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Test your basic knowledge |
Emergency Medicine
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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. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
ED treatment for Ectopic Pregnancy
Ovarian Torsion
Acute Coronary syndrome
Early miscarriage (20 weeks)
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
UTI
Common Presentation of GIB
Types of Infectious diarrhea Shigella
Appendicitis work up
3. 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
When are Beta Blockers contraindicated
Pancreatitis work up
ED workup of kidney stones
Acute Coronary syndrome
4. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Where to check pulses
LBO - Large bowel obstruction
Testicular Torsion
STEMI vs Nstemi
5. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Dx of Aortic dissection
The vital signs
What should be done after CDAB's
Pericarditis
6. 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
Kidney Stones
Advanced airway techniques
Common Presentation of GIB
7. 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
Supplemental O2
Stable vs unstable angina`
Bradycardia
STEMI vs Nstemi
8. 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
Pain scale for infants
Hypertensive Emergency
GIB work up
The vital signs
9. 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
Kidney Stones
Tachycardia
Common risk factors for LGIB
Acute Coronary syndrome
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
Initial steps in stabilizing a patient
Other major arteries
Ovarian Torsion
Cardiac Enzymes
11. 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
Hypertensive Emergency
Miscarriage
Abdominal Aortic Aneurysm
12. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
EMTALA
Pancreatitis work up
When to do a pelvic exam
13. 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
Acute Coronary syndrome
SBO
LBO - Large bowel obstruction
Stable vs. Unstable Ectopic Pregnancy
14. 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
Emergency Severity Index
Aortic Dissection definition - risks and S/S
Cardiac Enzymes
ED workup of kidney stones
15. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
ED work up for cholecystitis
Ovarian Torsion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Other major arteries
16. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Acute Arterial occlusion - to lower extremities
Incarcerated vs strangulated hernias
Gonorrhea
Aortic Dissection definition - risks and S/S
17. 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
Stable vs unstable angina`
Dx of Aortic dissection
Common risk factors for UGIB
Early miscarriage (20 weeks)
18. 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
EKG changes
Contraindications for thrombolytics
Types of Infectious diarrhea Shigella
Stable vs unstable angina`
19. 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
Tx of CHF
Breathing
ED workup of kidney stones
ED treatment for Ectopic Pregnancy
20. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
Incomplete abortion
Tachycardia
Common risk factors for LGIB
21. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
EKG changes
DUKE criteria for endocarditis
Lateral Leads
22. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Placental Abruption
Cardiac Tamponade
Inferior leads
Types of Infectious diarrhea Campylobacter
23. 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
Acute Coronary syndrome
Early miscarriage (20 weeks)
Genital Herpes
Lateral Leads
24. 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
Initial steps in stabilizing a patient
ED workup of kidney stones
Endocarditis
Viral Gastroenteritis
25. 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
Emergency Severity Index
Endocarditis
What should be done after CDAB's
ED work up for cholecystitis
26. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Incidence of AMI
What to do with weak/thready pulses
Cardiac Tamponade
GIB work up
27. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
ED Tx of GIB
When to do a pelvic exam
Tx of Unstable Angina
Lateral Leads
28. Leads I - aVL - V4-V6 - Left circumflex artery
Other major arteries
Lateral Leads
Ranson's criteria
Advanced airway techniques
29. 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
EMTALA
Pericarditis
When to do a pelvic exam
Contraindications for thrombolytics
30. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Aortic Dissection definition - risks and S/S
Early miscarriage (20 weeks)
31. 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)
Acute Coronary syndrome
EKG changes
LCA
Define Acute Cholecystitis
32. 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
Define Acute Cholecystitis
Acute Mesenteric Ishemia
Symptoms of Ruptured ovarian cysts
Supplemental O2
33. 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
Tx of CHF
RCA
Chlamydia
Tachycardia
34. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
UTI
Lateral Leads
GIB work up
RCA
35. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Supplemental O2
Appendicitis
LBO - Large bowel obstruction
Triage
36. 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
Where to check pulses
Placenta Previa
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Divertriculitis
37. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Bradycardia
LCA
Acute Arterial occlusion - to lower extremities
Lateral Leads
38. 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
Ectopic Pregnancy
Abdominal Aortic Aneurysm
CHF
When is Rho GAM used
39. 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
Symptoms of Ruptured ovarian cysts
CHF
When to do a pelvic exam
EKG changes
40. 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
Gonorrhea
How to monitor CDAB
Volvulus
Kidney Stones
41. 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
Placental Abruption
When are Beta Blockers contraindicated
ED workup of kidney stones
Gonorrhea
42. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Triage
Ovarian Cysts
Stable vs. Unstable Ectopic Pregnancy
Define Biliary colic
43. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
What should be done after CDAB's
Gonorrhea
Incidence of AMI
44. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Gonorrhea
Types of Infectious diarrhea E coli
Types of Infectious diarrhea - Salmonella
Anteroseptal leads and Anterior
45. Check Vital Signs
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46. 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
Emergency Severity Index
Initial steps in stabilizing a patient
Placental Abruption
Contraindications for thrombolytics
47. 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)
DUKE criteria for endocarditis
Types of Infectious diarrhea Yersinia
Pain scale for infants
Incomplete abortion
48. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Missed Abortion
Ovarian Cysts
Ovarian Torsion
Abdominal Aortic Aneurysm
49. 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
Acute Mesenteric Ishemia
Hypertensive Emergency
Miscarriage
50. 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
Testicular Torsion
Initial steps in stabilizing a patient
ED work up for cholecystitis
Breathing