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Test your basic knowledge |
Emergency Medicine
Start Test
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. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
What to do with weak/thready pulses
ED Tx of GIB
How to monitor CDAB
2. 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)
Dx of Aortic dissection
Breathing
DUKE criteria for endocarditis
Bradycardia
3. 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
Incidence of AMI
How to assess Airway
ED treatment for Ectopic Pregnancy
RCA
4. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
SBO
STEMI vs Nstemi
Breathing
Missed Abortion
5. 16-18 Gauge
Cardiac Tamponade
CHF
What is a large bore IV?
What should be done after CDAB's
6. 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
DUKE criteria for endocarditis
Urosepsis
Posterior
Testicular Torsion
7. 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)
Dx of Aortic dissection
Miscarriage
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
8. 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
Dx of Aortic dissection
How to monitor CDAB
CHF
Initial steps in stabilizing a patient
9. 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
Symptoms of Ruptured ovarian cysts
Missed Abortion
CHF
Types of Infectious diarrhea Yersinia
10. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Tachycardia
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Urosepsis
Chlamydia
11. 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
Hypertensive Emergency
Divertriculitis
Miscarriage
Causes of 3rd trimester bleeding
12. 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
Lateral Leads
Where to check pulses
Incidence of AMI
Stable vs. Unstable Ectopic Pregnancy
13. 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
Triage
Types of Infectious diarrhea Campylobacter
Acute Coronary syndrome
Define Biliary colic
14. 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 -
Endocarditis
Stable vs unstable angina`
Posterior
Placental Abruption
15. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Initial steps in stabilizing a patient
Define Acute Cholecystitis
Emergency Severity Index
Types of Infectious diarrhea E coli
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
Types of GI bleeds
Chlamydia
Divertriculitis
Breathing
17. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Syphillis
ED treatment for Ectopic Pregnancy
Acute Arterial occlusion - to lower extremities
Testicular Torsion
18. Check Vital Signs
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19. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Abdominal Aortic Aneurysm
LCA
Gonorrhea
Types of Infectious diarrhea - Salmonella
20. 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
Ovarian Cysts
Chlamydia
EKG changes
21. II - III - aVF - Means RCA involved
Appendicitis work up
Inferior leads
ED treatment for Ectopic Pregnancy
Cardiac Tamponade
22. 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
Types of Infectious diarrhea E coli
Supplemental O2
Ascending Cholangitis
EKG changes
23. 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
Pain scale for infants
Aortic Dissection definition - risks and S/S
Urosepsis
Lateral Leads
24. 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
STEMI vs Nstemi
SBO
Appendicitis work up
Missed Abortion
25. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Pancreatitis work up
Stable vs unstable angina`
Bradycardia
Ovarian Cysts
26. 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)
STEMI vs Nstemi
When is Rho GAM used
LBO - Large bowel obstruction
Stable vs unstable angina`
27. 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
Syphillis
ED work up for cholecystitis
Early miscarriage (20 weeks)
Acute Coronary syndrome
28. 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
Incomplete abortion
Define Biliary colic
Gonorrhea
SBO
29. 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
ED work up for cholecystitis
EMTALA
Placenta Previa
Gonorrhea
30. 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
Abdominal Aortic Aneurysm
Genital Herpes
Kidney Stones
Dx of Aortic dissection
31. 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? -
GIB work up
Hypertensive Emergency
Miscarriage
Tx of Unstable Angina
32. 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
Aortic Dissection definition - risks and S/S
How to monitor CDAB
Pericarditis
Placental Abruption
33. 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
Stable vs unstable angina`
Define Acute Cholecystitis
The vital signs
Abdominal Aortic Aneurysm
34. 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)
Types of Infectious diarrhea Shigella
Types of GI bleeds
DUKE criteria for endocarditis
ED workup of kidney stones
35. Left coronary artery (short and branches quickly)
When to do a pelvic exam
LBO - Large bowel obstruction
LCA
Pericarditis
36. 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
Cardiac Enzymes
Emergency Severity Index
Ascending Cholangitis
Endocarditis
37. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
DUKE criteria for endocarditis
Urosepsis
Placenta Previa
What is a large bore IV?
38. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Additional cardiac Tests
Breathing
Aortic Dissection definition - risks and S/S
Miscarriage
39. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
DUKE criteria for endocarditis
Viral Gastroenteritis
CHF
Gonorrhea
40. 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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41. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Posterior
ED treatment of a Miscarriage
Tachycardia
Advanced airway techniques
42. 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
CHF
Additional cardiac Tests
Volvulus
Acute Arterial occlusion - to lower extremities
43. 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
Placenta Previa
Lateral Leads
Where to check pulses
ED treatment of a Miscarriage
44. 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
STEMI vs Nstemi
Pain scale for infants
Hypertensive Emergency
Tx of CHF
45. 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
Supplemental O2
Genital Herpes
Emergency Severity Index
EMTALA
46. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Other major arteries
Tx of Unstable Angina
Gonorrhea
47. 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
Acute Mesenteric Ishemia
Incarcerated vs strangulated hernias
Ascending Cholangitis
Ectopic Pregnancy
48. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Syphillis
Types of Infectious diarrhea Campylobacter
When to do a pelvic exam
Testicular Torsion
49. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Common risk factors for LGIB
Tx of CHF
What to do with weak/thready pulses
Acute Arterial occlusion - to lower extremities
50. 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
Volvulus
Inferior leads
Additional cardiac Tests
Breathing