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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. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
How to monitor CDAB
The vital signs
Ascending Cholangitis
LBO - Large bowel obstruction
2. II - III - aVF - Means RCA involved
Missed Abortion
Inferior leads
RCA
Ovarian Torsion
3. 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
Triage
Types of Infectious diarrhea - Salmonella
Testicular Torsion
Ranson's criteria
4. Old age - chronic anticoagulation - divertriculosis
What to do with weak/thready pulses
LCA
Common risk factors for LGIB
Pain scale for infants
5. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Emergency Severity Index
RCA
Placental Abruption
Incidence of AMI
6. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Ascending Cholangitis
Cardiac Tamponade
LCA
Lateral Leads
7. 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
Bradycardia
Ovarian Torsion
Stable vs. Unstable Ectopic Pregnancy
8. 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
Additional cardiac Tests
Tachycardia
RCA
Common risk factors for LGIB
9. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Incidence of AMI
Miscarriage
How to monitor CDAB
Ranson's criteria
10. 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:
Syphillis
Ovarian Cysts
Testicular Torsion
Ovarian Torsion
11. 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 E coli
Bradycardia
ED Tx of GIB
What is a large bore IV?
12. 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
Incomplete abortion
Types of Infectious diarrhea Campylobacter
Supplemental O2
Lateral Leads
13. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Causes of 3rd trimester bleeding
Pancreatitis work up
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea Campylobacter
14. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Anteroseptal leads and Anterior
Types of Infectious diarrhea E coli
When to do a pelvic exam
Triage
15. 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
Placental Abruption
When are Beta Blockers contraindicated
ED work up for cholecystitis
Kidney Stones
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
Abdominal Aortic Aneurysm
CHF
Cardiac Enzymes
GIB work up
17. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Syphillis
Contraindications for thrombolytics
Causes of 3rd trimester bleeding
When are Beta Blockers contraindicated
18. 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
Types of Infectious diarrhea Yersinia
Miscarriage
Volvulus
Types of Infectious diarrhea E coli
19. 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
Acute Arterial occlusion - to lower extremities
Stable vs unstable angina`
Common Presentation of GIB
Common risk factors for UGIB
20. 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
Emergency Severity Index
The vital signs
Ectopic Pregnancy
Define Acute Cholecystitis
21. 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
Syphillis
EKG changes
STEMI vs Nstemi
When is Rho GAM used
22. 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
ED Tx of GIB
Kidney Stones
Volvulus
What is a large bore IV?
23. 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
Anteroseptal leads and Anterior
Breathing
Symptoms of Ruptured ovarian cysts
Where to check pulses
24. 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
Missed Abortion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Placenta Previa
Tachycardia
25. 16-18 Gauge
Common risk factors for UGIB
What is a large bore IV?
Hypertensive Emergency
Types of GI bleeds
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
Divertriculitis
Urosepsis
Additional cardiac Tests
How to assess Airway
27. 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
Lateral Leads
Hypertensive Emergency
Pericarditis
EKG changes
28. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Acute Coronary syndrome
ED Tx of GIB
How to monitor CDAB
Incarcerated vs strangulated hernias
29. 'trier' - to separate - sift or select based on priority of condition
Incomplete abortion
When are Beta Blockers contraindicated
Triage
Divertriculitis
30. 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
EMTALA
Missed Abortion
Gonorrhea
When are Beta Blockers contraindicated
31. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Define Acute Cholecystitis
Cardiac Tamponade
When to do a pelvic exam
Types of Infectious diarrhea Shigella
32. V1-V2 Right Posterior Descending Artery
EKG changes
Posterior
Acute Mesenteric Ishemia
How to assess Airway
33. Left coronary artery (short and branches quickly)
LCA
Pancreatitis work up
Contraindications for thrombolytics
Acute Arterial occlusion - to lower extremities
34. 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
Define Acute Cholecystitis
When are Beta Blockers contraindicated
Acute Coronary syndrome
SBO
35. 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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36. 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
Kidney Stones
Common risk factors for UGIB
Types of Infectious diarrhea - Salmonella
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
What to do with weak/thready pulses
Contraindications for thrombolytics
Triage
Causes of 3rd trimester bleeding
38. 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
Kidney Stones
UTI
Define Acute Cholecystitis
Inferior leads
39. 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)
EMTALA
EKG changes
Supplemental O2
Ovarian Cysts
40. 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
UTI
Genital Herpes
Supplemental O2
Aortic Dissection definition - risks and S/S
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
Abdominal Aortic Aneurysm
Triage
Incarcerated vs strangulated hernias
Dx of Aortic dissection
42. 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
Defibrillation
Divertriculitis
Other major arteries
43. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Lateral Leads
Divertriculitis
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea - Salmonella
44. 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
Genital Herpes
Pancreatitis work up
Incarcerated vs strangulated hernias
Lateral Leads
45. 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
Viral Gastroenteritis
Define Acute Cholecystitis
Incidence of AMI
46. 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
When is Rho GAM used
GIB work up
Incomplete abortion
Supplemental O2
47. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
CHF
Types of Infectious diarrhea Campylobacter
Volvulus
Abdominal Aortic Aneurysm
48. 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)
Defibrillation
Additional cardiac Tests
Cardiac Tamponade
RCA
49. 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)
DUKE criteria for endocarditis
What should be done after CDAB's
Symptoms of Ruptured ovarian cysts
UTI
50. 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)
Bradycardia
Lateral Leads
Pericarditis
When are Beta Blockers contraindicated