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Emergency Medicine > Emergency Medicine3 > Flashcards

Emergency Medicine3 Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Q400. treatment of temporal arteritis?

A

A400. prednisone 60mg po, arrange a biopsy to confirm diagnosis

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2
Q

Q401. Often compression of ______________ can improve the pain of migraine?

A

A401. the ipsilateral superficial temporal or carotid artery

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3
Q

Q402. ergotamine is contraindicated in… ? Should be used w/ caution in ….?

A

A402. Pregnancy; Caution in HTN or CAD

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4
Q

Q403. Patients should avoid _____ while in the midst of cluster headaches?

A

A403. Alcohol

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5
Q

Q404. This causes headaches often in overweight women in their 30s…

A

A404. Pseudotumor Cerebri (benign intracranial HTN)

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6
Q

Q405. 90% of patients with Pseudotumor Cerebri have ….?

A

A405. papilledema

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7
Q

Q406. in Pseudotumor Cerebri, head CT will show…? LP will show…?

A

A406. CT - slit-like ventricles; LP - increased opening pressure

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8
Q

Q407. treatment of Pseudotumor Cerebri..?

A

A407. Acetazolamide 250 mg pid

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9
Q

Q408. treatment of post LP HA?

A

A408. caffeine sodium benzoate

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10
Q

Q409. cherry-red coloration of skin/mucous membranes, retinal hemorrhages, AMS?

A

A409. CO poisoning

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11
Q

Q410. sudden onset of head/eye pain, decreased visual acuity?

A

A410. Acute angle closure glaucoma

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12
Q

Q411. treatment of acute uncomplicated UTI?

A

A411. Bactrim for 3 days

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13
Q

Q412. Pyelonephritis w/ systemic sx tx?

A

A412. admit for IV antibiotics

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14
Q

Q413. pregnant women with UTI tx?

A

A413. macrobid for 7 days

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15
Q

Q414. What % of pts presenting with classic UTI sx show minimal to no bacteria on UA?

A

A414. 30-40%

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16
Q

Q415. Sudden onset of testicular pain in children and young men?

A

A415. Testicular torsion

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17
Q

Q416. most common cause of urinary retention?

A

A416. BPH

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18
Q

Q417. >100 ml postvoid residual urine volume is diagnostic of…?

A

A417. urinary retention

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19
Q

Q418. what is fournier’s gangrene?

A

A418. aggressive fasciitis of the perineum in a toxic appearing pt likely with history of DM, urethral trauma, surgery, or obstruction

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20
Q

Q419. treatment of fournier’s gangrene??

A

A419. immediate surgery - complete debridement of necrotic tissue

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21
Q

Q420. tender, swollen, painful epididymis and testis usually accompanied by fever?

A

A420. Epididymitis

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22
Q

Q421. testicular US can distinguish…?

A

A421. torsion from epididymitis

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23
Q

Q422. the cremasteric reflex is present in _____ but not in ___________?

A

A422. epididymitis; torsion

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24
Q

Q423. nonspecific infection of the glans penis is called…?

A

A423. balanitis

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25
Q

Q424. abnormally small opening in the foreskin?

A

A424. phimosis

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26
Q

Q425. abnormal painful swelling of the glans penis occurring after aggressive retraction of a phimotic foreskin?

A

A425. paraphimosis

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27
Q

Q426. flank/abdominal pain, does not change with position or remaining still, radiation to groin…

A

A426. stones

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28
Q

Q427. work up of stones?

A

A427. IVF; IV narcotics; UA - will generally show hematuria; BMP

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29
Q

Q428. test of choice for kidney stones?

A

A428. noncontrast CT

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30
Q

Q429. stone <3mm probability of passing spontaneously?

A

A429. 0.8

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31
Q

Q430. Indications for urology consults or admission in kidney stones…?

A

A430. Associated UTI; uncontrolled pain/emesis; extravasation of contrast; renal failure; single kidney; hydronephrosis + hydroureter; stone > 6mm

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32
Q

Q431. in a patient >60, first time renal colic is _________ until proven otherwise…

A

A431. AAA

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33
Q

Q432. of those women who experience bleeding in the first trimester, ______________ will undergo spontaneous abortion

A

A432. 40180

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34
Q

Q433. threatened abortion…?

A

A433. vaginal bleeding with a pre-viable fetus and closed cervix

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35
Q

Q434. inevitable abortion?

A

A434. vaginal bleeding with cervical dilatation

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36
Q

Q435. incomplete abortion

A

A435. vaginal bleeding with partial passage of products of conception and dilated cervix

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37
Q

Q436. complete abortion

A

A436. passage of all products of conception and closed cervix

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38
Q

Q437. missed abortion

A

A437. fetal demise and retention of products of conception, cervix closed

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39
Q

Q438. 6-8 weeks gestation with amenorrhea, spotting, and cramping lower abdominal pain….concerning for…?

A

A438. ectopic

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40
Q

Q439. gold standard in diagnosing an ectopic?

A

A439. US

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41
Q

Q440. any patient who presents with vaginal bleeding and is _____ should be given RhoGAM?

A

A440. Rh -

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42
Q

Q441. 2 most common pregnancy related causes of vaginal bleeding in the second trimester?

A

A441. miscarriage; hydatidiform mole

43
Q

Q442. pre-eclampsia that occurs prior to 20 weeks gestation is pathognomonic for…?

A

A442. trophoblastic disease

44
Q

Q443. most common presentation of placenta previa?

A

A443. late 2nd to early 3rd trimester painless bleeding

45
Q

Q444. ____________- may occur in up to 1/3 of placental abruptions?

A

A444. DIC

46
Q

Q445. pre-eclampsia?

A

A445. triad of HTN, edema, and proteinuria of >100 mg/dl

47
Q

Q446. HELLP syndrome?

A

A446. subset of pre-eclamptic pts:; Hemolysis, Elevated Liver enzymes, and Low Platelets

48
Q

Q447. In preeclampsia and eclampsia, the most important part of the CBC is…?

A

A447. the platelet count

49
Q

Q448. seizure prophylaxis in pre, eclampsia?

A

A448. MgSO4

50
Q

Q449. preterm labor is defined as occurring…?

A

A449. before 37 weeks gestation

51
Q

Q450. Strawberry cervix?

A

A450. trichomonas

52
Q

Q451. average blood loss in normal menses/

A

A451. 30-60cc

53
Q

Q452. benign leiomyomas that develop in the uterus and often result in menometrorraghia?

A

A452. fibroids

54
Q

Q453. dysfunctional uterine bleeding tx..?

A

A453. NSAIDs, and OCPs; rule out endometrial carcinoma

55
Q

Q454. Chlamydia can cause….?

A

A454. Asymptomatic infection; Urethritis; Cervicitis; PID

56
Q

Q455. PID?

A

A455. Lower abdomen. tenderness, cervical motion tenderness, and adnexal tenderness; + fever or increased WBC or ESR etc..

57
Q

Q456. most common cause of infectious arthritis in young sexually active adults?

A

A456. Gonorrhea

58
Q

Q457. green-gray discharge?

A

A457. trichomonas

59
Q

Q458. thin-gray malodorous discharge, non sexually transmitted

A

A458. bacterial vaginosis

60
Q

Q459. most common cause of pelvic pain in women not associated with infection is…?

A

A459. Rupture of an ovarian cyst

61
Q

Q460. 50% of cases of ovarian torsion are caused by..?

A

A460. Benign dermoids that cause the ovary to twist

62
Q

Q461. A major cause of pelvic pain, dyspareunia, and dysmenorrhea

A

A461. Endometriosis

63
Q

Q462. postcoital contraception?

A

A462. norgestrel

64
Q

Q463. first, second, etc degree frostbite?

A

A463. 1st - warm, hyperemic, sensate; 2nd - clear vesicles; 3rd - purple bullae; 4th - mummification

65
Q

Q464. ED management of frostbite?

A

A464. treatment hypothermia; IVF; remove nonadherent wet apparel; rapid thawing thawing in 42C water bath; unroofing clear blisters; aloe vera; tetanus prophy; ibuprofen, ascorbic acid, nifedipine

66
Q

Q465. How to estimate total body surface area for burns..?

A

A465. 9’s; LUE - 9%,; LLE - 18%,; posterior torso - 18%,; head - 9%

67
Q

Q466. burn degrees?

A

A466. 1st - superficial epidermis (no blisters, heals w/out scar); 2nd - superficial dermis (blisters, scarring in 3 wks…); 3rd - all of dermis (charred, painless, scars with contractures)

68
Q

Q467. How do you determine IVF needs in a burn victim?

A

A467. If TBSA >15%…. 4ml x kg weight x tbsa% = total volume of replacement needed in first 24 hrs

69
Q

Q468. don’t forget _________ in frostbite, burns, and a variety of other injuries….?

A

A468. tetanus prophylaxis

70
Q

Q469. hypothermia defined?

A

A469. core temp < 35 C

71
Q

Q470. presentation of mild hypothermia?

A

A470. confusion, lethargy, fatigue, shivering, tachycardia, respiratory alkalosis

72
Q

Q471. resuscitation in severe hypothermia should include _________ in order to treat cardiac dysrhythmias…?

A

A471. Warming until core temp > 32 C

73
Q

Q472. severe dehydration, thermoregulaory failure, temp >40C, tachycardia, hypotension, confusion, rhabdo…?

A

A472. Heat stroke

74
Q

Q473. treatment of heat stroke..?

A

A473. rapid cooling, monitoring, seizure prophylaxis

75
Q

Q474. voltage > _____________ is considered high tension..?

A

A474. 1000 V

76
Q

Q475. the _________ the resistance, the more the current and damage

A

A475. less

77
Q

Q476. AC current is ___________ dangerous than DC, because?

A

A476. more; increased duration of exposure; increased likelihood of Vfib

78
Q

Q477. barotrauma of ascent?

A

A477. when a diver fails to exhale when ascending, exacerbating the overexpansion of the airspaces

79
Q

Q478. type 1 decompression sickness? type 2?; treatment if severe?

A

A478. 1 - joint, skin, bone problems; 2 - neuro, lung, CV problems; Hyperbaric oxygen chamber

80
Q

Q479. what agent can mimic acclimatized state in the treatment of altitude sickness?

A

A479. Acetazolamide - causes a compensatory respiratory alkalosis

81
Q

Q480. most infection prone bite injury?

A

A480. human bite to the hand

82
Q

Q481. ___________ is implicated in 50% of infected cat bites and 30% of infected dog bites?

A

A481. Pasteurella

83
Q

Q482. complications of this infection include encephalitis, Painaud’s, osteolytic bone lesions, purpura, and erythema nodosum

A

A482. Bartonella

84
Q

Q483. describe phases of rabies briefly?

A

A483. Incubation period - couple months; Prodrome - 1 week of localized pain, malaise, N/V; Acute neuro phase - 1 week; Coma - up to 2 weeks

85
Q

Q484. Loxosceles spider bite tx?

A

A484. wound care; antibiotics if superinfected; antihistamines and analgesics; dapsone to prevent ulceration; IV steroids in viscerocutaneous loxoscelism to prevent hemolysis

86
Q

Q485. sudden onset fever, centripetal rash spread, severe HA, myalgia, N/V, and abdominal pain

A

A485. Rocky mountain spotted fever

87
Q

Q486. treatment of rocky mountain?

A

A486. teracycline or chloramphenicol; supportive care for shock, DIC, ARDS, CHF

88
Q

Q487. complications of auricular hematoma?

A

A487. cauliflower ear, cartilage necrosis

89
Q

Q488. pathogens of otitis externa?

A

A488. pseudomonas and staph

90
Q

Q489. treatment of anterior bleeding epistaxis?

A

A489. pinching pressure, decongestion, silver nitrate, packing, abx to prevent sinusitis

91
Q

Q490. problem with posterior bleeding epistaxis?

A

A490. pharyngeally stimulated hypoxia and stopped breathing

92
Q

Q491. ____________ cures >95% of peritonsillar abscesses?

A

A491. I and D

93
Q

Q492. Ludwig’s angina? big concern?

A

A492. Trench mouth - dental origin infection of submandibular space due to horrible hygiene; Concern - airway compromise

94
Q

Q493. duck quack cry is characteristic of…?

A

A493. Retropharyngeal deep space infection

95
Q

Q494. swallowed coins appear ____________ in trachea, _____________ in esophagus?

A

A494. side on; face on

96
Q

Q495. diagnosis and treatment of esophageal foreign body?

A

A495. EGD for visualization; glucagon for esophageal relaxation

97
Q

Q496. epiglotitis has traditionally been associated with which infection?

A

A496. Hemophillus B

98
Q

Q497. diagnosis of epiglotitis?

A

A497. loss of V-shaped dip in neck plain film (valecula sign)

99
Q

Q498. if suspecting epiglotitis in kids….what next?

A

A498. call ENT or anesthesia - no IV’s, oral exam, nothing that stimulates/agitates the child

100
Q

Q499. croup? what type of cough?

A

A499. laryngotracheobronchitis - viral infection; seal-like barking cough

101
Q

Q500. difference in presentation in kids with croup vs. epiglotitis?

A

A500. in croup, kids generally appear well

102
Q

Q501. treatment of croup?

A

A501. racemic epinephrine,; humidified air,; steroids

103
Q

Q502. angioedema? tx

A

A502. inflammatory autoimmune reaction, increased capillary permeability; treatment - H1 blocker, steroids, H2 blocker, epinephrine for severe cases

104
Q

Q503. causes of pharyngitis?

A

A503. group A strep; Mono with lymphadenopathy, splenomegaly; adenovirus

Emergency Medicine (3 decks)

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