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Test your basic knowledge |
Emergency Medicine
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Subjects
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health-sciences
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emergency-medicine
Instructions:
Answer 50 questions in 15 minutes.
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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. 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
Types of Infectious diarrhea E coli
What is a large bore IV?
Ascending Cholangitis
EMTALA
2. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Advanced airway techniques
Gonorrhea
Ovarian Cysts
RCA
3. ABC's - IV - O2 - cardiac monitor - Diuretics - Lasix - Lasix naive patients start at 20 mg IV - chronic users start at 40 mg IV - Morphine - Nitro if pain - Pressors prn
Defibrillation
What should be done after CDAB's
When to do a pelvic exam
Tx of CHF
4. 16-18 Gauge
What is a large bore IV?
Ovarian Cysts
Chlamydia
Types of Infectious diarrhea Shigella
5. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Acute Coronary syndrome
Common risk factors for UGIB
EMTALA
6. 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
Missed Abortion
How to monitor CDAB
Types of Infectious diarrhea Campylobacter
Breathing
7. 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
Emergency Severity Index
Divertriculitis
Ascending Cholangitis
Missed Abortion
8. 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
Incidence of AMI
Endocarditis
Tachycardia
Appendicitis
9. 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
Pancreatitis work up
GIB work up
Kidney Stones
Ectopic Pregnancy
10. 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 -
How to assess Airway
Placental Abruption
Additional cardiac Tests
Aortic Dissection definition - risks and S/S
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
Ranson's criteria
Contraindications for thrombolytics
EMTALA
Types of Infectious diarrhea Campylobacter
12. 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
Missed Abortion
Volvulus
How to monitor CDAB
Types of Infectious diarrhea Shigella
13. 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
ED treatment for Ectopic Pregnancy
Pain scale for infants
Pericarditis
Incomplete abortion
14. 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
Stable vs. Unstable Ectopic Pregnancy
Chlamydia
Incarcerated vs strangulated hernias
Early miscarriage (20 weeks)
15. 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
Acute Mesenteric Ishemia
Common risk factors for UGIB
Placenta Previa
Acute Coronary syndrome
16. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Aortic Dissection definition - risks and S/S
Pericarditis
Define Biliary colic
Defibrillation
17. 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
Early miscarriage (20 weeks)
Dx of Aortic dissection
Urosepsis
Cardiac Tamponade
18. 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
Viral Gastroenteritis
Hypertensive Emergency
Cardiac Tamponade
ED workup of kidney stones
19. 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
Ascending Cholangitis
Miscarriage
Placenta Previa
20. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
ED Tx of GIB
Types of Infectious diarrhea - Salmonella
Types of Infectious diarrhea Campylobacter
What to do with weak/thready pulses
21. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
What should be done after CDAB's
When to do a pelvic exam
Cardiac Tamponade
Stable vs unstable angina`
22. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Symptoms of Ruptured ovarian cysts
Acute Coronary syndrome
Pain scale for infants
ED treatment of a Miscarriage
23. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Miscarriage
Define Biliary colic
Ovarian Cysts
Causes of 3rd trimester bleeding
24. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Acute Coronary syndrome
Types of Infectious diarrhea Yersinia
Define Acute Cholecystitis
Incomplete abortion
25. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Placental Abruption
Types of Infectious diarrhea Shigella
Types of Infectious diarrhea Campylobacter
Additional cardiac Tests
26. 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
ED treatment for Ectopic Pregnancy
GIB work up
Kidney Stones
Contraindications for thrombolytics
27. 'trier' - to separate - sift or select based on priority of condition
Causes of 3rd trimester bleeding
Testicular Torsion
Triage
When are Beta Blockers contraindicated
28. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Divertriculitis
When are Beta Blockers contraindicated
Emergency Severity Index
When to do a pelvic exam
29. 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 work up for cholecystitis
Gonorrhea
STEMI vs Nstemi
Where to check pulses
30. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
GIB work up
STEMI vs Nstemi
Other major arteries
Emergency Severity Index
31. 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
Types of Infectious diarrhea Shigella
Dx of Aortic dissection
Appendicitis
Volvulus
32. 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
Where to check pulses
Divertriculitis
DUKE criteria for endocarditis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
33. 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
ED workup of kidney stones
GIB work up
Additional cardiac Tests
Anteroseptal leads and Anterior
34. 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
Tx of Unstable Angina
Additional cardiac Tests
Ovarian Cysts
Pericarditis
35. 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
Cardiac Enzymes
Acute Mesenteric Ishemia
Ranson's criteria
36. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Divertriculitis
ED treatment for Ectopic Pregnancy
Symptoms of Ruptured ovarian cysts
Causes of 3rd trimester bleeding
37. 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
Acute Arterial occlusion - to lower extremities
Emergency Severity Index
Acute Mesenteric Ishemia
SBO
38. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Supplemental O2
Appendicitis
STEMI vs Nstemi
Emergency Severity Index
39. 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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40. 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
What is a large bore IV?
Supplemental O2
GIB work up
Tachycardia
41. 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
Appendicitis
Cardiac Enzymes
Pain scale for infants
Types of GI bleeds
42. 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
Types of Infectious diarrhea E coli
Placenta Previa
Types of GI bleeds
When are Beta Blockers contraindicated
43. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
What is a large bore IV?
Incomplete abortion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Contraindications for thrombolytics
44. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Dx of Aortic dissection
The vital signs
Where to check pulses
Lateral Leads
45. 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
How to monitor CDAB
EKG changes
Divertriculitis
Define Acute Cholecystitis
46. 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)
When to do a pelvic exam
Defibrillation
EKG changes
What should be done after CDAB's
47. 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
Pain scale for infants
Stable vs unstable angina`
EMTALA
Viral Gastroenteritis
48. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Types of GI bleeds
What to do with weak/thready pulses
Cardiac Enzymes
ED work up for cholecystitis
49. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
EMTALA
Acute Arterial occlusion - to lower extremities
Other major arteries
LCA
50. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Pericarditis
How to monitor CDAB
Genital Herpes
Advanced airway techniques
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