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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. 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
Ascending Cholangitis
LBO - Large bowel obstruction
Where to check pulses
Volvulus
2. 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
Testicular Torsion
Acute Coronary syndrome
Types of GI bleeds
Kidney Stones
3. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Appendicitis
Urosepsis
ED treatment for Ectopic Pregnancy
Advanced airway techniques
4. 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 -
Placental Abruption
Breathing
The vital signs
Appendicitis work up
5. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Endocarditis
The vital signs
Tx of CHF
Appendicitis
6. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Cardiac Tamponade
Appendicitis
Causes of 3rd trimester bleeding
Miscarriage
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
ED treatment for Ectopic Pregnancy
Testicular Torsion
UTI
Kidney Stones
8. 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)
Missed Abortion
Tx of Unstable Angina
When is Rho GAM used
Initial steps in stabilizing a patient
9. 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? -
Types of Infectious diarrhea E coli
Tx of Unstable Angina
Ovarian Cysts
The vital signs
10. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
ED treatment for Ectopic Pregnancy
Common Presentation of GIB
Types of Infectious diarrhea E coli
Appendicitis
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
Endocarditis
Viral Gastroenteritis
Ascending Cholangitis
Common risk factors for UGIB
12. V1-V2 Right Posterior Descending Artery
CHF
Miscarriage
LCA
Posterior
13. 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
STEMI vs Nstemi
What should be done after CDAB's
Initial steps in stabilizing a patient
Acute Arterial occlusion - to lower extremities
14. Shock to electrically terminate abnormal heart rate and restart. - The earlier a fibrillating heart is defibrillated - the more successful (survival drops by 10% with each minute)
Types of GI bleeds
Incidence of AMI
Defibrillation
Other major arteries
15. 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
Syphillis
Other major arteries
Lateral Leads
16. 'trier' - to separate - sift or select based on priority of condition
When is Rho GAM used
Testicular Torsion
Triage
Types of Infectious diarrhea Shigella
17. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Breathing
Pain scale for infants
Additional cardiac Tests
18. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Stable vs unstable angina`
Tx of CHF
Pain scale for infants
What should be done after CDAB's
19. 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
Ectopic Pregnancy
Types of GI bleeds
Bradycardia
20. 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
Genital Herpes
Hypertensive Emergency
Missed Abortion
Chlamydia
21. Old age - chronic anticoagulation - divertriculosis
Anteroseptal leads and Anterior
Common risk factors for LGIB
Urosepsis
Common Presentation of GIB
22. 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:
Ovarian Torsion
Types of Infectious diarrhea - Salmonella
Cardiac Enzymes
Supplemental O2
23. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Inferior leads
Pain scale for infants
Miscarriage
What is a large bore IV?
24. 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
Incidence of AMI
Common Presentation of GIB
Types of Infectious diarrhea Shigella
25. 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
Common risk factors for LGIB
Missed Abortion
Types of Infectious diarrhea E coli
Acute Mesenteric Ishemia
26. II - III - aVF - Means RCA involved
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
DUKE criteria for endocarditis
Inferior leads
Ovarian Torsion
27. 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
Miscarriage
Types of Infectious diarrhea - Salmonella
Pain scale for infants
Types of GI bleeds
28. 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
Divertriculitis
Initial steps in stabilizing a patient
Types of Infectious diarrhea E coli
Emergency Severity Index
29. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Acute Mesenteric Ishemia
ED treatment for Ectopic Pregnancy
When to do a pelvic exam
Define Acute Cholecystitis
30. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Advanced airway techniques
ED workup of kidney stones
Define Biliary colic
Testicular Torsion
31. 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
Genital Herpes
ED workup of kidney stones
Where to check pulses
32. 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 LGIB
Cardiac Enzymes
Common risk factors for UGIB
Tx of CHF
33. School/work outbreak - Common viruses: rotavirus - norwalk - adenovirus - astrovirus - last 24 to 48 hours - ALWAYS DX as VOMITING AND DIARRHEA - never use the term viral gastroenteritis (CYA medicine) Tx: CBC - chem 7 - LFT's - lIpase - UA - general
Where to check pulses
Genital Herpes
Viral Gastroenteritis
Dx of Aortic dissection
34. 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
Incomplete abortion
Gonorrhea
Inferior leads
Emergency Severity Index
35. 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
Stable vs. Unstable Ectopic Pregnancy
GIB work up
SBO
Tx of CHF
36. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Incomplete abortion
CHF
Inferior leads
ED work up for cholecystitis
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
SBO
Aortic Dissection definition - risks and S/S
Inferior leads
When are Beta Blockers contraindicated
38. 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
Other major arteries
Stable vs unstable angina`
GIB work up
Missed Abortion
39. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Gonorrhea
Pain scale for infants
Types of GI bleeds
When are Beta Blockers contraindicated
40. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Cardiac Tamponade
Aortic Dissection definition - risks and S/S
UTI
RCA
41. 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 risk factors for UGIB
Pancreatitis work up
RCA
Kidney Stones
42. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
When are Beta Blockers contraindicated
Stable vs. Unstable Ectopic Pregnancy
ED treatment of a Miscarriage
Cardiac Tamponade
43. 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
Define Acute Cholecystitis
ED workup of kidney stones
Types of Infectious diarrhea - Salmonella
44. 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
Placenta Previa
How to monitor CDAB
Common risk factors for LGIB
What to do with weak/thready pulses
45. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Gonorrhea
STEMI vs Nstemi
Types of GI bleeds
Types of Infectious diarrhea - Salmonella
46. 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
Viral Gastroenteritis
Symptoms of Ruptured ovarian cysts
Tachycardia
Pericarditis
47. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Abdominal Aortic Aneurysm
Miscarriage
The vital signs
Types of Infectious diarrhea Shigella
48. 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
Hypertensive Emergency
Pancreatitis work up
ED treatment of a Miscarriage
49. 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)
Define Acute Cholecystitis
Urosepsis
Lateral Leads
DUKE criteria for endocarditis
50. 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
When are Beta Blockers contraindicated
Emergency Severity Index
Volvulus
Chlamydia