ER Board key terms

Acute myocardial infarction with ST-segment elevation on the ECG, reflecting complete coronary artery occlusion; emergency reperfusion by primary angioplasty or fibrinolysis is time-critical to limit infarct size and preserve ventricular function.

A tear in the aortic intima lets blood track within the vessel wall, causing abrupt severe tearing chest or back pain with pulse or blood pressure asymmetry; needs rapid rate and pressure control plus surgical or endovascular repair.

Pericardial fluid raises intrapericardial pressure enough to impair ventricular filling, producing hypotension, distended neck veins, and muffled heart sounds; treat with cautious fluids and urgent pericardiocentesis or drainage.

An organized rhythm on the monitor without a palpable pulse, usually caused by profound hypovolemia, hypoxia, tamponade, tension pneumothorax, or thrombosis; management is high-quality CPR with rapid correction of the underlying cause.

Markedly elevated blood pressure with acute target-organ damage such as encephalopathy, aortic dissection, pulmonary edema, or renal injury; requires monitored intravenous therapy that lowers pressure gradually rather than normalizing it abruptly.

Air trapped in the pleural space enlarges with each breath, shifting mediastinal structures and obstructing venous return; hypotension, unilateral absent breath sounds, and distended neck veins call for immediate needle or finger decompression before imaging.

A severe asthma attack that persists despite repeated bronchodilator treatment, with air trapping, rising carbon dioxide, and risk of respiratory arrest; needs continuous nebulization, corticosteroids, magnesium, and possibly intubation.

Diffuse inflammatory lung injury producing bilateral infiltrates and severe hypoxemia not fully explained by cardiac failure; ventilate with low tidal volumes, consider prone positioning, and treat the precipitating cause.

Thrombus obstructing pulmonary arteries causes sudden dyspnea, pleuritic chest pain, and hypoxemia; clinical scores, biomarkers, and imaging guide decisions about anticoagulation, thrombolysis, or catheter and surgical embolectomy.

Coughing of large volumes of blood from the airways, threatening asphyxiation more than exsanguination; secure the airway, position the patient to protect the good lung, and pursue bronchoscopy or bronchial artery embolization.

Bedside ultrasound survey of the pericardium and dependent abdominal spaces for free fluid in injured patients; it is rapid, repeatable, and helps decide whether an unstable patient needs immediate operative care.

Rising pressure inside a closed fascial compartment compromises tissue perfusion, causing pain out of proportion, tense swelling, and pain on passive stretch; urgent fasciotomy is required to prevent irreversible muscle and nerve death.

The self-reinforcing combination of hypothermia, acidosis, and coagulopathy in severe hemorrhage, which worsens bleeding and increases death; management targets warming, rapid hemorrhage control, and balanced blood product resuscitation.

A grading system for open fractures based on wound size, soft-tissue injury, and contamination that guides antibiotic selection and surgical urgency; higher grades carry greater risks of infection and amputation.

Bleeding into the space surrounding the brain, often from a ruptured aneurysm, producing a sudden severe headache, neck stiffness, vomiting, and possible coma; CT followed by lumbar puncture or angiography confirms the diagnosis.

Continuous seizure activity, or repeated seizures without recovery between them, lasting about five minutes or longer; give benzodiazepines immediately, then second-line anticonvulsants, and screen for hypoglycemia and structural causes.

The skull contains brain, blood, and cerebrospinal fluid in a fixed volume, so any added mass raises intracranial pressure unless another component shrinks; this principle explains herniation risk and the rationale for pressure-lowering measures.

Compression of the lumbosacral nerve roots causes saddle anesthesia, bladder or bowel dysfunction, and bilateral leg weakness; it is a surgical emergency requiring urgent imaging and decompression to limit permanent deficit.

The interval after ischemic stroke onset during which intravenous alteplase or tenecteplase may be given, generally up to 4.5 hours; beyond that, treatment decisions rely on advanced imaging and eligibility for mechanical thrombectomy.

Inadequate blood flow to the intestine causes pain out of proportion to examination findings, often in older patients with vascular disease or atrial fibrillation; early CT angiography and revascularization prevent bowel infarction and death.

Full-thickness rupture of the esophagus after forceful vomiting causes severe chest pain, subcutaneous emphysema, and mediastinitis; prompt antibiotics, drainage, and surgical or endoscopic repair are needed to reduce mortality.

Twisting of the spermatic cord cuts off blood supply to the testicle, causing abrupt severe scrotal pain, nausea, and a high-riding testis; surgical detorsion within hours offers the best chance of preserving the organ.

Skeletal muscle breakdown releases myoglobin and intracellular contents into the blood, causing dark urine, elevated creatine kinase, hyperkalemia, and acute kidney injury; treat with aggressive intravenous fluids and electrolyte correction.

Infection of ascitic fluid in cirrhosis that may present without classic peritonitis signs; diagnosis rests on an elevated ascitic neutrophil count, and treatment is prompt antibiotics with consideration of albumin and prophylaxis.

Excess serotonergic activity, usually from combining serotonergic drugs, causes agitation, clonus, hyperreflexia, and hyperthermia; stop the offending agents, give benzodiazepines, and use cyproheptadine in severe cases.

Insulin deficiency drives ketone production and osmotic diuresis, producing hyperglycemia, metabolic acidosis, dehydration, and total-body potassium depletion; treatment is intravenous fluids, insulin infusion, and careful potassium replacement.

Carbon monoxide binds hemoglobin far more avidly than oxygen, impairing oxygen delivery and causing headache, confusion, syncope, and myocardial ischemia; give high-flow oxygen and consider hyperbaric therapy for severe or high-risk cases.

Large paracetamol ingestions deplete glutathione, allowing a toxic metabolite to injure the liver; N-acetylcysteine restores detoxification and is most effective when started early, so risk assessment and timely treatment matter.

Aspirin overdose uncouples oxidative phosphorylation, causing respiratory alkalosis, metabolic acidosis, tinnitus, vomiting, and altered mental status; treat with bicarbonate, glucose, potassium, and hemodialysis in severe poisoning.

Life-threatening organ dysfunction caused by a dysregulated host response to infection; recognize with screening tools, obtain cultures, give broad-spectrum antibiotics and fluids promptly, and control the infection source.

Fever in a patient with very low neutrophils signals possible rapid bloodstream infection; obtain cultures and start empiric antipseudomonal antibiotics within an hour, then reassess for fungal infection or resistant organisms.

Rapid destruction of cancer cells releases potassium, phosphate, and nucleic acids, causing hyperkalemia, hyperuricemia, hypocalcemia, and kidney injury; prevent and treat with hydration, urate-lowering drugs, and electrolyte management.

Widespread coagulation activation consumes platelets and clotting factors, producing simultaneous thrombosis and bleeding; management centers on treating the triggering condition with supportive transfusion of blood products as indicated.

Implantation outside the uterine cavity, usually within a fallopian tube, causes abdominal pain, vaginal bleeding, and possible rupture with shock; pregnancy testing and ultrasound guide surgical or medical treatment.

Pregnancy-related hypertension accompanied by proteinuria or organ dysfunction such as headache, visual disturbance, elevated liver enzymes, or low platelets; management includes magnesium, blood pressure control, and timely delivery.

A severe variant of preeclampsia defined by hemolysis, elevated liver enzymes, and low platelets, causing right upper quadrant pain, malaise, and bleeding risk; treatment is maternal stabilization and urgent delivery.

One segment of bowel telescopes into the adjacent segment, causing intermittent colicky pain, vomiting, and currant-jelly stool in young children; ultrasound confirms the diagnosis and an air or contrast enema often reduces it.

A short episode in an infant under one year involving cyanosis, breathing change, altered muscle tone, or unresponsiveness that resolves completely; low-risk infants need caregiver education and follow-up rather than extensive testing.