Emergency Medicine Flashcards

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1
Q

If a pt is 12+ weeks pregnant, what type of bedside US should be performed?

If a pt is 10-12 weeks pregnant, what type of bedside US should be performed?

A

12+ weeks: Transabdominal

10-12 weeks: Transvaginal

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2
Q

A pt reports to the ED w/ obvious ascites. When performing a paracentesis with a 60 cc syringe, you notice the fluid is very yellow. What medical condition could the patient have that would cause his ascites to be this color?

A

Liver cirrhosis

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3
Q

When performing a paracentesis, you should pull down on the pt’s abd, approximately __-__ cm. After drawing fluid, you should analyze it for what?

A

1-2 cm; infection

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4
Q

You have expertly repaired a child’s laceration on their face with beautiful suture technique. When giving the patient discharge instructions, you inform them that they will need to return to have the sutures removed in __-__ days.

A

3-5

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5
Q

If the patient’s sutures were placed on the lips, mouth, or tongue, you should send the patient home with what?

A

A Rx for oral abx

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6
Q

A pt presents to the ED with a swollen knee. You are concerned that she may have a septic joint. What are your next steps?

A

Perform arthrocentesis: remove fluid and send for analysis as a septic joint could lead to loss of the joint or limb. Rx abx.

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7
Q

A pt presents to the ED with a swollen knee. You are concerned that she may be experiencing an inflammatory process like gout. What are your next steps?

A

Arthrocentesis: remove fluid, send fluid for analysis looking for crystals etc, refer to a rheumatologist

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8
Q

Where can abscesses occur?

A

Anywhere!

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9
Q

You have just drained an abscess in a pt’s mouth. Do you pack it with sterile gauze? Should you send the pt home with anything?

A

No, you do not use packing in the mouth

Yes, abx Rx

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10
Q

With orbital or preseptal cellulitis is there a concern for vision loss?

A

Orbital cellulitis presents a concern for losing vision

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11
Q

Before performing an I&D of a pt’s paronychia, you need to numb the site. How is this performed? How long will you need to wait before the site is numb?

A

Digital block; 20-30 minutes for numbness to reach tip of finger

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12
Q

Pt presents to the ED with an abscess. She has never had one before. You perform an I&D following proper technique. The pt has no known Hx of MRSA infection. Does this pt require abx?

A

No; would Rx abx if pt had Hx of multiple abscesses or MRSA

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13
Q

A pt presents to the ED and mentions that she has a pilonidal cyst. Being a smart PA, you know that a pilonidal cyst is located ____ and is a cyst that has become infected. She has no Hx of MRSA infection. After performing an I&D of the pilonidal cyst, do you Rx abx?

A

Gluteal region

Yes, you would Rx abx after performing an I&D of a pilonidal cyst.

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14
Q

What imaging study can be utilized to assess an abscess for fluctuance, or relative “ripeness”?

A

US

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15
Q

Where is a Bartholin gland cyst usually located?

A

Usually at 3/4 o’clock or 7/8 o’clock posterior/lateral to the vaginal opening, anterior to the rectum

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16
Q

Do you drain a Bartholin gland cyst?

A

No

17
Q

After incision, what do you insert in a Bartholin gland cyst in order to help it drain?

A

Word catheter

then have pt f/u w/ GYN

18
Q

What are the two sizes of sterile gauze typically associated with I&D kits?

A

1/4 inch and 1/2 inch

19
Q

What is CroFab used for?

A

Snake bites or other envenomation

20
Q

Level 1-5?
High risk of deterioration, or signs of a time-critical problem
i.e. cardiac related CP, asthma attack

A

2 (Emergent)

21
Q

Level 1-5?

Immediate, life-saving intervention required without delay, i.e. cardiac arrest, massive bleeding

A

1 (Resuscitation)

22
Q

Level 1-5?
Stable, with only one type of resource anticipated (such as only an X-ray, or only sutures)
i.e. simple laceration, pain on urination

A

4 (Less Urgent)

23
Q

Level 1-5?
Stable, with multiple types of resources needed to investigate or treat (such as lab tests plus X-ray imaging)
i.e. abd pain, high fever with cough

A

3 (Urgent)

24
Q

Stable, with no resources anticipated except oral or topical medications, or prescriptions
i.e. rash, Rx refill

A

5 (Nonurgent)

25
Q

What does the primary survey consist of?

A

ABCDE

26
Q

What does ABCDE stand for?

A
Airway patency and c-spine protection
Breathing and ventilation
Circulation and hemorrhage control
Disability and neurological status
Exposure/Environmental control
27
Q

What is an AMPLE history?

A
Allergies
Medications
PMHx
Last meal
Events leading up to ED visit
28
Q

What does the secondary survey consist of?

A

A head to toe physical examination

29
Q

Examples of life-threatening abd pain include…

A
Abdominal aortic aneurysm
Bowel obstruction
Ruptured ectopic pregnancy or ectopic pregnancy
Splenic rupture
Myocardial infarction
Mesenteric ischemia
GI perforation
Testicular torsion
Ovarian torsion
30
Q
The following conditions may present as pain in what abd quadrant?
Retrocecal appendicitis
Empyema
Gallbladder and biliary tract
Hepatitis
Hepatomegaly
Peptic ulcer
Pancreatitis
Renal pain
Herpes zoster
MI
PNA
A

RUQ

31
Q
The following conditions may present as pain in what abd quadrant?
Appendicitis
Diverticulitis
Intestinal obstruction
Leaking aneurysm
Abdominal wall hematoma
Ectopic pregnancy
Ureteral calculi
Renal pain 
Psoas abscess
Seminal vasculitis
A

LLQ

32
Q
The following conditions may present as pain in what abd quadrant?
Appendicitis
Intestinal obstruction
Regional enteritis
Diverticulitis
Perforated ulcer 
Ectopic pregnancy
Ovarian cyst or torsion
Endometriosis
A

RLQ

33
Q
The following conditions may present as pain in what abd quadrant?
Gastritis
Empyema
Pancreatitis
Splenic (enlargement, rupture, aneurysm, infraction)
MI
Renal pain
Herpes zoster
PNA
A

LUQ

34
Q

Reportable events include examples of complaints like …

A

Animal bites, STDs, child abuse, sexual abuse