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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. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Lateral Leads
When is Rho GAM used
Causes of 3rd trimester bleeding
Anteroseptal leads and Anterior
2. 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
When are Beta Blockers contraindicated
LBO - Large bowel obstruction
Cardiac Enzymes
UTI
3. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Defibrillation
Volvulus
Types of Infectious diarrhea Shigella
Additional cardiac Tests
4. 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
How to monitor CDAB
EKG changes
Dx of Aortic dissection
Testicular Torsion
5. 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
UTI
Common Presentation of GIB
Define Acute Cholecystitis
Endocarditis
6. 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
Additional cardiac Tests
Incomplete abortion
What should be done after CDAB's
Breathing
7. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Ovarian Torsion
Acute Arterial occlusion - to lower extremities
GIB work up
Initial steps in stabilizing a patient
8. 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
Emergency Severity Index
Syphillis
Placental Abruption
9. 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
Defibrillation
Early miscarriage (20 weeks)
Acute Coronary syndrome
Chlamydia
10. 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
Defibrillation
Viral Gastroenteritis
Where to check pulses
Incidence of AMI
11. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
Gonorrhea
Acute Coronary syndrome
Initial steps in stabilizing a patient
12. 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
LCA
Posterior
Ascending Cholangitis
Tx of CHF
13. 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
Common Presentation of GIB
Cardiac Tamponade
Pericarditis
STEMI vs Nstemi
14. 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
Cardiac Enzymes
Where to check pulses
Acute Mesenteric Ishemia
15. 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
Common risk factors for UGIB
Abdominal Aortic Aneurysm
Gonorrhea
What is a large bore IV?
16. 16-18 Gauge
Acute Coronary syndrome
When is Rho GAM used
What is a large bore IV?
ED Tx of GIB
17. 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? -
Testicular Torsion
Ovarian Cysts
Lateral Leads
Tx of Unstable Angina
18. Check Vital Signs
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19. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of Infectious diarrhea Campylobacter
Contraindications for thrombolytics
Inferior leads
ED work up for cholecystitis
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
Types of Infectious diarrhea Yersinia
Posterior
Appendicitis
Syphillis
21. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Dx of Aortic dissection
Miscarriage
Pain scale for infants
Cardiac Enzymes
22. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
EKG changes
Acute Mesenteric Ishemia
The vital signs
ED treatment for Ectopic Pregnancy
23. 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
Common risk factors for LGIB
Chlamydia
Common Presentation of GIB
How to monitor CDAB
24. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
How to assess Airway
LBO - Large bowel obstruction
Tx of Unstable Angina
Symptoms of Ruptured ovarian cysts
25. 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
Pain scale for infants
Lateral Leads
Incarcerated vs strangulated hernias
Volvulus
26. 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
Ovarian Cysts
ED workup of kidney stones
Types of Infectious diarrhea E coli
Emergency Severity Index
27. 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
Acute Coronary syndrome
The vital signs
Ovarian Torsion
Stable vs unstable angina`
28. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
ED Tx of GIB
What to do with weak/thready pulses
Types of Infectious diarrhea - Salmonella
CHF
29. 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
Divertriculitis
CHF
LBO - Large bowel obstruction
30. Left coronary artery (short and branches quickly)
Cardiac Tamponade
Acute Coronary syndrome
LCA
Cardiac Enzymes
31. 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
Bradycardia
Where to check pulses
Tx of Unstable Angina
Breathing
32. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
RCA
Aortic Dissection definition - risks and S/S
Causes of 3rd trimester bleeding
Ovarian Cysts
33. 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
Posterior
Pericarditis
Hypertensive Emergency
Types of Infectious diarrhea Shigella
34. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Symptoms of Ruptured ovarian cysts
SBO
What to do with weak/thready pulses
When are Beta Blockers contraindicated
35. V1-V2 Right Posterior Descending Artery
What to do with weak/thready pulses
Types of GI bleeds
Incomplete abortion
Posterior
36. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Types of Infectious diarrhea Shigella
Appendicitis
Triage
ED work up for cholecystitis
37. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Pancreatitis work up
Acute Arterial occlusion - to lower extremities
Cardiac Tamponade
Testicular Torsion
38. 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
Bradycardia
Incomplete abortion
GIB work up
Supplemental O2
39. 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
LBO - Large bowel obstruction
What should be done after CDAB's
Posterior
Initial steps in stabilizing a patient
40. 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
LCA
Placental Abruption
How to monitor CDAB
Acute Mesenteric Ishemia
41. 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
GIB work up
Placenta Previa
Early miscarriage (20 weeks)
Other major arteries
42. 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
Advanced airway techniques
Additional cardiac Tests
Common risk factors for UGIB
ED workup of kidney stones
43. 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)
EKG changes
Placenta Previa
Supplemental O2
Advanced airway techniques
44. 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
Anteroseptal leads and Anterior
Hypertensive Emergency
ED treatment of a Miscarriage
45. 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
Genital Herpes
Incarcerated vs strangulated hernias
Acute Mesenteric Ishemia
Chlamydia
46. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Cardiac Tamponade
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
When is Rho GAM used
Types of Infectious diarrhea Campylobacter
47. 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
Tx of CHF
What is a large bore IV?
Types of Infectious diarrhea Yersinia
EMTALA
48. 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
SBO
Where to check pulses
Divertriculitis
Tx of CHF
49. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Stable vs. Unstable Ectopic Pregnancy
What should be done after CDAB's
Early miscarriage (20 weeks)
STEMI vs Nstemi
50. 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
Abdominal Aortic Aneurysm
Ovarian Torsion
Acute Mesenteric Ishemia
Types of Infectious diarrhea Yersinia