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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.
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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. 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
Lateral Leads
EMTALA
Pericarditis
Types of Infectious diarrhea Yersinia
2. 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
The vital signs
Divertriculitis
Define Acute Cholecystitis
DUKE criteria for endocarditis
3. Check Vital Signs
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4. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
EKG changes
Ectopic Pregnancy
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Stable vs unstable angina`
5. 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
Cardiac Tamponade
What to do with weak/thready pulses
Genital Herpes
Tx of CHF
6. 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)
Miscarriage
UTI
Additional cardiac Tests
Bradycardia
7. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Defibrillation
Acute Arterial occlusion - to lower extremities
Pain scale for infants
Types of Infectious diarrhea Shigella
8. 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
Advanced airway techniques
Tx of CHF
SBO
UTI
9. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Incomplete abortion
Acute Arterial occlusion - to lower extremities
SBO
What to do with weak/thready pulses
10. 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
Incarcerated vs strangulated hernias
Placenta Previa
Gonorrhea
11. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
EKG changes
Define Acute Cholecystitis
Abdominal Aortic Aneurysm
12. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Pericarditis
Ovarian Cysts
Define Biliary colic
Ascending Cholangitis
13. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Where to check pulses
Emergency Severity Index
STEMI vs Nstemi
When are Beta Blockers contraindicated
14. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Types of Infectious diarrhea - Salmonella
How to assess Airway
Causes of 3rd trimester bleeding
Common risk factors for LGIB
15. 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
Acute Mesenteric Ishemia
Hypertensive Emergency
STEMI vs Nstemi
Urosepsis
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
Emergency Severity Index
Types of GI bleeds
DUKE criteria for endocarditis
17. 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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18. 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
Appendicitis work up
Acute Coronary syndrome
Incomplete abortion
Causes of 3rd trimester bleeding
19. 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
Missed Abortion
Types of GI bleeds
Tx of Unstable Angina
Ectopic Pregnancy
20. 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)
Genital Herpes
Posterior
When is Rho GAM used
STEMI vs Nstemi
21. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Types of Infectious diarrhea - Salmonella
The vital signs
Missed Abortion
Ovarian Cysts
22. 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
STEMI vs Nstemi
Define Biliary colic
Tachycardia
Ovarian Torsion
23. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
ED treatment for Ectopic Pregnancy
Types of Infectious diarrhea Shigella
Ascending Cholangitis
Types of Infectious diarrhea E coli
24. 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
Types of Infectious diarrhea Shigella
Divertriculitis
Syphillis
LCA
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
Define Acute Cholecystitis
Missed Abortion
When is Rho GAM used
Tx of Unstable Angina
26. 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
When to do a pelvic exam
Chlamydia
When are Beta Blockers contraindicated
Ectopic Pregnancy
27. 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
Placental Abruption
ED work up for cholecystitis
Incidence of AMI
Supplemental O2
28. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Advanced airway techniques
Acute Mesenteric Ishemia
Incidence of AMI
Types of GI bleeds
29. 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
LBO - Large bowel obstruction
Supplemental O2
Volvulus
ED Tx of GIB
30. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Cysts
Hypertensive Emergency
LBO - Large bowel obstruction
EKG changes
31. 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
Additional cardiac Tests
Advanced airway techniques
LCA
Define Acute Cholecystitis
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
Types of Infectious diarrhea - Salmonella
Initial steps in stabilizing a patient
Common risk factors for UGIB
Define Biliary colic
33. IV fluids - monitor Bp - EKG prn - CBC - chem 7 - LFT's - Lipase - UA - HCG - Ultrasound of gallbladder - Surgical cx - CCY in 24-48 hours - Broad spectrum Abx (Unasyn or Levaquin) - Pain control (morphine or dilaudid) - don't use Toradol (NSAID) - N
Bradycardia
Appendicitis work up
ED work up for cholecystitis
Volvulus
34. 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
Urosepsis
UTI
Emergency Severity Index
ED work up for cholecystitis
35. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
When to do a pelvic exam
Types of Infectious diarrhea E coli
Contraindications for thrombolytics
The vital signs
36. 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)
DUKE criteria for endocarditis
Early miscarriage (20 weeks)
SBO
Common Presentation of GIB
37. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
ED treatment for Ectopic Pregnancy
ED treatment of a Miscarriage
What should be done after CDAB's
UTI
38. 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
Types of Infectious diarrhea E coli
Types of Infectious diarrhea Shigella
Abdominal Aortic Aneurysm
Causes of 3rd trimester bleeding
39. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
EKG changes
LBO - Large bowel obstruction
Placental Abruption
ED work up for cholecystitis
40. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
DUKE criteria for endocarditis
Miscarriage
Types of GI bleeds
Acute Arterial occlusion - to lower extremities
41. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Defibrillation
Tx of CHF
Where to check pulses
42. 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
Bradycardia
How to monitor CDAB
Abdominal Aortic Aneurysm
GIB work up
43. 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
Acute Mesenteric Ishemia
Define Biliary colic
Cardiac Tamponade
Stable vs. Unstable Ectopic Pregnancy
44. 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
Tachycardia
Common Presentation of GIB
Types of Infectious diarrhea Shigella
45. 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
What is a large bore IV?
Kidney Stones
Missed Abortion
Ovarian Cysts
46. Left coronary artery (short and branches quickly)
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea Campylobacter
LCA
Acute Arterial occlusion - to lower extremities
47. 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? -
Cardiac Tamponade
Tachycardia
Tx of Unstable Angina
LBO - Large bowel obstruction
48. 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
Symptoms of Ruptured ovarian cysts
Stable vs. Unstable Ectopic Pregnancy
Causes of 3rd trimester bleeding
Lateral Leads
49. 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
Testicular Torsion
Endocarditis
When to do a pelvic exam
Gonorrhea
50. 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
When is Rho GAM used
LBO - Large bowel obstruction
Cardiac Enzymes
Testicular Torsion