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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. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Pancreatitis work up
Advanced airway techniques
Appendicitis
Tx of Unstable Angina
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
CHF
The vital signs
Define Acute Cholecystitis
ED work up for cholecystitis
3. 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
Dx of Aortic dissection
Incidence of AMI
Viral Gastroenteritis
Acute Mesenteric Ishemia
4. 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
ED Tx of GIB
Types of Infectious diarrhea - Salmonella
Gonorrhea
Contraindications for thrombolytics
5. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
What should be done after CDAB's
Appendicitis
DUKE criteria for endocarditis
Tachycardia
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
Bradycardia
ED work up for cholecystitis
Acute Mesenteric Ishemia
Additional cardiac Tests
7. V1-V2 Right Posterior Descending Artery
Types of Infectious diarrhea E coli
What is a large bore IV?
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Posterior
8. 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
Ectopic Pregnancy
EMTALA
Acute Coronary syndrome
The vital signs
9. 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
Supplemental O2
Ovarian Cysts
Acute Arterial occlusion - to lower extremities
Initial steps in stabilizing a patient
10. 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
RCA
Supplemental O2
Common risk factors for UGIB
Triage
11. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Tx of Unstable Angina
Common risk factors for LGIB
LCA
Define Biliary colic
12. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Genital Herpes
CHF
Incidence of AMI
Causes of 3rd trimester bleeding
13. 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
Types of Infectious diarrhea - Salmonella
How to assess Airway
Pancreatitis work up
EKG changes
14. 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
Anteroseptal leads and Anterior
Genital Herpes
Placental Abruption
15. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
ED treatment of a Miscarriage
Early miscarriage (20 weeks)
Incarcerated vs strangulated hernias
ED work up for cholecystitis
16. 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
SBO
Breathing
UTI
Ovarian Torsion
17. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Posterior
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Kidney Stones
Divertriculitis
18. 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
Types of Infectious diarrhea Campylobacter
Hypertensive Emergency
Emergency Severity Index
19. 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:
LBO - Large bowel obstruction
Types of Infectious diarrhea - Salmonella
Placental Abruption
Ovarian Torsion
20. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Ovarian Cysts
Urosepsis
Other major arteries
What should be done after CDAB's
21. 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
Acute Coronary syndrome
GIB work up
What should be done after CDAB's
Defibrillation
22. 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? -
Contraindications for thrombolytics
Tx of Unstable Angina
Ranson's criteria
What should be done after CDAB's
23. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
What is a large bore IV?
Types of Infectious diarrhea E coli
Types of Infectious diarrhea - Salmonella
When to do a pelvic exam
24. 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 Ectopic Pregnancy
Abdominal Aortic Aneurysm
Incidence of AMI
ED work up for cholecystitis
25. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Pericarditis
Common Presentation of GIB
Placental Abruption
Types of Infectious diarrhea Yersinia
26. 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
Tx of Unstable Angina
Incidence of AMI
Incomplete abortion
Cardiac Enzymes
27. 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
Missed Abortion
Volvulus
Endocarditis
The vital signs
28. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
LBO - Large bowel obstruction
Initial steps in stabilizing a patient
Ovarian Cysts
Cardiac Tamponade
29. 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
Stable vs unstable angina`
Emergency Severity Index
STEMI vs Nstemi
30. 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 -
Syphillis
Placental Abruption
Types of GI bleeds
Ectopic Pregnancy
31. 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
LCA
EMTALA
Types of Infectious diarrhea - Salmonella
32. 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
Early miscarriage (20 weeks)
Incomplete abortion
Missed Abortion
Bradycardia
33. Old age - chronic anticoagulation - divertriculosis
Ranson's criteria
Common risk factors for LGIB
Types of GI bleeds
Acute Mesenteric Ishemia
34. 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
Other major arteries
ED Tx of GIB
Advanced airway techniques
Appendicitis work up
35. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Contraindications for thrombolytics
Stable vs unstable angina`
Types of Infectious diarrhea Campylobacter
Supplemental O2
36. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Acute Mesenteric Ishemia
Pancreatitis work up
Miscarriage
How to monitor CDAB
37. 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
Acute Coronary syndrome
Endocarditis
Pericarditis
Placenta Previa
38. 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
Endocarditis
Contraindications for thrombolytics
How to assess Airway
ED treatment of a Miscarriage
39. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
LCA
UTI
ED workup of kidney stones
Types of Infectious diarrhea - Salmonella
40. Stable - NOT ruptured - vitals stable - no drop in H/H - no pain or tenderness Tx - with Methotrexate per OB GYN - inhibits folate so cells stop multiplying (used in RA and cancers) Don't use Methotrexate if fetal HR identified - Unstable - RUPTURED
Stable vs. Unstable Ectopic Pregnancy
Breathing
How to assess Airway
Advanced airway techniques
41. 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
Incomplete abortion
Tx of CHF
Anteroseptal leads and Anterior
Types of Infectious diarrhea Campylobacter
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
Incidence of AMI
ED workup of kidney stones
Cardiac Tamponade
Tx of CHF
43. 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
Define Acute Cholecystitis
Ectopic Pregnancy
LCA
The vital signs
44. 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)
Common Presentation of GIB
EKG changes
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Gonorrhea
45. 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)
Aortic Dissection definition - risks and S/S
DUKE criteria for endocarditis
Hypertensive Emergency
Types of GI bleeds
46. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Additional cardiac Tests
Urosepsis
RCA
Ovarian Cysts
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
Ascending Cholangitis
Common risk factors for UGIB
Breathing
Ranson's criteria
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
Breathing
Where to check pulses
Placenta Previa
Posterior
49. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
LCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
STEMI vs Nstemi
Where to check pulses
50. 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
Missed Abortion
EKG changes
DUKE criteria for endocarditis
Genital Herpes