Review Questions from Guide Flashcards
What are the 5 vital signs:
O2 Sat, RR, HR, BP, Temp
What other past histories would suggest that a pt has CAD?
MI, CABG, stents, angioplasty
Does PMHx of CVA mean the pt has CAD?
no
Explain the diff b/t CAD and MI
CAD leads to MI
If someone has a PMHx of A-Fib or CHF do they also have CAD?
no
What are the cardiac risk factors?
HTN, HLD, CAD, DM, smoking, FHx of MI <55 yo
Name 2 ways that an MI can be diagnosed?
Troponin, EKG
What are some assoc sx of MI other than CP?
Diaphoresis, N/V
What are some assoc sx of CHF?
SOB, pedal edema, orhopnea
What would be the CC of a pt with a PE?
CP or SOB
What are the risk factors for a PE?
DVT, pregnancy, BCP, cancer, immobility
What study would diagnose a PE?
CTA w/contrast or VQ scan depending on Creat levels
What is a PTX?
collapsed lung
What is the difference b/t a nebulizer and inhaler?
nebulizer is the machine that gives breathing treatments. inhaler is portable, mostly used for an attack
What is asthma?
inflammation of the bronchioles
What might a person with PNA complain of?
SOB or productive cough
Name the 7 areas of the abdomen
RUQ, LUQ, RLQ, LLQ, periumbilical, suprapubic, epigastric
What might someone with GERD complain of?
epigastric burning
For older pt with GERD, what other disease must be r/o?
CAD
What does bile do and where is it stored?
liver, digests fat
What might be the CC of a pt with gallstones?
RUQ pain
What PE finding is closely associated with Cholecystitis
Murphy’s sign
How are gallstones Dx?
US RUQ
Name associated sx of appendicitis:
fever, N/V, decreased appetite
How is appendicitis Dx?
CT A/P w/PO
What would someone with pancreatitis c/o?
epigastric or LUQ pain
How is pancreatitis Dx?
elevated Lipase
Name four possible CCs for a GI bleed pt.
hematemesis, coffee ground emesis, melena, hematochezia
How is a GI bleed Dx in the ED?
guaiac test, poop test
What will be the CC for someone with diverticulitis?
LLQ pain
What studies would Dx diverticulitis?
CT A/P w/PO
What might a person with a SBO c/o?
abd pain, vomiting
How is a SBO Dx?
CT A/P w/PO
What will be the CC of someone with a UTI?
dysuria
How is a UTI Dx?
urine dip or UA
What might a person with kidney stones c/o?
flank pain and dysuria
How are kidney stones Dx?
CT A/P NO CONTRAST
How is an ectopic pregnancy Dx?
US Pelvis
What is ovarian torsion?
twisted ovarian artery
How is ovarian torsion Dx?
US pelvis
What sx might a person with a brain bleed c/o?
sudden onset headache
What study would Dx a brain bleed?
CT head or LP
What sx would a person with an Ischemic CVA c/o?
FNDs
How is an ischemic CVA Dx?
clinically
What is a common cause of sz in children?
fever
What are 3 symptoms of meningitis?
fever, headache, neck stiffness
What are 4 causes of AMS?
infection, intoxication, hypoglycemia, neurological
How is AMS different than FND?
AMS is generalized, affecting the whole brain, FNDs affect specific functions
What are the risk factors for a DVT?
PHx, recent surgery, LE casts, BCP, pregnancy, smoking
what are common signs of a DVT?
calf pain, cords, Homan’s sign
What is an aortic dissection?
separation of muscle wall from membrane of artery
What are 3 symptoms of cellulitis?
red, swollen, tender, warm skin
What are the ONLY three symptoms of a true allergic reaction?
itching, swelling, rash
How can DKA be Dx?
ABG/VBG showing low pH
Name 5 (of 8) elements of the HPI:
- onset
- timing
- location
- quality
- severity
- modifying factors
- associated sx
- context
Name 8 of the 14 body systems listed in the ROS:
- constitutional
- integumentary
- CV
- MS
- GI
- GU
- Endocrine
- Lymph
- ENT
- Eyes
- Neuro
- Respiratory
- Psychiatric
- Immunologic
Can the symptoms in the HPI ever contradict the symptoms in the ROS?
no
What do you need to remember to document in the HPI and ROS for any pt that is unconscious or incapable of providing information?
“Complete HPI/ROS is not possible due to patient’s status”
Name one (of five) detail that is important to document if the patient has been evaluated in the past for a similar complaint:
- what symptoms prompted the prior evaluation.
- How long agoe did the prior evaluation occur?
- Who did they see (Name/specialty)
- What treatment did they receive?
- What diagnosis was given?
What is the formula for writing an HPI? (7 steps)
- age/sex
- complaint/onset
- quality, location, timing
- modifying factors
- assoc sx
- pertinent negs
- other important context
What does MOI stand for in a Trauma HPI?
Mechanism of Injury
Name 3 PSHx that indicate the pt has a history of CAD
angioplasty, cardiac stent, CABG
What are the risk factors of a CVA?
HTN, HLD, DM, smoking, FHx CVA, HxTIA/CVA, Afib
Describe the G/P/A
Gravida: # times pt has been pregnant
Para: # live births
Abort: # miscarriages or elective abortions
If a pt has pale conjunctiva what does that indicate?
anemia
What is scleral icterus and what does it indicate?
Yellow sclera, liver failure
Name an instrument a physician may use to closely investigate the eyes.
Opthalmoscope
In which body system would you document “TM erythema and bulging.”?
ears
What is the medical term for nostril?
naris singular, nares plural
What would dry mucous membranes indicate?
dehydration
Why is midline bony tenderness “worse” than paraspinal tenderness?
Midline body tenderness indicates spine damage, while paraspinal tenderness could mean kidney stones
If you saw RRR written in the cardiac exam, what do you think that might mean?
regular rate and rhythm
If the physician checks the pulse on the right wrist and says “The pulses are fine”, what would you document?
right radial pulse is 2+
Name 2 peritoneal signs in the abdominal exam:
voluntary/involuntary guarding, rebound tenderness, rigidity
What abdominal sign is indicative of Cholecystitis?
Murphy’s sign
If the doctor takes 1 finger and presses in a specific spot in the RLQ what is the name of the finding they are investigating?
McBurney’s point tenderness, looking for appendicitis
Which of these is not a peritoneal sign? Guarding, Rebound, Tenderness, Rigidity?
Tenderness
What phrase do you have to document in the GU for every female pelvic exam performed by a male physician?
“female chaperone present”
What is bony tenderness a sign of?
injury/trauma
What is CVA tenderness?
costovertebral tenderness, could be a sign of kidney stone or kidney damage, pyelonephritis
What is fluctuance a sign of?
presence of pus, bacterial infection
What section of the neurological exam would you document “normal finger-nose-finger test” and “normal heel-to-shin”?
cerebellum exam
What does DTR stand for?
deep tendon reflex
What part of the body do the cranial nerves control?
the face
In the psychiatric exam, what do SI and HI stand for?
Suicidal Ideation, Homicidal Ideation
Is the Glascow Coma Scale (GCS) associated with Trauma pts or Medical pts?
trauma
Would you document RUE strength 3/5 under the neurological or extremities section of the exam?
extremities
What does TTP mean?
tender to palpation
A mother states that her child has been extremely tired and drowsy recently; based on that can you document “lethargic” in the child’s PE?
no
What is the medical term for hives?
urticaria
What is the medical term for swollen lymph nodes?
lymphadenopathy
What lab order contains the “H&H”?
CBC
What is the difference between the BMP and the CMP?
The CMP includes the BMP and adds the LFTs
What part of the CBC does the “differential” further characterize?
the WBC
What does Creatinine measure?
Kidney function
Which cardiac enzyme is more specific to heart damage? Troponin or CK-MB?
Troponin
What does a negative D-dimer mean?
no PE
What does a postive D-Dimer mean?
possible PE, order a VQ scan or CTA chest to r/o
What does an elevated BNP diagnose?
CHF
Name some parts of the cardiac order set
CBC, BMP, CK, CK-MB, Troponin, EKG, CXR
What do Coag tests determine?
the viscosity of blood
What does lipase diagnose?
pancreatitis
What do both CRP and ESR test for?
inflammation
What is the difference between a urine dip and a urine micro?
urine micro is more accurate, quantitative analysis
What are the efficiency labs?
D-dimer, troponin, creatinine
Do emergency physicians interpret XRs or CTs?
XRs
What is the difference between a CTA and a CT
the A is for angiogram
Name some orthopedic procedures that may be performed by the EP
arthrocentesis, joint reduction, splint application
Name some procedures that qualify the pt for critical care:
chest tube, CPAP/BiPAP,
What does LAD stand for as an EKG abbreviation?
Left axis deviation
Name two diagnoses that would qualify a pt for critical care time
sepsis, PTX,
