx of CHF
Kidney Stones
Volvulus
12. 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 -
ED treatment of a Miscarriage
Placental Abruption
Where to check pulses
Ranson's criteria
13. CDAB - Circulation (rapid CPR to reestablish circulation) - Defibrillaiton - Airway - Breathing - the main goal is to restore effective oxygenation -ventilation and circulation until return of spontaneous circulation or ACLS
Genital Herpes
Initial steps in stabilizing a patient
Miscarriage
Define Acute Cholecystitis
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)
EKG changes
What is a large bore IV?
DUKE criteria for endocarditis
Ovarian Torsion
15. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Anteroseptal leads and Anterior
Urosepsis
LBO - Large bowel obstruction
Stable vs unstable angina`
16. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Tachycardia
Ranson's criteria
Define Biliary colic
Appendicitis work up
17. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
RCA
Incidence of AMI
Kidney Stones
18. 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
Incomplete abortion
Appendicitis
Symptoms of Ruptured ovarian cysts
19. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Posterior
LBO - Large bowel obstruction
Cardiac Tamponade
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
20. 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
Acute Coronary syndrome
Supplemental O2
Contraindications for thrombolytics
Tx of CHF
21. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
CHF
Dx of Aortic dissection
How to monitor CDAB
RCA
22. 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
Where to check pulses
STEMI vs Nstemi
ED treatment of a Miscarriage
GIB work up
23. 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
Early miscarriage (20 weeks)
Urosepsis
Divertriculitis
Emergency Severity Index
24. 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
Miscarriage
Tx of Unstable Angina
Breathing
Stable vs unstable angina`
25. 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
Ranson's criteria
Stable vs unstable angina`
Emergency Severity Index
Appendicitis work up
26. 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
Abdominal Aortic Aneurysm
Divertriculitis
Define Acute Cholecystitis
Types of GI bleeds
27. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
ED work up for cholecystitis
Viral Gastroenteritis
Aortic Dissection definition - risks and S/S
28. 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
ED work up for cholecystitis
Defibrillation
Triage
Stable vs. Unstable Ectopic Pregnancy
29. 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
The vital signs
EKG changes
Causes of 3rd trimester bleeding
30. 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
ED treatment of a Miscarriage
When are Beta Blockers contraindicated
Appendicitis
Additional cardiac Tests
31. 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
Chlamydia
ED treatment of a Miscarriage
Syphillis
Cardiac Enzymes
32. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Acute Arterial occlusion - to lower extremities
Inferior leads
Contraindications for thrombolytics
Abdominal Aortic Aneurysm
33. 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
Hypertensive Emergency
What should be done after CDAB's
Kidney Stones
RCA
34. II - III - aVF - Means RCA involved
How to assess Airway
Inferior leads
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Breathing
35. 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
Stable vs unstable angina`
ED treatment for Ectopic Pregnancy
What to do with weak/thready pulses
Common risk factors for UGIB
36. V1-V2 Right Posterior Descending Artery
Divertriculitis
How to assess Airway
Posterior
Where to check pulses
37. Old age - chronic anticoagulation - divertriculosis
Volvulus
Ovarian Torsion
Common risk factors for LGIB
Define Biliary colic
38. 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
Cardiac Tamponade
Ectopic Pregnancy
Genital Herpes
ED Tx of GIB
39. 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
Lateral Leads
Urosepsis
RCA
Dx of Aortic dissection
40. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Early miscarriage (20 weeks)
Acute Coronary syndrome
Abdominal Aortic Aneurysm
41. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Miscarriage
Ectopic Pregnancy
The vital signs
Stable vs. Unstable Ectopic Pregnancy
42. Left coronary artery (short and branches quickly)
Define Acute Cholecystitis
LCA
Placenta Previa
Ovarian Cysts
43. 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
Posterior
Where to check pulses
Divertriculitis
Appendicitis work up
44. 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
How to monitor CDAB
CHF
Pain scale for infants
45. 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
Syphillis
Ectopic Pregnancy
Acute Mesenteric Ishemia
Pericarditis
46. 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
Lateral Leads
ED workup of kidney stones
ED treatment of a Miscarriage
Incomplete abortion
47. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Testicular Torsion
How to monitor CDAB
Types of Infectious diarrhea Campylobacter
Ovarian Cysts
48. 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
Pancreatitis work up
Incomplete abortion
Miscarriage
Pericarditis
49. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
RCA
Types of Infectious diarrhea Shigella
Ovarian Cysts
LCA
50. 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 - Salmonella
Emergency Severity Index
STEMI vs Nstemi