EM SAEM EXAM QUESTIONS WITH CORRECT ANSWERS

EM SAEM EXAM QUESTIONS WITH CORRECT ANSWERS AEIOU TIPS (differential for AMS) - Answer ️️ -A Alcohol E Epilepsy, Electrolytes, and Encephalopathy I Insulin O Opiates and Oxygen U Uremia T Trauma and Temperature I Infection P Poisons and Psychogenic S Shock, Stroke, Subarachnoid Hemorrhage and Space-Occupying Lesion Delirium vs psychosis hallucinations - Answer ️️ -delerium= visual psychosis=auditory systolic vs dystolic failure - Answer ️️ -Systolic failure is the hearts inability to pump the blood forward in the circulatory system. It is essentially has lost the "squeeze." Diastolic heart failure occurs due the fact that the muscles of the heart are unable to relax adequately and allow the heart to fill appropriately. lung sounds in - Answer ️️ - Anterior MI -leads and artery affected - Answer ️️ -V1-V6 Left Anterior Descending Septal MI - Answer ️️ -V1-V3 Left Anterior Descending Inferior MI - Answer ️️ -II, III, aVF (recipricol changes in I, aVL) Right coronary artery (80%) or Left Circumflex (20% Lateral MI - Answer ️️ -Lateral MI I, aVL, V5, V6 left circumflex posterior MI - Answer ️️ -v5 v6 RCA or L Circumflex ACS markers (initial, peak, baseline) - Answer ️️ -Myoglobin 1-4 h 6-7 h 18-24 h CK-MB 4-12 h 10-24 h 48-72 h Cardiac Trop I 3-12 h 10-24 h 3-10 d Cardiac Trop T 3-12 h 12-48 h 5-14 d For STEMI what are you looking for on EKG? - Answer ️️ -ST-elevations of 1 mm or more in two contiguous limb lead TIMI Risk Score for Unstable Angina and Non-ST-Elevation MI's (UA/NSTEMI - Answer ️️ - •65 or older? • 3+ CAD risk factors? •Known CAD? •Aspirin use in past week? •Severe angina? •ST segment changes? •Positive cardiac markers blood pressures in arms in aortic dissection - Answer ️️ -measurement of bilateral upper extremity blood pressures with increased concern for thoracic aortic dissection when a systolic BP differential of greater than 20 mmHg between arms is obtained. Blood pressure is typically elevated, especially in patients with type B dissection, though a normal or hypotensive reading may indicate complications of the dissection, such as retroperitoneal hemorrhage or cardiogenic shock from myocardial ischemia or acute aortic insufficiency aortic dissection A vs B presentation - Answer ️️ -Type A dissection is more likely to cause chest pain or syncope and less likely to cause back or abdominal pain when compared to type B dissection. Patients with type B dissection are about two times as likely to present with hypertension (SBP ≥150 mmHg), whereas type A dissections are many times more likely to cause hypotension (SBP aortic dissection pearls - Answer ️️ -· D-dimer is not adequately sensitive for aortic dissection to independently exclude the diagnosis. · Heart rate and blood pressure should be kept as low as possible while maintaining end-organ perfusio