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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. 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
Ascending Cholangitis
LCA
Placenta Previa
What to do with weak/thready pulses
2. Old age - chronic anticoagulation - divertriculosis
Kidney Stones
Common risk factors for LGIB
What should be done after CDAB's
LCA
3. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
The vital signs
Ovarian Cysts
Initial steps in stabilizing a patient
Pain scale for infants
4. 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
Stable vs unstable angina`
How to monitor CDAB
DUKE criteria for endocarditis
ED Tx of GIB
5. 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)
Types of Infectious diarrhea E coli
Emergency Severity Index
DUKE criteria for endocarditis
Define Acute Cholecystitis
6. 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
What should be done after CDAB's
When are Beta Blockers contraindicated
Where to check pulses
Acute Arterial occlusion - to lower extremities
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
Contraindications for thrombolytics
Early miscarriage (20 weeks)
Appendicitis work up
How to monitor CDAB
8. 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 workup of kidney stones
ED Tx of GIB
Contraindications for thrombolytics
Tx of Unstable Angina
9. 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
Breathing
EKG changes
Placenta Previa
UTI
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
Define Acute Cholecystitis
Syphillis
Posterior
Symptoms of Ruptured ovarian cysts
11. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
GIB work up
Divertriculitis
Define Biliary colic
When are Beta Blockers contraindicated
12. Often a complicaiton of a patient with ACS (often s/p AMI) - HR > 100 BPM - Dx: Look for P waves to see a fib vs a flutter - Tx: Adenosine to slow heart for diagnostic purposes - always check TSH - classifications: narrow complex vs wide complex - re
Abdominal Aortic Aneurysm
How to monitor CDAB
Define Acute Cholecystitis
Tachycardia
13. 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
Pain scale for infants
SBO
UTI
14. 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
Other major arteries
Where to check pulses
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Missed Abortion
15. 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
Emergency Severity Index
Acute Arterial occlusion - to lower extremities
Breathing
Hypertensive Emergency
16. 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
RCA
Stable vs. Unstable Ectopic Pregnancy
Additional cardiac Tests
Chlamydia
17. 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
Tx of CHF
Endocarditis
Common Presentation of GIB
Incarcerated vs strangulated hernias
18. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Ranson's criteria
When is Rho GAM used
Common risk factors for UGIB
Placenta Previa
19. Leads I - aVL - V4-V6 - Left circumflex artery
Placenta Previa
Lateral Leads
EKG changes
Cardiac Enzymes
20. 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
Ovarian Cysts
EMTALA
Pancreatitis work up
Ascending Cholangitis
21. V1-V2 Right Posterior Descending Artery
When are Beta Blockers contraindicated
Posterior
Ectopic Pregnancy
Pancreatitis work up
22. 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
Aortic Dissection definition - risks and S/S
Abdominal Aortic Aneurysm
RCA
23. 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 Coronary syndrome
Hypertensive Emergency
GIB work up
Viral Gastroenteritis
24. 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)
Stable vs. Unstable Ectopic Pregnancy
Bradycardia
Inferior leads
Defibrillation
25. 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 Yersinia
Stable vs unstable angina`
CHF
Types of Infectious diarrhea Campylobacter
26. 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
Incomplete abortion
How to monitor CDAB
Causes of 3rd trimester bleeding
ED treatment for Ectopic Pregnancy
27. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
DUKE criteria for endocarditis
Posterior
What to do with weak/thready pulses
Placenta Previa
28. II - III - aVF - Means RCA involved
Inferior leads
Types of Infectious diarrhea Yersinia
Miscarriage
Hypertensive Emergency
29. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Ovarian Cysts
Breathing
ED workup of kidney stones
30. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Chlamydia
GIB work up
Advanced airway techniques
Common risk factors for UGIB
31. 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
Hypertensive Emergency
Genital Herpes
STEMI vs Nstemi
Inferior leads
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
Aortic Dissection definition - risks and S/S
Divertriculitis
When is Rho GAM used
What is a large bore IV?
33. 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
Posterior
Pericarditis
Acute Mesenteric Ishemia
Supplemental O2
34. 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
Acute Mesenteric Ishemia
Urosepsis
Types of GI bleeds
Ovarian Cysts
35. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Types of Infectious diarrhea E coli
ED Tx of GIB
Miscarriage
How to assess Airway
36. 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
EMTALA
Acute Arterial occlusion - to lower extremities
Incomplete abortion
Inferior leads
37. 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
Define Biliary colic
ED Tx of GIB
Types of Infectious diarrhea Shigella
Syphillis
38. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Acute Coronary syndrome
Causes of 3rd trimester bleeding
EKG changes
39. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Common risk factors for UGIB
Types of Infectious diarrhea - Salmonella
Incarcerated vs strangulated hernias
When to do a pelvic exam
40. 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
Appendicitis work up
Ovarian Torsion
ED work up for cholecystitis
41. 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
Posterior
Testicular Torsion
Pericarditis
42. 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
Posterior
Stable vs unstable angina`
SBO
Common risk factors for LGIB
43. 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
Contraindications for thrombolytics
DUKE criteria for endocarditis
Appendicitis work up
44. Check Vital Signs
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45. 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
When is Rho GAM used
Miscarriage
Hypertensive Emergency
Pain scale for infants
46. 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
What is a large bore IV?
Pancreatitis work up
Anteroseptal leads and Anterior
Acute Coronary syndrome
47. 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
DUKE criteria for endocarditis
Syphillis
Tx of CHF
Causes of 3rd trimester bleeding
48. 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
Appendicitis work up
Additional cardiac Tests
EMTALA
Bradycardia
49. 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
Tx of Unstable Angina
Tx of CHF
Viral Gastroenteritis
ED Tx of GIB
50. 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
What should be done after CDAB's
Incidence of AMI
Common Presentation of GIB