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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. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Appendicitis work up
When to do a pelvic exam
ED Tx of GIB
Other major arteries
2. 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
Divertriculitis
ED Tx of GIB
When is Rho GAM used
What should be done after CDAB's
3. 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)
When is Rho GAM used
Acute Coronary syndrome
How to monitor CDAB
Endocarditis
4. 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
Endocarditis
What should be done after CDAB's
Pericarditis
Chlamydia
5. Old age - chronic anticoagulation - divertriculosis
Types of GI bleeds
Placenta Previa
Common risk factors for LGIB
Common Presentation of GIB
6. V1-V2 Right Posterior Descending Artery
Hypertensive Emergency
Posterior
STEMI vs Nstemi
UTI
7. 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
ED Tx of GIB
Hypertensive Emergency
Common risk factors for LGIB
LBO - Large bowel obstruction
8. 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
Where to check pulses
Appendicitis
SBO
Testicular Torsion
9. LMA: Laryngeal Mask Airway - Cricothyroidotomy -surgical airway done as last resort when unable to maintain oxygenation with other methods
Appendicitis work up
Viral Gastroenteritis
Advanced airway techniques
Types of GI bleeds
10. II - III - aVF - Means RCA involved
Divertriculitis
Supplemental O2
Inferior leads
Contraindications for thrombolytics
11. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Appendicitis
When is Rho GAM used
Acute Arterial occlusion - to lower extremities
Define Acute Cholecystitis
12. 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
Abdominal Aortic Aneurysm
Early miscarriage (20 weeks)
Cardiac Tamponade
13. Inflammation of the pericardial sac with or without effusion - S/S: sharp - pleuritic chest pain that's worse when laying down - pericardial friction rub on exam - ST elevations in ALL leads!!! - depressed PR intervals
Pericarditis
Pancreatitis work up
Chlamydia
Other major arteries
14. 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
Other major arteries
LBO - Large bowel obstruction
Aortic Dissection definition - risks and S/S
Anteroseptal leads and Anterior
15. 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
Divertriculitis
Genital Herpes
What is a large bore IV?
Volvulus
16. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Common Presentation of GIB
Incarcerated vs strangulated hernias
Abdominal Aortic Aneurysm
Gonorrhea
17. 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
ED work up for cholecystitis
Supplemental O2
LCA
Initial steps in stabilizing a patient
18. Left coronary artery (short and branches quickly)
Appendicitis
Pancreatitis work up
LCA
What should be done after CDAB's
19. 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
Causes of 3rd trimester bleeding
Syphillis
Bradycardia
Emergency Severity Index
20. 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
Placenta Previa
When is Rho GAM used
Types of Infectious diarrhea Shigella
The vital signs
21. 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
Cardiac Tamponade
Urosepsis
LBO - Large bowel obstruction
22. Check Vital Signs
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23. 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
ED work up for cholecystitis
Incarcerated vs strangulated hernias
Appendicitis work up
Types of GI bleeds
24. Leads I - aVL - V4-V6 - Left circumflex artery
Define Acute Cholecystitis
Emergency Severity Index
Tx of Unstable Angina
Lateral Leads
25. 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
Ascending Cholangitis
Acute Arterial occlusion - to lower extremities
Incomplete abortion
How to assess Airway
26. 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
Cardiac Enzymes
GIB work up
Kidney Stones
27. 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
Define Biliary colic
Other major arteries
Cardiac Enzymes
28. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
LCA
Stable vs. Unstable Ectopic Pregnancy
Viral Gastroenteritis
Types of Infectious diarrhea E coli
29. 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
Genital Herpes
Placenta Previa
Miscarriage
30. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Types of Infectious diarrhea Shigella
STEMI vs Nstemi
Miscarriage
Ovarian Torsion
31. 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
Ascending Cholangitis
Inferior leads
When are Beta Blockers contraindicated
Endocarditis
32. 16-18 Gauge
Breathing
What is a large bore IV?
Inferior leads
The vital signs
33. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Endocarditis
The vital signs
Ectopic Pregnancy
Kidney Stones
34. RUQ/epigastric pain - lasts 30 min to 6 hours - once gallbladder contracts and it relieves the obstruction - pain resolves - NO Fever
Initial steps in stabilizing a patient
Define Biliary colic
Breathing
Placenta Previa
35. 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)
DUKE criteria for endocarditis
Contraindications for thrombolytics
Volvulus
Acute Arterial occlusion - to lower extremities
36. Spontaneous abortion - Never CALL IT ABORTION IN FRONT OF PATIENT
Types of Infectious diarrhea Campylobacter
Miscarriage
Types of Infectious diarrhea Shigella
Define Biliary colic
37. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Stable vs. Unstable Ectopic Pregnancy
LCA
Supplemental O2
LBO - Large bowel obstruction
38. 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)
Missed Abortion
Bradycardia
Placental Abruption
Viral Gastroenteritis
39. Start IVF resuscitaiton - IV access or IO as second option - Thready pulses indicate hypotension and poor perfusion - Check frequent BP to reassess
When are Beta Blockers contraindicated
Ectopic Pregnancy
What to do with weak/thready pulses
Genital Herpes
40. 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
Common risk factors for LGIB
When is Rho GAM used
Tx of CHF
Kidney Stones
41. 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
Divertriculitis
Stable vs. Unstable Ectopic Pregnancy
Acute Coronary syndrome
Types of Infectious diarrhea Campylobacter
42. 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)
Stable vs unstable angina`
Defibrillation
Incidence of AMI
Types of Infectious diarrhea Shigella
43. 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? -
Inferior leads
Tx of Unstable Angina
Urosepsis
Abdominal Aortic Aneurysm
44. 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
Chlamydia
What to do with weak/thready pulses
Testicular Torsion
Dx of Aortic dissection
45. Common complication after an AMI - S/S: edema - elevated JVP - hepatojugular reflux - pulm rales - rhochi - decrease BS - +/- cardiac murmurs - low O2 sat - elevated BNP
Dx of Aortic dissection
ED work up for cholecystitis
Types of Infectious diarrhea Yersinia
CHF
46. 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
Where to check pulses
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Volvulus
Types of Infectious diarrhea E coli
47. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
RCA
Supplemental O2
Breathing
Placental Abruption
48. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
Early miscarriage (20 weeks)
The vital signs
Stable vs. Unstable Ectopic Pregnancy
49. Gram negative - bad eggs - dairy - poultry. - S/S: bloody diarrhea - fever - abd pain - Resolves in 10-14 days.
DUKE criteria for endocarditis
Defibrillation
Types of Infectious diarrhea - Salmonella
Incidence of AMI
50. 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
Cardiac Enzymes
Volvulus
Stable vs unstable angina`
ED work up for cholecystitis