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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. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
RCA
CHF
Supplemental O2
STEMI vs Nstemi
2. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
What should be done after CDAB's
Appendicitis
Miscarriage
Ectopic Pregnancy
3. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
ED workup of kidney stones
Tx of CHF
Ectopic Pregnancy
Types of Infectious diarrhea - Salmonella
4. 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
Ascending Cholangitis
Defibrillation
ED treatment for Ectopic Pregnancy
Triage
5. 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
Abdominal Aortic Aneurysm
ED workup of kidney stones
Where to check pulses
Gonorrhea
6. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Symptoms of Ruptured ovarian cysts
Breathing
Triage
7. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
Tx of Unstable Angina
Volvulus
Early miscarriage (20 weeks)
8. 16-18 Gauge
What is a large bore IV?
Define Biliary colic
Tx of CHF
Abdominal Aortic Aneurysm
9. 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)
DUKE criteria for endocarditis
Ranson's criteria
Cardiac Tamponade
Appendicitis work up
10. 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
Inferior leads
LCA
Define Acute Cholecystitis
Genital Herpes
11. 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
Abdominal Aortic Aneurysm
Contraindications for thrombolytics
Syphillis
Types of Infectious diarrhea - Salmonella
12. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Bradycardia
Kidney Stones
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
SBO
13. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Types of Infectious diarrhea Shigella
STEMI vs Nstemi
Advanced airway techniques
Types of Infectious diarrhea Campylobacter
14. V1-V2 Right Posterior Descending Artery
Incarcerated vs strangulated hernias
Triage
Posterior
Acute Mesenteric Ishemia
15. Left coronary artery (short and branches quickly)
LCA
Define Acute Cholecystitis
Urosepsis
Volvulus
16. 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
Supplemental O2
Genital Herpes
Acute Mesenteric Ishemia
Types of GI bleeds
17. Look for ST elevation in at least 2 contiguous lead (at least 1mm) - may see a new LBBB - Reciprocal changes - T wave inversion (end of the infarct or old) - Q waves (old infarct)
ED treatment for Ectopic Pregnancy
Defibrillation
How to monitor CDAB
EKG changes
18. 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
Abdominal Aortic Aneurysm
Where to check pulses
EMTALA
How to assess Airway
19. Old age - chronic anticoagulation - divertriculosis
What to do with weak/thready pulses
DUKE criteria for endocarditis
Incidence of AMI
Common risk factors for LGIB
20. 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
Tachycardia
ED treatment for Ectopic Pregnancy
Endocarditis
Hypertensive Emergency
21. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Triage
LBO - Large bowel obstruction
The vital signs
EKG changes
22. 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
The vital signs
Incomplete abortion
Cardiac Enzymes
GIB work up
23. 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
LBO - Large bowel obstruction
Incomplete abortion
Early miscarriage (20 weeks)
Ovarian Torsion
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
Genital Herpes
Syphillis
Chlamydia
Types of Infectious diarrhea Yersinia
25. 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
When are Beta Blockers contraindicated
Initial steps in stabilizing a patient
Lateral Leads
Ectopic Pregnancy
26. 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
Cardiac Enzymes
Gonorrhea
Placental Abruption
Acute Mesenteric Ishemia
27. II - III - aVF - Means RCA involved
What is a large bore IV?
Inferior leads
What to do with weak/thready pulses
Tx of Unstable Angina
28. 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:
Tx of Unstable Angina
Ovarian Torsion
What to do with weak/thready pulses
Defibrillation
29. 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
The vital signs
Causes of 3rd trimester bleeding
Ovarian Cysts
How to monitor CDAB
30. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Appendicitis
Divertriculitis
What to do with weak/thready pulses
Acute Arterial occlusion - to lower extremities
31. 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
Types of Infectious diarrhea Shigella
Dx of Aortic dissection
ED treatment for Ectopic Pregnancy
Endocarditis
32. 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
Contraindications for thrombolytics
Incomplete abortion
RCA
Emergency Severity Index
33. 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
Genital Herpes
Miscarriage
ED Tx of GIB
SBO
34. 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)
Tx of Unstable Angina
Defibrillation
Additional cardiac Tests
Missed Abortion
35. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea - Salmonella
Common Presentation of GIB
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Yersinia
36. 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
Breathing
Causes of 3rd trimester bleeding
Ascending Cholangitis
Defibrillation
37. 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
Initial steps in stabilizing a patient
The vital signs
Syphillis
Placental Abruption
38. 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
Ectopic Pregnancy
Other major arteries
UTI
39. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Incarcerated vs strangulated hernias
What is a large bore IV?
Types of Infectious diarrhea Campylobacter
When to do a pelvic exam
40. 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
Ectopic Pregnancy
Incidence of AMI
When to do a pelvic exam
Endocarditis
41. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Posterior
What to do with weak/thready pulses
Common Presentation of GIB
Divertriculitis
42. 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)
What to do with weak/thready pulses
Bradycardia
Ascending Cholangitis
LBO - Large bowel obstruction
43. 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)
Pericarditis
DUKE criteria for endocarditis
Testicular Torsion
Types of Infectious diarrhea Shigella
44. 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
How to assess Airway
Types of Infectious diarrhea E coli
LCA
Urosepsis
45. 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
Genital Herpes
Divertriculitis
Appendicitis work up
Testicular Torsion
46. 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
Stable vs unstable angina`
Acute Coronary syndrome
LCA
Types of Infectious diarrhea Yersinia
47. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Chlamydia
ED work up for cholecystitis
Define Biliary colic
Common risk factors for UGIB
48. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Causes of 3rd trimester bleeding
Define Biliary colic
Emergency Severity Index
Urosepsis
49. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Campylobacter
EKG changes
Dx of Aortic dissection
50. 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
Lateral Leads
Dx of Aortic dissection
Acute Arterial occlusion - to lower extremities
Early miscarriage (20 weeks)