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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. 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
Tx of CHF
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Urosepsis
2. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Incarcerated vs strangulated hernias
Lateral Leads
STEMI vs Nstemi
EKG changes
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
Tachycardia
Symptoms of Ruptured ovarian cysts
Advanced airway techniques
RCA
4. 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
Placental Abruption
Initial steps in stabilizing a patient
Tx of Unstable Angina
Symptoms of Ruptured ovarian cysts
5. 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
Ectopic Pregnancy
Acute Coronary syndrome
Appendicitis work up
6. 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)
Bradycardia
ED treatment of a Miscarriage
When is Rho GAM used
DUKE criteria for endocarditis
7. 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
Ascending Cholangitis
Lateral Leads
Endocarditis
Types of Infectious diarrhea E coli
8. 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
Kidney Stones
Tx of CHF
Endocarditis
Additional cardiac Tests
9. 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
Kidney Stones
ED work up for cholecystitis
When is Rho GAM used
LBO - Large bowel obstruction
10. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Types of GI bleeds
Where to check pulses
Cardiac Tamponade
Types of Infectious diarrhea Yersinia
11. 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 -
Placental Abruption
SBO
Incomplete abortion
Ovarian Cysts
12. 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
Acute Coronary syndrome
Placental Abruption
Tachycardia
Ectopic Pregnancy
13. 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
Tx of Unstable Angina
Placental Abruption
Incomplete abortion
14. 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
Bradycardia
Hypertensive Emergency
Ovarian Cysts
Common Presentation of GIB
15. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
Ectopic Pregnancy
EMTALA
STEMI vs Nstemi
16. 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
Defibrillation
Define Acute Cholecystitis
UTI
17. 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
Aortic Dissection definition - risks and S/S
When are Beta Blockers contraindicated
When is Rho GAM used
Pain scale for infants
18. 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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19. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
What is a large bore IV?
Acute Mesenteric Ishemia
Contraindications for thrombolytics
20. 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
Syphillis
LCA
SBO
Ranson's criteria
21. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Campylobacter
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea Yersinia
Testicular Torsion
22. 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
Early miscarriage (20 weeks)
Placenta Previa
Incidence of AMI
CHF
23. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Testicular Torsion
Advanced airway techniques
Bradycardia
How to monitor CDAB
24. 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 assess Airway
The vital signs
How to monitor CDAB
Appendicitis
25. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Common risk factors for UGIB
Urosepsis
Appendicitis work up
Pancreatitis work up
26. 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
ED treatment of a Miscarriage
Advanced airway techniques
Common Presentation of GIB
Hypertensive Emergency
27. 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
Pain scale for infants
Types of GI bleeds
Volvulus
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
28. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
EKG changes
Missed Abortion
How to assess Airway
29. 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:
Ectopic Pregnancy
Ovarian Torsion
When to do a pelvic exam
Aortic Dissection definition - risks and S/S
30. 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)
Bradycardia
Tx of CHF
When is Rho GAM used
Genital Herpes
31. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Causes of 3rd trimester bleeding
Appendicitis work up
Placenta Previa
SBO
32. 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
Stable vs. Unstable Ectopic Pregnancy
Types of Infectious diarrhea Campylobacter
Contraindications for thrombolytics
Where to check pulses
33. leading caUse of death inUS - Includes angina (stable and unstable) and MI (STEMI vs NSTEMI) - risk factors: HTN - Hyperlipidemia - smoking - DM - fam hx under age 55 - advanced age - males and postmenopausal females - Patho: atherosclerosis of arter
ED treatment for Ectopic Pregnancy
Lateral Leads
Early miscarriage (20 weeks)
Acute Coronary syndrome
34. Left coronary artery (short and branches quickly)
LCA
Initial steps in stabilizing a patient
ED work up for cholecystitis
When are Beta Blockers contraindicated
35. 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
Ranson's criteria
When to do a pelvic exam
ED workup of kidney stones
ED work up for cholecystitis
36. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
When to do a pelvic exam
Appendicitis
What to do with weak/thready pulses
Inferior leads
37. 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
EMTALA
Ovarian Torsion
Additional cardiac Tests
The vital signs
38. 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
Inferior leads
Ovarian Torsion
Define Acute Cholecystitis
Pancreatitis work up
39. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Causes of 3rd trimester bleeding
Ovarian Cysts
DUKE criteria for endocarditis
Contraindications for thrombolytics
40. 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
Common Presentation of GIB
Viral Gastroenteritis
Stable vs. Unstable Ectopic Pregnancy
41. 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
Ovarian Cysts
Types of Infectious diarrhea E coli
Viral Gastroenteritis
Divertriculitis
42. 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
Pericarditis
STEMI vs Nstemi
ED workup of kidney stones
43. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
Missed Abortion
Pericarditis
Inferior leads
44. 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
GIB work up
Tx of CHF
STEMI vs Nstemi
45. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Causes of 3rd trimester bleeding
Cardiac Enzymes
Chlamydia
Miscarriage
46. 'trier' - to separate - sift or select based on priority of condition
Triage
Posterior
Missed Abortion
Other major arteries
47. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Emergency Severity Index
Types of Infectious diarrhea E coli
LCA
Where to check pulses
48. 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
Pain scale for infants
Tx of CHF
Chlamydia
49. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
RCA
Acute Arterial occlusion - to lower extremities
Where to check pulses
Posterior
50. 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
Tachycardia
ED work up for cholecystitis
Emergency Severity Index
Ovarian Torsion