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Test your basic knowledge |
Emergency Medicine
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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. 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
Testicular Torsion
Missed Abortion
Gonorrhea
How to monitor CDAB
2. Check Vital Signs
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3. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
CHF
Contraindications for thrombolytics
EMTALA
When to do a pelvic exam
4. 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)
Types of GI bleeds
Gonorrhea
Bradycardia
ED work up for cholecystitis
5. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Tx of CHF
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Common risk factors for UGIB
6. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Divertriculitis
Cardiac Tamponade
Types of Infectious diarrhea Shigella
Kidney Stones
7. 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
Kidney Stones
Ovarian Cysts
Divertriculitis
Symptoms of Ruptured ovarian cysts
8. 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 -
Pericarditis
Placental Abruption
Cardiac Enzymes
Abdominal Aortic Aneurysm
9. 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
UTI
Acute Mesenteric Ishemia
The vital signs
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
Other major arteries
Appendicitis
Cardiac Enzymes
Pericarditis
11. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Common risk factors for LGIB
Anteroseptal leads and Anterior
Missed Abortion
Pericarditis
12. 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
EKG changes
Acute Coronary syndrome
Types of Infectious diarrhea E coli
13. 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
Pericarditis
Aortic Dissection definition - risks and S/S
Types of GI bleeds
Placenta Previa
14. 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
Gonorrhea
Ectopic Pregnancy
Ovarian Cysts
Pancreatitis work up
15. 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)
Pericarditis
ED work up for cholecystitis
Ranson's criteria
DUKE criteria for endocarditis
16. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
Miscarriage
Advanced airway techniques
Ascending Cholangitis
17. U GIB - ** DARK STOOLS - above the ligament of Treitz: Esophageal varices - Dieulafoy lesion - PUD - Mallory Weiss Tear - LGIB: ** BRight red blood - below lig of Treitz AVM (Atrio-venous malformation) -Divertriculitis - Meckel's divertriculum - colo
Types of GI bleeds
Acute Mesenteric Ishemia
Testicular Torsion
When are Beta Blockers contraindicated
18. 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
Types of Infectious diarrhea Shigella
What to do with weak/thready pulses
Other major arteries
Hypertensive Emergency
19. 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
Tx of Unstable Angina
Missed Abortion
Placenta Previa
EKG changes
20. 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
Where to check pulses
Causes of 3rd trimester bleeding
Endocarditis
Dx of Aortic dissection
21. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Testicular Torsion
Cardiac Enzymes
Other major arteries
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
Supplemental O2
Ascending Cholangitis
Syphillis
Miscarriage
23. 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
EKG changes
UTI
Acute Mesenteric Ishemia
Additional cardiac Tests
24. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
When are Beta Blockers contraindicated
Acute Arterial occlusion - to lower extremities
Hypertensive Emergency
ED workup of kidney stones
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
Volvulus
EMTALA
ED treatment for Ectopic Pregnancy
Advanced airway techniques
26. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Supplemental O2
Cardiac Enzymes
Urosepsis
Miscarriage
27. 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
Placenta Previa
Pancreatitis work up
STEMI vs Nstemi
Types of Infectious diarrhea Shigella
28. 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)
Contraindications for thrombolytics
EKG changes
How to monitor CDAB
Causes of 3rd trimester bleeding
29. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Appendicitis work up
Chlamydia
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
30. 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
Initial steps in stabilizing a patient
Placenta Previa
Abdominal Aortic Aneurysm
Tx of CHF
31. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Defibrillation
ED treatment for Ectopic Pregnancy
Tachycardia
When are Beta Blockers contraindicated
32. 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
When are Beta Blockers contraindicated
Pericarditis
Dx of Aortic dissection
Other major arteries
33. V1-V2 Right Posterior Descending Artery
Acute Mesenteric Ishemia
Tx of Unstable Angina
Posterior
Stable vs unstable angina`
34. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
EMTALA
UTI
Define Acute Cholecystitis
35. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Chlamydia
Emergency Severity Index
Kidney Stones
What to do with weak/thready pulses
36. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
Inferior leads
Types of GI bleeds
Types of Infectious diarrhea E coli
37. 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
Incidence of AMI
Early miscarriage (20 weeks)
Types of GI bleeds
Testicular Torsion
38. 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? -
What is a large bore IV?
Anteroseptal leads and Anterior
EMTALA
Tx of Unstable Angina
39. 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
Incomplete abortion
UTI
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Define Acute Cholecystitis
40. 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
Tachycardia
ED workup of kidney stones
EKG changes
41. 'trier' - to separate - sift or select based on priority of condition
Types of Infectious diarrhea - Salmonella
Acute Arterial occlusion - to lower extremities
Anteroseptal leads and Anterior
Triage
42. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Early miscarriage (20 weeks)
LBO - Large bowel obstruction
When to do a pelvic exam
Incidence of AMI
43. 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
Aortic Dissection definition - risks and S/S
Bradycardia
44. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Types of Infectious diarrhea Shigella
Define Biliary colic
Pain scale for infants
Acute Arterial occlusion - to lower extremities
45. 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
LCA
RCA
Contraindications for thrombolytics
CHF
46. 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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47. 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
ED treatment of a Miscarriage
Stable vs. Unstable Ectopic Pregnancy
Stable vs unstable angina`
Triage
48. 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
Ovarian Torsion
STEMI vs Nstemi
Genital Herpes
Inferior leads
49. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
ED Tx of GIB
Lateral Leads
Causes of 3rd trimester bleeding
Anteroseptal leads and Anterior
50. 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
Early miscarriage (20 weeks)
Anteroseptal leads and Anterior
Ascending Cholangitis
Genital Herpes