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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. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
RCA
Pericarditis
Common Presentation of GIB
Anteroseptal leads and Anterior
2. 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
Define Biliary colic
Testicular Torsion
STEMI vs Nstemi
Early miscarriage (20 weeks)
3. 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)
Tx of CHF
Tx of Unstable Angina
Appendicitis work up
Pain scale for infants
4. 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
Appendicitis
EMTALA
Viral Gastroenteritis
Hypertensive Emergency
5. 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
Additional cardiac Tests
ED treatment for Ectopic Pregnancy
Appendicitis
Tachycardia
6. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Appendicitis
Causes of 3rd trimester bleeding
Miscarriage
Bradycardia
7. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
GIB work up
Symptoms of Ruptured ovarian cysts
Stable vs. Unstable Ectopic Pregnancy
Advanced airway techniques
8. 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
Initial steps in stabilizing a patient
UTI
Syphillis
9. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Lateral Leads
LBO - Large bowel obstruction
Ovarian Cysts
Pericarditis
10. 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
Incidence of AMI
DUKE criteria for endocarditis
Tx of Unstable Angina
ED work up for cholecystitis
11. 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
Early miscarriage (20 weeks)
What to do with weak/thready pulses
Emergency Severity Index
GIB work up
12. 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
When is Rho GAM used
Placental Abruption
Ascending Cholangitis
ED work up for cholecystitis
13. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Pancreatitis work up
When is Rho GAM used
Appendicitis
Breathing
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
Types of GI bleeds
GIB work up
Incidence of AMI
Where to check pulses
15. 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
How to assess Airway
Pericarditis
Volvulus
Pancreatitis work up
16. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Incidence of AMI
Hypertensive Emergency
Ectopic Pregnancy
17. 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
Causes of 3rd trimester bleeding
STEMI vs Nstemi
Placental Abruption
Endocarditis
18. 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
Gonorrhea
Chlamydia
Testicular Torsion
Contraindications for thrombolytics
19. 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
UTI
Other major arteries
Aortic Dissection definition - risks and S/S
Define Acute Cholecystitis
20. 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
Cardiac Tamponade
Ascending Cholangitis
Types of Infectious diarrhea - Salmonella
21. 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)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Placenta Previa
GIB work up
Bradycardia
22. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Lateral Leads
RCA
Tx of Unstable Angina
Posterior
23. 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
EMTALA
Syphillis
Volvulus
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
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
When are Beta Blockers contraindicated
Triage
Testicular Torsion
Syphillis
25. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
When are Beta Blockers contraindicated
Types of Infectious diarrhea Yersinia
Acute Coronary syndrome
26. 'trier' - to separate - sift or select based on priority of condition
Abdominal Aortic Aneurysm
Triage
Aortic Dissection definition - risks and S/S
Testicular Torsion
27. 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
LBO - Large bowel obstruction
Pancreatitis work up
Stable vs unstable angina`
Acute Arterial occlusion - to lower extremities
28. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
LCA
ED workup of kidney stones
Tx of Unstable Angina
The vital signs
29. 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
Additional cardiac Tests
ED Tx of GIB
Chlamydia
Where to check pulses
30. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Gonorrhea
When to do a pelvic exam
Endocarditis
LBO - Large bowel obstruction
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
Types of Infectious diarrhea E coli
Pericarditis
ED workup of kidney stones
Common risk factors for LGIB
32. V1-V2 Right Posterior Descending Artery
Posterior
Gonorrhea
When is Rho GAM used
Cardiac Enzymes
33. 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
Incomplete abortion
EMTALA
EKG changes
34. 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
Ovarian Cysts
Urosepsis
Types of GI bleeds
Pancreatitis work up
35. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Endocarditis
Bradycardia
Types of Infectious diarrhea Campylobacter
Breathing
36. 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
Tx of CHF
EMTALA
Contraindications for thrombolytics
Types of Infectious diarrhea E coli
37. 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:
Ovarian Torsion
Incidence of AMI
Placenta Previa
Gonorrhea
38. 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
ED work up for cholecystitis
Missed Abortion
Stable vs unstable angina`
How to monitor CDAB
39. 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
EMTALA
Appendicitis
Pericarditis
Incomplete abortion
40. 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? -
Tx of Unstable Angina
Other major arteries
Cardiac Tamponade
EKG changes
41. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Anteroseptal leads and Anterior
Other major arteries
STEMI vs Nstemi
Initial steps in stabilizing a patient
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
Urosepsis
Volvulus
Ectopic Pregnancy
Stable vs unstable angina`
43. 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
Aortic Dissection definition - risks and S/S
SBO
ED workup of kidney stones
GIB work up
44. 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
ED workup of kidney stones
How to monitor CDAB
Tx of CHF
Pancreatitis work up
45. 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
Pericarditis
ED work up for cholecystitis
Supplemental O2
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
46. 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
What is a large bore IV?
LBO - Large bowel obstruction
Hypertensive Emergency
Early miscarriage (20 weeks)
47. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Ovarian Cysts
Ovarian Torsion
Emergency Severity Index
48. 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 Arterial occlusion - to lower extremities
Acute Mesenteric Ishemia
Emergency Severity Index
Additional cardiac Tests
49. Check Vital Signs
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50. 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
Cardiac Enzymes
Placenta Previa
Pericarditis
Stable vs. Unstable Ectopic Pregnancy