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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. 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? -
Testicular Torsion
Ranson's criteria
Abdominal Aortic Aneurysm
Tx of Unstable Angina
2. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Types of Infectious diarrhea Yersinia
What to do with weak/thready pulses
Placental Abruption
Testicular Torsion
3. II - III - aVF - Means RCA involved
SBO
Syphillis
Inferior leads
Anteroseptal leads and Anterior
4. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
GIB work up
Incidence of AMI
Aortic Dissection definition - risks and S/S
5. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Missed Abortion
Aortic Dissection definition - risks and S/S
Pain scale for infants
The vital signs
6. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Ectopic Pregnancy
Causes of 3rd trimester bleeding
Stable vs unstable angina`
When is Rho GAM used
7. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Stable vs. Unstable Ectopic Pregnancy
Acute Arterial occlusion - to lower extremities
Pain scale for infants
Types of Infectious diarrhea - Salmonella
8. 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
Incarcerated vs strangulated hernias
How to monitor CDAB
Common risk factors for LGIB
Aortic Dissection definition - risks and S/S
9. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Tx of Unstable Angina
Cardiac Tamponade
SBO
Where to check pulses
10. 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
STEMI vs Nstemi
Genital Herpes
Endocarditis
Volvulus
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
Miscarriage
Kidney Stones
GIB work up
Ascending Cholangitis
12. 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)
LCA
Common risk factors for UGIB
Urosepsis
Bradycardia
13. 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`
Genital Herpes
Common risk factors for LGIB
How to monitor CDAB
14. 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
Incomplete abortion
Incidence of AMI
Endocarditis
Early miscarriage (20 weeks)
15. 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
Stable vs unstable angina`
Stable vs. Unstable Ectopic Pregnancy
Cardiac Enzymes
16. 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
How to monitor CDAB
Missed Abortion
When is Rho GAM used
Dx of Aortic dissection
17. 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
Ranson's criteria
Cardiac Enzymes
Ovarian Cysts
Types of Infectious diarrhea Shigella
18. 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
Posterior
Endocarditis
Symptoms of Ruptured ovarian cysts
19. 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
Tx of CHF
Bradycardia
Incidence of AMI
Miscarriage
20. 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
LBO - Large bowel obstruction
Symptoms of Ruptured ovarian cysts
Early miscarriage (20 weeks)
UTI
21. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
Contraindications for thrombolytics
Ascending Cholangitis
CHF
22. 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
Divertriculitis
LBO - Large bowel obstruction
Tx of Unstable Angina
Types of GI bleeds
23. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Urosepsis
Appendicitis
Define Biliary colic
24. 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
Testicular Torsion
Causes of 3rd trimester bleeding
Stable vs. Unstable Ectopic Pregnancy
Define Biliary colic
25. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Bradycardia
Hypertensive Emergency
Advanced airway techniques
When is Rho GAM used
26. 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
Breathing
Pancreatitis work up
Tx of CHF
CHF
27. 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
Contraindications for thrombolytics
Types of GI bleeds
SBO
CHF
28. 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
ED Tx of GIB
Posterior
When to do a pelvic exam
What should be done after CDAB's
29. 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
Common risk factors for UGIB
Ovarian Cysts
Additional cardiac Tests
Posterior
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
Appendicitis work up
Ectopic Pregnancy
Gonorrhea
When is Rho GAM used
31. Check Vital Signs
32. 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
When to do a pelvic exam
Types of Infectious diarrhea Campylobacter
Define Acute Cholecystitis
Ectopic Pregnancy
33. 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
Where to check pulses
Symptoms of Ruptured ovarian cysts
Acute Coronary syndrome
Cardiac Tamponade
34. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
LCA
Where to check pulses
Incarcerated vs strangulated hernias
Syphillis
35. 'trier' - to separate - sift or select based on priority of condition
Placenta Previa
GIB work up
Triage
Types of Infectious diarrhea Campylobacter
36. Left coronary artery (short and branches quickly)
Syphillis
Lateral Leads
LCA
DUKE criteria for endocarditis
37. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Where to check pulses
Contraindications for thrombolytics
Types of Infectious diarrhea E coli
Viral Gastroenteritis
38. 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
Early miscarriage (20 weeks)
Inferior leads
When is Rho GAM used
How to assess Airway
39. 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
Emergency Severity Index
Symptoms of Ruptured ovarian cysts
Additional cardiac Tests
ED treatment for Ectopic Pregnancy
40. 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
What should be done after CDAB's
Abdominal Aortic Aneurysm
ED work up for cholecystitis
EMTALA
41. Old age - chronic anticoagulation - divertriculosis
Emergency Severity Index
Common risk factors for LGIB
Urosepsis
Pancreatitis work up
42. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Defibrillation
Additional cardiac Tests
ED treatment for Ectopic Pregnancy
When are Beta Blockers contraindicated
43. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Bradycardia
Common risk factors for UGIB
Pericarditis
44. 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
Chlamydia
Acute Mesenteric Ishemia
Endocarditis
Kidney Stones
45. 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
Common Presentation of GIB
Volvulus
Viral Gastroenteritis
46. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
RCA
Kidney Stones
Other major arteries
When to do a pelvic exam
47. 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
Types of Infectious diarrhea E coli
Ranson's criteria
Pericarditis
48. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Inferior leads
Pericarditis
Incarcerated vs strangulated hernias
ED treatment for Ectopic Pregnancy
49. 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
Pancreatitis work up
Types of Infectious diarrhea Campylobacter
Ovarian Cysts
50. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
EMTALA
Emergency Severity Index
What is a large bore IV?
Pain scale for infants