EM Exam
Terms
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- The most common organ damaged by penetrating trauma
- Liver
- CASE STUDY: Pt has massive hemothorax. Chest releases 1600mm of blood in initial chest output. What is the treatment?
- Transport immediately to surgery.
- Meniscal tears are seen best on which form of imaging?
- MRI
- What is the best pre-hospital care for MI patients?
- MONA (Morphine, Oxygen, Nitrogen, ASA)
- What percentage of heart attacks are silent?
- 30%
- If the pt's ECG presents with a long PR interval, what should you avoid giving the pt?
- Avoid giving Morphine
- What deficiency leads to presentation of Wernicke-Korsakoff Syndrome?
- Thiamine (Vitamin B1)
- What do you give a pt with altered mental status?
- Thiamine, Dextrose, Naloxlone
- You give Naloxlone to avoid intoxication of what?
- Opioids
- One ounce of whiskey, one beer, one glass of wine raises blood-alcohol level to what?
- 25mg/d
-
Calcium anion gap:
Na - (Cl + HCO3) - Answer: 20
- History most likely to cause hip dislocation
- MVA with hit to knees
- Which LeFort fracture involves maxilla, nasal bones, and medial aspects of orbits?
- LeFort II
- Orbital blow out fracture
- Ophthalmus, Diplopia, Infraorbital Hypesthesia, Inability of ocular movement
- N-AC (N-acetylcysteine) is given to a pt for intoxication of what?
- Acetaminophen
- Most snake bites occur where?
- In or near the home
- Most common ocean bite is what?
- Sting ray
- CASE STUDY: An older man is hospitalized for CHF and develops upper abdominal pain. His most likely dx is what?
- MI
- CASE STUDY: 24yo girl with LLQ pain.
- Ectopic Pregnancy
- CASE STUDY: Soapy-burn on arm
- Corrosive Alkaline
- Most common cause of facial trauma
- MVA
- Pt has a tearing pain in chest/abdomen and his BP is different in each arm. What is the likely dx?
- Dissection of aorta (AAA)
- When do most trauma deaths occur?
- Immediately
- Raccoon eyes is a sign of which fracture?
- Basilar fracture
- Colic flank pain that migrates to inguinal area is indicative of which condition?
- Passage of renal stone
- You happen upon a victim of a gunshot wound. Besides asking someone to call 911 for help, what is the top priority in management of this patient?
- Management of airway and breathing
- CASE STUDY: A pt presents post-MI with multiple PVCs. What must you monitor in this pt?
- Potassium/Magnesium
- CASE STUDY: A 20yo male presents with scrotal edema & tenderness. His cremasteric reflex is intact. WBCs are 4-6. Pt has A Fib. Your dx is?
- Epididymitis
- Pt presents with a tension pneumothorax. How should you treat the patient?
- Needle thoracotomy
- An MVA pt with minor head injury is awake and disoriented then goes unconscious. She awakens in the ambulance, and opens her eyes on command. She is oriented and converses with you. However, she is only able to localize to painful stimuli. What is her Gl
- 14
- What is a common sign found in Korsakoff Psychosis that is indicative of this disease?
- Confabulation
-
Patient has a Glasgow Coma Scale of 14. Which of the following is indicative of this score?
a) Massive head trauma
b) Minor head injury
c) Comatose
d) Stroke - b) Minor head injury
- Pt presents with motor weakness in arms greater than in legs. Which spinal cord injury may this patient have?
- Central cord syndrome
- Ipsilateral loss of motor function, proprioception, and vibratory sensation with contralateral loss of pain and temperature distal to level of injury.
- Brown-Sequard
- Dilated loops of bowel, air fluid levels, distended stomach
- Small Bowel Obstruction
- Involuntary guarding, board-like abdomen
- Peritonitis
- Which drug causes urinary retention?
- Amitriptyline (tricyclic antidepressant)
- Which is NOT indicator of pulmonary embolism?
- D-dimer
- Which is NOT a risk factor for Pulmonary Embolism?
- Diabetis Mellitus
- CASE STUDY: A lady lost lots of blood. You don't know her blood-type, but she needs an emergency blood transfusion. What blood type do you give her?
- O-negative blood
- Blood loss, initial fluid replacement
- Lactated ringers (the one without %)
- You should give all multi-system trauma patients what?
- 100% oxygen
- What do you give to MI patient?
- IV beta-blockers
-
When would you NOT give prophylactic anti-convulsant meds?
a) Previous seizures
b) Depressed skull fracture
c) Penetrating GSW (brain injury)
d) Sub-dural hemorrhage
e) Sub-arachnoid hemorrhage - e) Sub-arachnoid hemorrhage
- CASE STUDY: Pt with may have gallstones. Which imaging procedure do you initiate to confirm this?
- Ultrasound