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Test your basic knowledge |
Emergency Medicine
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Subjects
:
health-sciences
,
emergency-medicine
Instructions:
Answer 50 questions in 15 minutes.
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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. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
Dx of Aortic dissection
Ovarian Torsion
Where to check pulses
2. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Anteroseptal leads and Anterior
Emergency Severity Index
Other major arteries
Aortic Dissection definition - risks and S/S
3. 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
Pericarditis
Endocarditis
Lateral Leads
How to assess Airway
4. 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)
Aortic Dissection definition - risks and S/S
Defibrillation
Triage
ED treatment of a Miscarriage
5. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Stable vs unstable angina`
Anteroseptal leads and Anterior
Appendicitis
ED treatment of a Miscarriage
6. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
ED work up for cholecystitis
What to do with weak/thready pulses
Acute Mesenteric Ishemia
7. 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
Missed Abortion
Pericarditis
Common risk factors for UGIB
Miscarriage
8. 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
Emergency Severity Index
Common Presentation of GIB
Ranson's criteria
Types of Infectious diarrhea Yersinia
9. 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
Syphillis
Advanced airway techniques
Dx of Aortic dissection
Anteroseptal leads and Anterior
10. 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
Additional cardiac Tests
Kidney Stones
Acute Coronary syndrome
Tachycardia
11. 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
Symptoms of Ruptured ovarian cysts
LBO - Large bowel obstruction
Syphillis
Viral Gastroenteritis
12. Left coronary artery (short and branches quickly)
LCA
Pancreatitis work up
Aortic Dissection definition - risks and S/S
How to assess Airway
13. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Lateral Leads
Kidney Stones
Define Biliary colic
Incarcerated vs strangulated hernias
14. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
ED Tx of GIB
ED treatment for Ectopic Pregnancy
GIB work up
When are Beta Blockers contraindicated
15. 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
LCA
Anteroseptal leads and Anterior
Genital Herpes
16. 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
SBO
Define Acute Cholecystitis
When are Beta Blockers contraindicated
Cardiac Enzymes
17. 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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18. 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
Syphillis
Types of Infectious diarrhea E coli
Appendicitis
19. II - III - aVF - Means RCA involved
Early miscarriage (20 weeks)
Incidence of AMI
Other major arteries
Inferior leads
20. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Anteroseptal leads and Anterior
STEMI vs Nstemi
Kidney Stones
How to monitor CDAB
21. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
Stable vs unstable angina`
Ascending Cholangitis
Types of GI bleeds
22. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Dx of Aortic dissection
Tachycardia
Types of Infectious diarrhea - Salmonella
Appendicitis work up
23. 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
Symptoms of Ruptured ovarian cysts
What is a large bore IV?
RCA
Acute Coronary syndrome
24. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Appendicitis work up
Appendicitis
When to do a pelvic exam
Types of Infectious diarrhea Campylobacter
25. 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
Inferior leads
GIB work up
Common risk factors for LGIB
Aortic Dissection definition - risks and S/S
26. 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
RCA
The vital signs
How to monitor CDAB
Ovarian Cysts
27. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
How to assess Airway
Ectopic Pregnancy
Ovarian Cysts
Urosepsis
28. 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)
Breathing
Appendicitis work up
Genital Herpes
STEMI vs Nstemi
29. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Ectopic Pregnancy
Types of GI bleeds
ED treatment for Ectopic Pregnancy
Appendicitis
30. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Tachycardia
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Anteroseptal leads and Anterior
Types of Infectious diarrhea Yersinia
31. 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
Ascending Cholangitis
Symptoms of Ruptured ovarian cysts
Divertriculitis
SBO
32. 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)
Types of GI bleeds
Early miscarriage (20 weeks)
Bradycardia
Triage
33. 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:
Incomplete abortion
Ectopic Pregnancy
Cardiac Tamponade
Ovarian Torsion
34. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
What is a large bore IV?
Ovarian Torsion
When to do a pelvic exam
Breathing
35. 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
Contraindications for thrombolytics
Gonorrhea
Ovarian Cysts
Incarcerated vs strangulated hernias
36. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Types of Infectious diarrhea Yersinia
Kidney Stones
How to assess Airway
CHF
37. 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
ED treatment for Ectopic Pregnancy
CHF
When are Beta Blockers contraindicated
38. 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
Ascending Cholangitis
Pericarditis
Define Acute Cholecystitis
Types of Infectious diarrhea E coli
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
Define Biliary colic
Acute Mesenteric Ishemia
Incarcerated vs strangulated hernias
Tachycardia
40. 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
Common Presentation of GIB
EMTALA
Where to check pulses
Divertriculitis
41. 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
Anteroseptal leads and Anterior
Hypertensive Emergency
Ovarian Torsion
Pancreatitis work up
42. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Acute Coronary syndrome
When are Beta Blockers contraindicated
Supplemental O2
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
43. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
UTI
Tx of Unstable Angina
Appendicitis
STEMI vs Nstemi
44. CDAB - Circulation (rapid CPR to reestablish circulation) - Defibrillaiton - Airway - Breathing - the main goal is to restore effective oxygenation -ventilation and circulation until return of spontaneous circulation or ACLS
Pancreatitis work up
Syphillis
Common risk factors for UGIB
Initial steps in stabilizing a patient
45. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Tx of CHF
Miscarriage
LBO - Large bowel obstruction
Appendicitis
46. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
Advanced airway techniques
Urosepsis
Common risk factors for UGIB
Breathing
47. 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
Stable vs. Unstable Ectopic Pregnancy
Viral Gastroenteritis
Miscarriage
Types of Infectious diarrhea Yersinia
48. 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
ED work up for cholecystitis
Chlamydia
Gonorrhea
Causes of 3rd trimester bleeding
49. 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
What should be done after CDAB's
Syphillis
Abdominal Aortic Aneurysm
ED work up for cholecystitis
50. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Chlamydia
EKG changes
Defibrillation
RCA
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