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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. II - III - aVF - Means RCA involved
Cardiac Enzymes
Inferior leads
Volvulus
Types of Infectious diarrhea Yersinia
2. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
Miscarriage
What to do with weak/thready pulses
Incidence of AMI
3. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Ascending Cholangitis
When is Rho GAM used
What should be done after CDAB's
Miscarriage
4. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Initial steps in stabilizing a patient
Define Biliary colic
The vital signs
What to do with weak/thready pulses
5. V1-V2 Right Posterior Descending Artery
Ovarian Cysts
Define Acute Cholecystitis
Posterior
Syphillis
6. 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
GIB work up
Additional cardiac Tests
Stable vs unstable angina`
Volvulus
7. 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)
Advanced airway techniques
Incarcerated vs strangulated hernias
DUKE criteria for endocarditis
Gonorrhea
8. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
What should be done after CDAB's
CHF
Ovarian Torsion
Types of Infectious diarrhea Yersinia
9. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
ED treatment for Ectopic Pregnancy
EKG changes
When is Rho GAM used
10. 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
Pancreatitis work up
Viral Gastroenteritis
What is a large bore IV?
Additional cardiac Tests
11. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Kidney Stones
Tx of Unstable Angina
Incarcerated vs strangulated hernias
Define Biliary colic
12. 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
Pericarditis
Supplemental O2
ED work up for cholecystitis
Common Presentation of GIB
13. 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
Placenta Previa
ED treatment of a Miscarriage
Ovarian Cysts
UTI
14. 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)
Placenta Previa
When is Rho GAM used
Tx of Unstable Angina
Urosepsis
15. 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
LCA
When to do a pelvic exam
What should be done after CDAB's
How to monitor CDAB
16. 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
Advanced airway techniques
Cardiac Enzymes
Emergency Severity Index
Appendicitis work up
17. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Common Presentation of GIB
STEMI vs Nstemi
Miscarriage
Genital Herpes
18. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Divertriculitis
Bradycardia
Types of Infectious diarrhea Campylobacter
Define Biliary colic
19. Accounts for 20% o all 3rd trimester bleeding - Placenta overlaps with the cervix near the os (complete - partial - vaginal -low lying) - S/s: bright red vaginal bleeding - painless - NO NOT PERFORM VAGINAL DIGITAL EXAM - risk factors: prior c sect
Initial steps in stabilizing a patient
Acute Arterial occlusion - to lower extremities
Placenta Previa
EMTALA
20. 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
Supplemental O2
SBO
Gonorrhea
Breathing
21. 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
Miscarriage
CHF
Missed Abortion
22. 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
When to do a pelvic exam
EMTALA
UTI
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
23. 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
Types of GI bleeds
Symptoms of Ruptured ovarian cysts
What is a large bore IV?
Incomplete abortion
24. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Syphillis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Endocarditis
Urosepsis
25. School/work outbreak - Common viruses: rotavirus - norwalk - adenovirus - astrovirus - last 24 to 48 hours - ALWAYS DX as VOMITING AND DIARRHEA - never use the term viral gastroenteritis (CYA medicine) Tx: CBC - chem 7 - LFT's - lIpase - UA - general
DUKE criteria for endocarditis
What to do with weak/thready pulses
Viral Gastroenteritis
Ovarian Cysts
26. 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
When are Beta Blockers contraindicated
Aortic Dissection definition - risks and S/S
Bradycardia
Acute Mesenteric Ishemia
27. Most due to E coli - Lower UTI - bladder and /or urethra - Upper UTI: bladder - urethra and kidneys (so ureters to) S/S: dysuria - urgency and frequency - may be asymptomatic in prego - elderly and immunosuppressed - may see confusion or AMS Tx: Uri
UTI
Defibrillation
How to assess Airway
Urosepsis
28. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Ranson's criteria
Breathing
Syphillis
29. 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
Ectopic Pregnancy
Pancreatitis work up
Divertriculitis
ED treatment for Ectopic Pregnancy
30. 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
Abdominal Aortic Aneurysm
Appendicitis work up
Aortic Dissection definition - risks and S/S
31. Ovary torsion causes venous and arterial obstruction leading to ischemia and obstruction - At risk: long fallopian tubes - pregnancy - enlarged ovaries - ovarian tumors - tubal surgery - large ovarian cysts **anything that enlarges the ovary! - S/S:
ED treatment for Ectopic Pregnancy
Incomplete abortion
Ovarian Torsion
Bradycardia
32. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Early miscarriage (20 weeks)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Triage
What to do with weak/thready pulses
33. CDAB - Circulation (rapid CPR to reestablish circulation) - Defibrillaiton - Airway - Breathing - the main goal is to restore effective oxygenation -ventilation and circulation until return of spontaneous circulation or ACLS
Types of GI bleeds
Causes of 3rd trimester bleeding
Chlamydia
Initial steps in stabilizing a patient
34. 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
Appendicitis
Ectopic Pregnancy
ED Tx of GIB
Missed Abortion
35. 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
GIB work up
Miscarriage
LCA
36. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
ED work up for cholecystitis
ED treatment for Ectopic Pregnancy
Stable vs unstable angina`
Types of Infectious diarrhea Yersinia
37. 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
Breathing
Common risk factors for UGIB
The vital signs
How to assess Airway
38. 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
Defibrillation
Genital Herpes
When to do a pelvic exam
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
39. 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)
Types of Infectious diarrhea Yersinia
What should be done after CDAB's
Defibrillation
Kidney Stones
40. 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
Define Acute Cholecystitis
Cardiac Tamponade
Ovarian Torsion
41. 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
Ranson's criteria
Where to check pulses
RCA
Missed Abortion
42. 'trier' - to separate - sift or select based on priority of condition
Triage
Initial steps in stabilizing a patient
Contraindications for thrombolytics
EMTALA
43. Check Vital Signs
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44. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Acute Arterial occlusion - to lower extremities
When is Rho GAM used
Placental Abruption
Anteroseptal leads and Anterior
45. 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
Appendicitis work up
EMTALA
Ectopic Pregnancy
46. Leads I - aVL - V4-V6 - Left circumflex artery
When is Rho GAM used
Tx of CHF
Pancreatitis work up
Lateral Leads
47. 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 -
Initial steps in stabilizing a patient
Tx of Unstable Angina
Dx of Aortic dissection
Placental Abruption
48. 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
DUKE criteria for endocarditis
ED treatment of a Miscarriage
Incarcerated vs strangulated hernias
Where to check pulses
49. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Posterior
Abdominal Aortic Aneurysm
Contraindications for thrombolytics
Types of Infectious diarrhea - Salmonella
50. 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)
Ovarian Cysts
ED work up for cholecystitis
CHF
Bradycardia