Bootcamp EDE Abdominal Video Pretest

1.

1 point

In the pelvic scan you can see free fluid in the area posterior to the solid organ (uterus or rectum) that lies behind the bladder in:

Females only

Females and males

Males only

none of the above

2.

1 point

If you don't find free fluid in the RUQ then:

Scan the pelvis next since it is most dependent.

You are done the scan as all significant bleeds will be seen in RUQ.

Get a CT scan next.

Scan the LUQ because it can contain significant free fluid

3.

1 point

A major cause of a FALSE negative in abdominal EDE is:

Large amounts of free fluid

Liver laceration

Physiologic free fluid

Adhesions

4.

1 point

The LUQ scan is harder than the RUQ scan most of the time because:

Fluid is only seen medial to the spleen.

The spleen is larger and more superior.

The diaphragm interferes with the scan.

The spleen is smaller, more mobile, and more superior.

5.

1 point

Abdominal EDE is a skill tested in the Canadian EM residency programs since

2010

2013

2001

1988

6.

1 point

Significant bleeds in the LUQ normally flow to:

RUQ via mesentery of transverse colon

RUQ via uterine ligaments

Pelvis via paracolic gutter

across entire abdomen

7.

1 point

Ultrasound is a great test for:

Free fluid

Hollow organ injury

Solid organ injury

Delayed bleeding

8.

1 point

In the LUQ the diaphragm:

Is often not seen between 9 and 12 o'clock

Begins where the interface ends

Is an arc that looks tilted 90 degrees to the interface

All of the above

9.

1 point

In men a cause of false positive pelvic scan for free fluid includes:

Prostate

rectal surgery

UTI

Bladder stones

10.

1 point

For abdominal EDE the probe is held

In a firm grip of probe handle and cord

Resting on a platform made by the hand

With the index finger and thumb only

In a grip like holding a dagger

11.

1 point

Manoeuvres to improve the view of the UQ's include:

Have patient take a deep breath in to move the interface

Angulate or rotate the probe to align with ribs

Use lots of gel

All of the above

12.

1 point

In abdominal EDE screen LEFT corresponds to patient:

Cephalad or head

Lateral

Caudal or feet

Medial

13.

1 point

Patients with clinically benign history and physical along with a negative EDE should be:

Urgent surgical referral

Discharged home immediately

Rescanned at least once more before discharge

Urgent CT scan

14.

1 point

PALMS approach includes: (pick all that apply)

Magnify the area of interest

Slide towards the pelvis

Work the PA to find the kidney

Work the Longitudinal to define the interface

15.

1 point

If the patient has free fluid on EDE but is not tachycardic, then they are stable and can wait for elective scan or consultation.

True

False

16.

1 point

The second step of abdominal EDE has the probe slide cephalad and caudal to find the interface. If done correctly the kidney should:

Slide side to side on the screen

Change shape as you slide the probe

Get bigger or smaller

All of the above

17.

1 point

A patient with free fluid on abdominal EDE and clinical instability should

Get rescanned in 15min

Get an ultrasound in radiology

Go straight to the O.R.

Go to the CT scanner

18.

1 point

To properly scan the UQ's you must always get the entire interface on the screen at once before sweeping.

Only if there is free fluid present.

Yes or else it is an indeterminate scan.

No, you can do overlapping sweeps.

Only if there is no free fluid present.

19.

1 point

Free fluid at the interface in the UQ's will track between:

Perinephric fat and liver or spleen

Kidney and perinephric fat

Both

Neither

20.

1 point

Sweeping the area of interface is done until:

the rib shadows disappear

until the diaphragm is seen from 6 to 9 o'clock

until the kidney disappears in both directions

the probe is 90 degrees to the patient

21.

1 point

A complete scan of the LUQ includes visualization of:

Area medial to spleen

Diaphragm from 6 to 9 o'clock

All of the above

Splenorenal interface

22.

1 point

Abdominal EDE is the scan most likely to change from negative to positive during the patient's stay in the emergency department.

True

False

23.

1 point

To get an adequate acoustic window for the pelvic scan you often need

A completely empty bladder

A bladder with at least 250ml of fluid within.

A major bleed

No bowel gas in the lower quadrants

24.

1 point

Abdominal EDE is always started in:

Paracolic gutter

RUQ

LUQ

Pelvis

25.

1 point

Abdominal EDE was pioneered by:

OB-Gyne in Italy

Surgeons in Japan and Germany

Intensivists in France

Radiologists in the United States

26.

1 point

If the patient is clinically suspicious of serious internal bleeding or injury but the abdominal EDE is negative you should:

Consider urgent CT scan

Consider urgent surgical consultation

Rescan the patient in 15 min

All of the above

27.

1 point

The starting position for abdominal EDE is:

Level of xiphoid in posterior axillary line

Level of xiphoid in anterior axillary line

Level of nipple in mid-axillary line

Level of nipple in posterior axillary line

28.

1 point

When sliding the probe in the anterior-posterior plane, the probe should be

Perpendicular to the surface of the patient

None of the above

Parallel to the bed

Parallel to the surface of the patient

29.

1 point

In abdominal EDE nearfield on the screen corresponds to patient:

Medial

Caudal

Cephalad

Lateral

30.

1 point

In patients with free fluid but clinically stable you should

Insist the patient go to the O.R. immediately

Rescan the patient in 15 min

Put the patient in Trendelenburg and scan again

Do further workup, usually a CT scan and consult surgery