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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. 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
LCA
Ectopic Pregnancy
ED workup of kidney stones
2. 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 - Salmonella
EMTALA
Acute Mesenteric Ishemia
STEMI vs Nstemi
3. 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
Cardiac Tamponade
Viral Gastroenteritis
Pancreatitis work up
SBO
4. 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 - Salmonella
Pain scale for infants
DUKE criteria for endocarditis
GIB work up
5. 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
EKG changes
Divertriculitis
Syphillis
When are Beta Blockers contraindicated
6. 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)
Volvulus
What should be done after CDAB's
When is Rho GAM used
Advanced airway techniques
7. 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
Other major arteries
UTI
Incomplete abortion
How to assess Airway
8. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Aortic Dissection definition - risks and S/S
Testicular Torsion
Tachycardia
STEMI vs Nstemi
9. 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)
CHF
EKG changes
Types of Infectious diarrhea Yersinia
Common risk factors for LGIB
10. II - III - aVF - Means RCA involved
Viral Gastroenteritis
Missed Abortion
Define Acute Cholecystitis
Inferior leads
11. 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
Advanced airway techniques
Contraindications for thrombolytics
Miscarriage
12. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Ranson's criteria
Types of Infectious diarrhea Yersinia
What to do with weak/thready pulses
Advanced airway techniques
13. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Stable vs unstable angina`
Miscarriage
RCA
Dx of Aortic dissection
14. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
EMTALA
ED workup of kidney stones
When is Rho GAM used
Other major arteries
15. 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
Initial steps in stabilizing a patient
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
GIB work up
Pancreatitis work up
16. 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
Urosepsis
Abdominal Aortic Aneurysm
Hypertensive Emergency
Incarcerated vs strangulated hernias
17. 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
Appendicitis
Divertriculitis
DUKE criteria for endocarditis
Missed Abortion
18. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Defibrillation
Anteroseptal leads and Anterior
Types of Infectious diarrhea Shigella
Early miscarriage (20 weeks)
19. 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
Common Presentation of GIB
Define Acute Cholecystitis
Acute Coronary syndrome
Pericarditis
20. 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
Acute Arterial occlusion - to lower extremities
Emergency Severity Index
CHF
Tx of CHF
21. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Early miscarriage (20 weeks)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Bradycardia
Defibrillation
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
Incidence of AMI
Advanced airway techniques
Tachycardia
Types of Infectious diarrhea Shigella
23. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Testicular Torsion
When are Beta Blockers contraindicated
Inferior leads
Symptoms of Ruptured ovarian cysts
24. 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
Types of Infectious diarrhea Shigella
Tachycardia
Genital Herpes
25. 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 -
Dx of Aortic dissection
What should be done after CDAB's
Placental Abruption
Kidney Stones
26. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Types of GI bleeds
Define Biliary colic
Hypertensive Emergency
Common Presentation of GIB
27. 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
Tachycardia
LCA
Anteroseptal leads and Anterior
How to monitor CDAB
28. 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`
Volvulus
Ovarian Cysts
Contraindications for thrombolytics
29. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
Testicular Torsion
Types of GI bleeds
Types of Infectious diarrhea Yersinia
30. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Acute Arterial occlusion - to lower extremities
Define Biliary colic
Define Acute Cholecystitis
31. 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 Presentation of GIB
Common risk factors for UGIB
Volvulus
Syphillis
32. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Ectopic Pregnancy
Other major arteries
Incarcerated vs strangulated hernias
When is Rho GAM used
33. 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
Divertriculitis
Missed Abortion
Dx of Aortic dissection
34. 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
Initial steps in stabilizing a patient
GIB work up
Inferior leads
35. 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
Aortic Dissection definition - risks and S/S
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea E coli
Dx of Aortic dissection
36. 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
Tx of CHF
When are Beta Blockers contraindicated
Genital Herpes
UTI
37. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Types of GI bleeds
Common Presentation of GIB
What to do with weak/thready pulses
Miscarriage
38. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Symptoms of Ruptured ovarian cysts
CHF
Pain scale for infants
How to assess Airway
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)
Tx of Unstable Angina
EMTALA
ED treatment of a Miscarriage
Defibrillation
40. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Chlamydia
Ectopic Pregnancy
Appendicitis work up
When to do a pelvic exam
41. 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
GIB work up
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Define Biliary colic
SBO
42. 'trier' - to separate - sift or select based on priority of condition
How to assess Airway
Common Presentation of GIB
Triage
LBO - Large bowel obstruction
43. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
When to do a pelvic exam
Gonorrhea
ED Tx of GIB
The vital signs
44. Check Vital Signs
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45. Left coronary artery (short and branches quickly)
Bradycardia
Syphillis
LCA
Contraindications for thrombolytics
46. 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
What to do with weak/thready pulses
EKG changes
Acute Mesenteric Ishemia
Additional cardiac Tests
47. 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
Types of GI bleeds
ED Tx of GIB
Where to check pulses
Symptoms of Ruptured ovarian cysts
48. 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)
Causes of 3rd trimester bleeding
Hypertensive Emergency
Inferior leads
Bradycardia
49. 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
Types of Infectious diarrhea E coli
Incarcerated vs strangulated hernias
CHF
50. 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
Tx of CHF
GIB work up
Stable vs. Unstable Ectopic Pregnancy
Stable vs unstable angina`