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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. 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
DUKE criteria for endocarditis
Genital Herpes
Other major arteries
Define Acute Cholecystitis
2. 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
Endocarditis
Testicular Torsion
EKG changes
Pancreatitis work up
3. 'trier' - to separate - sift or select based on priority of condition
LBO - Large bowel obstruction
Emergency Severity Index
Inferior leads
Triage
4. 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
Tx of Unstable Angina
Pancreatitis work up
Ascending Cholangitis
Early miscarriage (20 weeks)
5. Explosive - frothy and foul smellng diarrhea - Entamoeba hystlytica - crypto - isospora (HIV)
Tx of Unstable Angina
ED work up for cholecystitis
DUKE criteria for endocarditis
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
6. 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
What should be done after CDAB's
Abdominal Aortic Aneurysm
Types of Infectious diarrhea E coli
Syphillis
7. 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)
Divertriculitis
CHF
Bradycardia
Ovarian Cysts
8. 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
Common risk factors for LGIB
ED workup of kidney stones
Breathing
Types of Infectious diarrhea Campylobacter
9. 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
Tx of CHF
Pericarditis
The vital signs
ED treatment for Ectopic Pregnancy
10. 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
Viral Gastroenteritis
LBO - Large bowel obstruction
Kidney Stones
11. 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
Where to check pulses
Common risk factors for LGIB
Viral Gastroenteritis
Endocarditis
12. 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
Causes of 3rd trimester bleeding
Placenta Previa
Urosepsis
ED Tx of GIB
13. 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
Syphillis
Define Biliary colic
Types of Infectious diarrhea Yersinia
ED Tx of GIB
14. 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
Pain scale for infants
Types of Infectious diarrhea - Salmonella
Triage
Kidney Stones
15. Especially O157: H7 causes enterohemorrhagic diarrhea. Inundercooked beef - complicated by hemolytic uremic syndrome and TTP
Types of Infectious diarrhea E coli
Placenta Previa
Ovarian Torsion
Stable vs unstable angina`
16. 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
Tx of Unstable Angina
Symptoms of Ruptured ovarian cysts
Genital Herpes
Stable vs. Unstable Ectopic Pregnancy
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)
Acute Coronary syndrome
Inferior leads
When is Rho GAM used
Symptoms of Ruptured ovarian cysts
18. 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
Tachycardia
Pain scale for infants
Tx of CHF
ED treatment of a Miscarriage
19. Left coronary artery (short and branches quickly)
How to assess Airway
LCA
Emergency Severity Index
Miscarriage
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
Hypertensive Emergency
Cardiac Enzymes
Placenta Previa
Stable vs unstable angina`
21. 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
Defibrillation
ED treatment of a Miscarriage
What should be done after CDAB's
Ascending Cholangitis
22. V1-V3 - V2-V4 Means LAD (left anterior descending) involved
Volvulus
Triage
Anteroseptal leads and Anterior
ED treatment for Ectopic Pregnancy
23. II - III - aVF - Means RCA involved
UTI
Stable vs unstable angina`
Inferior leads
Appendicitis
24. life threatening pericardial effusion -S/S: muffled heart sounds - JVD - hypotension - pulsus paradoxus - Water bottle heart on CXR - ellarged heart Tx: peicardiocentesis
Incarcerated vs strangulated hernias
Cardiac Tamponade
Types of GI bleeds
What should be done after CDAB's
25. 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
Aortic Dissection definition - risks and S/S
Bradycardia
SBO
How to monitor CDAB
26. 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
Types of Infectious diarrhea - Salmonella
ED treatment for Ectopic Pregnancy
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
Contraindications for thrombolytics
27. 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
EKG changes
Hypertensive Emergency
Lateral Leads
Aortic Dissection definition - risks and S/S
28. Sepsis due to urologic infection - common in elderly - 2 large bore IV - crystalloid IVF - Blood cultures - IV antibiotics - hosptial admission
Urosepsis
Ovarian Torsion
Endocarditis
What should be done after CDAB's
29. 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
ED treatment for Ectopic Pregnancy
Acute Coronary syndrome
Missed Abortion
Initial steps in stabilizing a patient
30. Abd pain: varies - achy - burning - Melena: dark - tarry stool (UGIB) - Hematemesis - vomiting blood - Hematochezia - BRBPR - Hypotension - tachycardia - Pallor - Guaiac + rectal exam
Common Presentation of GIB
What to do with weak/thready pulses
Defibrillation
Dx of Aortic dissection
31. V1-V2 Right Posterior Descending Artery
Types of GI bleeds
Define Acute Cholecystitis
Posterior
The vital signs
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
Stable vs. Unstable Ectopic Pregnancy
SBO
ED workup of kidney stones
EKG changes
33. 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
Acute Mesenteric Ishemia
Posterior
Pericarditis
Defibrillation
34. Check Vital Signs
35. Leads I - aVL - V4-V6 - Left circumflex artery
Lateral Leads
Viral Gastroenteritis
SBO
Volvulus
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:
Ovarian Torsion
Advanced airway techniques
What is a large bore IV?
Types of Infectious diarrhea Protozo -Giardia (dirty water sources)
37. On ANY FEMALE WITH ABDOMINAL PAIN- including bimanual vagino-rectal exam
Volvulus
When to do a pelvic exam
Urosepsis
Lateral Leads
38. 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)
Missed Abortion
ED Tx of GIB
Kidney Stones
Defibrillation
39. STEMI - due to complete arterial occlusion NSTEMI - ARTERY NOT completely blocked or have collateral vessels
Posterior
STEMI vs Nstemi
Emergency Severity Index
Supplemental O2
40. 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
STEMI vs Nstemi
How to monitor CDAB
RCA
Chlamydia
41. 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)
Define Biliary colic
Acute Arterial occlusion - to lower extremities
DUKE criteria for endocarditis
Define Acute Cholecystitis
42. 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
Incarcerated vs strangulated hernias
Causes of 3rd trimester bleeding
Incidence of AMI
GIB work up
43. 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
EMTALA
Common risk factors for UGIB
Dx of Aortic dissection
When is Rho GAM used
44. 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
Tachycardia
Define Acute Cholecystitis
LBO - Large bowel obstruction
ED Tx of GIB
45. 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
Acute Mesenteric Ishemia
Abdominal Aortic Aneurysm
Symptoms of Ruptured ovarian cysts
Ascending Cholangitis
46. Old age - chronic anticoagulation - divertriculosis
Appendicitis
Symptoms of Ruptured ovarian cysts
ED Tx of GIB
Common risk factors for LGIB
47. LAD - Left Anterior Descending Artery (anterior) - Diagonal branch of LAD (anterior) - Left Circumflex artery (posterior) - Obtuse Marginal Artery
Other major arteries
CHF
ED Tx of GIB
Pain scale for infants
48. 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
Endocarditis
Ectopic Pregnancy
Dx of Aortic dissection
Ascending Cholangitis
49. 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
Incomplete abortion
Cardiac Tamponade
Endocarditis
Gonorrhea
50. 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
Stable vs. Unstable Ectopic Pregnancy
GIB work up
Miscarriage
Volvulus