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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.
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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. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Define Acute Cholecystitis
EMTALA
When are Beta Blockers contraindicated
Types of GI bleeds
2. 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
Appendicitis
Stable vs. Unstable Ectopic Pregnancy
STEMI vs Nstemi
Define Acute Cholecystitis
3. Look for ST elevation in at least 2 contiguous lead (at least 1mm) - may see a new LBBB - Reciprocal changes - T wave inversion (end of the infarct or old) - Q waves (old infarct)
Pancreatitis work up
EKG changes
STEMI vs Nstemi
What is a large bore IV?
4. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Incarcerated vs strangulated hernias
Types of Infectious diarrhea Yersinia
ED work up for cholecystitis
How to monitor CDAB
5. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Contraindications for thrombolytics
UTI
Pain scale for infants
How to monitor CDAB
6. 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
Pain scale for infants
GIB work up
ED Tx of GIB
ED treatment of a Miscarriage
7. 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)
How to assess Airway
Dx of Aortic dissection
Defibrillation
8. 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 Arterial occlusion - to lower extremities
EKG changes
Ectopic Pregnancy
Placenta Previa
9. 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
Bradycardia
Additional cardiac Tests
Gonorrhea
Inferior leads
10. 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
Chlamydia
Where to check pulses
Endocarditis
11. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
ED work up for cholecystitis
Placenta Previa
Ranson's criteria
12. 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
Other major arteries
Additional cardiac Tests
Tachycardia
EMTALA
13. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
ED work up for cholecystitis
Types of Infectious diarrhea - Salmonella
Pancreatitis work up
Acute Mesenteric Ishemia
14. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Placenta Previa
Ovarian Cysts
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Placental Abruption
15. 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
Additional cardiac Tests
Ascending Cholangitis
Breathing
ED treatment for Ectopic Pregnancy
16. Shock to electrically terminate abnormal heart rate and restart. - The earlier a fibrillating heart is defibrillated - the more successful (survival drops by 10% with each minute)
Types of Infectious diarrhea Shigella
What to do with weak/thready pulses
Causes of 3rd trimester bleeding
Defibrillation
17. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
DUKE criteria for endocarditis
Appendicitis
Chlamydia
Types of Infectious diarrhea - Salmonella
18. 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
Incidence of AMI
What is a large bore IV?
Inferior leads
How to monitor CDAB
19. 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
Common risk factors for LGIB
Supplemental O2
What to do with weak/thready pulses
Appendicitis work up
20. 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
Types of Infectious diarrhea E coli
Ovarian Cysts
What is a large bore IV?
Endocarditis
21. 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
Initial steps in stabilizing a patient
Genital Herpes
Miscarriage
22. 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
Volvulus
Initial steps in stabilizing a patient
Ectopic Pregnancy
Pericarditis
23. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Breathing
Ovarian Cysts
Aortic Dissection definition - risks and S/S
Common risk factors for UGIB
24. 'trier' - to separate - sift or select based on priority of condition
Genital Herpes
Ascending Cholangitis
Bradycardia
Triage
25. 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
Missed Abortion
Types of Infectious diarrhea - Salmonella
Where to check pulses
26. 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
Acute Coronary syndrome
EKG changes
Pericarditis
EMTALA
27. 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
Kidney Stones
Pain scale for infants
Other major arteries
Genital Herpes
28. 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)
What should be done after CDAB's
Appendicitis work up
Types of Infectious diarrhea Campylobacter
Early miscarriage (20 weeks)
29. 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
Emergency Severity Index
Define Acute Cholecystitis
ED workup of kidney stones
30. 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
Other major arteries
Incomplete abortion
How to monitor CDAB
31. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Anteroseptal leads and Anterior
Stable vs. Unstable Ectopic Pregnancy
Contraindications for thrombolytics
32. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
ED treatment for Ectopic Pregnancy
Advanced airway techniques
Common risk factors for UGIB
Cardiac Tamponade
33. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Types of Infectious diarrhea Shigella
Urosepsis
Ovarian Cysts
How to monitor CDAB
34. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Gonorrhea
Supplemental O2
Types of Infectious diarrhea Shigella
Acute Arterial occlusion - to lower extremities
35. 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
Missed Abortion
Types of GI bleeds
Common risk factors for LGIB
36. Check Vital Signs
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37. 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
Incarcerated vs strangulated hernias
ED work up for cholecystitis
Where to check pulses
38. 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 -
Hypertensive Emergency
Breathing
Triage
Placental Abruption
39. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Acute Coronary syndrome
Types of Infectious diarrhea Campylobacter
ED treatment of a Miscarriage
EKG changes
40. 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
Common risk factors for LGIB
Volvulus
Advanced airway techniques
41. 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
Stable vs. Unstable Ectopic Pregnancy
Incomplete abortion
Ranson's criteria
Acute Coronary syndrome
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
Ovarian Torsion
Volvulus
ED work up for cholecystitis
Advanced airway techniques
43. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Define Acute Cholecystitis
Types of Infectious diarrhea Yersinia
The vital signs
Early miscarriage (20 weeks)
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
CHF
Supplemental O2
Cardiac Tamponade
Dx of Aortic dissection
45. 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
Tachycardia
Anteroseptal leads and Anterior
LBO - Large bowel obstruction
Viral Gastroenteritis
46. 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
Types of Infectious diarrhea E coli
Syphillis
Bradycardia
Symptoms of Ruptured ovarian cysts
47. 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
Advanced airway techniques
Incidence of AMI
ED Tx of GIB
Endocarditis
48. 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
Tx of Unstable Angina
The vital signs
Tachycardia
Gonorrhea
49. 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
Types of GI bleeds
Ectopic Pregnancy
Abdominal Aortic Aneurysm
ED treatment of a Miscarriage
50. V1-V2 Right Posterior Descending Artery
Ovarian Torsion
Lateral Leads
Posterior
ED treatment for Ectopic Pregnancy