Emergency Medicine Anesthesiology Syllabus

Anesthesiology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Anesthesiology in Emergency Medicine, not a summary of it.

1. 1

   Introduction to Emergency Medicine

   2 topics

   • History and Evolution
     • Origins of Emergency Medicine
     • Development of Emergency Medical Systems
     • Modern Emergency Medicine Practice
   • Principles of Emergency Medicine
     • Triage
     • Initial Assessment and Management
     • Resuscitation
2. 2

   Cardiovascular Emergencies

   4 topics

   • Acute Coronary Syndromes
     • Pathophysiology
     • Clinical Presentation
     • Management and Treatment
   • Arrhythmias
     • Types of Arrhythmias
     • Recognition and Diagnosis
     • Acute Management
   • Heart Failure
     • Acute Decompensated Heart Failure
     • Management Strategies
     • Long-term Care Considerations
   • Hypertensive Emergencies
     • Definition and Classification
     • Clinical Features
     • Treatment Protocols
3. 3

   Respiratory Emergencies

   5 topics

   • Acute Respiratory Distress Syndrome (ARDS)
     • Etiology
     • Clinical Manifestations
     • Management and Treatment
   • Asthma Exacerbations
     • Pathophysiology
     • Clinical Features
     • Emergency Management
   • Chronic Obstructive Pulmonary Disease (COPD) Exacerbations
     • Pathophysiology
     • Clinical Presentation
     • Management and Treatment
   • Pneumonia
     • Community-Acquired Pneumonia
     • Hospital-Acquired Pneumonia
     • Management Strategies
   • Pulmonary Embolism
     • Risk Factors
     • Clinical Presentation
     • Diagnostic Approaches
     • Management and Treatment
4. 4

   Neurological Emergencies

   4 topics

   • Stroke
     • Ischemic Stroke
     • Hemorrhagic Stroke
     • Acute Management
     • Post-Stroke Care
   • Seizures
     • Types of Seizures
     • Acute Management
     • Status Epilepticus
   • Traumatic Brain Injury
     • Pathophysiology
     • Initial Assessment
     • Management and Treatment
   • Meningitis and Encephalitis
     • Etiology
     • Clinical Presentation
     • Diagnostic Approaches
     • Management and Treatment
5. 5

   Trauma Emergencies

   6 topics

   • Initial Assessment and Management
     • Primary Survey
     • Secondary Survey
     • Trauma Resuscitation
   • Head and Neck Trauma
     • Skull Fractures
     • Cervical Spine Injuries
     • Facial Trauma
   • Thoracic Trauma
     • Rib Fractures
     • Pneumothorax
     • Hemothorax
     • Cardiac Tamponade
   • Abdominal Trauma
     • Solid Organ Injuries
     • Hollow Viscus Injuries
     • Pelvic Fractures
   • Extremity Trauma
     • Fractures and Dislocations
     • Soft Tissue Injuries
     • Compartment Syndrome
   • Burns
     • Classification of Burns
     • Initial Management
     • Complications and Long-term Care
6. 6

   Pediatric Emergencies

   3 topics

   • Pediatric Assessment
     • Pediatric Vital Signs
     • Pediatric Assessment Triangle
     • Approach to the Ill Child
   • Common Pediatric Emergencies
     • Respiratory Distress
     • Seizures
     • Dehydration
     • Fever and Infections
   • Pediatric Trauma
     • Patterns of Injury
     • Management and Resuscitation
     • Child Abuse and Non-Accidental Trauma
7. 7

   Toxicological Emergencies

   3 topics

   • General Principles of Toxicology
     • Toxidromes
     • Decontamination
     • Antidotes
   • Common Poisonings
     • Alcohol and Drug Overdose
     • Pesticides and Herbicides
     • Household Chemicals
   • Environmental Exposures
     • Bites and Stings
     • Heat and Cold Injuries
     • Drowning and Near-Drowning
8. 8

   Obstetric and Gynecological Emergencies

   2 topics

   • Pregnancy-Related Emergencies
     • Ectopic Pregnancy
     • Pre-eclampsia and Eclampsia
     • Postpartum Hemorrhage
   • Gynecological Emergencies
     • Ovarian Torsion
     • Pelvic Inflammatory Disease
     • Acute Vaginal Bleeding
9. 9

   Psychiatric Emergencies

   3 topics

   • Acute Psychosis
     • Etiology
     • Clinical Presentation
     • Management and Treatment
   • Suicidal Ideation and Self-Harm
     • Risk Assessment
     • Management Strategies
     • Follow-Up Care
   • Substance Abuse Emergencies
     • Acute Intoxication
     • Withdrawal Syndromes
     • Management and Treatment

Anesthesiology flashcards for Emergency Medicine

23 of 50 cards from the Anesthesiology deck — real questions with worked answers.

1. In the history of emergency medicine, in what year was Emergency Medicine formally recognized as a distinct medical specialty in the United States?

   1979, when the American Board of Medical Specialties recognized Emergency Medicine as the 23rd medical specialty.

2. What does the 'golden hour' concept in emergency and trauma medicine refer to?

   The principle that a critically injured patient's chance of survival is greatest if definitive care is delivered within the first hour after injury, when timely resuscitation prevents irreversible shock.

3. State the sequence of the primary survey (ABCDE approach) used in initial emergency assessment.

   A - Airway (with cervical spine protection), B - Breathing/ventilation, C - Circulation with hemorrhage control, D - Disability (neurologic status), E - Exposure/Environment control.

4. What are the three components scored in the Glasgow Coma Scale (GCS), and what is its total range?

   Eye opening (1-4), Verbal response (1-5), and Motor response (1-6); total score ranges from 3 (deep coma) to 15 (fully alert).

5. Define the ECG criteria for STEMI (ST-elevation myocardial infarction) at the J-point.

   New ST elevation $\geq 1\,\text{mm}$ ($0.1\,\text{mV}$) in $\geq 2$ contiguous limb leads, or $\geq 2\,\text{mm}$ in men ($\geq 1.5\,\text{mm}$ in women) in leads $V_2$-$V_3$.

6. List the components of the initial 'MONA-B' style medical therapy for acute coronary syndrome.

   Morphine (for refractory pain), Oxygen (if $\text{SpO}_2 < 90\%$), Nitroglycerin, Aspirin ($162$-$325\,\text{mg}$ chewed), and a Beta-blocker; plus a second antiplatelet and anticoagulation.

7. What is the door-to-balloon time goal for primary PCI in STEMI patients presenting to a PCI-capable hospital?

   $\leq 90$ minutes from first medical contact to reperfusion by primary percutaneous coronary intervention.

8. How do STEMI, NSTEMI, and unstable angina differ in terms of ECG and biomarkers?

   STEMI: ST elevation with elevated troponin. NSTEMI: no ST elevation but elevated troponin (myocardial necrosis). Unstable angina: ischemic symptoms, no ST elevation, and normal troponin (no necrosis).

9. What is the first-line electrical treatment for a patient in pulseless ventricular tachycardia or ventricular fibrillation?

   Immediate unsynchronized defibrillation (e.g., $200\,\text{J}$ biphasic) followed by immediate resumption of CPR.

10. Differentiate synchronized cardioversion from defibrillation.

    Synchronized cardioversion delivers a shock timed to the R wave (for unstable patients with a pulse, e.g., unstable SVT/AF/VT); defibrillation delivers an unsynchronized shock for pulseless VT/VF.

11. What is the first-line drug for a stable patient with narrow-complex regular supraventricular tachycardia after vagal maneuvers fail?

    Adenosine $6\,\text{mg}$ rapid IV push, followed by $12\,\text{mg}$ if needed.

12. Using the $CHA_2DS_2\text{-}VASc$ score, which components each contribute 2 points?

    Age $\geq 75$ years and prior Stroke/TIA/thromboembolism each contribute 2 points; all other factors (CHF, hypertension, age 65-74, diabetes, vascular disease, female sex) contribute 1 point each.

13. Contrast systolic (HFrEF) and diastolic (HFpEF) heart failure by ejection fraction.

    HFrEF (reduced): $\text{LVEF} \leq 40\%$ due to impaired contraction. HFpEF (preserved): $\text{LVEF} \geq 50\%$ with impaired relaxation/filling. HFmrEF (mildly reduced): LVEF $41$-$49\%$.

14. What is the mnemonic 'LMNOP' for the emergency treatment of acute decompensated heart failure with pulmonary edema?

    Lasix (furosemide/diuresis), Morphine, Nitrates, Oxygen (and positioning upright), and Positive pressure ventilation (CPAP/BiPAP).

15. Define a hypertensive emergency versus hypertensive urgency.

    Hypertensive emergency: severely elevated BP (often $>180/120\,\text{mmHg}$) WITH acute target-organ damage. Hypertensive urgency: similarly elevated BP WITHOUT acute target-organ damage.

16. By how much should mean arterial pressure (MAP) generally be lowered in the first hour of most hypertensive emergencies?

    By no more than about $10$-$20\%$ (roughly $\leq 25\%$) in the first hour to avoid organ hypoperfusion, then gradually toward normal over 24-48 hours.

17. Give the formula for mean arterial pressure (MAP) in terms of systolic (SBP) and diastolic (DBP) pressures.

    $$\text{MAP} = \text{DBP} + \frac{1}{3}(\text{SBP} - \text{DBP})$$

18. State the Berlin definition oxygenation criterion for ARDS and its severity categories.

    ARDS requires $\frac{P_aO_2}{F_iO_2} \leq 300\,\text{mmHg}$ with PEEP $\geq 5\,\text{cmH}_2\text{O}$. Mild: $200 < \text{ratio} \leq 300$; Moderate: $100 < \text{ratio} \leq 200$; Severe: ratio $\leq 100$.

19. What lung-protective tidal volume is recommended in ARDS ventilation, and what plateau pressure limit is targeted?

    Low tidal volume of $6\,\text{mL/kg}$ of predicted body weight, targeting a plateau pressure $\leq 30\,\text{cmH}_2\text{O}$.

20. What are the first-line pharmacologic treatments for an acute asthma exacerbation in the ED?

    Inhaled short-acting beta-2 agonists (albuterol/salbutamol), inhaled ipratropium bromide, and systemic corticosteroids; add magnesium sulfate IV for severe cases.

21. In an asthma exacerbation, what does a 'normal' or rising $P_aCO_2$ signify?

    It is an ominous sign of impending respiratory failure/fatigue, since a tachypneic patient should be hypocapnic; a normalizing or rising $\text{CO}_2$ indicates the patient can no longer sustain ventilation.

22. What are the components of first-line treatment for a COPD exacerbation?

    Short-acting bronchodilators (beta-agonist + anticholinergic), systemic corticosteroids, antibiotics (if increased sputum purulence/volume), controlled oxygen, and noninvasive positive-pressure ventilation (BiPAP) for respiratory acidosis.

23. In COPD patients, what is the recommended target oxygen saturation range during exacerbation, and why is it not higher?

    Target $\text{SpO}_2$ of $88$-$92\%$, because excessive oxygen can worsen ventilation-perfusion mismatch and blunt hypoxic respiratory drive, causing $\text{CO}_2$ retention.

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