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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. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Acute Coronary syndrome
Tachycardia
Triage
Common risk factors for UGIB
2. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Common Presentation of GIB
Types of GI bleeds
Pancreatitis work up
3. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Types of Infectious diarrhea Shigella
Acute Coronary syndrome
The vital signs
ED workup of kidney stones
4. 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
ED Tx of GIB
ED treatment for Ectopic Pregnancy
Ranson's criteria
Ascending Cholangitis
5. 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
Additional cardiac Tests
Tachycardia
Types of Infectious diarrhea Campylobacter
6. 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
Cardiac Enzymes
Inferior leads
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Endocarditis
7. 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
Aortic Dissection definition - risks and S/S
CHF
Incidence of AMI
Stable vs. Unstable Ectopic Pregnancy
8. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
DUKE criteria for endocarditis
LBO - Large bowel obstruction
Types of Infectious diarrhea Yersinia
Appendicitis
9. 'trier' - to separate - sift or select based on priority of condition
LBO - Large bowel obstruction
Triage
Define Acute Cholecystitis
Miscarriage
10. 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
LBO - Large bowel obstruction
Emergency Severity Index
ED work up for cholecystitis
Bradycardia
11. 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
When are Beta Blockers contraindicated
Missed Abortion
Chlamydia
Additional cardiac Tests
12. 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
Tx of CHF
DUKE criteria for endocarditis
Divertriculitis
UTI
13. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Tx of Unstable Angina
Types of Infectious diarrhea - Salmonella
Gonorrhea
Urosepsis
14. 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
When to do a pelvic exam
Dx of Aortic dissection
Types of Infectious diarrhea E coli
Tx of CHF
15. 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
Posterior
Tx of CHF
Volvulus
16. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
Symptoms of Ruptured ovarian cysts
ED treatment of a Miscarriage
Types of Infectious diarrhea Campylobacter
17. 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
Cardiac Tamponade
Genital Herpes
EKG changes
Where to check pulses
18. Check Vital Signs
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19. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Endocarditis
Causes of 3rd trimester bleeding
Where to check pulses
Miscarriage
20. 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
SBO
Other major arteries
Pancreatitis work up
Dx of Aortic dissection
21. Old age - chronic anticoagulation - divertriculosis
Contraindications for thrombolytics
When is Rho GAM used
Define Acute Cholecystitis
Common risk factors for LGIB
22. 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
Kidney Stones
Types of GI bleeds
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis work up
23. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
When are Beta Blockers contraindicated
Types of Infectious diarrhea Shigella
Define Biliary colic
Tachycardia
24. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Hypertensive Emergency
Types of Infectious diarrhea Campylobacter
Acute Mesenteric Ishemia
Types of Infectious diarrhea - Salmonella
25. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Ranson's criteria
STEMI vs Nstemi
ED workup of kidney stones
Inferior leads
26. 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
Define Acute Cholecystitis
How to assess Airway
When are Beta Blockers contraindicated
Gonorrhea
27. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Placenta Previa
EMTALA
GIB work up
Common Presentation of GIB
28. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
ED workup of kidney stones
Gonorrhea
Syphillis
29. 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
Additional cardiac Tests
Types of Infectious diarrhea - Salmonella
Missed Abortion
Breathing
30. 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
Genital Herpes
Breathing
How to monitor CDAB
Cardiac Tamponade
31. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
Genital Herpes
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea - Salmonella
32. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Kidney Stones
Types of Infectious diarrhea Campylobacter
EKG changes
EMTALA
33. 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
Incidence of AMI
Triage
Symptoms of Ruptured ovarian cysts
Pancreatitis work up
34. 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
Tx of Unstable Angina
Miscarriage
Endocarditis
35. 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
Placenta Previa
ED workup of kidney stones
Tachycardia
Ranson's criteria
36. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Other major arteries
LBO - Large bowel obstruction
Tachycardia
Tx of Unstable Angina
37. 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
Stable vs. Unstable Ectopic Pregnancy
Types of Infectious diarrhea E coli
ED treatment of a Miscarriage
RCA
38. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Initial steps in stabilizing a patient
Causes of 3rd trimester bleeding
Dx of Aortic dissection
Pericarditis
39. 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
Lateral Leads
Placental Abruption
How to monitor CDAB
40. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Viral Gastroenteritis
Symptoms of Ruptured ovarian cysts
Anteroseptal leads and Anterior
EMTALA
41. 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
Common Presentation of GIB
Incomplete abortion
GIB work up
What is a large bore IV?
42. 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
Miscarriage
Divertriculitis
Cardiac Enzymes
Syphillis
43. 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
Emergency Severity Index
SBO
Tx of Unstable Angina
Pericarditis
44. 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
EMTALA
Aortic Dissection definition - risks and S/S
Stable vs unstable angina`
Types of Infectious diarrhea Shigella
45. 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
Initial steps in stabilizing a patient
Ectopic Pregnancy
Kidney Stones
Genital Herpes
46. 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
Ovarian Cysts
Ovarian Torsion
Pericarditis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
47. 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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48. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Stable vs unstable angina`
Common risk factors for UGIB
Initial steps in stabilizing a patient
Types of Infectious diarrhea E coli
49. 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)
Dx of Aortic dissection
Defibrillation
How to assess Airway
Urosepsis
50. 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
Appendicitis
Supplemental O2
When is Rho GAM used
Ovarian Cysts