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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. 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
Aortic Dissection definition - risks and S/S
Genital Herpes
Pain scale for infants
2. 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
3. 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
Emergency Severity Index
Endocarditis
Kidney Stones
Hypertensive Emergency
4. 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
Ascending Cholangitis
EMTALA
ED treatment for Ectopic Pregnancy
Cardiac Enzymes
5. 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
What is a large bore IV?
Placenta Previa
Abdominal Aortic Aneurysm
What should be done after CDAB's
6. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Bradycardia
Genital Herpes
Initial steps in stabilizing a patient
7. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
ED workup of kidney stones
STEMI vs Nstemi
Stable vs unstable angina`
Lateral Leads
8. 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
Incomplete abortion
Placental Abruption
ED workup of kidney stones
Triage
9. 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:
Bradycardia
ED Tx of GIB
Ovarian Torsion
Placenta Previa
10. V1-V2 Right Posterior Descending Artery
Miscarriage
STEMI vs Nstemi
Posterior
Aortic Dissection definition - risks and S/S
11. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Ovarian Cysts
Acute Arterial occlusion - to lower extremities
Testicular Torsion
CHF
12. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
ED treatment of a Miscarriage
Defibrillation
Types of Infectious diarrhea Yersinia
Ovarian Cysts
13. 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
Early miscarriage (20 weeks)
SBO
Additional cardiac Tests
Incomplete abortion
14. 'trier' - to separate - sift or select based on priority of condition
The vital signs
Triage
Pancreatitis work up
What is a large bore IV?
15. 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
Types of GI bleeds
Pain scale for infants
Define Biliary colic
Stable vs unstable angina`
16. Check Vital Signs
17. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
When are Beta Blockers contraindicated
Lateral Leads
Cardiac Tamponade
Miscarriage
18. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Where to check pulses
ED work up for cholecystitis
Urosepsis
Incarcerated vs strangulated hernias
19. 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
How to assess Airway
EMTALA
Stable vs unstable angina`
20. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Common risk factors for UGIB
Cardiac Tamponade
Divertriculitis
Incomplete abortion
21. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Advanced airway techniques
Endocarditis
Symptoms of Ruptured ovarian cysts
Anteroseptal leads and Anterior
22. 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
Volvulus
Miscarriage
Types of Infectious diarrhea E coli
Symptoms of Ruptured ovarian cysts
23. 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
Emergency Severity Index
Supplemental O2
Types of Infectious diarrhea Shigella
UTI
24. 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
Ascending Cholangitis
Symptoms of Ruptured ovarian cysts
Pericarditis
Common risk factors for LGIB
25. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Miscarriage
Causes of 3rd trimester bleeding
STEMI vs Nstemi
RCA
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
Hypertensive Emergency
Bradycardia
Ascending Cholangitis
27. 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 Infectious diarrhea Yersinia
Types of GI bleeds
Appendicitis work up
Abdominal Aortic Aneurysm
28. 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`
Types of Infectious diarrhea E coli
Abdominal Aortic Aneurysm
GIB work up
29. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Posterior
ED treatment for Ectopic Pregnancy
EMTALA
Tachycardia
30. II - III - aVF - Means RCA involved
Gonorrhea
Define Biliary colic
Inferior leads
Urosepsis
31. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
What to do with weak/thready pulses
Volvulus
How to assess Airway
Incarcerated vs strangulated hernias
32. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
What is a large bore IV?
Advanced airway techniques
Miscarriage
Types of Infectious diarrhea Shigella
33. 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
Syphillis
Emergency Severity Index
Types of Infectious diarrhea Shigella
Volvulus
34. 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
Incomplete abortion
Inferior leads
Aortic Dissection definition - risks and S/S
Stable vs unstable angina`
35. 16-18 Gauge
What is a large bore IV?
DUKE criteria for endocarditis
When are Beta Blockers contraindicated
EMTALA
36. 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
Breathing
Tx of Unstable Angina
What to do with weak/thready pulses
SBO
37. Chronic anticoagulation - Coumadin - Pradaxa/Dabigatran (no meds to reverse it) - Lovenox - ESLD / alcoholism (lack clotting factors) - NSAIDS (increase risk PUD and blood thinning) - Smoking
How to monitor CDAB
When is Rho GAM used
Common risk factors for UGIB
EMTALA
38. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Triage
Where to check pulses
Tachycardia
Types of Infectious diarrhea Campylobacter
39. 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
Testicular Torsion
Initial steps in stabilizing a patient
Types of Infectious diarrhea Campylobacter
Contraindications for thrombolytics
40. 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
Dx of Aortic dissection
How to assess Airway
When to do a pelvic exam
Incidence of AMI
41. 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
LBO - Large bowel obstruction
When are Beta Blockers contraindicated
ED work up for cholecystitis
42. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Syphillis
Appendicitis
Where to check pulses
ED treatment of a Miscarriage
43. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Common Presentation of GIB
When is Rho GAM used
LBO - Large bowel obstruction
Defibrillation
44. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
What is a large bore IV?
Abdominal Aortic Aneurysm
Missed Abortion
What to do with weak/thready pulses
45. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Pericarditis
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea Campylobacter
Kidney Stones
46. 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
Testicular Torsion
Appendicitis work up
Viral Gastroenteritis
UTI
47. 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
EKG changes
Breathing
Other major arteries
Acute Mesenteric Ishemia
48. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Genital Herpes
Ovarian Cysts
DUKE criteria for endocarditis
Define Biliary colic
49. 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
ED Tx of GIB
Incidence of AMI
Chlamydia
Ascending Cholangitis
50. Risk Factors: PID - Mirena IUD - tubal surgery - pelvic surgery - endometriosis - IVF -DES exposure S/S - R or L adnexal tenderness - R shoulder pain could be referred pain from intraabdominal hemorrhage (gallbladder - liver also) - Workup -CBC - C
UTI
ED Tx of GIB
Testicular Torsion
Ectopic Pregnancy