Rmp Prep: Emergency Medicine

An electrocardiogram (ECG) is a test that measures the electrical activity of the heart. It is commonly performed on patients presenting with chest pain to evaluate for any abnormalities in the heart's rhythm or function. This test helps to diagnose conditions such as heart attacks, arrhythmias, and other cardiac abnormalities. An electroencephalogram (EEG) is a test that measures the electrical activity of the brain, and it is not directly related to chest pain. A myelogram is a test used to evaluate the spinal cord, and an esophagogram is a test used to evaluate the esophagus. Therefore, the correct test to be performed on a patient presenting with chest pain is an electrocardiogram.

The ABCs of trauma evaluation refer to airway, breathing, and circulation. This acronym is used to prioritize the assessment and treatment of a trauma patient. Airway refers to ensuring that the patient's airway is clear and open, breathing involves assessing and addressing any issues with the patient's breathing, and circulation focuses on checking for adequate blood flow and addressing any bleeding or shock. This approach helps healthcare providers quickly identify and address life-threatening issues in trauma patients.

DNR stands for "do not resuscitate." This term is commonly used in medical settings to indicate that a patient does not wish to receive cardiopulmonary resuscitation (CPR) or other life-saving measures in the event of cardiac or respiratory arrest. It is typically documented in a patient's medical records or stated in an advance directive to ensure that healthcare providers are aware of the patient's wishes.

Hypoxia is a condition characterized by below normal levels of oxygen in the body. This can occur due to various reasons such as high altitudes, lung diseases, or inadequate oxygen supply to the tissues. When the body doesn't receive enough oxygen, it can lead to symptoms like shortness of breath, dizziness, and fatigue. Hypoxia can be a serious medical condition and prompt treatment is necessary to restore oxygen levels and prevent complications.

Aspirin should be given immediately for patients with acute coronary syndrome. Aspirin is a commonly used over-the-counter medication that helps to prevent blood clot formation. Acute coronary syndrome is a condition characterized by reduced blood flow to the heart, often caused by a blood clot in the coronary arteries. Aspirin works by inhibiting the aggregation of platelets, which helps to prevent the formation of blood clots and reduces the risk of further complications in patients with acute coronary syndrome. Therefore, it is crucial to administer aspirin promptly in order to improve outcomes for these patients.

Following a motor vehicle accident, immobilizing the neck is necessary in case of a cervical injury. The neck is a vulnerable area and any trauma to the cervical vertebrae can result in serious damage to the spinal cord. Immobilization helps prevent further injury and reduces the risk of spinal cord compression or nerve damage. It also allows medical professionals to assess the extent of the injury and provide appropriate treatment.

Activated charcoal is commonly used as a treatment for poisoning because it has the ability to absorb toxins and chemicals in the digestive system. When ingested, activated charcoal binds to the toxins and prevents their absorption into the bloodstream, allowing them to be safely eliminated from the body. This makes it an effective treatment for various types of poisoning, including drug overdoses, food poisoning, and chemical exposures. Heartburn, stroke, and sunburn are not typically treated with activated charcoal.

The Glasgow coma scale is a widely used scoring system to assess impaired consciousness following traumatic brain injury. It evaluates three aspects of a patient's neurological functioning: eye-opening, verbal response, and motor response. Each aspect is assigned a score, and the total score indicates the level of consciousness. This scale helps healthcare professionals to objectively assess and monitor the severity of brain injury, guide treatment decisions, and predict outcomes.

A nasogastric tube is a medical device that is inserted through the nasal passages and into the stomach. It is commonly used for various purposes such as feeding, medication administration, or removal of stomach contents. The term "nasogastric" combines "naso" which refers to the nose and "gastric" which refers to the stomach, indicating that the tube goes from the nose to the stomach.

Fresh frozen plasma (FFP) is the correct answer. FFP is a blood product that is used to replace various clotting factors in patients who have bleeding disorders or have undergone massive blood transfusions. It contains a variety of clotting factors such as fibrinogen, factors V and VIII, and other proteins necessary for blood clotting. In this case, the patient who has been in a motor vehicle accident and received 2 units of packed red blood cells (pRBCs) may be experiencing bleeding and therefore requires FFP to replenish clotting factors and promote blood clot formation.

Epinephrine would be the treatment of choice for a severe allergic reaction because it is a fast-acting medication that can quickly reverse the symptoms of an allergic reaction. It works by constricting blood vessels, relaxing the muscles in the airways, and reducing swelling, which can help improve breathing and prevent a life-threatening reaction. Penicillin, pseudoephedrine, and sulfasalazine are not typically used in the treatment of severe allergic reactions.

Nitroglycerin would be given to a patient with angina pectoris. Angina pectoris is chest pain caused by reduced blood flow to the heart muscles. Nitroglycerin is a medication that helps to relax and widen the blood vessels, improving blood flow to the heart. It is commonly used to relieve the symptoms of angina, such as chest pain and discomfort. Ativan is a sedative, Zantac is an antacid, and acetaminophen is a pain reliever, none of which specifically target the symptoms of angina pectoris.

In a motor vehicle accident, it is common for patients to experience significant blood loss. Ordering 2 units of packed red blood cells (pRBCs) is a way to replace the lost blood and restore the patient's blood volume. This helps to ensure that the patient's vital organs receive adequate oxygenation and perfusion, preventing further complications and potentially saving their life.

The symptoms of changes in mental status, fever, and nuchal rigidity are indicative of bacterial meningitis. Bacterial meningitis is an infection of the meninges, the protective membranes covering the brain and spinal cord. It is characterized by inflammation, which can lead to symptoms such as fever, altered mental status, and neck stiffness (nuchal rigidity). Prompt diagnosis and treatment are crucial in bacterial meningitis cases to prevent complications and potential long-term neurological damage.

Hemothorax refers to the presence of blood in the pleural cavity, which is the space between the lungs and the chest wall. This condition usually occurs as a result of trauma or injury to the chest, such as a puncture wound or a fractured rib. The accumulation of blood in the pleural cavity can cause difficulty in breathing, chest pain, and decreased lung function. Prompt medical intervention is necessary to treat hemothorax, which may involve draining the blood from the pleural cavity and addressing the underlying cause of the bleeding.

RICE is an acronym commonly used in the treatment of sprained ankles. "Rest" refers to the need for the patient to avoid putting weight on the injured ankle. "Ice" suggests the application of ice to reduce swelling and pain. "Compression" involves wrapping the ankle with a bandage or brace to provide support and reduce swelling. "Elevation" means keeping the ankle elevated above the level of the heart to further reduce swelling. The correct answer includes all these components, making it the most appropriate choice.

The correct answer is nose. In this scenario, the patient's severely deviated septum indicates an injury to the nose. The septum is the cartilage and bone that divides the nasal cavity into two nostrils. A deviated septum occurs when the septum is displaced to one side, often due to trauma like a motor vehicle accident. This can lead to difficulty breathing, nasal congestion, and other symptoms.

Triage is a process used in medical emergencies to prioritize patients based on the severity of their condition. The term "treat the sickest person first" accurately describes the concept of triage, where the most critically ill or injured individuals receive immediate attention and care. This approach ensures that limited resources are allocated effectively and that the patients with the highest chances of survival are treated promptly.

Epistaxis is another term for nosebleed. It refers to the bleeding from the nose, which can occur due to various reasons such as dry air, nasal trauma, allergies, or underlying medical conditions. The term "hematemesis" refers to vomiting blood, "hemoptysis" refers to coughing up blood, and "hematochezia" refers to the passage of fresh blood in the stool. Therefore, the correct answer is "epistaxis" as it specifically relates to bleeding from the nose.

Asystole refers to the absence of a heartbeat. It is a condition where the heart stops contracting and there is no electrical activity in the heart. This is a medical emergency and often referred to as "flatline" as it is depicted on electrocardiogram (ECG) readings. Diastole, on the other hand, refers to the relaxation phase of the heartbeat. Ectopy and atopy are unrelated terms and do not describe the absence of a heartbeat.

A pneumothorax refers to the collection of air or gas in the pleural space, which is the space between the lungs and the chest wall. This condition can occur due to a variety of reasons, such as a punctured lung or a rupture in the airways. The presence of air in the pleural space can cause the lung to collapse partially or completely, leading to symptoms like chest pain, shortness of breath, and decreased lung function. Treatment for a pneumothorax may involve the removal of the air through a chest tube or surgical intervention.

The ER physician will likely first order a UA, which stands for Urinalysis. This is because the patient is complaining of burning with urination, which is a common symptom of a urinary tract infection (UTI). A UA can help diagnose a UTI by analyzing the urine for the presence of bacteria, white blood cells, and red blood cells. It can also provide information about the pH level, specific gravity, and presence of other substances in the urine, which can help determine the underlying cause of the symptoms. A UA is a quick and non-invasive test that can provide valuable information for the physician to make an accurate diagnosis and determine the appropriate treatment plan.

The McBurney sign is indicative of appendicitis. This sign is characterized by tenderness and pain in the right lower quadrant of the abdomen, specifically at a point called McBurney's point. This point is located between the belly button and the right hip bone. The presence of this sign suggests inflammation of the appendix, which is a key symptom of appendicitis. The other options - Tinel sign, Murphy sign, and Phalen sign - are not specific to appendicitis and are associated with other medical conditions.

The patient's symptoms of severe right upper quadrant pain radiating to the shoulder, diaphoresis, nausea, and a positive Murphy sign are indicative of acute cholecystitis. Acute cholecystitis is inflammation of the gallbladder, typically caused by gallstones blocking the cystic duct. This can lead to symptoms such as severe pain, especially in the right upper quadrant, and referred pain to the shoulder. Diaphoresis and nausea are common associated symptoms. The positive Murphy sign, which is pain upon palpation of the gallbladder, further supports the diagnosis of acute cholecystitis. Pancreatitis, myocardial ischemia, and diverticulitis may present with abdominal pain, but they do not typically cause pain in the right upper quadrant or radiate to the shoulder.

The sudden onset of excruciating pain in the left lower abdomen and blood in the urine are classic symptoms of a kidney stone. Kidney stones are hard deposits that form in the kidneys and can cause severe pain as they pass through the urinary tract. The presence of blood in the urine, known as hematuria, is a common sign of kidney stones. Appendicitis typically causes pain in the right lower abdomen, while a herniated disk would cause pain in the back or neck. A urinary tract infection (UTI) may cause pain or discomfort in the lower abdomen, but it is not typically associated with blood in the urine.

An emetic is a class of drugs that is used to induce vomiting. When someone ingests a toxin, inducing vomiting can help remove the toxin from the body before it can be absorbed and cause harm. Therefore, an emetic would be the appropriate class of drug to treat ingestion of a toxin.

Severe back pain after lifting an extremely heavy object may be diagnosed as a herniated nucleus pulposus. This condition occurs when the soft, gel-like center of a spinal disc protrudes through a tear in the outer layer, putting pressure on the surrounding nerves and causing pain. Lifting heavy objects can put excessive strain on the spine, leading to this injury. Symptoms of a herniated nucleus pulposus may include localized pain, radiating pain down the leg, numbness, and weakness. Treatment options may include pain medication, physical therapy, and in severe cases, surgery.

The finding of a positive Battle sign, which refers to bruising behind the ear, is typically associated with head trauma. Therefore, it would be appropriate to place this finding under the HEENT (Head, Eyes, Ears, Nose, Throat) heading.

RSV (Respiratory Syncytial Virus) is the correct answer because it is known to cause a serious respiratory infection that primarily affects infants and the elderly. RSV is highly contagious and can lead to severe symptoms such as coughing, wheezing, and difficulty breathing. Infants and the elderly are more susceptible to RSV due to their weaker immune systems. This respiratory infection can be particularly dangerous for these age groups, often requiring hospitalization for treatment and care.

Silvadene would be used to treat a burn caused by scalding water. Silvadene is a topical cream that contains silver sulfadiazine, which has antimicrobial properties. It is commonly used to prevent and treat infections in burn wounds. The cream helps to reduce pain, prevent bacterial growth, and promote healing. It is applied directly to the affected area and is effective in treating burns caused by scalding water.