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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. 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)
When to do a pelvic exam
Posterior
Aortic Dissection definition - risks and S/S
Defibrillation
2. 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? -
Tx of Unstable Angina
Supplemental O2
The vital signs
Common Presentation of GIB
3. 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
Incidence of AMI
Hypertensive Emergency
Pain scale for infants
Types of Infectious diarrhea E coli
4. 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
Appendicitis
Acute Mesenteric Ishemia
Chlamydia
EKG changes
5. 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
Placental Abruption
EMTALA
Types of GI bleeds
6. 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 workup of kidney stones
How to monitor CDAB
Kidney Stones
ED treatment for Ectopic Pregnancy
7. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
Contraindications for thrombolytics
Additional cardiac Tests
ED work up for cholecystitis
8. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Pericarditis
Placental Abruption
Urosepsis
Pancreatitis work up
9. 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)
EKG changes
Supplemental O2
Symptoms of Ruptured ovarian cysts
Placenta Previa
10. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Common Presentation of GIB
How to monitor CDAB
Ectopic Pregnancy
Anteroseptal leads and Anterior
11. 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)
Appendicitis work up
Ectopic Pregnancy
Types of Infectious diarrhea Shigella
Tx of CHF
12. 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
Stable vs unstable angina`
Gonorrhea
13. 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
Dx of Aortic dissection
Supplemental O2
Cardiac Tamponade
Gonorrhea
14. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
ED work up for cholecystitis
Advanced airway techniques
Stable vs unstable angina`
15. Leads I - aVL - V4-V6 - Left circumflex artery
Ranson's criteria
Lateral Leads
Volvulus
What should be done after CDAB's
16. 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
UTI
Breathing
What is a large bore IV?
Defibrillation
17. 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
Pancreatitis work up
Types of Infectious diarrhea Yersinia
Types of Infectious diarrhea E coli
Appendicitis
18. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
ED workup of kidney stones
Posterior
Divertriculitis
CHF
19. 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
Additional cardiac Tests
Acute Mesenteric Ishemia
Divertriculitis
ED treatment of a Miscarriage
20. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Common risk factors for UGIB
STEMI vs Nstemi
When are Beta Blockers contraindicated
What should be done after CDAB's
21. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Endocarditis
Define Acute Cholecystitis
Common Presentation of GIB
SBO
22. 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
Symptoms of Ruptured ovarian cysts
Pericarditis
ED treatment of a Miscarriage
GIB work up
23. 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
Pancreatitis work up
Volvulus
UTI
Supplemental O2
24. 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
When is Rho GAM used
Initial steps in stabilizing a patient
Ascending Cholangitis
Acute Coronary syndrome
25. 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
Symptoms of Ruptured ovarian cysts
Appendicitis
Ovarian Cysts
Incidence of AMI
26. 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
Tachycardia
Emergency Severity Index
Additional cardiac Tests
Ectopic Pregnancy
27. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Appendicitis
Types of Infectious diarrhea Campylobacter
Acute Arterial occlusion - to lower extremities
Endocarditis
28. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Testicular Torsion
Types of Infectious diarrhea - Salmonella
What should be done after CDAB's
CHF
29. Old age - chronic anticoagulation - divertriculosis
Hypertensive Emergency
Common risk factors for LGIB
Kidney Stones
Abdominal Aortic Aneurysm
30. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
RCA
Acute Arterial occlusion - to lower extremities
The vital signs
Incarcerated vs strangulated hernias
31. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Inferior leads
Define Acute Cholecystitis
Pain scale for infants
32. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
Causes of 3rd trimester bleeding
What to do with weak/thready pulses
How to monitor CDAB
SBO
33. 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
Cardiac Enzymes
Ectopic Pregnancy
STEMI vs Nstemi
Incomplete abortion
34. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Incomplete abortion
Common risk factors for UGIB
RCA
EKG changes
35. 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)
Where to check pulses
Contraindications for thrombolytics
Appendicitis work up
Bradycardia
36. 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)
What to do with weak/thready pulses
Cardiac Tamponade
When is Rho GAM used
Tx of Unstable Angina
37. Directly invades the intestine - s/s abd pain - watery or bloody diarrhea - vomiting
Types of Infectious diarrhea Yersinia
Pericarditis
Viral Gastroenteritis
DUKE criteria for endocarditis
38. 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
Acute Mesenteric Ishemia
Where to check pulses
Stable vs. Unstable Ectopic Pregnancy
Tachycardia
39. 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
Aortic Dissection definition - risks and S/S
Placenta Previa
Ranson's criteria
Incomplete abortion
40. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Types of Infectious diarrhea Campylobacter
Causes of 3rd trimester bleeding
GIB work up
Pericarditis
41. 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
Tx of Unstable Angina
Additional cardiac Tests
Appendicitis
Testicular Torsion
42. 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
Acute Coronary syndrome
Abdominal Aortic Aneurysm
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
ED treatment of a Miscarriage
43. 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
Dx of Aortic dissection
CHF
Hypertensive Emergency
Viral Gastroenteritis
44. II - III - aVF - Means RCA involved
Lateral Leads
EKG changes
Incarcerated vs strangulated hernias
Inferior leads
45. 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
Types of Infectious diarrhea Shigella
Emergency Severity Index
Abdominal Aortic Aneurysm
46. 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
Testicular Torsion
ED Tx of GIB
Acute Mesenteric Ishemia
LCA
47. 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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48. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Define Biliary colic
Acute Arterial occlusion - to lower extremities
Bradycardia
Types of Infectious diarrhea Campylobacter
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)
ED treatment for Ectopic Pregnancy
Stable vs unstable angina`
DUKE criteria for endocarditis
Ascending Cholangitis
50. Check Vital Signs
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