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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. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Abdominal Aortic Aneurysm
Inferior leads
Anteroseptal leads and Anterior
Incarcerated vs strangulated hernias
2. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
ED work up for cholecystitis
Missed Abortion
Gonorrhea
3. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
DUKE criteria for endocarditis
Ovarian Cysts
Causes of 3rd trimester bleeding
Incarcerated vs strangulated hernias
4. 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
Incarcerated vs strangulated hernias
Placenta Previa
Gonorrhea
Missed Abortion
5. 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
Appendicitis work up
Genital Herpes
Pericarditis
When is Rho GAM used
6. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Ovarian Cysts
Posterior
Incarcerated vs strangulated hernias
Placental Abruption
7. 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 CHF
Tx of Unstable Angina
Pancreatitis work up
Appendicitis
8. 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
The vital signs
Where to check pulses
What is a large bore IV?
Appendicitis work up
9. 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
Stable vs unstable angina`
Anteroseptal leads and Anterior
How to assess Airway
How to monitor CDAB
10. 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)
When are Beta Blockers contraindicated
Define Biliary colic
Appendicitis work up
Types of Infectious diarrhea - Salmonella
11. 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:
Pancreatitis work up
Ovarian Torsion
When are Beta Blockers contraindicated
Advanced airway techniques
12. 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
RCA
When are Beta Blockers contraindicated
Ascending Cholangitis
Incomplete abortion
13. 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
Types of Infectious diarrhea Campylobacter
Symptoms of Ruptured ovarian cysts
Dx of Aortic dissection
Viral Gastroenteritis
14. 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
Ectopic Pregnancy
ED work up for cholecystitis
Define Acute Cholecystitis
UTI
15. 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
Volvulus
Acute Coronary syndrome
Incidence of AMI
Abdominal Aortic Aneurysm
16. 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
Emergency Severity Index
What is a large bore IV?
Tachycardia
CHF
17. 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)
Advanced airway techniques
Placenta Previa
When is Rho GAM used
EMTALA
18. 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
Incidence of AMI
ED workup of kidney stones
When to do a pelvic exam
Hypertensive Emergency
19. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
Additional cardiac Tests
Types of Infectious diarrhea - Salmonella
The vital signs
Missed Abortion
20. 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
LCA
Placental Abruption
Pancreatitis work up
Stable vs. Unstable Ectopic Pregnancy
21. 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
Testicular Torsion
Tachycardia
Abdominal Aortic Aneurysm
Syphillis
22. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of GI bleeds
UTI
Kidney Stones
23. 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
Urosepsis
Where to check pulses
Kidney Stones
Ectopic Pregnancy
24. 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
Genital Herpes
Abdominal Aortic Aneurysm
Dx of Aortic dissection
25. 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)
Contraindications for thrombolytics
Where to check pulses
Testicular Torsion
DUKE criteria for endocarditis
26. Old age - chronic anticoagulation - divertriculosis
Common risk factors for LGIB
RCA
Types of Infectious diarrhea E coli
When is Rho GAM used
27. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Syphillis
Incidence of AMI
Breathing
28. 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
DUKE criteria for endocarditis
Initial steps in stabilizing a patient
Ectopic Pregnancy
Lateral Leads
29. 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
Appendicitis work up
Incomplete abortion
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
30. 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
How to assess Airway
Volvulus
Common risk factors for UGIB
Genital Herpes
31. Premature separation of the implanted placenta - S/S: abdominal pain - dark vaginal bleeding -hypertonic and tender uterus - fetal distress - may see signs of shock without visible bleeding if intrauterine bleeding Risk factors: HTN - pelvic trauma -
Stable vs. Unstable Ectopic Pregnancy
Early miscarriage (20 weeks)
Placental Abruption
EMTALA
32. 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
Where to check pulses
GIB work up
Contraindications for thrombolytics
Breathing
33. 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)
Acute Mesenteric Ishemia
Defibrillation
Incarcerated vs strangulated hernias
Volvulus
34. 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
LBO - Large bowel obstruction
Ectopic Pregnancy
Early miscarriage (20 weeks)
Hypertensive Emergency
35. IVF w crystalloid CBC - chem 7 - LFT's - lipase - UA - urine cx - HCG - Abdominal/pelvis CT with NO CONTRAST (if suspect a stone) - Ultrasound is an alternative - will show hydronephrosis - Pain control - Dilaudid 1 mg IV - Toradol 30 mg IV (caution
ED workup of kidney stones
LCA
Acute Mesenteric Ishemia
Types of Infectious diarrhea E coli
36. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis work up
Appendicitis
EMTALA
Kidney Stones
37. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Types of Infectious diarrhea Campylobacter
Appendicitis
Endocarditis
Cardiac Tamponade
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
Additional cardiac Tests
UTI
Appendicitis work up
CHF
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
Types of Infectious diarrhea - Salmonella
Hypertensive Emergency
Aortic Dissection definition - risks and S/S
Incarcerated vs strangulated hernias
40. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
RCA
LCA
LBO - Large bowel obstruction
Types of Infectious diarrhea Campylobacter
41. 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
SBO
Common risk factors for UGIB
Breathing
EKG changes
42. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
When to do a pelvic exam
Placental Abruption
Viral Gastroenteritis
When is Rho GAM used
43. 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
Endocarditis
Gonorrhea
Types of GI bleeds
SBO
44. 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
ED workup of kidney stones
Kidney Stones
UTI
Divertriculitis
45. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Incarcerated vs strangulated hernias
Advanced airway techniques
Testicular Torsion
Types of Infectious diarrhea E coli
46. 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
EKG changes
Viral Gastroenteritis
Cardiac Enzymes
Additional cardiac Tests
47. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
Pain scale for infants
Types of Infectious diarrhea E coli
Causes of 3rd trimester bleeding
Miscarriage
48. For any chest pain due to COCAINE USE!!! (because cocaine makes the arteries spasm)
Incomplete abortion
When are Beta Blockers contraindicated
CHF
Lateral Leads
49. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
Appendicitis
CHF
Ectopic Pregnancy
ED treatment for Ectopic Pregnancy
50. 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
How to monitor CDAB
Kidney Stones
Contraindications for thrombolytics
Common risk factors for LGIB