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Questions and Answers (Courses 1-5)
Fill in the blanks for ED Flow: Walk in > Blank 1 > Bed > Physician Assessment > Lab/Rad/Meds > Results > MDM > Diagnosis > Consults > Blank 2 - correct answer ✅Triage, Disposition What are the 3 disposition options? - correct answer ✅Discharge, Admit, Transfer What are the 5 vital signs? - correct answer ✅Heart Rate, Blood Pressure, Respiratory Rate, Temperature, Oxygen Saturation The HPI and ROS are what type of information (subjective or objective)?
correct answer ✅subjective The Physical Exam is what type of information (subjective or objective)?
correct answer ✅objective While evaluating a patient complaining of chest pain, your physician tells you that the heart sounds are normal. Would you document it in the HPI, ROS, or PE? - correct answer ✅PE
Questions and Answers (Courses 1-5)
Would you be contradicting yourself if you wrote "The patient has abdominal pain" in the HPI, but then later in the physical exam documented "The abdomen is nontender." Why or why not? - correct answer ✅No, because the patient stating they have abdominal pain is a subjective complaint. A non-tender abdomen is an objective finding. What is the difference between the HPI and ROS? - correct answer ✅HPI focuses on the details related to their chief complaint. ROS is a head-to-toe checklist of symptoms. It includes the chief complaint, associated symptoms, and all other complaints the patient may have. What does disposition (dispo) mean? - correct answer ✅The patient's destination after they leave the Emergency Department. What subcategories are included within the Past History section of the template? - correct answer ✅PMHx (Past Medical History- HTN, DM, HLD, CAD, MI.......), PSHx, (Past Surgical History- Appendectomy, Cholecystectomy, CABG......)FHx, (Family History- Hx of CAD < 55 y/o....)SHx, (Social History- ETOH, Smoking, Drug Abuse, Occupation.....) What is the abbreviation for a heart attack? - correct answer ✅MI- Myocardial Infarction
Questions and Answers (Courses 1-5)
If the doctor says the exam was "benign", what does that mean? - correct answer ✅Normal- Nothing of concern What is CAD? - correct answer ✅Coronary Artery Disease. What other past histories would suggest that a patient has CAD? - correct answer ✅MI, Angina, CABG, Stent, Angioplasty Does a PMHx of CVA mean the patient has CAD? - correct answer ✅No Does a surgical history of angioplasty mean the patient has CAD? - correct answer ✅Yes Explain the difference between CAD and an MI. - correct answer ✅CAD is a broad term for heart disease. MI is included in CAD. It's an active heart attack. If someone has a PMHx of A - correct answer ✅Fib or CHF, do they also have CAD?- No
Questions and Answers (Courses 1-5)
What are the "cardiac risk factors?" - correct answer ✅HTN, DM, HLD, CAD, Smoking, FHx CAD < 55 y/o How is CAD diagnosed? - correct answer ✅By a cardiologist during a cardiac catheterization. Not done in the ED. Name two ways that an MI can be diagnosed? - correct answer ✅STEMI- EKG, Non-STEMI- Troponin What are some associated symptoms of an MI other than CP? - correct answer ✅N/V, SOB, Diaphoresis What are some associated symptoms for CHF? - correct answer ✅SOB (Orthopnea, PND, DOE), pedal edema What 2 studies would diagnose CHF? - correct answer ✅CXR or elevated BNP What is A Fib? - correct answer ✅Electrical abnormality of the heart causing the top of the heart to quiver
Questions and Answers (Courses 1-5)
- What is a PTX? - correct answer ✅Pneumothorax ("collapsed lung")
- What is the most common cause of a PTX? - correct answer ✅Trauma
- How is a PTX diagnosed? - correct answer ✅CXR
- What social history will most COPD patients also have? - correct answer ✅Smoking
- What is the difference between an inhaler and a nebulizer for asthma? - correct answer ✅An inhaler is portable and gives a one time dose and provides a rapid release of medication. A nebulizer is a home machine that delivers continuous treatment over a period of time.
- What is asthma? - correct answer ✅Constricting of the airway due to inflammation and muscular contraction of the bronchioles. Also called Reactive Airway Disease
Questions and Answers (Courses 1-5)
- What physical exam finding closely associates with asthma? - correct answer ✅Wheezes/ing
- What is PNA? - correct answer ✅Pneumonia. Usually a bacterial infection (infiltrates) and inflammation inside the lung
- What might a person with PNA complain of? - correct answer ✅Productive cough and fever
- How is PNA diagnosed? - correct answer ✅CXR
- Name all 7 areas of the abdomen. - correct answer ✅Epigastric, RUQ, LUQ, RLQ, LLQ, Suprapubic, Periumbilical (Right/ Left flank)
- What is the layman's name for GERD? - correct answer ✅"Heartburn" or Acid Reflux
- What might someone with GERD complain of? - correct answer ✅Epigastric pain "burning"
Questions and Answers (Courses 1-5)
pain- gradual, constant, worse w/ movements is the CC (not associated sx))
- How is appendicitis diagnosed? - correct answer ✅CT A/P with PO contrast
- What would someone with pancreatitis c/o? - correct answer ✅LUQ or epigastric abdominal pain, N/V, fever
- How is pancreatitis diagnosed? - correct answer ✅Elevated Lipase (or Amylase which is less specific)
- Name four possible CC's for a GI bleed pt. - correct answer ✅Hematemesis, coffee ground emesis, hematochezia, melena
- How is a GI bleed diagnosed in the ED? - correct answer ✅Guaiac positive or heme + stool, gastroccult
- What are we worried about for someone with a GI bleed? - correct answer ✅Too much blood loss, Anemia
Questions and Answers (Courses 1-5)
- What is the pre existing condition you must have before you can get diverticulitis? - correct answer ✅Diverticulosis
- What will be the CC for someone with diverticulitis? - correct answer ✅LLQ abdominal pain
- What studies would diagnose diverticulitis? - correct answer ✅CT A/P with PO contrast
- What might a person with a SBO complain of? - correct answer ✅Abd pain/bloating, vomiting, abdominal distention, no BM's, constipation
- How is an SBO diagnosed? - correct answer ✅CT A/P w/ PO contrast or AAS (acute abd series) X-ray
- What is a UTI? - correct answer ✅Urinary tract infection
- What is pyelo? - correct answer ✅Pyelonephritis, Kidney infection (different and worse than a UTI), usually spread from an UTI
Questions and Answers (Courses 1-5)
- What is ovarian torsion? - correct answer ✅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? - correct answer ✅US Pelvis
- Name the 2 types of CVA's (strokes). - correct answer ✅Hemorrhagic CVA. Ischemic CVA. (TIA is not a type of a stroke)
- What sx might a person with a brain bleed c/o? - correct answer ✅HA- sudden ("thunderclap") onset, worst HA of their life, changes in speech, vision, motor (weakness), sensation (numbness), AMS
- What study would diagnose a brain bleed? - correct answer ✅CT Head or Lumbar Puncture
- What sx might a person with an ischemic CVA c/o? - correct answer ✅Focal Neurological Deficit: changes in speech, changes in vision, one-sided motor changes (weakness), one-sided sensation changes (numbness)
Questions and Answers (Courses 1-5)
- How is an ischemic CVA diagnosed? - correct answer ✅Clinically, potentially normal CT head
- What is a TIA? - correct answer ✅Transient Ischemic Attack. Mini-stroke. Temporary loss of blood supply to the brain
- How does a TIA differ from a CVA? - correct answer ✅TIA - mini stroke, symptoms usually resolve in less than a hour. CVA - Stroke, symptoms last longer, and potentially may not go away
- What is a common cause for seizures in children? - correct answer ✅Fevers
- What is the name of the state after a seizure? - correct answer ✅Post-ictal
- What are 3 symptoms of meningitis? - correct answer ✅Fever, neck pain/stiffness, headache
- What study would diagnose meningitis? - correct answer ✅LP- Lumbar puncture
Questions and Answers (Courses 1-5)
- What is an AAA? - correct answer ✅Abdominal aortic aneurysm
- What is an aortic dissection? - correct answer ✅The separation of the muscular wall from the membrane of the artery, putting the pt at risk for aortic rupture and death
- What are 3 symptoms of cellulitis? - correct answer ✅Redness, swelling, and pain to an area of the skin
- How is an abscess different from cellulitis? - correct answer ✅Abscess is cellulitis with fluctuance (pus pocket)
- What procedure will be performed for every abscess? - correct answer ✅Incision and drainage
- What is the main concern with an allergic reaction? - correct answer ✅Anaphylaxis or respiratory failure
- What are the ONLY three symptoms of a true allergic reaction? - correct answer ✅Rash, itching, swelling, SOB due to airway swelling
Questions and Answers (Courses 1-5)
- How can Diabetic Ketoacidosis (DKA) be diagnosed? - correct answer ✅Arterial Blood Gas showing low pH or Positive Serum Ketones
- What is the Emergency Physician's main responsibility for psychiatric patients? - correct answer ✅Medical clearance
- Name three important things to document for any trauma patient. - correct answer ✅LOC, head injury, neck pain, back pain, numbness, weakness
- In your own words, describe the significance of an HPI. - correct answer ✅The HPI is the story of the symptoms and events that led to the patient's ED visit. It includes the CC and the associated sx
- How is the HPI different from the ROS? - correct answer ✅HPI focuses is a story about the chief complaint and its associated symptoms. ROS is a checklist of symptoms. It includes the chief complaint, associated symptoms, and all other complaints the pt may have.
- Name five "elements" of the HPI. - correct answer ✅Onset, timing, location, quality, severity, modifying factors, associated symptoms, context
Questions and Answers (Courses 1-5)
- Name one detail that is important to document if the patient has been evaluated in the past for a similar complaint. - correct answer ✅What symptoms prompted the prior evaluation? How long ago did the prior evaluation occur? Who did they see? (Name and specialty) What treatment did they receive? Did it help What diagnosis was given? Any prior test results?
- What should you focus on when writing an HPI (choose one). (a) Capturing everything that is said by the patient (b) Documenting the answers to every question asked by the doctor - correct answer ✅B. Documenting the answers to every question asked by the doctor
- Which is the first item in the formula for writing an HPI? (a) Pertinent negatives (b) Timing, quality, and location (c) Chief complaint and onset (d) Associated symptoms - correct answer ✅C. chief complaint and onset
- What does MOI stand for in a Trauma HPI? - correct answer ✅Mechanism of Injury
- True or False: In the ROS, you should document "All other systems negative except as marked" for every patient. - correct answer ✅False
Questions and Answers (Courses 1-5)
- Based on your knowledge from Day 2, why should you always pay special attention to the complaints of Chest Pain and SOB? - correct answer ✅Direct concern for MI
- Name three past surgical histories that indicate that the patient has a history of CAD. - correct answer ✅Angioplasty, CABG, stents
- What is the difference between a cardiac stress test and a cardiac catheterization? - correct answer ✅Cardiac catheterization - insertion of a catheter with injection of dye into the coronary artery, used to diagnose CAD. Stress test - measures the heart's ability to respond to physical stress to determine if there is adequate blood flow to your heart during increasing levels of activity. (There are two different types of stress tests. Exercise (treadmill) stress test. Nuclear stress test is for patients with a medical problem (e.g. arthritis) that prevents you from exercising. They use a medication to stresses the heart (mimicking exercise))
- What are the risk factors for an MI? - correct answer ✅CAD, HTN, DM, hyperlipidemia, smoking, FHx of CAD < 55 y/o
