Clin Med Test Review ?s

Front 1

What is the easiest thing to use to close a scalp wound?

Back 1

staples

Front 2

what is an emergency?

Back 2

Any condition perceived by the prudent person as requiring immediate medical or surgical evaluation and treatment

Front 3

Which federal law mandates that all emergency departments provide screening, stabilization, and appropriate transfer to all patients with any medical condition?

Back 3

1986 Emergency Medical Treatment and Active Labor Act

Front 4

thoracentesis: where do you put the needle?

Back 4

midaxillary line, on TOP of the rib, (not under because the nerve, artery, and vein are there)..this is also where you would put xlycaine to number the chest for a chest tube

Front 5

NG tubes indications:

Back 5

if someone is nauseating and vomiting and you put this in and put it on low suction you are making sure you keep the stomach empty (prevents it from filling up and them vomiting)..another reason would be in an overdose so you might wanna lavage/clean out..another reason is to get gastric contents and figure out what's in there

Front 6

arthrocentesis is for joints..reasons for this?

Back 6

find out if there is blood, serous fluid, crystals, etc

Front 7

benefit of incising and draining an abscess?

Back 7

the antibiotics can't penetrate if there is pus there and stuff..will also help to heal it and ease some of the discomfort

Front 8

an older person in the ER with a sudden onset of tearing back pain..think what?

Back 8

dissecting aortic aneurysm

Front 9

what poison would make a person go blind?

Back 9

methanol (wood alcohol)

Front 10

antidote for methanol

Back 10

ethanol

Front 11

antidote for aceteminophen poisoning

Back 11

acetylcysteine (aka mucomyst)

Front 12

SLUDGE is seen in what and stands for what?

Back 12

organophosphate poisoning and anticholinergic poisoning

salivation, lacrimation, urination, defecation, GI cramping, emesis

Front 13

burning in the chest and irritation of the mouth, N/V, diarrhea, muscle twitching is usually due to what kind of poisoning?

Back 13

arsenic

Front 14

gas/diesel smell indicates what kind of poisoning?

Back 14

CO

Front 15

heavy metal poisoning antidote (for lead, mercury)

Back 15

-****BAL (chelator of heavy metals)
-Penicillamine
-Oral succimer

Front 16

the amaneeta mushroom is a very toxic mushroom..jimson weed is another thing used and both give you symptoms of __

Back 16

SLUDGE (anticholinergic toxicity)

Front 17

bitter almond aroma indicates?

Back 17

cyanide poisoning

Front 18

garlic aroma indicates?

Back 18

arsenic or organophosphate poisoning

Front 19

TCA poisoning..give what?

Back 19

charcoal and sodium bicarb

Front 20

anthrax naturally occurs in?

Back 20

herbivores (cows, etc..things that graze on plants)

Front 21

3 main bioterrorism diseases

Back 21

anthrax, smallpox, botulism

Front 22

how is anthrax exposed to humans?

Back 22

Inhalation, ingestion, open skin exposure

Front 23

can anthrax be spread by person to person?

Back 23

no, but smallpox can be

Front 24

how can you identify smallpox?

Back 24

All the lesions are in the same stage (whereas in chicken pox they are all in different stages)

Front 25

complications of an IV?

Back 25

Infiltration, extravasation, phlebitis, infection

Front 26

.nociception is usually pain that is sent to the CNS and tells us about tissue damage..initial pain is good, chronic pain is not good..example of pain without nociception (where they don't know they are in pain)?

Back 26

Phantom limb pain (nothing is there to be injured but they are having pain)

Front 27

if a patient has epiglottitis, what should you be prepared and ready for?

Back 27

intubation

Front 28

with needle gauges, as the diameter increases, does the number of the size of needle increase of decreases?

Back 28

decrease

Front 29

where's the most common place veins are placed?

Back 29

dorsal aspect of the hand (don't put across joints, antecubital fossa, etc)

Front 30

what are signs of a basilar skull fracture?

Back 30

raccoon eyes and battle sign

Front 31

flail chest..think?

Back 31

multiple rib fractures

Front 32

in general, you wanna give crystalloid as resuscitative fluid before giving them blood, especially in people who are in shock..how much fluid do you want to give?

Back 32

two liters

Front 33

what EKG finding might you see in cardiac tamponade?

Back 33

electric alternans

Front 34

in BLUNT trauma to the abdomen, the __is the most common organ damaged.

Back 34

spleen

Front 35

In PENETRATING trauma to teh abdomen, the __ are the most common organs damaged

Back 35

liver and small bowel

Front 36

coming in with false-positive is __

Back 36

hysteria

Front 37

coming in with false-negative is __

Back 37

denial

Front 38

how do you find the exact location that a patient is hurting?

Back 38

have them point to it

Front 39

when would you not do a rectal exam?

Back 39

when the pt. doesn't have a rectum DUH

Front 40

chemical peritonitis is caused by what?

Back 40

Blood, acids, bile, pancreatic enzymes..NOT water, NOT narcotics

Front 41

what is the standard test to get to identify abdominal organ injury in a stable patient?

Back 41

CT WITH CONTRAST (if they have stones, CT without)

Front 42

if an xray shows you an upright AP film (standing) of the abdomen and you see air fluid levels, what does this indicate?

Back 42

bowel obstruction

Front 43

.if you saw free air under the diaphragm on an upright xray, what would the patient complain of? what would this be indicative of?

Back 43

shoulder pain

perforation

Front 44

what might give you rigid abdomen? non-ridig?

Back 44

A ruptured aortic aneurysm (also perforation of bowel??)

Ulcer that isn't ruptured, gastritis (cholecystitis is not rigid ??)

Front 45

When a patient has referred left shoulder pain due to diaphragmatic irritation caused by hemoperitoneum and splenic injuries it is called a () sign.

Back 45

Kehr

Front 46

When a patient has a periumbilical ecchymosis (bruise) it is called a () sign.

Back 46

Cullen

Front 47

When a patient has flank ecchymosis, it is called a () sign.

Back 47

Grey-Turner

Front 48

psoas sign

Back 48

It is elicited by performing the psoas test by passively extending the thigh of a patient lying on his side with knees extended, or asking the patient to actively flex his thigh at the hip. If abdominal pain results, it is a "positive psoas sign".

Front 49

obturator sign

Back 49

The technique for detecting the obturator sign, called the obturator test, is carried out on each leg in succession. The patient lies on his back with the hip and knee both flexed at ninety degrees. The examiner holds the patient's ankle with one hand and knee with the other hand. The examiner rotates the hip by moving the patient's ankle away from the patient's body while allowing the knee to move only inward. This is flexion and internal rotation of the hip.

(performed when appendicitis is suspected..same for psoas sign)

Front 50

What controls the flow of folks in the ER?

Back 50

the number of patients coming in

Front 51

name 3 plant-derived toxins

Back 51

nicotine, oxalate, cyanogenic glycoside

Front 52

Isotonic fluids have close to the same osmolality as serum. This means that the fluid will ().

Back 52

stay in the intravascular compartment and expand it

Front 53

Hypotonic fluids dilute the serum and decrease the serum osmolarity. What does this do to water?

Back 53

pulls water from the vascular compartment into the interstitial fluid compartment (into cells)

aka sugar water

Front 54

what do hypertonic fluids do?

Back 54

Pull fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment (fluid leaves cell & enters vessels)

Front 55

Crystalloids are ()-tonic and remain that way.

Back 55

isotonic

Front 56

Give some examples of a crystalloid solution.

Back 56

lactated ringer's and normal saline

Front 57

crystalloid solutions are ideal for?

Back 57

fluid replacement/ volume expansion

Front 58

examples of colloid solutions; what are they used for?

Back 58

albumin and steroids

-Reducing edema and expanding the vascular compartment
-They are also anti-inflammatory

Front 59

when is ipepac a good choice?

Back 59

-Ingestions are recent
-Patient is alert and has a gag reflex
-Has not ingested caustic or sedating substance