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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. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Divertriculitis
Symptoms of Ruptured ovarian cysts
Genital Herpes
Ovarian Cysts
2. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
LBO - Large bowel obstruction
LCA
SBO
Triage
3. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Stable vs. Unstable Ectopic Pregnancy
CHF
Breathing
Incarcerated vs strangulated hernias
4. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Define Biliary colic
Pain scale for infants
When is Rho GAM used
Pancreatitis work up
5. 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
Stable vs unstable angina`
Bradycardia
Common risk factors for LGIB
6. 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
Other major arteries
Cardiac Enzymes
Types of Infectious diarrhea - Salmonella
Lateral Leads
7. 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
EMTALA
Acute Arterial occlusion - to lower extremities
When is Rho GAM used
8. Cysts rupture and cause pelvic bleeding --> peritonitis --> hypotension --> shock S/S: unilateral sharp - lower abd pain - work up: IVF w. crystalloids - - O2 prn - CBC - chem 7 - HCG - UA - ABO/Rh - PT/PTT - Pelvic ultrasound with color doppler fl
What should be done after CDAB's
Common risk factors for LGIB
LCA
Symptoms of Ruptured ovarian cysts
9. 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
Tx of CHF
Ectopic Pregnancy
ED Tx of GIB
Endocarditis
10. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Placenta Previa
Pancreatitis work up
Cardiac Tamponade
Defibrillation
11. 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
SBO
Lateral Leads
Ovarian Cysts
Dx of Aortic dissection
12. 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
Missed Abortion
Early miscarriage (20 weeks)
Abdominal Aortic Aneurysm
Define Acute Cholecystitis
13. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Common risk factors for LGIB
Types of Infectious diarrhea Campylobacter
Abdominal Aortic Aneurysm
Emergency Severity Index
14. Left coronary artery (short and branches quickly)
Cardiac Enzymes
DUKE criteria for endocarditis
LCA
STEMI vs Nstemi
15. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Chlamydia
Types of Infectious diarrhea Yersinia
Pain scale for infants
CHF
16. 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
DUKE criteria for endocarditis
Ascending Cholangitis
Urosepsis
Divertriculitis
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)
Genital Herpes
Acute Mesenteric Ishemia
DUKE criteria for endocarditis
Early miscarriage (20 weeks)
18. 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
STEMI vs Nstemi
When is Rho GAM used
Appendicitis
Additional cardiac Tests
19. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Appendicitis
Acute Arterial occlusion - to lower extremities
LCA
Common Presentation of GIB
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)
When is Rho GAM used
SBO
Endocarditis
Stable vs. Unstable Ectopic Pregnancy
21. 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
Where to check pulses
Tachycardia
ED workup of kidney stones
RCA
22. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Breathing
Other major arteries
Common Presentation of GIB
Lateral Leads
23. 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
Hypertensive Emergency
Missed Abortion
Stable vs. Unstable Ectopic Pregnancy
UTI
24. 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 Infectious diarrhea Protozo -Giardia (dirty water sources)
Appendicitis
ED Tx of GIB
DUKE criteria for endocarditis
25. 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
Posterior
When to do a pelvic exam
Contraindications for thrombolytics
Define Biliary colic
26. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Abdominal Aortic Aneurysm
Early miscarriage (20 weeks)
How to assess Airway
27. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Supplemental O2
Urosepsis
Define Biliary colic
Ovarian Torsion
28. 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
Define Acute Cholecystitis
Viral Gastroenteritis
Miscarriage
EKG changes
29. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Dx of Aortic dissection
Contraindications for thrombolytics
Types of Infectious diarrhea E coli
30. 'trier' - to separate - sift or select based on priority of condition
Other major arteries
Triage
Testicular Torsion
Posterior
31. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Anteroseptal leads and Anterior
Defibrillation
Types of Infectious diarrhea E coli
What to do with weak/thready pulses
32. 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 Campylobacter
What should be done after CDAB's
Types of Infectious diarrhea Shigella
EMTALA
33. 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
Ovarian Torsion
Inferior leads
What is a large bore IV?
Genital Herpes
34. 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
Kidney Stones
CHF
Syphillis
Types of GI bleeds
35. 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:
Abdominal Aortic Aneurysm
The vital signs
Cardiac Tamponade
Ovarian Torsion
36. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Initial steps in stabilizing a patient
Appendicitis
Miscarriage
Ovarian Torsion
37. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
LCA
LBO - Large bowel obstruction
Causes of 3rd trimester bleeding
Supplemental O2
38. 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
Divertriculitis
Volvulus
ED treatment of a Miscarriage
Bradycardia
39. 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
Hypertensive Emergency
The vital signs
Acute Mesenteric Ishemia
Define Acute Cholecystitis
40. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Incidence of AMI
RCA
Cardiac Enzymes
41. 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
Acute Arterial occlusion - to lower extremities
Kidney Stones
Additional cardiac Tests
Initial steps in stabilizing a patient
42. 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
EMTALA
Lateral Leads
Ranson's criteria
Supplemental O2
43. 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
Cardiac Enzymes
UTI
SBO
Types of Infectious diarrhea E coli
44. 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
Anteroseptal leads and Anterior
Cardiac Tamponade
Stable vs. Unstable Ectopic Pregnancy
Missed Abortion
45. 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
Miscarriage
Types of Infectious diarrhea Yersinia
Define Acute Cholecystitis
Stable vs unstable angina`
46. II - III - aVF - Means RCA involved
Stable vs unstable angina`
Hypertensive Emergency
Inferior leads
Types of Infectious diarrhea Campylobacter
47. IVF with crystalloids - RhoGAM for Rh Negative - Abx if sepsis or suspect retained POC - D and C if retained POC's - F/you with OB GYN in 48 hours - monitor HCG is trending down - Return for worsening sxs
Ovarian Cysts
ED workup of kidney stones
ED treatment of a Miscarriage
RCA
48. 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
Cardiac Tamponade
Incidence of AMI
Pericarditis
49. 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
Define Biliary colic
Initial steps in stabilizing a patient
Inferior leads
Emergency Severity Index
50. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Cardiac Tamponade
When are Beta Blockers contraindicated
LCA
Common risk factors for UGIB