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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. 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
Define Acute Cholecystitis
Stable vs unstable angina`
Types of Infectious diarrhea Yersinia
Ectopic Pregnancy
2. 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
ED workup of kidney stones
Incidence of AMI
Breathing
Stable vs unstable angina`
3. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
ED Tx of GIB
EKG changes
STEMI vs Nstemi
Miscarriage
4. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Types of GI bleeds
Chlamydia
Other major arteries
When to do a pelvic exam
5. 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
LBO - Large bowel obstruction
Genital Herpes
Divertriculitis
Supplemental O2
6. 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
Volvulus
CHF
Stable vs unstable angina`
7. 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
Kidney Stones
ED work up for cholecystitis
SBO
Common risk factors for UGIB
8. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
Incarcerated vs strangulated hernias
UTI
Abdominal Aortic Aneurysm
9. 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
Symptoms of Ruptured ovarian cysts
Gonorrhea
UTI
10. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What should be done after CDAB's
Advanced airway techniques
What to do with weak/thready pulses
Viral Gastroenteritis
11. 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
Viral Gastroenteritis
Divertriculitis
Pancreatitis work up
GIB work up
12. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Viral Gastroenteritis
How to assess Airway
Placenta Previa
13. 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
Lateral Leads
How to assess Airway
DUKE criteria for endocarditis
Stable vs unstable angina`
14. 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
Common Presentation of GIB
Causes of 3rd trimester bleeding
EMTALA
Lateral Leads
15. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Testicular Torsion
Define Biliary colic
Stable vs unstable angina`
Emergency Severity Index
16. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Placental Abruption
Contraindications for thrombolytics
Causes of 3rd trimester bleeding
Early miscarriage (20 weeks)
17. 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
Dx of Aortic dissection
CHF
Cardiac Enzymes
EMTALA
18. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
DUKE criteria for endocarditis
Defibrillation
Where to check pulses
19. 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
RCA
Ectopic Pregnancy
What should be done after CDAB's
Types of GI bleeds
20. 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
How to monitor CDAB
Incomplete abortion
ED workup of kidney stones
ED treatment for Ectopic Pregnancy
21. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
Triage
Pancreatitis work up
ED treatment for Ectopic Pregnancy
22. 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)
Appendicitis work up
Defibrillation
Viral Gastroenteritis
Tachycardia
23. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
EMTALA
What to do with weak/thready pulses
Advanced airway techniques
Miscarriage
24. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Acute Arterial occlusion - to lower extremities
Common Presentation of GIB
DUKE criteria for endocarditis
Ascending Cholangitis
25. 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)
Ovarian Torsion
Abdominal Aortic Aneurysm
DUKE criteria for endocarditis
Placental Abruption
26. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Divertriculitis
Pain scale for infants
What should be done after CDAB's
ED treatment for Ectopic Pregnancy
27. 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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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
STEMI vs Nstemi
ED work up for cholecystitis
Symptoms of Ruptured ovarian cysts
Gonorrhea
29. 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
Pericarditis
ED treatment of a Miscarriage
Where to check pulses
Types of GI bleeds
30. 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
Aortic Dissection definition - risks and S/S
GIB work up
What is a large bore IV?
Tx of CHF
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
Types of Infectious diarrhea Yersinia
Stable vs. Unstable Ectopic Pregnancy
When are Beta Blockers contraindicated
ED work up for cholecystitis
32. 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
Appendicitis
What to do with weak/thready pulses
Abdominal Aortic Aneurysm
Inferior leads
33. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Supplemental O2
Appendicitis
Gonorrhea
Urosepsis
34. 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
Types of Infectious diarrhea - Salmonella
Aortic Dissection definition - risks and S/S
Kidney Stones
Missed Abortion
35. 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
Ascending Cholangitis
Common Presentation of GIB
Divertriculitis
Endocarditis
36. 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
LBO - Large bowel obstruction
When are Beta Blockers contraindicated
Acute Mesenteric Ishemia
Cardiac Tamponade
37. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Kidney Stones
Ovarian Cysts
Emergency Severity Index
Advanced airway techniques
38. 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
Cardiac Tamponade
Other major arteries
Hypertensive Emergency
Ovarian Torsion
39. 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
ED workup of kidney stones
Acute Mesenteric Ishemia
Where to check pulses
DUKE criteria for endocarditis
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
What should be done after CDAB's
Abdominal Aortic Aneurysm
Emergency Severity Index
41. 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 Unstable Angina
STEMI vs Nstemi
Gonorrhea
Divertriculitis
42. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
ED work up for cholecystitis
Types of Infectious diarrhea - Salmonella
Incarcerated vs strangulated hernias
What is a large bore IV?
43. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Advanced airway techniques
Symptoms of Ruptured ovarian cysts
Bradycardia
44. 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
Pancreatitis work up
Syphillis
Initial steps in stabilizing a patient
STEMI vs Nstemi
45. 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
Supplemental O2
Ovarian Torsion
The vital signs
46. BRADYCARDIA - due to depressed SA node act or delayed conduction - excessive beta blockers - HR < 50 BPM - Tx: Atropine - Pacing ready / defibrillator prn - treat underlying cause (electrolyte imbalance - drugs - hypothermia)
Bradycardia
Genital Herpes
Define Acute Cholecystitis
Ovarian Torsion
47. 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
Genital Herpes
Early miscarriage (20 weeks)
Ranson's criteria
Incidence of AMI
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
Divertriculitis
Acute Mesenteric Ishemia
Causes of 3rd trimester bleeding
Symptoms of Ruptured ovarian cysts
49. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
ED workup of kidney stones
What is a large bore IV?
Incarcerated vs strangulated hernias
RCA
50. 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
Types of Infectious diarrhea - Salmonella
ED treatment of a Miscarriage
STEMI vs Nstemi
Syphillis