Final Exam Flashcards
What other past histories would suggest that a pt has CAD?
MI, angina, stents, angioplasty, CABG
Cardiac risk factors (6)
- CAD
- HTN
- DM
- dyslipidemia
- smoking
- FHx of CAD
How is CAD diagnosed?
Cardiac catheterization
Two ways an MI can be diagnosed
- NSTEMI (Elevated Troponin)
* STEMI (EKG)
Associated Sx of an MI other than CP?
SOB, diaphoresis, nausea, vomiting
Associated Sx of CHF?
SOB, Orthopnea, PND, pedal edema, DOE
What 2 studies would diagnose CHF?
CXR or elevated BNP
What is A Fib?
Atrial fibrillation: electrical abnormality in the heart causing the top of the heart to quiver
What might someone feel with A-fib?
Palpitations- fast, pounding, irregular heart beat
How is an A-Fib diagnosed?
EKG
What could be the CC of someone with a PE?
Pleuritic CP, SOB
What study would diagnose a PE?
D-Dimer (cannot diagnose) , CTA chest w/ IV contrast, VQ scan
Pneumothorax
Collapsed lung
Common cause of PTX
Trauma
How is a PTX diagnosed?
CXR
What social history will most COPD have?
Smoking
What is an inhaler?
Portable and gives a one time dose and provides a rapid release of medication
What is a nebulizer?
Home machine that delivers continuous treatment over a period of time
What is asthma?
Constricting of the airway due to inflammation and muscular contraction of the bronchioles. Reactive airway disease
What PE finding closely associated with asthma?
Wheezing
What is PNA?
Bacterial infection (infiltrates) and inflammation inside the lung
What might a person with PNA complain of?
Productive cough and fever
How is PNA diagnosed?
CXR
Layman’s name for GERD
Heart burn or acid reflux
What might someone with GERD complain of?
Epigastric pain/burning
What else might we have to R/O for GERD?
MI
What does bile do?
Bile emulsifies the fats in foods
Where is bile stored?
Gallbladder but it is made in the liver
Cholelithiasis
Gallstones
Cholecystitis
Acute inflammation of the gallbladder
What might be the chief complaint of a person with gallstones?
RUQ abdominal pain
What PE finding is closely associated with cholecystitis?
Murphy’s sign
How are gallstones diagnosed?
Abdominal US of the RUQ
Name associated symptoms of appendicitis
Fever, N/V, anorexia
What is the CC for appendicitis?
RLQ pain
How is appendicitis diagnosed?
CT A/P with PO contrast
What would someone with pancreatitis c/o?
LUQ and/or epigastric pain with N/V
How is pancreatitis diagnosed?
Elevated lipase
4 possible CC’s for a GI bleed pt
Hematemesis (blood in vomit), hematochezia (bloody stool), coffee ground emesis, melena
How is a GI bleed diagnosed in the ED?
Heme positive stool (guaiac +), gastroccult
What are we worried about for someone w/ GI bleed?
Too much blood loss, anemia
What is the pre-existing condition you must have before you can get diverticulitis?
Diverticulosis
What will be the CC for someone with diverticulitis?
LLQ pain
What studies would diagnose diverticulitis?
CT A/P w/ PO contrast
What might a person with a SBO complain of?
Abd pain/bloating, vomiting, distension, no BM’s
How is a SBO diagnosed?
CT A/P w/ PO contrast or AAS (acute abdominal series) X-Ray
What is Pyelo?
Pyelonephritis, kidney infection
CC of UTI
Dysuria, frequency, burning, hesitancy, malodorous urine
What pain would suggest Pyelo?
Flank pain, fever and dysuria
How is UTI diagnosed?
Urine dip or urinalysis (UA) showing white blood cells
What might a person with kidney stones c/o?
Flank pain, sudden onset, radiating to groin
How are kidney stones diagnosed?
CT A/P or RBC in UA
What is an ectopic pregnancy?
Tubal pregnancy, when a fertilized egg develops outside the uterus (usually in the Fallopian tube)
How is an ectopic pregnancy diagnosed?
US of the pelvis
What is an ovarian torsion?
Twisting of the ovarian artery, which reduces the blood flow to the ovary. Could result in infarct of the ovary.
How is ovarian torsion diagnosed?
US pelvis
Two types of strokes
Hemorrhagic CVA and ischemic CVA
What study would diagnose a brain bleed?
CT head or LP
How is an ischemic CVA diagnosed?
Clinically, potentially normal CT scan
What is a TIA?
Transient Ischemic attack. Temporary loss of blood supply to the brain. No permanent damage
Common cause of seizures in children
Fever
Name of the state after a seizure
Post-ictal
3 Sx of meningitis
Fever, neck pain/stiffness, HA
What study would diagnose meningitis?
LP
4 things to document for syncopal episodes/syncope?
How they felt before, during, after and how they currently feel
4 causes of AMS
Hypoglycemia, infection, intoxication, neurological
DVT
Deep vein thrombosis
Common signs of a DVT
Extremity pain, swelling (atraumatic)
AAA
Abdominal aortic aneurysm
Aortic dissection
Separation of the muscular wall from the membrane of the artery
3 Sx of cellulitis
Redness, swelling, pain to an area of the skin
Abcess
Cellulitis with flunctuance
Procedure for every abcess
I and D (incision and drainage)
Main concern with an allergic reaction
Anaphylaxis or respiratory failure
True allergic reaction
Rash, itching, swelling, SOB
Diabetic ketoacidosis
Atrial blood gas showing low pH or positive serum ketones
What is the ED physician main responsibility for psychiatric patients?
Medical clearance
3 things to document for any trauma pt
LOC, head injury, neck pain, back pain, numbness, weakness
What does MOI stand for?
Mechanism of injury
Three past surgical histories that indicate the pt has a history of CAD
Angioplasty, CABG, stents
Two types of stress test
Exercise (treadmill) stress test and nuclear (medication) stress test
Risk factors for PE
Known DVT, PMHx of DVT or PE, FHx of DVT or PE, recent surgery, CA, A-Fib, immobility, pregnancy, BCP, smoking
Risk factors for CVA
HTN, HLD, DM, Hx TIA/CVA, smoking, FHx CVA, A-Fib
PERRL
Pupils are equal round and reactive to light
AT/NC
Atraumatic/Normocephalic
NAD
No acute distress
What does pale conjunctiva indicate?
Anemia
Sclera icterus
Yellowing of the eyes. Indicates liver failure
TM erythema and bulging
Ears
Nostril
Naris
Runny nose
Rhinorrhea
What do dry mucous membranes indicate?
Dehydration
Which is worse, midline bony tenderness or paraspinal tenderness?
Bony tenderness because it points towards a spinal fracture
RRR
Regular rate and rhythm
What rhythm would the physician hear if the pt was in A-Fib
Irregularly irregular rhythm
Peritoneal signs
Guarding, rebound tenderness, rigidity
What abdominal sign is indicative of appendicitis?
McBurney’s point tenderness
What would a “guaiac positive” stool sample diagnose?
GI bleed
What is bony tenderness a sign of?
Bone deformity, fracture, or injury
What is CVA tenderness?
Flank tenderness
Incision in the skin that typically need sutures
Laceration
DTR
Deep tendon reflex
Normal finger-nose-finger test
Cerebellar
Normal heel to shin
Coordination
Normal gait
Walking normally
Glascow coma scale
Trauma
TTP
Tender to Palpation
Hives
Urticaria
Swollen lymph nodes
Lymphadenopathy
What lab order contains the HandH?
CBC
BMP
Basic metabolic panel. Contains electrolytes, kidney function, and glucose levels
CMP
Comprehensive metabolic panel. BMP and LFTs (liver function tests)
What does creatinine measure?
Renal function
High potassium level
Hyperkalemia
High sodium level
Hypernatremia
Heart damage enzyme
Troponin
Negative D-Dimer
No evidence of PE
Positive D-Dimer
Possible PE
Elevated BNP diagnose equals…?
CHF
Blood sample for Atrial blood gas (ABG) comes from…?
Artery
Cardiac order set (4)
CBC, BMP, EKG, CXR
What do CRP and ESR test for?
Inflammation
Will blood cultures result during a patient’s ED visit?
No
Three labs to track efficiency
Troponin, creatinine, D-Dimer
CTA
CT angiogram looks at the arteries (uses IV contrast)
CT
No IV contrast but may or may not use PO contrast
Types of orthopedic procedures that may be performed by the EP
Splinting, joint reduction, arthrocentesis
Procedures that qualify the patient for critical care
Cardioversion, central line placement, chest tube placement, endotracheal intubation
LAD
Left axis deviation
Redness
Erythema
Bruising
Ecchymosis
