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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. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Testicular Torsion
Other major arteries
Acute Arterial occlusion - to lower extremities
Emergency Severity Index
2. 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
Initial steps in stabilizing a patient
Hypertensive Emergency
Contraindications for thrombolytics
Acute Mesenteric Ishemia
3. 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
Triage
Pain scale for infants
How to assess Airway
Dx of Aortic dissection
4. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
LCA
Kidney Stones
Anteroseptal leads and Anterior
Types of Infectious diarrhea Shigella
5. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Triage
Incidence of AMI
Urosepsis
Miscarriage
6. 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:
Inferior leads
Ovarian Torsion
When to do a pelvic exam
Additional cardiac Tests
7. 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
UTI
Ascending Cholangitis
GIB work up
Early miscarriage (20 weeks)
8. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Testicular Torsion
Types of Infectious diarrhea E coli
When to do a pelvic exam
Define Biliary colic
9. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Divertriculitis
When to do a pelvic exam
Testicular Torsion
Appendicitis
10. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Urosepsis
Types of Infectious diarrhea Campylobacter
Ovarian Cysts
11. 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
Genital Herpes
Hypertensive Emergency
Cardiac Tamponade
Pancreatitis work up
12. 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
Inferior leads
EMTALA
Placental Abruption
GIB work up
13. 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
Stable vs unstable angina`
Appendicitis work up
Posterior
Abdominal Aortic Aneurysm
14. 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
Divertriculitis
How to assess Airway
Triage
15. 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
STEMI vs Nstemi
Other major arteries
Abdominal Aortic Aneurysm
Syphillis
16. 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
Tachycardia
Emergency Severity Index
Chlamydia
When is Rho GAM used
17. V1-V2 Right Posterior Descending Artery
Symptoms of Ruptured ovarian cysts
ED treatment of a Miscarriage
Stable vs unstable angina`
Posterior
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
Cardiac Tamponade
Placental Abruption
Early miscarriage (20 weeks)
How to monitor CDAB
19. 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)
EMTALA
Types of Infectious diarrhea Campylobacter
EKG changes
Viral Gastroenteritis
20. 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
Acute Mesenteric Ishemia
Tachycardia
Pain scale for infants
Lateral Leads
21. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Ectopic Pregnancy
Common risk factors for UGIB
Breathing
Hypertensive Emergency
22. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Abdominal Aortic Aneurysm
Advanced airway techniques
Tx of CHF
23. 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
Endocarditis
Where to check pulses
ED treatment for Ectopic Pregnancy
Ascending Cholangitis
24. 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
DUKE criteria for endocarditis
The vital signs
Incomplete abortion
Emergency Severity Index
25. 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
EKG changes
Types of Infectious diarrhea Shigella
Placental Abruption
SBO
26. 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
Tachycardia
How to monitor CDAB
Types of Infectious diarrhea - Salmonella
27. 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
Incidence of AMI
Incomplete abortion
Bradycardia
Define Biliary colic
28. 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
Urosepsis
Tx of Unstable Angina
Aortic Dissection definition - risks and S/S
29. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Anteroseptal leads and Anterior
Stable vs. Unstable Ectopic Pregnancy
How to monitor CDAB
30. 'trier' - to separate - sift or select based on priority of condition
Pain scale for infants
How to assess Airway
Triage
Contraindications for thrombolytics
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? -
Tx of Unstable Angina
Tachycardia
Additional cardiac Tests
ED Tx of GIB
32. 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
Stable vs. Unstable Ectopic Pregnancy
Advanced airway techniques
Posterior
Acute Coronary syndrome
33. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Abdominal Aortic Aneurysm
Pancreatitis work up
The vital signs
Define Acute Cholecystitis
34. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Common Presentation of GIB
Placenta Previa
Missed Abortion
ED treatment for Ectopic Pregnancy
35. 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
Advanced airway techniques
Pericarditis
Types of Infectious diarrhea Campylobacter
Inferior leads
36. 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
Urosepsis
Types of Infectious diarrhea Yersinia
Inferior leads
Viral Gastroenteritis
37. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Appendicitis work up
Types of Infectious diarrhea Yersinia
Other major arteries
EKG changes
38. 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)
Syphillis
Urosepsis
ED treatment for Ectopic Pregnancy
Defibrillation
39. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
How to monitor CDAB
Urosepsis
Tx of Unstable Angina
40. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Lateral Leads
Viral Gastroenteritis
Cardiac Tamponade
Appendicitis
41. Check Vital Signs
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42. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Acute Arterial occlusion - to lower extremities
When is Rho GAM used
Ranson's criteria
Incarcerated vs strangulated hernias
43. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Cardiac Tamponade
Anteroseptal leads and Anterior
UTI
Pain scale for infants
44. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
How to assess Airway
What to do with weak/thready pulses
Genital Herpes
EKG changes
45. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
Abdominal Aortic Aneurysm
Tx of CHF
Bradycardia
46. 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)
Other major arteries
DUKE criteria for endocarditis
ED Tx of GIB
Kidney Stones
47. 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
Chlamydia
UTI
RCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
48. 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
Chlamydia
Types of GI bleeds
Placenta Previa
Common risk factors for LGIB
49. 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
Pancreatitis work up
Early miscarriage (20 weeks)
Types of Infectious diarrhea - Salmonella
CHF
50. 16-18 Gauge
What is a large bore IV?
GIB work up
UTI
Types of Infectious diarrhea Campylobacter