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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. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Posterior
Anteroseptal leads and Anterior
Pericarditis
2. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Cardiac Tamponade
EKG changes
Ovarian Torsion
Appendicitis
3. 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
Kidney Stones
Acute Mesenteric Ishemia
Testicular Torsion
Define Biliary colic
4. 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
CHF
LBO - Large bowel obstruction
How to assess Airway
Stable vs. Unstable Ectopic Pregnancy
5. 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
Where to check pulses
Ectopic Pregnancy
ED treatment for Ectopic Pregnancy
6. 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
Acute Coronary syndrome
Ascending Cholangitis
7. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Kidney Stones
Types of Infectious diarrhea Yersinia
Advanced airway techniques
Define Acute Cholecystitis
8. 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
Cardiac Tamponade
RCA
Types of Infectious diarrhea Campylobacter
Stable vs unstable angina`
9. 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
Genital Herpes
Aortic Dissection definition - risks and S/S
Types of Infectious diarrhea Campylobacter
Common risk factors for LGIB
10. 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
Cardiac Tamponade
Ectopic Pregnancy
Miscarriage
11. 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
Triage
Incomplete abortion
Pericarditis
ED work up for cholecystitis
12. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
What is a large bore IV?
Early miscarriage (20 weeks)
Ectopic Pregnancy
13. V1-V2 Right Posterior Descending Artery
Types of Infectious diarrhea Campylobacter
Posterior
Miscarriage
Hypertensive Emergency
14. 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 -
Triage
RCA
Placental Abruption
LBO - Large bowel obstruction
15. 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
Volvulus
How to monitor CDAB
Acute Arterial occlusion - to lower extremities
Where to check pulses
16. 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
Types of Infectious diarrhea Shigella
Divertriculitis
Cardiac Enzymes
Testicular Torsion
17. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Anteroseptal leads and Anterior
LBO - Large bowel obstruction
Genital Herpes
Bradycardia
18. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
ED Tx of GIB
Early miscarriage (20 weeks)
Common Presentation of GIB
RCA
19. 16-18 Gauge
Tx of Unstable Angina
CHF
Gonorrhea
What is a large bore IV?
20. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
The vital signs
Common risk factors for LGIB
Appendicitis work up
Other major arteries
21. 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
Syphillis
EKG changes
Divertriculitis
Dx of Aortic dissection
22. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Chlamydia
Divertriculitis
DUKE criteria for endocarditis
Other major arteries
23. 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
Viral Gastroenteritis
What is a large bore IV?
Types of Infectious diarrhea - Salmonella
EMTALA
24. 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
When to do a pelvic exam
Acute Arterial occlusion - to lower extremities
Ranson's criteria
25. 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)
Syphillis
Supplemental O2
Viral Gastroenteritis
When is Rho GAM used
26. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Pain scale for infants
The vital signs
Ovarian Cysts
GIB work up
27. 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
Abdominal Aortic Aneurysm
Placenta Previa
ED workup of kidney stones
28. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
SBO
STEMI vs Nstemi
When is Rho GAM used
LCA
29. 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
Emergency Severity Index
Ascending Cholangitis
LBO - Large bowel obstruction
What is a large bore IV?
30. 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
CHF
What is a large bore IV?
Aortic Dissection definition - risks and S/S
Contraindications for thrombolytics
31. 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
Appendicitis
Ectopic Pregnancy
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
32. 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
Incidence of AMI
DUKE criteria for endocarditis
Pericarditis
Early miscarriage (20 weeks)
33. 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
Where to check pulses
Types of Infectious diarrhea Shigella
Types of GI bleeds
ED treatment for Ectopic Pregnancy
34. 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
35. 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)
Stable vs. Unstable Ectopic Pregnancy
Volvulus
Tx of CHF
Defibrillation
36. 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
EMTALA
Placenta Previa
Bradycardia
Early miscarriage (20 weeks)
37. 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
Volvulus
SBO
Urosepsis
Types of Infectious diarrhea E coli
38. 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
ED treatment of a Miscarriage
Common risk factors for LGIB
Advanced airway techniques
Kidney Stones
39. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
When are Beta Blockers contraindicated
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Stable vs unstable angina`
Types of Infectious diarrhea - Salmonella
40. 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
Tachycardia
ED workup of kidney stones
Ascending Cholangitis
Genital Herpes
41. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Miscarriage
Common risk factors for LGIB
Emergency Severity Index
CHF
42. 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
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Shigella
Abdominal Aortic Aneurysm
ED work up for cholecystitis
43. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
ED Tx of GIB
GIB work up
Acute Arterial occlusion - to lower extremities
STEMI vs Nstemi
44. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Genital Herpes
Types of Infectious diarrhea E coli
SBO
ED Tx of GIB
45. 'trier' - to separate - sift or select based on priority of condition
SBO
Placental Abruption
Viral Gastroenteritis
Triage
46. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
GIB work up
Supplemental O2
Define Biliary colic
47. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Common Presentation of GIB
Genital Herpes
Testicular Torsion
48. 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
ED Tx of GIB
Common risk factors for LGIB
The vital signs
49. 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
CHF
Acute Arterial occlusion - to lower extremities
Ectopic Pregnancy
Tx of CHF
50. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
DUKE criteria for endocarditis
Types of Infectious diarrhea E coli
Cardiac Tamponade
UTI