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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. Leads I - aVL - V4-V6 - Left circumflex artery
DUKE criteria for endocarditis
Lateral Leads
Common Presentation of GIB
LCA
2. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Where to check pulses
Bradycardia
3. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Ovarian Cysts
Types of Infectious diarrhea - Salmonella
Common risk factors for UGIB
Abdominal Aortic Aneurysm
4. 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
Dx of Aortic dissection
EKG changes
When are Beta Blockers contraindicated
Types of GI bleeds
5. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
When to do a pelvic exam
Bradycardia
Triage
6. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
UTI
Kidney Stones
Pancreatitis work up
Other major arteries
7. 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
Tachycardia
Supplemental O2
Testicular Torsion
When are Beta Blockers contraindicated
8. Check Vital Signs
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9. 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
Types of Infectious diarrhea Shigella
Stable vs unstable angina`
Dx of Aortic dissection
10. 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
Triage
Volvulus
Pancreatitis work up
How to assess Airway
11. 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
Symptoms of Ruptured ovarian cysts
Common Presentation of GIB
Tx of CHF
Types of Infectious diarrhea Shigella
12. 16-18 Gauge
What is a large bore IV?
Cardiac Tamponade
Ovarian Torsion
Types of GI bleeds
13. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Early miscarriage (20 weeks)
Other major arteries
Where to check pulses
Common risk factors for UGIB
14. 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
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
15. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
The vital signs
Placenta Previa
Ascending Cholangitis
16. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
When to do a pelvic exam
What is a large bore IV?
What should be done after CDAB's
Pain scale for infants
17. 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
Define Biliary colic
Divertriculitis
Tx of Unstable Angina
Contraindications for thrombolytics
18. 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
Pain scale for infants
Placenta Previa
Acute Mesenteric Ishemia
SBO
19. 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
GIB work up
Breathing
Stable vs. Unstable Ectopic Pregnancy
Incomplete abortion
20. V1-V2 Right Posterior Descending Artery
GIB work up
Pericarditis
Symptoms of Ruptured ovarian cysts
Posterior
21. 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
Incidence of AMI
Define Acute Cholecystitis
DUKE criteria for endocarditis
Cardiac Tamponade
22. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
Inferior leads
How to monitor CDAB
Posterior
23. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
STEMI vs Nstemi
Common Presentation of GIB
ED work up for cholecystitis
Triage
24. 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
Other major arteries
Viral Gastroenteritis
Early miscarriage (20 weeks)
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
CHF
Volvulus
Supplemental O2
Missed Abortion
26. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
What to do with weak/thready pulses
Endocarditis
LCA
27. 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
Kidney Stones
Acute Coronary syndrome
ED treatment of a Miscarriage
Types of GI bleeds
28. 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
Define Biliary colic
The vital signs
Syphillis
29. 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
When are Beta Blockers contraindicated
Initial steps in stabilizing a patient
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea - Salmonella
30. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
ED workup of kidney stones
Where to check pulses
Types of Infectious diarrhea E coli
STEMI vs Nstemi
31. 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
GIB work up
ED Tx of GIB
What is a large bore IV?
UTI
32. 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
Tx of CHF
Placental Abruption
Types of Infectious diarrhea - Salmonella
33. 'trier' - to separate - sift or select based on priority of condition
Chlamydia
Posterior
Incarcerated vs strangulated hernias
Triage
34. 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
Emergency Severity Index
What is a large bore IV?
Acute Mesenteric Ishemia
Missed Abortion
35. 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)
Supplemental O2
EKG changes
When is Rho GAM used
Bradycardia
36. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Triage
Placenta Previa
When to do a pelvic exam
Types of Infectious diarrhea - Salmonella
37. 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
Defibrillation
Where to check pulses
Genital Herpes
Other major arteries
38. 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
CHF
Where to check pulses
UTI
GIB work up
39. 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
Incarcerated vs strangulated hernias
Defibrillation
Tx of Unstable Angina
40. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
DUKE criteria for endocarditis
Kidney Stones
Urosepsis
Miscarriage
41. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Types of Infectious diarrhea Shigella
Genital Herpes
Acute Arterial occlusion - to lower extremities
Ranson's criteria
42. 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
STEMI vs Nstemi
Abdominal Aortic Aneurysm
Advanced airway techniques
43. 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
Causes of 3rd trimester bleeding
The vital signs
Endocarditis
LBO - Large bowel obstruction
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)
Initial steps in stabilizing a patient
EKG changes
Gonorrhea
Ectopic Pregnancy
45. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
When to do a pelvic exam
Triage
STEMI vs Nstemi
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. 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
Types of Infectious diarrhea Campylobacter
Abdominal Aortic Aneurysm
Incidence of AMI
48. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Cardiac Enzymes
Lateral Leads
Placental Abruption
Causes of 3rd trimester bleeding
49. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Additional cardiac Tests
Posterior
Types of Infectious diarrhea Shigella
Missed Abortion
50. 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
Chlamydia
Dx of Aortic dissection
Appendicitis
Stable vs unstable angina`