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Test your basic knowledge |
Emergency Medicine
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Subjects
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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. 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)
When is Rho GAM used
Placental Abruption
Stable vs. Unstable Ectopic Pregnancy
Symptoms of Ruptured ovarian cysts
2. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
What is a large bore IV?
Tx of Unstable Angina
Anteroseptal leads and Anterior
Other major arteries
3. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Abdominal Aortic Aneurysm
Cardiac Tamponade
Incarcerated vs strangulated hernias
Missed Abortion
4. 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
The vital signs
Causes of 3rd trimester bleeding
Endocarditis
Defibrillation
5. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Cardiac Tamponade
Ovarian Cysts
Types of Infectious diarrhea Yersinia
When are Beta Blockers contraindicated
6. 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
Appendicitis work up
RCA
EMTALA
Define Acute Cholecystitis
7. 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
Pericarditis
Placenta Previa
Lateral Leads
Inferior leads
8. 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
ED workup of kidney stones
Appendicitis
ED treatment for Ectopic Pregnancy
Placental Abruption
9. 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
Types of Infectious diarrhea Shigella
Endocarditis
Other major arteries
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
Ranson's criteria
Define Acute Cholecystitis
Ovarian Cysts
Volvulus
11. 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
Additional cardiac Tests
Cardiac Enzymes
Chlamydia
Missed Abortion
12. 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
Placenta Previa
EMTALA
Kidney Stones
13. 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)
Incarcerated vs strangulated hernias
Acute Arterial occlusion - to lower extremities
DUKE criteria for endocarditis
Causes of 3rd trimester bleeding
14. 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
Aortic Dissection definition - risks and S/S
Types of Infectious diarrhea Campylobacter
LCA
15. 16-18 Gauge
Early miscarriage (20 weeks)
What is a large bore IV?
Ovarian Torsion
Posterior
16. 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
UTI
When are Beta Blockers contraindicated
Emergency Severity Index
GIB work up
17. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Define Acute Cholecystitis
When are Beta Blockers contraindicated
ED Tx of GIB
Types of Infectious diarrhea Shigella
18. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Ovarian Torsion
Placenta Previa
Tx of Unstable Angina
Incarcerated vs strangulated hernias
19. 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
Tx of Unstable Angina
Types of Infectious diarrhea - Salmonella
Supplemental O2
Breathing
20. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Pancreatitis work up
Additional cardiac Tests
Types of Infectious diarrhea Campylobacter
Testicular Torsion
21. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Early miscarriage (20 weeks)
Cardiac Tamponade
Types of GI bleeds
Types of Infectious diarrhea - Salmonella
22. 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
Ectopic Pregnancy
Ovarian Torsion
Syphillis
Inferior leads
23. 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 treatment of a Miscarriage
Incomplete abortion
Stable vs. Unstable Ectopic Pregnancy
Missed Abortion
24. Old age - chronic anticoagulation - divertriculosis
Common Presentation of GIB
Bradycardia
Divertriculitis
Common risk factors for LGIB
25. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
GIB work up
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Kidney Stones
Types of GI bleeds
26. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Common risk factors for UGIB
Inferior leads
Lateral Leads
Emergency Severity Index
27. 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
Additional cardiac Tests
Testicular Torsion
Acute Mesenteric Ishemia
Types of GI bleeds
28. 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
Types of Infectious diarrhea E coli
Stable vs unstable angina`
SBO
Pain scale for infants
29. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Pericarditis
SBO
CHF
Other major arteries
30. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
Define Biliary colic
Gonorrhea
Common risk factors for UGIB
31. V1-V2 Right Posterior Descending Artery
Posterior
Supplemental O2
Pancreatitis work up
When are Beta Blockers contraindicated
32. 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
Types of GI bleeds
Gonorrhea
When is Rho GAM used
Anteroseptal leads and Anterior
33. Rectal exam for EVERYONE with belly pain - EKG (don't want to r/o MI) - Labs: CBC - chem 7 - PTT - blood type and screen/cross (in case need blood transfusion) - H Pylori: Rapid urease test or IgG / IgM - Endoscopy for UGIB (can be done in ED) - Colo
Incidence of AMI
How to monitor CDAB
GIB work up
Syphillis
34. 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
Types of Infectious diarrhea Shigella
Types of Infectious diarrhea Campylobacter
ED workup of kidney stones
Ectopic Pregnancy
35. 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
Incarcerated vs strangulated hernias
GIB work up
36. 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
Symptoms of Ruptured ovarian cysts
Early miscarriage (20 weeks)
Urosepsis
Acute Arterial occlusion - to lower extremities
37. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
Aortic Dissection definition - risks and S/S
Ranson's criteria
Types of Infectious diarrhea E coli
38. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Symptoms of Ruptured ovarian cysts
Acute Arterial occlusion - to lower extremities
What should be done after CDAB's
DUKE criteria for endocarditis
39. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
ED workup of kidney stones
Aortic Dissection definition - risks and S/S
40. 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
Contraindications for thrombolytics
Symptoms of Ruptured ovarian cysts
Pericarditis
Early miscarriage (20 weeks)
41. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
EMTALA
Advanced airway techniques
Types of Infectious diarrhea Yersinia
Common risk factors for LGIB
42. 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
Placenta Previa
Breathing
Incomplete abortion
Abdominal Aortic Aneurysm
43. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Abdominal Aortic Aneurysm
STEMI vs Nstemi
Ascending Cholangitis
Other major arteries
44. 'trier' - to separate - sift or select based on priority of condition
When to do a pelvic exam
Triage
SBO
Acute Arterial occlusion - to lower extremities
45. Check Vital Signs
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46. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Syphillis
Cardiac Tamponade
Incarcerated vs strangulated hernias
Urosepsis
47. 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
Kidney Stones
Contraindications for thrombolytics
Abdominal Aortic Aneurysm
Types of Infectious diarrhea Shigella
48. 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
Lateral Leads
RCA
Types of Infectious diarrhea Campylobacter
49. 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
When to do a pelvic exam
Tx of CHF
Missed Abortion
Acute Arterial occlusion - to lower extremities
50. 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
Incarcerated vs strangulated hernias
Stable vs. Unstable Ectopic Pregnancy
SBO
Additional cardiac Tests