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Test your basic knowledge |
Emergency Medicine
Start Test
Study First
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. 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
Gonorrhea
Endocarditis
Common risk factors for LGIB
Stable vs. Unstable Ectopic Pregnancy
2. Pay attention to resp rate - breathing pattern (normal vs. agonic breaths) - O2 sats - goal is > 94% - Chest rise/tidal volume - Waveform Capnography: measures CO2 input and output. Best measure for assessing ventilation - Bag-valve-mask helps patie
ED Tx of GIB
Breathing
Bradycardia
STEMI vs Nstemi
3. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Other major arteries
Acute Arterial occlusion - to lower extremities
Posterior
Incidence of AMI
4. Left coronary artery (short and branches quickly)
Gonorrhea
LCA
How to monitor CDAB
Triage
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
Types of Infectious diarrhea - Salmonella
Syphillis
Symptoms of Ruptured ovarian cysts
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
6. 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
UTI
Types of Infectious diarrhea Shigella
Chlamydia
7. 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
Where to check pulses
Volvulus
Supplemental O2
SBO
8. 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
Kidney Stones
Stable vs. Unstable Ectopic Pregnancy
How to assess Airway
Pancreatitis work up
9. 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
Genital Herpes
Hypertensive Emergency
How to assess Airway
Acute Mesenteric Ishemia
10. 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
Contraindications for thrombolytics
Viral Gastroenteritis
Acute Mesenteric Ishemia
Cardiac Enzymes
11. 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
Emergency Severity Index
Ectopic Pregnancy
Dx of Aortic dissection
Contraindications for thrombolytics
12. 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:
Causes of 3rd trimester bleeding
Cardiac Tamponade
Types of Infectious diarrhea - Salmonella
Ovarian Torsion
13. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Pain scale for infants
Tachycardia
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Shigella
14. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Advanced airway techniques
Anteroseptal leads and Anterior
Initial steps in stabilizing a patient
Types of GI bleeds
15. 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
Supplemental O2
Pain scale for infants
Appendicitis
Lateral Leads
16. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea Campylobacter
Viral Gastroenteritis
Other major arteries
17. 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
Testicular Torsion
RCA
Types of GI bleeds
ED workup of kidney stones
18. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Dx of Aortic dissection
Common risk factors for LGIB
Cardiac Tamponade
Lateral Leads
19. 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 GI bleeds
UTI
The vital signs
Appendicitis work up
20. 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
UTI
Viral Gastroenteritis
GIB work up
ED work up for cholecystitis
21. 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 -
Placental Abruption
Volvulus
When are Beta Blockers contraindicated
Common risk factors for LGIB
22. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Genital Herpes
Define Biliary colic
Volvulus
Posterior
23. 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
LCA
Common Presentation of GIB
Contraindications for thrombolytics
Breathing
24. 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
Incarcerated vs strangulated hernias
Ovarian Cysts
Gonorrhea
Dx of Aortic dissection
25. Old age - chronic anticoagulation - divertriculosis
Pericarditis
Common risk factors for LGIB
How to monitor CDAB
Incomplete abortion
26. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Anteroseptal leads and Anterior
Ovarian Cysts
Types of Infectious diarrhea E coli
Defibrillation
27. 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)
Supplemental O2
Bradycardia
Pancreatitis work up
Incomplete abortion
28. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Contraindications for thrombolytics
Incarcerated vs strangulated hernias
ED treatment of a Miscarriage
Common risk factors for UGIB
29. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Symptoms of Ruptured ovarian cysts
When to do a pelvic exam
Emergency Severity Index
Triage
30. 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
Types of Infectious diarrhea - Salmonella
Types of Infectious diarrhea Shigella
Additional cardiac Tests
31. 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
Tx of Unstable Angina
Cardiac Tamponade
Placenta Previa
32. 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
DUKE criteria for endocarditis
Acute Arterial occlusion - to lower extremities
Lateral Leads
33. 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
Additional cardiac Tests
GIB work up
Supplemental O2
34. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
UTI
Incomplete abortion
How to monitor CDAB
STEMI vs Nstemi
35. 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
Acute Arterial occlusion - to lower extremities
Lateral Leads
Common risk factors for UGIB
36. 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
Ectopic Pregnancy
Ascending Cholangitis
UTI
Types of Infectious diarrhea Campylobacter
37. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
When to do a pelvic exam
How to monitor CDAB
Abdominal Aortic Aneurysm
Ovarian Cysts
38. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
Common risk factors for UGIB
Types of GI bleeds
Gonorrhea
39. 'trier' - to separate - sift or select based on priority of condition
Triage
Ranson's criteria
What should be done after CDAB's
Missed Abortion
40. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Causes of 3rd trimester bleeding
Contraindications for thrombolytics
Symptoms of Ruptured ovarian cysts
Tx of CHF
41. Risk Factors: PID - Mirena IUD - tubal surgery - pelvic surgery - endometriosis - IVF -DES exposure S/S - R or L adnexal tenderness - R shoulder pain could be referred pain from intraabdominal hemorrhage (gallbladder - liver also) - Workup -CBC - C
What is a large bore IV?
Symptoms of Ruptured ovarian cysts
ED workup of kidney stones
Ectopic Pregnancy
42. 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
Incarcerated vs strangulated hernias
Initial steps in stabilizing a patient
Ectopic Pregnancy
43. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
Cardiac Enzymes
Types of Infectious diarrhea Shigella
Common Presentation of GIB
44. 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
Kidney Stones
Types of GI bleeds
CHF
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
45. 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
Genital Herpes
Divertriculitis
Define Acute Cholecystitis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
46. 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
When to do a pelvic exam
Early miscarriage (20 weeks)
Ovarian Torsion
ED treatment for Ectopic Pregnancy
47. 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 Shigella
Miscarriage
Abdominal Aortic Aneurysm
Acute Arterial occlusion - to lower extremities
48. 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
Advanced airway techniques
SBO
Ovarian Cysts
49. 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 E coli
Hypertensive Emergency
The vital signs
Types of Infectious diarrhea Yersinia
50. 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
Types of Infectious diarrhea E coli
Cardiac Enzymes
Ranson's criteria
Types of Infectious diarrhea - Salmonella