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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. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Syphillis
Cardiac Tamponade
2. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Types of Infectious diarrhea E coli
Bradycardia
CHF
Miscarriage
3. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Shigella
EKG changes
How to monitor CDAB
4. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Cardiac Enzymes
ED treatment of a Miscarriage
ED treatment for Ectopic Pregnancy
5. 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
Types of Infectious diarrhea Shigella
Additional cardiac Tests
Miscarriage
Viral Gastroenteritis
6. 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)
ED treatment of a Miscarriage
Tachycardia
When is Rho GAM used
Placental Abruption
7. 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)
Types of GI bleeds
Lateral Leads
Symptoms of Ruptured ovarian cysts
EKG changes
8. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Appendicitis work up
Urosepsis
Triage
Other major arteries
9. 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
GIB work up
Tx of CHF
DUKE criteria for endocarditis
10. 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
What should be done after CDAB's
Cardiac Enzymes
Acute Arterial occlusion - to lower extremities
Urosepsis
11. 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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12. 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
Urosepsis
Common risk factors for LGIB
UTI
13. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
Advanced airway techniques
DUKE criteria for endocarditis
Placenta Previa
14. 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
Define Biliary colic
Missed Abortion
Pain scale for infants
Posterior
15. 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
Acute Mesenteric Ishemia
What should be done after CDAB's
ED Tx of GIB
Common risk factors for UGIB
16. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Viral Gastroenteritis
Lateral Leads
Tachycardia
17. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Types of GI bleeds
Emergency Severity Index
Triage
18. 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
Types of Infectious diarrhea Shigella
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea - Salmonella
Dx of Aortic dissection
19. 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
When to do a pelvic exam
Missed Abortion
Testicular Torsion
Divertriculitis
20. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Breathing
RCA
UTI
Tachycardia
21. 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)
Common Presentation of GIB
Placental Abruption
Early miscarriage (20 weeks)
DUKE criteria for endocarditis
22. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Inferior leads
Incomplete abortion
Acute Arterial occlusion - to lower extremities
Acute Mesenteric Ishemia
23. 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
Pancreatitis work up
Ranson's criteria
ED workup of kidney stones
Miscarriage
24. 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
Aortic Dissection definition - risks and S/S
Abdominal Aortic Aneurysm
Urosepsis
ED treatment of a Miscarriage
25. 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:
Common risk factors for UGIB
Ovarian Torsion
STEMI vs Nstemi
Tx of CHF
26. 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
Tx of CHF
Appendicitis
Pancreatitis work up
Cardiac Enzymes
27. 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
STEMI vs Nstemi
Abdominal Aortic Aneurysm
Urosepsis
28. 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
EMTALA
Pancreatitis work up
Posterior
29. 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
Tachycardia
Defibrillation
EMTALA
30. 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
What to do with weak/thready pulses
LCA
Stable vs. Unstable Ectopic Pregnancy
31. 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
Inferior leads
Early miscarriage (20 weeks)
Tachycardia
Where to check pulses
32. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Types of GI bleeds
What to do with weak/thready pulses
Advanced airway techniques
How to monitor CDAB
33. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Common risk factors for LGIB
Types of Infectious diarrhea Campylobacter
Appendicitis
LBO - Large bowel obstruction
34. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Kidney Stones
Defibrillation
Common Presentation of GIB
Divertriculitis
35. V1-V2 Right Posterior Descending Artery
ED work up for cholecystitis
Acute Coronary syndrome
Kidney Stones
Posterior
36. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
Early miscarriage (20 weeks)
Contraindications for thrombolytics
Testicular Torsion
37. Check Vital Signs
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38. 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
Triage
What to do with weak/thready pulses
UTI
Testicular Torsion
39. 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
RCA
Other major arteries
Acute Mesenteric Ishemia
40. 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
ED work up for cholecystitis
Urosepsis
Incidence of AMI
41. 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 Campylobacter
Causes of 3rd trimester bleeding
Supplemental O2
Breathing
42. 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
Kidney Stones
Chlamydia
GIB work up
Tx of Unstable Angina
43. 16-18 Gauge
Endocarditis
What is a large bore IV?
Types of Infectious diarrhea Shigella
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
Hypertensive Emergency
Initial steps in stabilizing a patient
Common risk factors for LGIB
Define Biliary colic
45. 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
Tx of Unstable Angina
Ectopic Pregnancy
Lateral Leads
GIB work up
46. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Tx of CHF
Define Acute Cholecystitis
Divertriculitis
Types of Infectious diarrhea Campylobacter
47. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Incomplete abortion
LBO - Large bowel obstruction
Types of Infectious diarrhea Yersinia
Divertriculitis
48. 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
Pancreatitis work up
CHF
Common risk factors for UGIB
49. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Missed Abortion
Contraindications for thrombolytics
Emergency Severity Index
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
50. 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
The vital signs
Pericarditis
Kidney Stones
Supplemental O2