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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. 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 Yersinia
EMTALA
RCA
Symptoms of Ruptured ovarian cysts
2. 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
Ovarian Cysts
Stable vs unstable angina`
Common Presentation of GIB
3. 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
Triage
Endocarditis
When to do a pelvic exam
GIB work up
4. 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
Ranson's criteria
Gonorrhea
Chlamydia
Divertriculitis
5. 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
ED work up for cholecystitis
ED workup of kidney stones
Common risk factors for UGIB
Contraindications for thrombolytics
6. 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)
Appendicitis work up
Kidney Stones
Common risk factors for UGIB
ED workup of kidney stones
7. 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
LCA
Cardiac Tamponade
Incarcerated vs strangulated hernias
8. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Hypertensive Emergency
Anteroseptal leads and Anterior
Missed Abortion
LBO - Large bowel obstruction
9. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Types of Infectious diarrhea Campylobacter
Acute Coronary syndrome
Pain scale for infants
Miscarriage
10. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Supplemental O2
Placental Abruption
11. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
When are Beta Blockers contraindicated
Other major arteries
Dx of Aortic dissection
Genital Herpes
12. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
SBO
Lateral Leads
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Placental Abruption
13. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Divertriculitis
Dx of Aortic dissection
What to do with weak/thready pulses
The vital signs
14. 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
Breathing
Acute Mesenteric Ishemia
SBO
Types of Infectious diarrhea - Salmonella
15. 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
Emergency Severity Index
Gonorrhea
Divertriculitis
ED treatment of a Miscarriage
16. 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
When are Beta Blockers contraindicated
Tx of CHF
Ranson's criteria
Hypertensive Emergency
17. 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
Other major arteries
GIB work up
Define Biliary colic
18. 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
Contraindications for thrombolytics
Breathing
Ranson's criteria
Miscarriage
19. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
Early miscarriage (20 weeks)
ED Tx of GIB
LCA
20. Leads I - aVL - V4-V6 - Left circumflex artery
ED Tx of GIB
UTI
ED treatment for Ectopic Pregnancy
Lateral Leads
21. 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
Stable vs unstable angina`
Breathing
GIB work up
What is a large bore IV?
22. 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
RCA
Urosepsis
Defibrillation
23. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Types of Infectious diarrhea E coli
When are Beta Blockers contraindicated
Acute Coronary syndrome
24. 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
Emergency Severity Index
Contraindications for thrombolytics
ED workup of kidney stones
ED treatment of a Miscarriage
25. 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
Where to check pulses
Tx of Unstable Angina
Missed Abortion
Dx of Aortic dissection
26. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Pain scale for infants
When to do a pelvic exam
ED treatment of a Miscarriage
27. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Campylobacter
Other major arteries
Types of Infectious diarrhea Yersinia
GIB work up
28. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
UTI
Ovarian Cysts
STEMI vs Nstemi
Early miscarriage (20 weeks)
29. 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
Incidence of AMI
Ectopic Pregnancy
Gonorrhea
How to monitor CDAB
30. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Acute Mesenteric Ishemia
Ectopic Pregnancy
When are Beta Blockers contraindicated
Ovarian Torsion
31. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Aortic Dissection definition - risks and S/S
Incarcerated vs strangulated hernias
Causes of 3rd trimester bleeding
How to assess Airway
32. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
RCA
Initial steps in stabilizing a patient
LBO - Large bowel obstruction
Common risk factors for UGIB
33. 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
Stable vs. Unstable Ectopic Pregnancy
Acute Coronary syndrome
Where to check pulses
Stable vs unstable angina`
34. 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
Kidney Stones
Other major arteries
What is a large bore IV?
Emergency Severity Index
35. 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
Hypertensive Emergency
Causes of 3rd trimester bleeding
How to monitor CDAB
Aortic Dissection definition - risks and S/S
36. 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
LCA
STEMI vs Nstemi
Acute Mesenteric Ishemia
Dx of Aortic dissection
37. 16-18 Gauge
LCA
What is a large bore IV?
Triage
Types of Infectious diarrhea E coli
38. MONA - morphine - oxygen - nitroglycerin (sublingual or IV) -Aspirin 325 mg (consider Integrilin in high risk patients) - Beta Blocker (metoprolol) - decrease streght of heart contractility within first hour - Cardiology cx --> PCI vs surgery prn? -
Tx of Unstable Angina
Ovarian Cysts
Anteroseptal leads and Anterior
Endocarditis
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 -
Aortic Dissection definition - risks and S/S
Types of Infectious diarrhea - Salmonella
How to monitor CDAB
Placental Abruption
40. 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)
ED Tx of GIB
Bradycardia
When is Rho GAM used
Placenta Previa
41. 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
Stable vs. Unstable Ectopic Pregnancy
Dx of Aortic dissection
Other major arteries
Placenta Previa
42. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Advanced airway techniques
Stable vs unstable angina`
RCA
When to do a pelvic exam
43. Old age - chronic anticoagulation - divertriculosis
Anteroseptal leads and Anterior
Stable vs. Unstable Ectopic Pregnancy
Common risk factors for LGIB
Bradycardia
44. 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)
ED treatment of a Miscarriage
Bradycardia
The vital signs
Viral Gastroenteritis
45. 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
RCA
ED Tx of GIB
Syphillis
Cardiac Tamponade
46. 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
Chlamydia
Initial steps in stabilizing a patient
EMTALA
CHF
47. 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
What should be done after CDAB's
Advanced airway techniques
What is a large bore IV?
48. 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
Symptoms of Ruptured ovarian cysts
Hypertensive Emergency
Incarcerated vs strangulated hernias
EKG changes
49. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Incomplete abortion
Testicular Torsion
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Shigella
50. 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
When to do a pelvic exam
How to assess Airway
Additional cardiac Tests
Divertriculitis