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Test your basic knowledge |
Emergency Medicine
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Subjects
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health-sciences
,
emergency-medicine
Instructions:
Answer 50 questions in 15 minutes.
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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. 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
LCA
Cardiac Enzymes
Kidney Stones
ED workup of kidney stones
2. 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
Incidence of AMI
Syphillis
Dx of Aortic dissection
Cardiac Tamponade
3. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Ovarian Torsion
Types of Infectious diarrhea - Salmonella
Ovarian Cysts
Where to check pulses
4. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Lateral Leads
SBO
Miscarriage
ED Tx of GIB
5. 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
Types of Infectious diarrhea - Salmonella
Hypertensive Emergency
STEMI vs Nstemi
How to monitor CDAB
6. 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
Cardiac Enzymes
Placenta Previa
Appendicitis work up
Pain scale for infants
7. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Viral Gastroenteritis
LBO - Large bowel obstruction
Define Biliary colic
LCA
8. 'trier' - to separate - sift or select based on priority of condition
What to do with weak/thready pulses
Breathing
Triage
Inferior leads
9. Troponin T or I - mores specific for heart. Tropoinin I stays elevated for 7-10 days - Troponin T stays elevated for 10-14 days - CK - MB: - peaks 20 hours after AMI (specific to cardiac muscle) - CPK - measures muscle breakdown so nonspecific
Volvulus
Define Biliary colic
Pericarditis
Cardiac Enzymes
10. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Tachycardia
What should be done after CDAB's
ED workup of kidney stones
LBO - Large bowel obstruction
11. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
How to monitor CDAB
Divertriculitis
Anteroseptal leads and Anterior
Common risk factors for UGIB
12. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
ED treatment for Ectopic Pregnancy
Incomplete abortion
Endocarditis
Types of Infectious diarrhea - Salmonella
13. 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 workup of kidney stones
Dx of Aortic dissection
Symptoms of Ruptured ovarian cysts
14. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
ED Tx of GIB
Posterior
Common risk factors for LGIB
Types of Infectious diarrhea E coli
15. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Define Acute Cholecystitis
EMTALA
STEMI vs Nstemi
Acute Coronary syndrome
16. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Types of Infectious diarrhea Shigella
Causes of 3rd trimester bleeding
UTI
Pancreatitis work up
17. 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)
Tx of CHF
Tachycardia
DUKE criteria for endocarditis
CHF
18. 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
Additional cardiac Tests
LBO - Large bowel obstruction
Divertriculitis
Pain scale for infants
19. 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
LBO - Large bowel obstruction
RCA
Tx of Unstable Angina
Hypertensive Emergency
20. 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
Common risk factors for UGIB
Miscarriage
Types of Infectious diarrhea E coli
Aortic Dissection definition - risks and S/S
21. 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
Pericarditis
Acute Arterial occlusion - to lower extremities
Testicular Torsion
Hypertensive Emergency
22. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Ranson's criteria
How to monitor CDAB
Genital Herpes
23. 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
Types of GI bleeds
Tx of Unstable Angina
Chlamydia
Defibrillation
24. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
When are Beta Blockers contraindicated
Ovarian Torsion
Cardiac Tamponade
Supplemental O2
25. 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
Viral Gastroenteritis
GIB work up
Cardiac Enzymes
Tx of CHF
26. 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:
Emergency Severity Index
EKG changes
Ovarian Torsion
STEMI vs Nstemi
27. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
Advanced airway techniques
ED treatment of a Miscarriage
How to assess Airway
28. 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
Cardiac Enzymes
Defibrillation
Ectopic Pregnancy
29. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Volvulus
CHF
Advanced airway techniques
Common risk factors for LGIB
30. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Acute Mesenteric Ishemia
Pericarditis
The vital signs
STEMI vs Nstemi
31. 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
Acute Coronary syndrome
Genital Herpes
Volvulus
Incarcerated vs strangulated hernias
32. 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
Anteroseptal leads and Anterior
Lateral Leads
Causes of 3rd trimester bleeding
Supplemental O2
33. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Placenta Previa
Causes of 3rd trimester bleeding
Posterior
34. V1-V2 Right Posterior Descending Artery
What should be done after CDAB's
LCA
Posterior
SBO
35. 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
What should be done after CDAB's
LCA
SBO
Types of Infectious diarrhea E coli
36. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What to do with weak/thready pulses
Contraindications for thrombolytics
Testicular Torsion
ED Tx of GIB
37. 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
Contraindications for thrombolytics
STEMI vs Nstemi
Acute Arterial occlusion - to lower extremities
Viral Gastroenteritis
38. 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)
When is Rho GAM used
Hypertensive Emergency
EMTALA
Acute Coronary syndrome
39. 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
Ectopic Pregnancy
Pericarditis
Early miscarriage (20 weeks)
EKG changes
40. 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
Cardiac Enzymes
Gonorrhea
Abdominal Aortic Aneurysm
Define Biliary colic
41. 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
When to do a pelvic exam
Posterior
Common risk factors for UGIB
Dx of Aortic dissection
42. 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
Testicular Torsion
Inferior leads
Placental Abruption
Advanced airway techniques
43. 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
Common Presentation of GIB
Posterior
Genital Herpes
Chlamydia
44. 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
Gonorrhea
Dx of Aortic dissection
Volvulus
LCA
45. 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
Placenta Previa
ED work up for cholecystitis
Ranson's criteria
Tachycardia
46. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Where to check pulses
How to monitor CDAB
Hypertensive Emergency
47. 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
Symptoms of Ruptured ovarian cysts
What should be done after CDAB's
Emergency Severity Index
Viral Gastroenteritis
48. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
UTI
Incarcerated vs strangulated hernias
SBO
Acute Mesenteric Ishemia
49. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Tx of CHF
Early miscarriage (20 weeks)
Cardiac Tamponade
Types of Infectious diarrhea Yersinia
50. 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
Ovarian Torsion
Tx of CHF
Bradycardia
When are Beta Blockers contraindicated
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