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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. 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
Placenta Previa
What is a large bore IV?
Define Acute Cholecystitis
SBO
2. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
GIB work up
Types of Infectious diarrhea Campylobacter
Ranson's criteria
Appendicitis
3. 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
Types of Infectious diarrhea Yersinia
Ovarian Torsion
Defibrillation
Tx of CHF
4. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Stable vs. Unstable Ectopic Pregnancy
The vital signs
ED treatment for Ectopic Pregnancy
Acute Arterial occlusion - to lower extremities
5. 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
UTI
Anteroseptal leads and Anterior
Acute Mesenteric Ishemia
Incomplete abortion
6. 16-18 Gauge
What is a large bore IV?
The vital signs
Volvulus
Anteroseptal leads and Anterior
7. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Tx of CHF
Common risk factors for UGIB
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
8. 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
Advanced airway techniques
Additional cardiac Tests
Pericarditis
Ranson's criteria
9. 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
ED Tx of GIB
SBO
ED work up for cholecystitis
Types of GI bleeds
10. 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
Testicular Torsion
Initial steps in stabilizing a patient
Dx of Aortic dissection
Breathing
11. 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
Posterior
Symptoms of Ruptured ovarian cysts
Cardiac Enzymes
Types of Infectious diarrhea Shigella
12. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Where to check pulses
Types of Infectious diarrhea Yersinia
RCA
ED Tx of GIB
13. 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
EKG changes
ED treatment of a Miscarriage
Defibrillation
Ascending Cholangitis
14. 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
Bradycardia
Appendicitis work up
Where to check pulses
Common risk factors for LGIB
15. 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
Defibrillation
Common risk factors for LGIB
Types of GI bleeds
UTI
16. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Kidney Stones
Cardiac Tamponade
Miscarriage
Tx of Unstable Angina
17. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
Early miscarriage (20 weeks)
Chlamydia
Urosepsis
18. 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
Posterior
Acute Mesenteric Ishemia
Missed Abortion
Viral Gastroenteritis
19. 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
Endocarditis
Triage
Contraindications for thrombolytics
GIB work up
20. 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 E coli
ED treatment of a Miscarriage
Triage
21. 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
Tx of Unstable Angina
Acute Mesenteric Ishemia
Chlamydia
What is a large bore IV?
22. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Symptoms of Ruptured ovarian cysts
What to do with weak/thready pulses
What is a large bore IV?
Chlamydia
23. 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
What should be done after CDAB's
How to monitor CDAB
Genital Herpes
Incomplete abortion
24. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
ED treatment of a Miscarriage
Common risk factors for LGIB
Ascending Cholangitis
Cardiac Tamponade
25. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Breathing
Missed Abortion
Incidence of AMI
26. 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
What is a large bore IV?
Breathing
Acute Mesenteric Ishemia
Tx of Unstable Angina
27. 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
Incomplete abortion
Aortic Dissection definition - risks and S/S
UTI
28. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Testicular Torsion
What to do with weak/thready pulses
EKG changes
29. 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
Tachycardia
Emergency Severity Index
Ascending Cholangitis
Early miscarriage (20 weeks)
30. 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
How to monitor CDAB
Defibrillation
EKG changes
31. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
DUKE criteria for endocarditis
CHF
Types of Infectious diarrhea Yersinia
EMTALA
32. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Common risk factors for LGIB
Supplemental O2
EMTALA
When are Beta Blockers contraindicated
33. II - III - aVF - Means RCA involved
Placenta Previa
Contraindications for thrombolytics
Testicular Torsion
Inferior leads
34. 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
The vital signs
Dx of Aortic dissection
Defibrillation
35. 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 -
When to do a pelvic exam
STEMI vs Nstemi
Genital Herpes
Placental Abruption
36. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Cardiac Enzymes
LBO - Large bowel obstruction
Genital Herpes
37. 'trier' - to separate - sift or select based on priority of condition
Miscarriage
Ectopic Pregnancy
Triage
Ovarian Cysts
38. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
ED treatment of a Miscarriage
Testicular Torsion
Common risk factors for UGIB
Ovarian Cysts
39. 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
Appendicitis work up
Types of GI bleeds
STEMI vs Nstemi
Define Acute Cholecystitis
40. Common STI- S/S: skin pustules - fever - monarticular septic arthritis. - may be asymptomatic in females - or cervicitis - PID Males: epididimytis - urethritis - prostatitis Dx: cervical or urethral culture swab Tx: Ceftriaxone IM x 1or Cefixime 4
Acute Mesenteric Ishemia
Urosepsis
Gonorrhea
Syphillis
41. 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
What should be done after CDAB's
Contraindications for thrombolytics
Ovarian Cysts
Types of Infectious diarrhea Shigella
42. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Stable vs unstable angina`
Anteroseptal leads and Anterior
Miscarriage
Appendicitis
43. 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
Types of GI bleeds
Additional cardiac Tests
Miscarriage
Inferior leads
44. Check Vital Signs
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45. 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
RCA
Emergency Severity Index
Causes of 3rd trimester bleeding
Pericarditis
46. 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
Hypertensive Emergency
Additional cardiac Tests
STEMI vs Nstemi
Placental Abruption
47. 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
ED Tx of GIB
Pericarditis
What to do with weak/thready pulses
How to assess Airway
48. Risk Factors: PID - Mirena IUD - tubal surgery - pelvic surgery - endometriosis - IVF -DES exposure S/S - R or L adnexal tenderness - R shoulder pain could be referred pain from intraabdominal hemorrhage (gallbladder - liver also) - Workup -CBC - C
Advanced airway techniques
Define Biliary colic
Types of Infectious diarrhea - Salmonella
Ectopic Pregnancy
49. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Tachycardia
Types of Infectious diarrhea Yersinia
Ranson's criteria
Acute Arterial occlusion - to lower extremities
50. 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)
Appendicitis work up
Placental Abruption
When is Rho GAM used
Common risk factors for UGIB