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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. Placenta previa - vaginal/cervical trauma - polyps - genital infections - hemorrhoids - onset of labor (no fetal distress) - placental abruption (have fetal distress)
STEMI vs Nstemi
Causes of 3rd trimester bleeding
Emergency Severity Index
Initial steps in stabilizing a patient
2. Obstruction of appendiceal lumen (fecalith) - leads to edema - ischemia - infection - necrosis - ? perf and peritonitis - +Rosvig's sign (push and feel on opposite side)
Urosepsis
Endocarditis
Types of Infectious diarrhea - Salmonella
Appendicitis
3. 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
Tx of Unstable Angina
EMTALA
LCA
Ascending Cholangitis
4. Fluid filled sacs within the ovary - Common in infancy and teens - Causes: ovarian stimulation (in vitro fertilization) - hypothyroid - prego - PCOS
Appendicitis work up
Stable vs. Unstable Ectopic Pregnancy
When is Rho GAM used
Ovarian Cysts
5. FLACC Face - legs - activity - cry - consolability (0 - 1 - 2)
Symptoms of Ruptured ovarian cysts
Pericarditis
Pain scale for infants
RCA
6. 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
Pain scale for infants
Types of Infectious diarrhea Campylobacter
Aortic Dissection definition - risks and S/S
Volvulus
7. HR/pulse: 60-100 - Bp: 120/80 - Resp rate: 16-20 - Temp 97-99 - O2 sat > 94% - Pain!!! - 6th vital sign
Where to check pulses
How to monitor CDAB
Ascending Cholangitis
The vital signs
8. V1-V2 Right Posterior Descending Artery
Posterior
Incidence of AMI
ED workup of kidney stones
EKG changes
9. Incarcerated - means cannot reduce - Strangulated - bowel edema is compromosing blood flow
Bradycardia
Define Acute Cholecystitis
Incarcerated vs strangulated hernias
Types of Infectious diarrhea - Salmonella
10. Often embolic phenomenon triggered by afib or endocarditis - 6 P's: Pain - pallor - paralysis - paresthesias - poikilothermia - pulselessness - DX: dopplers with ABI - ankle brachial index
Acute Arterial occlusion - to lower extremities
EMTALA
Divertriculitis
Appendicitis work up
11. 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
Divertriculitis
Incomplete abortion
Triage
Define Biliary colic
12. 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)
Ranson's criteria
Gonorrhea
Placental Abruption
13. 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
Contraindications for thrombolytics
ED treatment of a Miscarriage
Types of Infectious diarrhea - Salmonella
Divertriculitis
14. 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
Acute Coronary syndrome
Placental Abruption
Testicular Torsion
Tachycardia
15. 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
UTI
Placenta Previa
ED treatment for Ectopic Pregnancy
Initial steps in stabilizing a patient
16. 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
Viral Gastroenteritis
Supplemental O2
Genital Herpes
How to assess Airway
17. 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
Ovarian Torsion
Viral Gastroenteritis
Placental Abruption
18. 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
Common risk factors for LGIB
Acute Coronary syndrome
Bradycardia
Stable vs unstable angina`
19. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Symptoms of Ruptured ovarian cysts
Cardiac Tamponade
CHF
Other major arteries
20. 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
Triage
Cardiac Enzymes
ED workup of kidney stones
RCA
21. 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
Acute Coronary syndrome
Common risk factors for LGIB
Missed Abortion
Defibrillation
22. 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)
Acute Coronary syndrome
Bradycardia
Symptoms of Ruptured ovarian cysts
EKG changes
23. Leads I - aVL - V4-V6 - Left circumflex artery
Cardiac Tamponade
Lateral Leads
ED Tx of GIB
Placenta Previa
24. O2 - 2 large bore IV's: IVF with crystalloid (NS or LR) - type and screen crossmatch - transfuse prn - OB GYN cx ASAP
ED treatment for Ectopic Pregnancy
Divertriculitis
How to monitor CDAB
Aortic Dissection definition - risks and S/S
25. 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
ED work up for cholecystitis
Acute Mesenteric Ishemia
ED treatment of a Miscarriage
Define Biliary colic
26. 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
Other major arteries
Pericarditis
Placental Abruption
How to monitor CDAB
27. Coffee bean signs on KUB for sigmoid volvulus - can also have cecal volvulus - 10% of LBO are sigmoid volvulus
Ovarian Torsion
DUKE criteria for endocarditis
Missed Abortion
LBO - Large bowel obstruction
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
Stable vs. Unstable Ectopic Pregnancy
EKG changes
Initial steps in stabilizing a patient
When are Beta Blockers contraindicated
29. 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
Define Biliary colic
Miscarriage
Tx of CHF
LCA
30. 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)
Acute Arterial occlusion - to lower extremities
Bradycardia
Acute Coronary syndrome
Supplemental O2
31. 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
Abdominal Aortic Aneurysm
Additional cardiac Tests
Emergency Severity Index
Where to check pulses
32. 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
SBO
Causes of 3rd trimester bleeding
ED Tx of GIB
Stable vs. Unstable Ectopic Pregnancy
33. 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
Appendicitis
Acute Mesenteric Ishemia
Breathing
Miscarriage
34. 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
Acute Coronary syndrome
Viral Gastroenteritis
Incidence of AMI
The vital signs
35. 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
ED treatment of a Miscarriage
Urosepsis
EMTALA
Testicular Torsion
36. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Lateral Leads
Inferior leads
Types of Infectious diarrhea E coli
Types of Infectious diarrhea - Salmonella
37. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Cardiac Tamponade
Common risk factors for LGIB
Acute Arterial occlusion - to lower extremities
Types of Infectious diarrhea Yersinia
38. 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
Appendicitis
Gonorrhea
Acute Coronary syndrome
Posterior
39. 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
Breathing
Additional cardiac Tests
Contraindications for thrombolytics
40. 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
Tx of Unstable Angina
Types of Infectious diarrhea - Salmonella
Volvulus
Pancreatitis work up
41. 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
Tachycardia
Chlamydia
Incarcerated vs strangulated hernias
Pericarditis
42. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Anteroseptal leads and Anterior
Volvulus
EMTALA
ED workup of kidney stones
43. Gram negative - contaminated salads (mayo) - dairy - mean. Severe Dysentery (bloody diarrhea)'
Miscarriage
Volvulus
Types of Infectious diarrhea Shigella
Pericarditis
44. 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
Hypertensive Emergency
Incarcerated vs strangulated hernias
Incidence of AMI
UTI
45. Right Coronary artery - SA node branch (anterior) - Acute marginal artery (anterior) - AV node branch (posterior) - Posterior descending artery (posterior)
Types of Infectious diarrhea Campylobacter
Lateral Leads
RCA
UTI
46. 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
Stable vs unstable angina`
Incidence of AMI
Symptoms of Ruptured ovarian cysts
Early miscarriage (20 weeks)
47. 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
Triage
Symptoms of Ruptured ovarian cysts
Tx of Unstable Angina
Ascending Cholangitis
48. 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
Kidney Stones
ED work up for cholecystitis
Other major arteries
Pericarditis
49. Reassess circulation: compression - check cardiac rhythm - pulse - give meds to help Bp or rhythm prn - Monitor Oxygen and IV - DDx -goalis to find and treat reversible causes
Acute Arterial occlusion - to lower extremities
Symptoms of Ruptured ovarian cysts
Ectopic Pregnancy
How to monitor CDAB
50. Left coronary artery (short and branches quickly)
LCA
Bradycardia
Causes of 3rd trimester bleeding
Genital Herpes