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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. 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
Causes of 3rd trimester bleeding
RCA
Hypertensive Emergency
Tachycardia
2. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Testicular Torsion
Appendicitis
Ascending Cholangitis
3. 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
ED workup of kidney stones
DUKE criteria for endocarditis
Symptoms of Ruptured ovarian cysts
4. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Incarcerated vs strangulated hernias
Placental Abruption
Acute Arterial occlusion - to lower extremities
Anteroseptal leads and Anterior
5. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Where to check pulses
Stable vs. Unstable Ectopic Pregnancy
Aortic Dissection definition - risks and S/S
6. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Pericarditis
How to assess Airway
Pain scale for infants
7. 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
ED treatment for Ectopic Pregnancy
Initial steps in stabilizing a patient
Early miscarriage (20 weeks)
Cardiac Enzymes
8. 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 -
Missed Abortion
Posterior
When are Beta Blockers contraindicated
Placental Abruption
9. 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
Missed Abortion
Endocarditis
Contraindications for thrombolytics
Common risk factors for LGIB
10. 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
Placenta Previa
Gonorrhea
Syphillis
Breathing
11. II - III - aVF - Means RCA involved
Ascending Cholangitis
Types of Infectious diarrhea Shigella
Gonorrhea
Inferior leads
12. 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
Incarcerated vs strangulated hernias
ED workup of kidney stones
Acute Mesenteric Ishemia
13. 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
When are Beta Blockers contraindicated
Testicular Torsion
Divertriculitis
Viral Gastroenteritis
14. 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
When is Rho GAM used
Incarcerated vs strangulated hernias
Abdominal Aortic Aneurysm
Where to check pulses
15. 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
SBO
Tachycardia
Initial steps in stabilizing a patient
STEMI vs Nstemi
16. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Define Biliary colic
Stable vs unstable angina`
Anteroseptal leads and Anterior
17. 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
Additional cardiac Tests
DUKE criteria for endocarditis
Early miscarriage (20 weeks)
18. 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
Chlamydia
Divertriculitis
ED workup of kidney stones
Stable vs. Unstable Ectopic Pregnancy
19. 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
Hypertensive Emergency
Stable vs. Unstable Ectopic Pregnancy
Pericarditis
EKG changes
20. 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
ED treatment for Ectopic Pregnancy
Viral Gastroenteritis
SBO
Acute Arterial occlusion - to lower extremities
21. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Kidney Stones
Additional cardiac Tests
Ovarian Cysts
RCA
22. 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
Appendicitis
Breathing
Cardiac Tamponade
Pericarditis
23. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Incomplete abortion
Acute Mesenteric Ishemia
Pancreatitis work up
Miscarriage
24. 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
When to do a pelvic exam
EKG changes
Anteroseptal leads and Anterior
SBO
25. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Hypertensive Emergency
When are Beta Blockers contraindicated
Appendicitis
Aortic Dissection definition - risks and S/S
26. 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
Emergency Severity Index
GIB work up
How to monitor CDAB
ED workup of kidney stones
27. 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
Cardiac Enzymes
Emergency Severity Index
ED work up for cholecystitis
Types of Infectious diarrhea Campylobacter
28. 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
Bradycardia
Incidence of AMI
ED treatment of a Miscarriage
Pericarditis
29. 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:
Pancreatitis work up
Ovarian Torsion
What should be done after CDAB's
Symptoms of Ruptured ovarian cysts
30. V1-V2 Right Posterior Descending Artery
How to monitor CDAB
Endocarditis
Inferior leads
Posterior
31. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Testicular Torsion
STEMI vs Nstemi
What should be done after CDAB's
Cardiac Tamponade
32. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Ranson's criteria
What is a large bore IV?
LBO - Large bowel obstruction
Ascending Cholangitis
33. 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
Ranson's criteria
Posterior
Additional cardiac Tests
Endocarditis
34. 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
Supplemental O2
Additional cardiac Tests
What should be done after CDAB's
Tx of Unstable Angina
35. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Kidney Stones
The vital signs
Aortic Dissection definition - risks and S/S
Symptoms of Ruptured ovarian cysts
36. 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
Pancreatitis work up
Ascending Cholangitis
Cardiac Tamponade
Additional cardiac Tests
37. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
EMTALA
Supplemental O2
Ranson's criteria
38. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Placental Abruption
Triage
What to do with weak/thready pulses
Breathing
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)
DUKE criteria for endocarditis
ED treatment for Ectopic Pregnancy
Lateral Leads
Defibrillation
40. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Tx of Unstable Angina
Types of Infectious diarrhea Campylobacter
Define Biliary colic
Posterior
41. 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
When are Beta Blockers contraindicated
When is Rho GAM used
Syphillis
42. 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
Tx of CHF
STEMI vs Nstemi
What is a large bore IV?
Ascending Cholangitis
43. 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
Posterior
Acute Arterial occlusion - to lower extremities
Stable vs unstable angina`
44. 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)
EKG changes
Gonorrhea
Incomplete abortion
Initial steps in stabilizing a patient
45. 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? -
Syphillis
Tx of Unstable Angina
Pericarditis
Anteroseptal leads and Anterior
46. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Dx of Aortic dissection
Placental Abruption
Ascending Cholangitis
Types of Infectious diarrhea Yersinia
47. 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
Initial steps in stabilizing a patient
Other major arteries
GIB work up
48. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
Ascending Cholangitis
EKG changes
Incidence of AMI
49. 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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50. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Pericarditis
ED treatment for Ectopic Pregnancy
SBO
Ascending Cholangitis