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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
Common Presentation of GIB
Genital Herpes
Other major arteries
Symptoms of Ruptured ovarian cysts
2. 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
ED treatment of a Miscarriage
CHF
Placenta Previa
Tx of Unstable Angina
3. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
UTI
Placental Abruption
Chlamydia
Define Biliary colic
4. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Causes of 3rd trimester bleeding
Pancreatitis work up
DUKE criteria for endocarditis
LBO - Large bowel obstruction
5. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Additional cardiac Tests
Pancreatitis work up
RCA
Advanced airway techniques
6. 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
Ovarian Cysts
Types of GI bleeds
LCA
Ascending Cholangitis
7. 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
ED workup of kidney stones
Cardiac Tamponade
RCA
Incarcerated vs strangulated hernias
8. 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
DUKE criteria for endocarditis
Testicular Torsion
Stable vs unstable angina`
9. 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
Lateral Leads
Common risk factors for LGIB
Types of Infectious diarrhea Shigella
Incidence of AMI
10. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
EMTALA
Ovarian Cysts
Initial steps in stabilizing a patient
11. 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
Common Presentation of GIB
Ascending Cholangitis
ED work up for cholecystitis
Gonorrhea
12. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
STEMI vs Nstemi
EKG changes
Incarcerated vs strangulated hernias
Ranson's criteria
13. 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
Abdominal Aortic Aneurysm
Pancreatitis work up
Contraindications for thrombolytics
Ascending Cholangitis
14. 16-18 Gauge
DUKE criteria for endocarditis
Endocarditis
What is a large bore IV?
When to do a pelvic exam
15. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Acute Mesenteric Ishemia
Common Presentation of GIB
Defibrillation
Hypertensive Emergency
16. 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
Breathing
Common risk factors for UGIB
Stable vs unstable angina`
Early miscarriage (20 weeks)
17. 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
LCA
Ectopic Pregnancy
Types of GI bleeds
18. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Pericarditis
Types of Infectious diarrhea Yersinia
Anteroseptal leads and Anterior
Advanced airway techniques
19. 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
Common risk factors for LGIB
Syphillis
Additional cardiac Tests
Bradycardia
20. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Genital Herpes
CHF
Anteroseptal leads and Anterior
21. 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
Viral Gastroenteritis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Tx of CHF
Define Acute Cholecystitis
22. 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
ED workup of kidney stones
Initial steps in stabilizing a patient
LCA
Dx of Aortic dissection
23. 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
Anteroseptal leads and Anterior
Additional cardiac Tests
The vital signs
Abdominal Aortic Aneurysm
24. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Common Presentation of GIB
Common risk factors for UGIB
Bradycardia
Stable vs. Unstable Ectopic Pregnancy
25. IVF - fill the tank - CBC - chem 7 - LFT's - Lipase - UA - HCG for females - surgery cx - Abd CT scan for adults - ultrasound for kids or to r/o ovarian pathology in females - NPO - Pain control - Pre op Antibiotics (Levo - Flagyl or Unasyn)
Appendicitis work up
When to do a pelvic exam
Tx of Unstable Angina
Early miscarriage (20 weeks)
26. 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
Common risk factors for UGIB
Miscarriage
Cardiac Enzymes
Cardiac Tamponade
27. 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
Incidence of AMI
Advanced airway techniques
Appendicitis work up
28. 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
EMTALA
Types of Infectious diarrhea E coli
Pericarditis
Other major arteries
29. 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
Genital Herpes
Appendicitis
Early miscarriage (20 weeks)
Hypertensive Emergency
30. 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
Supplemental O2
Genital Herpes
Endocarditis
Acute Mesenteric Ishemia
31. 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
Pancreatitis work up
Supplemental O2
Tachycardia
Ectopic Pregnancy
32. 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
LCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Acute Arterial occlusion - to lower extremities
Divertriculitis
33. 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
Incidence of AMI
Tachycardia
Cardiac Tamponade
Acute Coronary syndrome
34. 'trier' - to separate - sift or select based on priority of condition
Incarcerated vs strangulated hernias
Triage
ED Tx of GIB
Incomplete abortion
35. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
Emergency Severity Index
Ectopic Pregnancy
ED workup of kidney stones
36. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
What should be done after CDAB's
STEMI vs Nstemi
How to monitor CDAB
Initial steps in stabilizing a patient
37. 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
Stable vs. Unstable Ectopic Pregnancy
Ascending Cholangitis
Pericarditis
38. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Endocarditis
Acute Arterial occlusion - to lower extremities
Anteroseptal leads and Anterior
Abdominal Aortic Aneurysm
39. Left coronary artery (short and branches quickly)
Cardiac Enzymes
How to monitor CDAB
LCA
Types of Infectious diarrhea E coli
40. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
When is Rho GAM used
Incomplete abortion
Where to check pulses
41. 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
Emergency Severity Index
GIB work up
ED treatment of a Miscarriage
Tx of CHF
42. 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
Pericarditis
Ovarian Cysts
ED treatment of a Miscarriage
EMTALA
43. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
EMTALA
Types of Infectious diarrhea Campylobacter
Defibrillation
The vital signs
44. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
What should be done after CDAB's
Early miscarriage (20 weeks)
What is a large bore IV?
45. 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
How to monitor CDAB
Common Presentation of GIB
Pancreatitis work up
Kidney Stones
46. II - III - aVF - Means RCA involved
Inferior leads
How to assess Airway
The vital signs
RCA
47. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
DUKE criteria for endocarditis
Stable vs unstable angina`
Types of Infectious diarrhea Shigella
48. 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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49. 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
Ectopic Pregnancy
Other major arteries
Appendicitis
50. 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
Breathing
LCA
ED Tx of GIB
RCA