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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. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Defibrillation
Acute Arterial occlusion - to lower extremities
Symptoms of Ruptured ovarian cysts
ED treatment for Ectopic Pregnancy
2. 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
How to monitor CDAB
Posterior
GIB work up
Dx of Aortic dissection
3. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Stable vs. Unstable Ectopic Pregnancy
Where to check pulses
When are Beta Blockers contraindicated
Ranson's criteria
4. 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
Testicular Torsion
Stable vs unstable angina`
Genital Herpes
Ovarian Torsion
5. 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
6. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Chlamydia
Genital Herpes
Missed Abortion
7. 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
Early miscarriage (20 weeks)
LCA
Incidence of AMI
ED treatment for Ectopic Pregnancy
8. 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 -
ED workup of kidney stones
Stable vs. Unstable Ectopic Pregnancy
Ascending Cholangitis
Placental Abruption
9. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
LBO - Large bowel obstruction
Kidney Stones
Types of Infectious diarrhea Yersinia
EKG changes
10. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Triage
Common Presentation of GIB
How to monitor CDAB
Miscarriage
11. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
CHF
Types of Infectious diarrhea - Salmonella
Appendicitis work up
Causes of 3rd trimester bleeding
12. 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
Types of GI bleeds
Define Biliary colic
Types of Infectious diarrhea - Salmonella
13. 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
Ranson's criteria
LCA
Cardiac Tamponade
14. 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
Endocarditis
Early miscarriage (20 weeks)
Placenta Previa
Tx of Unstable Angina
15. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Incomplete abortion
Define Biliary colic
Acute Arterial occlusion - to lower extremities
How to monitor CDAB
16. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Ranson's criteria
Causes of 3rd trimester bleeding
Ascending Cholangitis
17. 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
Hypertensive Emergency
Divertriculitis
Types of Infectious diarrhea - Salmonella
Ectopic Pregnancy
18. 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)
Miscarriage
Ovarian Cysts
Defibrillation
Missed Abortion
19. II - III - aVF - Means RCA involved
Breathing
Common Presentation of GIB
Inferior leads
ED work up for cholecystitis
20. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Volvulus
LBO - Large bowel obstruction
Emergency Severity Index
How to monitor CDAB
21. 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
Ascending Cholangitis
What is a large bore IV?
Ectopic Pregnancy
Where to check pulses
22. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
How to monitor CDAB
Acute Arterial occlusion - to lower extremities
RCA
Initial steps in stabilizing a patient
23. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Abdominal Aortic Aneurysm
Viral Gastroenteritis
When to do a pelvic exam
Aortic Dissection definition - risks and S/S
24. 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
Ovarian Torsion
Incarcerated vs strangulated hernias
Chlamydia
Genital Herpes
25. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Common Presentation of GIB
Incomplete abortion
Define Acute Cholecystitis
26. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis
What is a large bore IV?
EKG changes
27. Causes: Alcohol - gallstones - high triglycerides - hypercalcemia - drugs - mumps - trauma Tx: CBC - chem 7 - LFT's - amylase - lipase - EKG Ultrasound CT scan IVF - IVF - IVF!!! NPO Pain control - anti emetics
Urosepsis
Pancreatitis work up
What to do with weak/thready pulses
UTI
28. 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
Aortic Dissection definition - risks and S/S
LBO - Large bowel obstruction
CHF
29. 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
Define Acute Cholecystitis
Syphillis
Ovarian Cysts
Cardiac Enzymes
30. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
UTI
When are Beta Blockers contraindicated
Cardiac Tamponade
When to do a pelvic exam
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
Miscarriage
UTI
Tachycardia
Acute Mesenteric Ishemia
32. 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
Pain scale for infants
ED workup of kidney stones
Symptoms of Ruptured ovarian cysts
What to do with weak/thready pulses
33. 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
Lateral Leads
GIB work up
Volvulus
Types of Infectious diarrhea E coli
34. 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
Define Biliary colic
Divertriculitis
DUKE criteria for endocarditis
Tx of CHF
35. 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
Emergency Severity Index
Types of GI bleeds
Common risk factors for UGIB
36. 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
Urosepsis
Acute Coronary syndrome
Common Presentation of GIB
Defibrillation
37. 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
Supplemental O2
Types of Infectious diarrhea Yersinia
Cardiac Enzymes
Types of GI bleeds
38. 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 UGIB
Defibrillation
Types of GI bleeds
Additional cardiac Tests
39. 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
Urosepsis
Ascending Cholangitis
When are Beta Blockers contraindicated
Symptoms of Ruptured ovarian cysts
40. 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
Chlamydia
The vital signs
Miscarriage
Ranson's criteria
41. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What to do with weak/thready pulses
EKG changes
Types of GI bleeds
STEMI vs Nstemi
42. 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
Types of GI bleeds
Appendicitis work up
Kidney Stones
Missed Abortion
43. 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
Additional cardiac Tests
Ovarian Cysts
LBO - Large bowel obstruction
44. 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)
How to monitor CDAB
STEMI vs Nstemi
Appendicitis work up
Incomplete abortion
45. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Triage
Placental Abruption
ED Tx of GIB
Miscarriage
46. 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
Stable vs. Unstable Ectopic Pregnancy
Urosepsis
Endocarditis
SBO
47. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
STEMI vs Nstemi
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Lateral Leads
CHF
48. 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
GIB work up
Common risk factors for UGIB
Testicular Torsion
49. 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? -
Tx of Unstable Angina
CHF
Initial steps in stabilizing a patient
Contraindications for thrombolytics
50. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Incomplete abortion
Types of Infectious diarrhea E coli
Additional cardiac Tests
Cardiac Enzymes