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Test your basic knowledge |
Emergency Medicine
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Study First
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. 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
Types of Infectious diarrhea Campylobacter
Additional cardiac Tests
Pericarditis
Stable vs. Unstable Ectopic Pregnancy
2. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What to do with weak/thready pulses
EMTALA
LBO - Large bowel obstruction
Posterior
3. 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
Viral Gastroenteritis
Symptoms of Ruptured ovarian cysts
ED Tx of GIB
Acute Arterial occlusion - to lower extremities
4. 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
What to do with weak/thready pulses
Ascending Cholangitis
Gonorrhea
5. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Ranson's criteria
Volvulus
Types of Infectious diarrhea E coli
How to assess Airway
6. 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
Aortic Dissection definition - risks and S/S
Where to check pulses
Acute Coronary syndrome
Tx of CHF
7. 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
LCA
EKG changes
EMTALA
ED Tx of GIB
8. 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
Pericarditis
Abdominal Aortic Aneurysm
Pancreatitis work up
Additional cardiac Tests
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
Contraindications for thrombolytics
Cardiac Tamponade
Types of Infectious diarrhea Campylobacter
10. 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
Missed Abortion
Tx of CHF
Anteroseptal leads and Anterior
Cardiac Enzymes
11. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
STEMI vs Nstemi
LBO - Large bowel obstruction
Common risk factors for LGIB
Acute Arterial occlusion - to lower extremities
12. 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
Placental Abruption
Syphillis
Define Biliary colic
GIB work up
13. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Pericarditis
Ovarian Cysts
Endocarditis
Where to check pulses
14. 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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15. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
What should be done after CDAB's
Endocarditis
SBO
16. 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
GIB work up
Define Acute Cholecystitis
Breathing
ED Tx of GIB
17. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
What to do with weak/thready pulses
Common risk factors for UGIB
Acute Mesenteric Ishemia
When are Beta Blockers contraindicated
18. 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
Dx of Aortic dissection
Ectopic Pregnancy
GIB work up
RCA
19. 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
Breathing
Chlamydia
Placenta Previa
Missed Abortion
20. 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
Symptoms of Ruptured ovarian cysts
GIB work up
ED Tx of GIB
21. 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
RCA
Types of Infectious diarrhea Yersinia
Ectopic Pregnancy
GIB work up
22. 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 monitor CDAB
Types of Infectious diarrhea Yersinia
ED treatment of a Miscarriage
How to assess Airway
23. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
RCA
ED Tx of GIB
Aortic Dissection definition - risks and S/S
24. Old age - chronic anticoagulation - divertriculosis
CHF
Divertriculitis
Common risk factors for LGIB
Acute Coronary syndrome
25. 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
Define Acute Cholecystitis
Incomplete abortion
Emergency Severity Index
When are Beta Blockers contraindicated
26. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Aortic Dissection definition - risks and S/S
STEMI vs Nstemi
Ovarian Cysts
EMTALA
27. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Acute Arterial occlusion - to lower extremities
Triage
Tx of CHF
28. 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
Symptoms of Ruptured ovarian cysts
When to do a pelvic exam
What to do with weak/thready pulses
29. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Missed Abortion
Types of Infectious diarrhea Shigella
Genital Herpes
GIB work up
30. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Supplemental O2
EKG changes
Appendicitis work up
When are Beta Blockers contraindicated
31. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Ectopic Pregnancy
Gonorrhea
Tachycardia
When to do a pelvic exam
32. Left coronary artery (short and branches quickly)
Ovarian Torsion
Acute Mesenteric Ishemia
LCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
33. 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
STEMI vs Nstemi
ED workup of kidney stones
Incomplete abortion
Gonorrhea
34. 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
Bradycardia
Initial steps in stabilizing a patient
What should be done after CDAB's
35. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
ED workup of kidney stones
Types of Infectious diarrhea - Salmonella
Bradycardia
Advanced airway techniques
36. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Testicular Torsion
RCA
Tx of Unstable Angina
Incomplete abortion
37. 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
Types of Infectious diarrhea Campylobacter
Pericarditis
Acute Coronary syndrome
SBO
38. 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
Initial steps in stabilizing a patient
Define Acute Cholecystitis
When are Beta Blockers contraindicated
Acute Arterial occlusion - to lower extremities
39. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
What to do with weak/thready pulses
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Emergency Severity Index
Incarcerated vs strangulated hernias
40. 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
The vital signs
What is a large bore IV?
Types of Infectious diarrhea Yersinia
41. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Missed Abortion
Types of Infectious diarrhea Campylobacter
Incidence of AMI
Syphillis
42. 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 Acute Cholecystitis
ED treatment for Ectopic Pregnancy
Early miscarriage (20 weeks)
Common risk factors for UGIB
43. 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
When is Rho GAM used
What to do with weak/thready pulses
Viral Gastroenteritis
How to assess Airway
44. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
When to do a pelvic exam
The vital signs
ED Tx of GIB
When is Rho GAM used
45. 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
Placenta Previa
Anteroseptal leads and Anterior
Tachycardia
SBO
46. 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
RCA
Emergency Severity Index
Symptoms of Ruptured ovarian cysts
CHF
47. V1-V2 Right Posterior Descending Artery
Testicular Torsion
LBO - Large bowel obstruction
Chlamydia
Posterior
48. 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
Advanced airway techniques
Kidney Stones
Bradycardia
GIB work up
49. 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
Common risk factors for UGIB
ED workup of kidney stones
Tx of Unstable Angina
The vital signs
50. 'trier' - to separate - sift or select based on priority of condition
Placental Abruption
Triage
When are Beta Blockers contraindicated
Types of GI bleeds