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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. 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
Posterior
Define Acute Cholecystitis
Appendicitis
EKG changes
2. 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:
Common risk factors for LGIB
Pericarditis
Ovarian Torsion
EMTALA
3. 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
Contraindications for thrombolytics
ED treatment of a Miscarriage
Abdominal Aortic Aneurysm
4. 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
ED work up for cholecystitis
Abdominal Aortic Aneurysm
Pain scale for infants
5. 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
ED treatment of a Miscarriage
The vital signs
Tachycardia
Additional cardiac Tests
6. 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
Viral Gastroenteritis
Urosepsis
ED Tx of GIB
Stable vs unstable angina`
7. 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
Divertriculitis
Types of Infectious diarrhea Campylobacter
Incarcerated vs strangulated hernias
Emergency Severity Index
8. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Causes of 3rd trimester bleeding
CHF
Tx of CHF
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
9. 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
Miscarriage
Missed Abortion
Acute Mesenteric Ishemia
Advanced airway techniques
10. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Common risk factors for UGIB
What is a large bore IV?
Incomplete abortion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
11. 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? -
Missed Abortion
DUKE criteria for endocarditis
Early miscarriage (20 weeks)
Tx of Unstable Angina
12. 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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13. 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
Where to check pulses
Other major arteries
Defibrillation
GIB work up
14. 'trier' - to separate - sift or select based on priority of condition
When to do a pelvic exam
RCA
Triage
How to monitor CDAB
15. 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
When to do a pelvic exam
Tx of CHF
Appendicitis
ED workup of kidney stones
16. 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)
Defibrillation
Stable vs. Unstable Ectopic Pregnancy
Divertriculitis
GIB work up
17. 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
Chlamydia
Common risk factors for LGIB
Placental Abruption
Viral Gastroenteritis
18. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Define Acute Cholecystitis
Posterior
STEMI vs Nstemi
Abdominal Aortic Aneurysm
19. 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)
Symptoms of Ruptured ovarian cysts
EKG changes
GIB work up
Inferior leads
20. 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
Abdominal Aortic Aneurysm
Stable vs. Unstable Ectopic Pregnancy
Appendicitis
ED Tx of GIB
21. Testis twists on a spermatic cord - restore blood flow in 6 hours or may have infertility - common at puberty and in 1 year olds - High risk - Bell Clapper Deformity (tunica vaginalis isterts high on the spermatic cord) - horizontal lie spermatic cor
Types of Infectious diarrhea Campylobacter
Abdominal Aortic Aneurysm
Tachycardia
Testicular Torsion
22. 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
Miscarriage
EMTALA
Pericarditis
Ranson's criteria
23. Left coronary artery (short and branches quickly)
Emergency Severity Index
Incarcerated vs strangulated hernias
Anteroseptal leads and Anterior
LCA
24. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Ranson's criteria
Types of Infectious diarrhea Yersinia
When to do a pelvic exam
Advanced airway techniques
25. 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
Triage
Dx of Aortic dissection
Common Presentation of GIB
Miscarriage
26. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Stable vs. Unstable Ectopic Pregnancy
ED treatment of a Miscarriage
Missed Abortion
Types of Infectious diarrhea E coli
27. 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
Acute Coronary syndrome
Common Presentation of GIB
Incarcerated vs strangulated hernias
Pancreatitis work up
28. 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
What to do with weak/thready pulses
EMTALA
UTI
Tachycardia
29. 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
How to monitor CDAB
Kidney Stones
What is a large bore IV?
Hypertensive Emergency
30. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Cardiac Enzymes
Ovarian Cysts
Lateral Leads
Stable vs. Unstable Ectopic Pregnancy
31. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Abdominal Aortic Aneurysm
Ovarian Torsion
Chlamydia
32. 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
Pancreatitis work up
UTI
Kidney Stones
33. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Initial steps in stabilizing a patient
UTI
RCA
Volvulus
34. 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)
Viral Gastroenteritis
Breathing
Incomplete abortion
When is Rho GAM used
35. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Define Biliary colic
ED workup of kidney stones
Incarcerated vs strangulated hernias
Tachycardia
36. 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
Hypertensive Emergency
Define Biliary colic
Incidence of AMI
Pericarditis
37. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
Types of GI bleeds
Aortic Dissection definition - risks and S/S
Stable vs. Unstable Ectopic Pregnancy
38. 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
Placenta Previa
Types of Infectious diarrhea Shigella
Tx of CHF
How to monitor CDAB
39. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Syphillis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
UTI
Missed Abortion
40. 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
Common risk factors for LGIB
How to monitor CDAB
Early miscarriage (20 weeks)
Acute Mesenteric Ishemia
41. 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)
Incarcerated vs strangulated hernias
Define Acute Cholecystitis
Bradycardia
SBO
42. 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
Cardiac Tamponade
How to monitor CDAB
Appendicitis
Volvulus
43. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Where to check pulses
Ovarian Torsion
Other major arteries
Ranson's criteria
44. 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
Hypertensive Emergency
ED work up for cholecystitis
GIB work up
Chlamydia
45. 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 -
EMTALA
Ascending Cholangitis
ED treatment of a Miscarriage
Placental Abruption
46. 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)
Types of Infectious diarrhea Campylobacter
Dx of Aortic dissection
GIB work up
Appendicitis work up
47. 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
EKG changes
The vital signs
Endocarditis
48. 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
Miscarriage
Emergency Severity Index
Endocarditis
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
ED Tx of GIB
Incomplete abortion
Acute Arterial occlusion - to lower extremities
Advanced airway techniques
50. 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
When is Rho GAM used
Genital Herpes
EMTALA
Common risk factors for LGIB