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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. Old age - chronic anticoagulation - divertriculosis
Ranson's criteria
Genital Herpes
Common risk factors for LGIB
Missed Abortion
2. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Tx of Unstable Angina
EMTALA
Types of Infectious diarrhea Shigella
3. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Divertriculitis
Contraindications for thrombolytics
ED treatment of a Miscarriage
4. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
What should be done after CDAB's
Aortic Dissection definition - risks and S/S
Acute Coronary syndrome
Types of Infectious diarrhea Yersinia
5. 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
Viral Gastroenteritis
Incomplete abortion
How to monitor CDAB
DUKE criteria for endocarditis
6. 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
Advanced airway techniques
Viral Gastroenteritis
Pancreatitis work up
7. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Miscarriage
Ranson's criteria
What is a large bore IV?
ED workup of kidney stones
8. Left coronary artery (short and branches quickly)
LCA
Ovarian Cysts
Other major arteries
Common risk factors for LGIB
9. 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
Additional cardiac Tests
Other major arteries
Tx of CHF
10. 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
UTI
Divertriculitis
Types of Infectious diarrhea Campylobacter
The vital signs
11. 'trier' - to separate - sift or select based on priority of condition
Triage
GIB work up
Hypertensive Emergency
LCA
12. 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)
Additional cardiac Tests
ED workup of kidney stones
DUKE criteria for endocarditis
Stable vs. Unstable Ectopic Pregnancy
13. 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
Dx of Aortic dissection
Breathing
Common risk factors for LGIB
Testicular Torsion
14. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
DUKE criteria for endocarditis
Early miscarriage (20 weeks)
Ovarian Cysts
How to monitor CDAB
15. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Divertriculitis
RCA
Types of Infectious diarrhea - Salmonella
What to do with weak/thready pulses
16. 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
Placental Abruption
Gonorrhea
Stable vs unstable angina`
Inferior leads
17. 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
Volvulus
Stable vs. Unstable Ectopic Pregnancy
SBO
Bradycardia
18. 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
Cardiac Tamponade
Types of Infectious diarrhea - Salmonella
Emergency Severity Index
Divertriculitis
19. 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
What should be done after CDAB's
Stable vs unstable angina`
Supplemental O2
STEMI vs Nstemi
20. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Supplemental O2
ED workup of kidney stones
Common risk factors for LGIB
21. 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
Volvulus
The vital signs
Cardiac Enzymes
22. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Ovarian Cysts
Dx of Aortic dissection
Syphillis
Common risk factors for UGIB
23. 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
Cardiac Enzymes
Bradycardia
Missed Abortion
When is Rho GAM used
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
Common risk factors for LGIB
Testicular Torsion
Tachycardia
When is Rho GAM used
25. 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:
Ovarian Torsion
Types of Infectious diarrhea E coli
EKG changes
Tx of CHF
26. 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
Incidence of AMI
Placenta Previa
The vital signs
Tachycardia
27. 16-18 Gauge
What is a large bore IV?
Types of Infectious diarrhea Shigella
Common risk factors for UGIB
Early miscarriage (20 weeks)
28. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Ovarian Cysts
Causes of 3rd trimester bleeding
Types of Infectious diarrhea Yersinia
EMTALA
29. 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
Breathing
Abdominal Aortic Aneurysm
Cardiac Tamponade
Initial steps in stabilizing a patient
30. 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
Bradycardia
When to do a pelvic exam
Supplemental O2
Gonorrhea
31. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
EKG changes
RCA
Incarcerated vs strangulated hernias
Ectopic Pregnancy
32. 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
Inferior leads
Types of GI bleeds
Appendicitis work up
Causes of 3rd trimester bleeding
33. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Testicular Torsion
Cardiac Enzymes
Define Biliary colic
ED workup of kidney stones
34. 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
Triage
Pericarditis
ED treatment for Ectopic Pregnancy
Emergency Severity Index
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
Ascending Cholangitis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Acute Arterial occlusion - to lower extremities
Syphillis
36. 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
Stable vs unstable angina`
Acute Mesenteric Ishemia
RCA
EKG changes
37. 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
Stable vs unstable angina`
Abdominal Aortic Aneurysm
Ascending Cholangitis
LBO - Large bowel obstruction
38. 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
Contraindications for thrombolytics
GIB work up
How to monitor CDAB
Anteroseptal leads and Anterior
39. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Urosepsis
Pain scale for infants
SBO
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
40. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Kidney Stones
Emergency Severity Index
What to do with weak/thready pulses
Anteroseptal leads and Anterior
41. 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
Stable vs unstable angina`
Define Acute Cholecystitis
Posterior
GIB work up
42. 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
Common risk factors for UGIB
Advanced airway techniques
Viral Gastroenteritis
43. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Common Presentation of GIB
Kidney Stones
Pain scale for infants
44. 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
Viral Gastroenteritis
When to do a pelvic exam
Divertriculitis
Syphillis
45. 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
Volvulus
EMTALA
What is a large bore IV?
Other major arteries
46. Check Vital Signs
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47. 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
Ovarian Torsion
Chlamydia
When are Beta Blockers contraindicated
Stable vs. Unstable Ectopic Pregnancy
48. 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
Pancreatitis work up
EKG changes
Where to check pulses
When is Rho GAM used
49. MONA - morphine - oxygen - nitroglycerin (sublingual or IV) -Aspirin 325 mg (consider Integrilin in high risk patients) - Beta Blocker (metoprolol) - decrease streght of heart contractility within first hour - Cardiology cx --> PCI vs surgery prn? -
Dx of Aortic dissection
Tx of Unstable Angina
Genital Herpes
Incidence of AMI
50. 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
SBO
CHF
Common risk factors for LGIB