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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. 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
2. 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
Causes of 3rd trimester bleeding
Define Acute Cholecystitis
EMTALA
Missed Abortion
3. 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 -
Placental Abruption
Common risk factors for LGIB
Additional cardiac Tests
Early miscarriage (20 weeks)
4. 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
Pain scale for infants
Syphillis
Stable vs unstable angina`
5. 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
Incomplete abortion
Chlamydia
Emergency Severity Index
Stable vs. Unstable Ectopic Pregnancy
6. 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
Anteroseptal leads and Anterior
Endocarditis
Kidney Stones
Gonorrhea
7. 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
Abdominal Aortic Aneurysm
Volvulus
Genital Herpes
Tx of CHF
8. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
CHF
Types of Infectious diarrhea - Salmonella
When is Rho GAM used
Additional cardiac Tests
9. 'trier' - to separate - sift or select based on priority of condition
Emergency Severity Index
Placenta Previa
Triage
Acute Arterial occlusion - to lower extremities
10. V1-V2 Right Posterior Descending Artery
Posterior
ED treatment of a Miscarriage
Kidney Stones
Define Biliary colic
11. 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
Initial steps in stabilizing a patient
Viral Gastroenteritis
Breathing
Common risk factors for LGIB
12. 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
EMTALA
Inferior leads
Types of GI bleeds
Acute Mesenteric Ishemia
13. 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
Breathing
What to do with weak/thready pulses
Aortic Dissection definition - risks and S/S
Inferior leads
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
Testicular Torsion
ED work up for cholecystitis
Causes of 3rd trimester bleeding
What to do with weak/thready pulses
15. 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
Chlamydia
Common Presentation of GIB
Urosepsis
Acute Arterial occlusion - to lower extremities
16. 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)
What to do with weak/thready pulses
Divertriculitis
Placental Abruption
EKG changes
17. 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 Infectious diarrhea Shigella
SBO
Bradycardia
Initial steps in stabilizing a patient
18. Check Vital Signs
19. Chinese food bug - Fever - abdo pain - blood diarrhea - lasts x 1 week.Get from dirty wateror poultry - may cause/trigger Guillan Barre
Types of Infectious diarrhea Campylobacter
Urosepsis
Tx of CHF
Acute Mesenteric Ishemia
20. 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
GIB work up
Ovarian Cysts
UTI
The vital signs
21. 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
Common risk factors for UGIB
Additional cardiac Tests
Symptoms of Ruptured ovarian cysts
GIB work up
22. Due to chromosomal abnormalities - check Rubella a) Threatened abortion if - 1st trimester vag bleed - < 20 weeks GA - os closed - membranes intact - some cramping. Tx - pelvic rest - bed rest - close OB GYN f/you b) Inevitable abortion - if < 20 wee
Early miscarriage (20 weeks)
Other major arteries
Define Biliary colic
Anteroseptal leads and Anterior
23. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Acute Mesenteric Ishemia
Types of Infectious diarrhea Shigella
Urosepsis
Miscarriage
24. 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
UTI
Define Biliary colic
Cardiac Enzymes
Dx of Aortic dissection
25. 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
Supplemental O2
Genital Herpes
Stable vs unstable angina`
What is a large bore IV?
26. 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
When to do a pelvic exam
Common risk factors for UGIB
Tx of CHF
Viral Gastroenteritis
27. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Emergency Severity Index
When are Beta Blockers contraindicated
Ovarian Torsion
28. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Pain scale for infants
Incidence of AMI
LCA
What is a large bore IV?
29. 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)
Defibrillation
Dx of Aortic dissection
Incidence of AMI
When to do a pelvic exam
30. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Common risk factors for LGIB
STEMI vs Nstemi
SBO
Ectopic Pregnancy
31. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Aortic Dissection definition - risks and S/S
Urosepsis
ED work up for cholecystitis
Kidney Stones
32. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Incarcerated vs strangulated hernias
ED Tx of GIB
Define Biliary colic
How to monitor CDAB
33. 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
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Types of Infectious diarrhea Yersinia
Tx of Unstable Angina
34. 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)
Triage
RCA
Additional cardiac Tests
When is Rho GAM used
35. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Where to check pulses
Types of Infectious diarrhea Yersinia
Placenta Previa
Ovarian Cysts
36. 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:
When to do a pelvic exam
Appendicitis
ED workup of kidney stones
Ovarian Torsion
37. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Hypertensive Emergency
Common risk factors for UGIB
Defibrillation
Advanced airway techniques
38. 16-18 Gauge
What is a large bore IV?
Early miscarriage (20 weeks)
Common risk factors for LGIB
ED Tx of GIB
39. 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
What should be done after CDAB's
Initial steps in stabilizing a patient
Incomplete abortion
When is Rho GAM used
40. 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
Gonorrhea
Chlamydia
Types of Infectious diarrhea Campylobacter
Volvulus
41. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
When is Rho GAM used
Other major arteries
Common Presentation of GIB
LBO - Large bowel obstruction
42. 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
Defibrillation
How to monitor CDAB
Define Acute Cholecystitis
43. 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
Triage
Breathing
Initial steps in stabilizing a patient
Placenta Previa
44. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
LCA
Stable vs unstable angina`
SBO
Types of Infectious diarrhea Shigella
45. 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
Ovarian Torsion
Types of Infectious diarrhea E coli
Testicular Torsion
Pancreatitis work up
46. 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
ED treatment of a Miscarriage
Bradycardia
Ovarian Torsion
Contraindications for thrombolytics
47. 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
When to do a pelvic exam
Syphillis
Chlamydia
EKG changes
48. 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
Common Presentation of GIB
Abdominal Aortic Aneurysm
Missed Abortion
Pericarditis
49. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Other major arteries
ED workup of kidney stones
Tx of Unstable Angina
Cardiac Tamponade
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
Incomplete abortion
Breathing
Symptoms of Ruptured ovarian cysts
Kidney Stones