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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.
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. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Viral Gastroenteritis
ED work up for cholecystitis
STEMI vs Nstemi
Symptoms of Ruptured ovarian cysts
2. 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)
Emergency Severity Index
ED treatment of a Miscarriage
When is Rho GAM used
How to monitor CDAB
3. 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 -
Additional cardiac Tests
Placental Abruption
Missed Abortion
Types of Infectious diarrhea Shigella
4. 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
Placental Abruption
STEMI vs Nstemi
Defibrillation
5. 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`
Symptoms of Ruptured ovarian cysts
Types of GI bleeds
Incomplete abortion
6. Left coronary artery (short and branches quickly)
LCA
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Cardiac Enzymes
Tx of CHF
7. Leads I - aVL - V4-V6 - Left circumflex artery
Gonorrhea
GIB work up
How to monitor CDAB
Lateral Leads
8. 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)
Urosepsis
Cardiac Tamponade
DUKE criteria for endocarditis
Incomplete abortion
9. 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
Appendicitis
Stable vs. Unstable Ectopic Pregnancy
Syphillis
Ranson's criteria
10. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Where to check pulses
Urosepsis
Pericarditis
11. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
LCA
When is Rho GAM used
Advanced airway techniques
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
12. 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
Types of Infectious diarrhea Campylobacter
What is a large bore IV?
Dx of Aortic dissection
13. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
EKG changes
Common risk factors for UGIB
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Common Presentation of GIB
14. 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
SBO
Tx of Unstable Angina
Triage
Dx of Aortic dissection
15. 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
Ranson's criteria
Where to check pulses
Missed Abortion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
16. 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
Aortic Dissection definition - risks and S/S
How to assess Airway
Placenta Previa
Ranson's criteria
17. 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
Volvulus
Initial steps in stabilizing a patient
Pancreatitis work up
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
18. 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
Ectopic Pregnancy
Acute Mesenteric Ishemia
LBO - Large bowel obstruction
Advanced airway techniques
19. 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
What should be done after CDAB's
Cardiac Enzymes
Early miscarriage (20 weeks)
Bradycardia
20. 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
Stable vs unstable angina`
Acute Coronary syndrome
Other major arteries
ED workup of kidney stones
21. 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
Tx of CHF
Early miscarriage (20 weeks)
UTI
ED treatment of a Miscarriage
22. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Aortic Dissection definition - risks and S/S
UTI
Additional cardiac Tests
Anteroseptal leads and Anterior
23. 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
Genital Herpes
Tx of CHF
RCA
Divertriculitis
24. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Initial steps in stabilizing a patient
DUKE criteria for endocarditis
Additional cardiac Tests
Pain scale for infants
25. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Incidence of AMI
Causes of 3rd trimester bleeding
Pancreatitis work up
Divertriculitis
26. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Gonorrhea
The vital signs
Anteroseptal leads and Anterior
Early miscarriage (20 weeks)
27. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
The vital signs
How to monitor CDAB
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea - Salmonella
28. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Incarcerated vs strangulated hernias
Incidence of AMI
Ovarian Cysts
Aortic Dissection definition - risks and S/S
29. 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
Emergency Severity Index
Contraindications for thrombolytics
ED treatment of a Miscarriage
When is Rho GAM used
30. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Bradycardia
Appendicitis
DUKE criteria for endocarditis
Ascending Cholangitis
31. 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
Placental Abruption
Common Presentation of GIB
Incomplete abortion
Ascending Cholangitis
32. 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
Viral Gastroenteritis
Ovarian Torsion
Missed Abortion
Stable vs unstable angina`
33. 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
Types of Infectious diarrhea - Salmonella
Where to check pulses
Lateral Leads
34. V1-V2 Right Posterior Descending Artery
Ovarian Cysts
Posterior
Missed Abortion
Types of Infectious diarrhea Shigella
35. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Supplemental O2
Breathing
RCA
Acute Arterial occlusion - to lower extremities
36. 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
How to assess Airway
Abdominal Aortic Aneurysm
Urosepsis
Missed Abortion
37. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Common Presentation of GIB
Appendicitis work up
Types of Infectious diarrhea Yersinia
When to do a pelvic exam
38. 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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39. 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
Tx of CHF
Tachycardia
Gonorrhea
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
40. 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
Types of Infectious diarrhea Campylobacter
Appendicitis
Pancreatitis work up
STEMI vs Nstemi
41. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Advanced airway techniques
Acute Mesenteric Ishemia
Incidence of AMI
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
42. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Dx of Aortic dissection
ED treatment for Ectopic Pregnancy
Breathing
Emergency Severity Index
43. II - III - aVF - Means RCA involved
Defibrillation
How to monitor CDAB
Inferior leads
Missed Abortion
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
Breathing
Types of Infectious diarrhea E coli
STEMI vs Nstemi
Hypertensive Emergency
45. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
Define Biliary colic
Triage
What is a large bore IV?
46. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Abdominal Aortic Aneurysm
Endocarditis
Define Biliary colic
Appendicitis work up
47. 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
Chlamydia
Aortic Dissection definition - risks and S/S
Kidney Stones
Early miscarriage (20 weeks)
48. 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
ED work up for cholecystitis
Other major arteries
Types of Infectious diarrhea Shigella
Triage
49. 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
When is Rho GAM used
Common risk factors for LGIB
Other major arteries
50. 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
Volvulus
Types of Infectious diarrhea Shigella
Incomplete abortion