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Test your basic knowledge |
Emergency Medicine
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Subjects
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health-sciences
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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. 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
Viral Gastroenteritis
Supplemental O2
How to assess Airway
ED work up for cholecystitis
2. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Appendicitis
Types of Infectious diarrhea E coli
Divertriculitis
ED treatment for Ectopic Pregnancy
3. 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
How to assess Airway
When to do a pelvic exam
LBO - Large bowel obstruction
Define Acute Cholecystitis
4. 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
GIB work up
Divertriculitis
Defibrillation
LCA
5. 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
What is a large bore IV?
Anteroseptal leads and Anterior
Dx of Aortic dissection
6. 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
SBO
Incomplete abortion
ED workup of kidney stones
The vital signs
7. 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
Types of Infectious diarrhea Campylobacter
Causes of 3rd trimester bleeding
Syphillis
Common Presentation of GIB
8. 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
Kidney Stones
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Common risk factors for UGIB
Pancreatitis work up
9. Given to any woman that is Rh Negative who is HCG positive and has any vaginal bleeding during pregnancy - to Rh Negative patients (prevent formation of anti Rh antibodies - against baby)
Anteroseptal leads and Anterior
Acute Coronary syndrome
ED treatment of a Miscarriage
When is Rho GAM used
10. 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
Acute Arterial occlusion - to lower extremities
What to do with weak/thready pulses
Appendicitis
UTI
11. 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
Ranson's criteria
What is a large bore IV?
Testicular Torsion
Types of Infectious diarrhea E coli
12. 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
Hypertensive Emergency
Types of Infectious diarrhea Yersinia
Incomplete abortion
Placental Abruption
13. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Lateral Leads
Ovarian Cysts
Pancreatitis work up
Causes of 3rd trimester bleeding
14. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Incidence of AMI
Common Presentation of GIB
Lateral Leads
Breathing
15. Check Vital Signs
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16. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Dx of Aortic dissection
CHF
Ectopic Pregnancy
GIB work up
17. 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
Common Presentation of GIB
GIB work up
ED workup of kidney stones
ED Tx of GIB
18. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Shigella
SBO
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Breathing
19. 16-18 Gauge
Supplemental O2
LBO - Large bowel obstruction
What is a large bore IV?
Cardiac Tamponade
20. 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
Gonorrhea
Breathing
Pericarditis
What is a large bore IV?
21. 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
Divertriculitis
How to monitor CDAB
The vital signs
Miscarriage
22. 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
ED Tx of GIB
ED work up for cholecystitis
Volvulus
Supplemental O2
23. 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
Initial steps in stabilizing a patient
Placenta Previa
Ovarian Cysts
ED treatment of a Miscarriage
24. 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
Pancreatitis work up
Aortic Dissection definition - risks and S/S
Cardiac Enzymes
Miscarriage
25. 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
Divertriculitis
Hypertensive Emergency
Where to check pulses
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
What to do with weak/thready pulses
Incidence of AMI
Advanced airway techniques
Hypertensive Emergency
27. 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:
Placenta Previa
Ovarian Torsion
ED workup of kidney stones
ED work up for cholecystitis
28. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
CHF
Anteroseptal leads and Anterior
Cardiac Tamponade
GIB work up
29. 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
Types of Infectious diarrhea E coli
Tachycardia
Appendicitis work up
Types of Infectious diarrhea Yersinia
30. 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
LCA
Abdominal Aortic Aneurysm
Types of Infectious diarrhea E coli
Acute Mesenteric Ishemia
31. 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
Contraindications for thrombolytics
Divertriculitis
Types of Infectious diarrhea E coli
LCA
32. 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 E coli
Symptoms of Ruptured ovarian cysts
Stable vs. Unstable Ectopic Pregnancy
33. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Types of Infectious diarrhea Shigella
Ranson's criteria
Define Biliary colic
Incarcerated vs strangulated hernias
34. 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
Bradycardia
Common risk factors for UGIB
Types of GI bleeds
Types of Infectious diarrhea Shigella
35. Leads I - aVL - V4-V6 - Left circumflex artery
Viral Gastroenteritis
Incomplete abortion
Acute Arterial occlusion - to lower extremities
Lateral Leads
36. 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
STEMI vs Nstemi
Advanced airway techniques
Incomplete abortion
Endocarditis
37. 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
SBO
Stable vs unstable angina`
Incidence of AMI
When to do a pelvic exam
38. 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
Incomplete abortion
Viral Gastroenteritis
Supplemental O2
39. 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)
Cardiac Tamponade
Bradycardia
DUKE criteria for endocarditis
Pancreatitis work up
40. II - III - aVF - Means RCA involved
Urosepsis
Syphillis
Inferior leads
What should be done after CDAB's
41. 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
Common risk factors for UGIB
Incidence of AMI
Appendicitis
Emergency Severity Index
42. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Ascending Cholangitis
Testicular Torsion
ED treatment for Ectopic Pregnancy
Defibrillation
43. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Placental Abruption
Pain scale for infants
Types of Infectious diarrhea Campylobacter
Pancreatitis work up
44. 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? -
Symptoms of Ruptured ovarian cysts
Tachycardia
DUKE criteria for endocarditis
Tx of Unstable Angina
45. 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
Appendicitis
Abdominal Aortic Aneurysm
Lateral Leads
EMTALA
46. 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
Cardiac Enzymes
Supplemental O2
Breathing
Additional cardiac Tests
47. 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
Abdominal Aortic Aneurysm
Incomplete abortion
Breathing
48. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Ovarian Cysts
Types of GI bleeds
Supplemental O2
When are Beta Blockers contraindicated
49. 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
Common risk factors for UGIB
Tx of CHF
Appendicitis work up
What to do with weak/thready pulses
50. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
When to do a pelvic exam
How to monitor CDAB
LBO - Large bowel obstruction
Common risk factors for UGIB