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Paramedic > 119 FINAL REVIEW for EXAM > Flashcards

119 FINAL REVIEW for EXAM Flashcards

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1
Q

Define histamines?

what do they cause

A

They are Chemical mediators from mast cell degranulation.

causes vasodilation and bronchoconstriction

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2
Q

What are leukotrienes?

A

Chemical mediator following histamine.

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3
Q

What is erythema?

A

Redness from capillary dilation and leakage.

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4
Q

What is pruritis?

A

Itching.

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5
Q

What is urticaria?

A

Hives.

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6
Q

What is epinephrine?

A

Alpha and beta agonist that stops mast cell degranulation.

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7
Q

Epinephrine 1:1000: Indications and effects? (and drug amount)

A

STOPS MAST CELL DEGRANULATION, bronchodilation, vasoconstriction, increased HR, contractility, and BP.

(1:1,000 = 1mg/1mL) allergic reaction

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8
Q

Diphenhydramine: Indications and effects?

A

H1 receptor antagonist, antihistamine, sedative effects.

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9
Q

Corticosteroids: Indications and effects?

(name one)

A

Anti-inflammatory, effects. PREVENTS LATER STAGE ANAPHYLAXIS.

(Dexamethasone)

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10
Q

Albuterol: Indications and effects?

(dose)

A

Beta2 agonist, bronchodilation, increased HR, contractility, and BP.

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11
Q

Benadryl: Indications and effects?

(dose)

A

H1 receptor antagonist, antihistamine, sedative effects.

(. )

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12
Q

H2 blockers: Indications and effects?

(name one)

A

Inhibits gastric acid secretion. SHOULD BE GIVEN WITH AN H1 BLOCKER IF THERE ARE GI MANIFESTATIONS, ALLERGIC REACTIONS.

(. )

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13
Q

Zantac (Ranitidine): Indications and effects?

A

H2 blocker, inhibits gastric acid secretion. Should be given with an H1 blocker

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14
Q

Mag Sulfate: Indications and effects? (and dose)

A

TERTIARY MED.
CNS depressant, muscle relaxant, anticonvulsant effects. SMOOTH MUSCLE RELAXER

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15
Q

Effects of A1, B1, and B2 stimulation?

A

A1: Vasoconstriction all over.

B1: Ino - contract,
Drom - Conductivity,
Chrono - rate.

B2: Lungs: Bronchodilation.

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16
Q

Inotropic
Dromotropic
Chronotropic

A

Ino - contract,
Drom - Conductivity,
Chrono - rate.

(B1)

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17
Q

What is the endocrine system?

A

A network of GLANDS secreting hormones into the bloodstream.

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18
Q

How does the endocrine system maintain homeostasis?

A

By using FEEDBACK mechanisms to regulate hormone levels.

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19
Q

What is the most common endocrine emergency in pre-hospital settings?

A

DIABETIC emergencies.

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20
Q

Is the nervous system an actual gland of the endocrine system?

A

NO

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21
Q

T/F
The hypothalamus produce its own regulatory hormones?

A

TRUE

It controls pituitary gland hormone release.

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22
Q

What is the function of the pineal gland?

A

It releases MELATONIN, which influences sleep/wake cycles.

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23
Q

Why is the pituitary gland referred to as the ‘master gland’?

A

It controls hormone release by other endocrine glands in the body.

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24
Q

What hormone does the thyroid gland produce?

A

THYROXINE hormone, which regulates metabolism.

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25
Q

Is weight gain always caused by the thyroid gland?

A

NO

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26
Q

What is the function of the thymus gland?

A

It produces IMMUNE CELLS.

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27
Q

Where are the adrenal glands located?

A

ON TOP of the kidneys.

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28
Q

Is the PANCREAS an endocrine or exocrine gland?

A

BOTH.

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29
Q

What do the islets of Langerhans in the pancreas secrete?

A

INSULIN and GLUCAGON.

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30
Q

What hormones are produced by the alpha and beta cells in the pancreas?

A

ALPHA cells produce GLUCAGON.

BETA cells produce INSULIN.

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31
Q

Where are the female gonads located?

A

IN THE OVARIES.

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32
Q

What is the breathing pattern associated with DKA?

A

KUSSMAULS - acidosis is causing faster breathing.

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33
Q

What is the process by which the liver stores glucose?

A

GLYCOGENESIS.

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34
Q

What is the BREAKDOWN of glycogen into glucose called?

A

GLYCOGENOLYSIS.

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35
Q

What is the process of FORMING glucose from non-carbohydrate forms called?

A

GLUCONEOGENESIS.

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36
Q

What fuels can the brain use?

A

GLUCOSE and Ketone Bodies

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37
Q

What is the difference between endocrine and exocrine glands?

A

ENDOCRINE has NO DUCTS, while EXOCRINE has DUCTS.

The PANCREAS has both endocrine and exocrine functions. Its endocrine cells secrete insulin and glucagon directly into the bloodstream, while its exocrine cells secrete digestive enzymes into the small intestine via a duct.

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38
Q

What is Kussmaul’s respiration?

A

DEEP, RAPID BREATHING due to ACIDOSIS.

A patient with diabetic ketoacidosis (DKA) may have Kussmaul’s respirations to compensate for the high levels of acid in the blood.

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39
Q

What are the symptoms of Addison’s disease or Addisonian crisis?

A

NOT ENOUGH ADRENAL secretion leads to WEAKNESS, FATIGUE, WEIGHT LOSS, and LOW BLOOD PRESSURE.

Example: A patient with Addison’s disease may feel weak, tired, and dizzy, and may experience a sudden drop in blood pressure, potentially leading to an Addisonian crisis.

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40
Q

What are the symptoms of Cushing’s syndrome?

A

EXCESSIVE ADRENAL secretion leads to WEIGHT GAIN, BUFFALO HUMP, MOON FACE, and THINNING SKIN.

Example: A patient with Cushing’s syndrome may have a round, moon-shaped face, a hump between the shoulders, and purple stretch marks on the skin.

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41
Q

What are the functions of the adrenal gland?

A

Answer: The adrenal gland secretes CORTISOL and ALDOSTERONE.

Example: Cortisol regulates metabolism, immune response, and stress response, while aldosterone helps regulate blood pressure and electrolyte balance.

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42
Q

What are the (2) treatment for severe hypoglycemia?

A

IV DEXTROSE 25G or IM/IN GLUCAGON 1MG.

Example: A patient with severe hypoglycemia who is unresponsive may receive glucagon via intramuscular injection as an emergency treatment.

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43
Q

What is diabetic ketoacidosis (DKA)?

A

DKA is a LIFE-THREATENING complication of diabetes caused by insulin deficiency, leading to KETONE production.

Example: A patient with type 1 diabetes who has not taken insulin for a prolonged period may develop DKA, presenting with symptoms such as hyperglycemia, ketosis, and metabolic acidosis.

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44
Q

What hormones are secreted by the THYROID gland?

A

THYROXINE and CALCITONIN.

Example: A patient with an underactive thyroid may experience fatigue, weight gain, and cold intolerance. They may be diagnosed with Hashimoto’s disease and require treatment with Synthroid.

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45
Q

What is the condition associated with an overactive thyroid gland?

A

THYROID STORM - High, hot, and fast.

Example: A patient with thyroid storm may present with severe agitation, high fever, and tachycardia. Treatment involves managing symptoms, cooling measures, and medications to block thyroid hormone production.

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46
Q

What is the condition associated with an underactive thyroid gland?

A

HASHIMOTO’S - Low, slow, and cold. May progress to MYXEDEMA COMA.

Example: A patient with myxedema coma due to severe hypothyroidism may present with decreased level of consciousness, hypothermia, and respiratory depression. Treatment includes airway management, warming measures, and administration of Synthroid.

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47
Q

What is the common cause of BRONCHIOLITIS in children under 1-2 years old?

A

RSV (Respiratory Syncytial Virus) infection.

Example: An infant with bronchiolitis may present with rhinorrhea, cough, and low-grade fever. Supportive care, such as maintaining hydration and providing oxygen therapy, is typically provided as there is no specific antiviral treatment for RSV.

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48
Q

What is the treatment for CROUP (and other name for)?

A

(Laryngotracheobronchitis)

DEXAMETHASONE orally for mild to moderate cases, NEBULIZED EPINEPHRINE for moderate to severe cases. It is VIRAL

Example: A 5-year-old child with croup may present with a barky, seal-like cough and stridor. Treatment may involve providing dexamethasone orally for mild cases and nebulized epinephrine for more severe cases.

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49
Q

What is the treatment for ANAPHYLAXIS?

A

OXYGEN, EPINEPHRINE 1:1, ANTIAHISTAMINES, and CORTICOSTEROIDS.

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50
Q

What is the treatment and signs of EPIGLOTTITIS?

A

AIRWAY MANAGEMENT and ANTIBIOTICS (e.g., ceftriaxone).

Example: A patient with epiglottitis may present with severe throat pain, difficulty swallowing, and drooling.

TREATMENT: Immediate airway management and administration of antibiotics are essential to treat the bacterial infection.

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51
Q

How is REACTIVE AIRWAY DISEASE (RAD) treated in children? AND SIGNS?

A

BRONCHODILATORS (e.g., albuterol) and STEROIDS (e.g., prednisolone).

Example: A child with RAD may present with recurrent episodes of wheezing and cough.

TREATMENT: involves using bronchodilators, such as albuterol, and oral or inhaled steroids to reduce airway inflammation.

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52
Q

What determines STROKE VOLUME?

A

HEART RATE (HR) x STROKE VOLUME (SV).

which is the volume of blood pumped by the left ventricle during each heartbeat.

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53
Q

What is the definition of PRELOAD?

A

The VOLUME available for VENTRICLES to pump during each contraction.

Example: A patient’s preload represents the volume of blood in the ventricles at the end of diastole, determining the amount available for the ventricles to pump during each contraction.

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54
Q

What produces BLOOD PRESSURE?

A

PERIPHERAL VASCULAR RESISTANCE (PVR) from peripheral vascular resistance.

Example: Blood pressure is generated by the resistance to blood flow in the peripheral vasculature, known as peripheral vascular resistance.

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55
Q

What produces BLOOD PRESSURE?

A

PERIPHERAL VASCULAR RESISTANCE (PVR) from peripheral vascular resistance.

Example: Blood pressure is generated by the resistance to blood flow in the peripheral vasculature, known as peripheral vascular resistance.

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56
Q

What happens during VASCULAR RELAXATION?

A

DIASTOLE occurs, allowing the heart to fill with blood.
Example: During the relaxation phase of the cardiac cycle, known as diastole, the heart fills with blood.

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57
Q

How is BLOOD PRESSURE determined?

A

CARDIAC OUTPUT (CO) and PERIPHERAL VASCULAR RESISTANCE (PVR).

Example: Blood pressure is determined by multiplying the cardiac output (volume of blood pumped per minute) by the peripheral vascular resistance (resistance to blood flow in the peripheral vasculature).

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58
Q

What is the definition of HYPERTENSIVE EMERGENCY?

A

A significant increase in SYSTOLIC and DIASTOLIC BLOOD PRESSURE, often with diastolic pressure exceeding 130 mmHg.

Example: A patient presents with a blood pressure reading of 180/110 mmHg, indicating a hypertensive emergency.

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59
Q

What is PERICARDITIS?

A

Inflammation of the PERICARDIUM caused by bacterial or viral infection or surgery.

Example: A patient complains of sharp chest pain worsened by deep breaths, which is indicative of pericarditis.

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60
Q

What is an AORTIC ANEURYSM?

A

Swelling of the AORTA that can rupture and cause high mortality rates.

Example: A patient presents with sudden, severe chest or abdominal pain, suggesting a possible aortic aneurysm.

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61
Q

What are signs and symptoms of AORTIC DISSECTION?

A

Different pulses on each side, decreased intensity of pulses, and CHEST PAIN.

Example: A patient experiences sudden, tearing chest pain radiating to the back, indicating a potential aortic dissection.

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62
Q

What is HEART FAILURE? (what does it cause)

A

The heart’s inability to pump blood effectively, leading to EDEMA and reduced cardiac output.

Example: A patient presents with swollen ankles, shortness of breath, and fatigue, indicating heart failure.

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63
Q

What does STARLING’S LAW describe?

A

Increased myocardial stretch (preload) leads to a stronger myocardial contraction (contractility), resulting in a greater stroke volume.

The bigger the stretch the bigger the squeeze

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64
Q

What is CORE PULMONALE? (what are signs)

A

Right-sided heart failure caused by PULMONARY EDEMA due to increased pressure in the pulmonary circuit.

Example: A patient with chronic obstructive pulmonary disease (COPD) develops right-sided heart failure characterized by PE and JVD

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65
Q

What is EPIGLOTTITIS?

A

Bacterial infection causing inflammation of the EPIGLOTTIS.

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66
Q

What should be done for PNEUMONIA patients regarding fluids?

A

Provide FLUIDS to prevent dehydration and promote recovery.

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67
Q

What is REACTIVE AIRWAY DISEASE (RAD)?

A

A condition similar to asthma, diagnosed in children when they reach a certain age.

Example: A child exhibits symptoms of wheezing and coughing, but a definitive asthma diagnosis cannot be made due to age, so it may be classified as reactive airway disease.

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68
Q

What are the characteristics of COPD with BRONCHITIS?

A

BLUE Bloater (Bronchitis), Excess MUCOUS production and problems with GOBLET CELLS.

Example: A patient with COPD and chronic bronchitis presents with a chronic productive cough, increased sputum production, and frequent exacerbations. Give Neb Albuterol 2.5mg

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69
Q

What are the characteristics of COPD with EMPHYSEMA?

A

Pink PUFFER (emphysema) , with problems in the ALVEOLI.

Example: A patient with COPD and emphysema presents with barrel chest, pursed-lip breathing, and increased respiratory rate. Give Neb Albuterol 2.5mg

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70
Q

What is this 12 lead showing and why?

A

Pericarditis - Inflammation of the pericardium causing chest pain and friction rub.

It has Diffuse ST segment elevation and PR segment depression.

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71
Q

What is seen on this12-lead ECG and why?

what is the treatment?

A

3rd Degree HB, Complete dissociation between P waves and QRS complexes.

Complete blockage of electrical impulses between atria and ventricles.

Treatment may involve immediate transcutaneous PACING

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72
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

SVT - Regular narrow complex tachycardia with rate > 150 bpm.

originating above the ventricles that may cause palpitations, lightheadedness, and shortness of breath.

Treatment may involve vagal maneuvers, ADENOSINE, or CARDIOVERSION depending on the underlying cause and patient stability.

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73
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

Uncontrolled A-FIB - Irregularly irregular rhythm with no discernible P waves.

Treatment may involve rate control with medications such as beta-blockers or calcium channel blockers

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74
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

HYPERKALEMIA: High levels of potassium in the blood that can cause cardiac arrhythmias and cardiac arrest.

On a 12 lead ECG, there may be peaked T waves, widened QRS complexes, or absent P waves.

Treatment may involve immediate administration of calcium, insulin and glucose, or dialysis depending on the severity of the hyperkalemia and the patient’s clinical status.

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75
Q

What is seen on this 12-lead ECG and why?

A

WOLF PARKINSON WHITE: (HAS DELTA WAVES) An accessory pathway between the atria and ventricles that can cause a rapid heart rate and potentially life-threatening arrhythmias such as atrial fibrillation or ventricular tachycardia.

On a 12 lead ECG, a short PR interval and a widened QRS complex (delta wave) can be seen.

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76
Q

What is seen on this 12-lead ECG and why?

A

WELLENS WAVES: A characteristic ECG finding that indicates a high risk of anterior wall myocardial infarction.

On a 12 lead ECG, biphasic or deeply inverted T waves in the precordial leads (V2-V3) can be seen.

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77
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

V-FIB: A chaotic and disorganized ventricular rhythm that can lead to cardiac arrest.

On a 12 lead ECG, there are no identifiable QRS complexes and the baseline is a quivering or undulating pattern.

Treatment may involve immediate DEFIBRILLATION and advanced cardiac life support measures.

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78
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

SINUS BRADY: A slow heart rate originating from the sinoatrial node that may cause symptoms such as fatigue or dizziness.

On a 12 lead ECG, there is a regular rhythm with a rate < 60 bpm and normal P wave morphology.

Treatment may involve observation in stable patients or administration of ATROPINE or PACE unstable

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79
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

2ND DEGREE TYPE 1: Also known as Mobitz Type 1 or Wenckebach, it is a second-degree AV block in which there is a progressive lengthening of the PR interval until a QRS complex is dropped. It is usually benign and requires no specific treatment unless it progresses to a more severe block.

On a 12-lead ECG, you can spot it by the presence of dropped beats and progressive prolongation of the PR interval before the dropped beat.

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80
Q

What is seen on this 12-lead ECG and why?

what is the treatment?

A

IDIOVENTRICULAR: Idioventricular rhythm is a regular rhythm with a rate of LESS THAN 40 bpm originating from the ventricles. It is usually a sign of severe myocardial damage and poor prognosis, especially when it is sustained.

On a 12-lead ECG, you can spot it by the ABSENSE of P waves and wide QRS complexes.

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81
Q

What is seen on this 12-lead ECG and why?

A

JUNCTIONAL: Junctional rhythm is a regular rhythm originating from the AV junction with a rate of 40-60 bpm. It can be a normal variant or a sign of underlying heart disease.

On a 12-lead ECG, you can spot it by the absence of P waves or by the presence of retrograde P waves.

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82
Q

What is seen on this 12-lead ECG and why?

A

A/V PACED SEQUENTIAL: A sequential paced rhythm in which the atria and ventricles are paced in a sequential manner to maintain AV synchrony. It is usually used in patients with complete heart block.

On a 12-lead ECG, you can spot it by the presence of paced spikes before each QRS complex.

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83
Q

What is seen on this 12-lead ECG and why?

A

LBB WIDE QRS, LEFT PATH AXIS: Left Bundle Branch Block (LBBB)

On a 12-lead ECG, you can spot it by the presence of a wide QRS complex (>0.12 seconds) with a characteristic QRS morphology in leads V1-V6, I, aVL, and aVF.

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84
Q

What is seen on this 12-lead ECG and why?

A

LVH: Left Ventricular Hypertrophy (LVH) is an increase in the thickness of the left ventricular myocardium due to chronic pressure overload, such as in hypertension or aortic stenosis.

On a 12-lead ECG, you can spot it by the presence of increased QRS voltage (S wave in V1 + R wave in V5 or V6 >35 mm) or by the presence of repolarization abnormalities.

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85
Q

What is seen on this 12-lead ECG and why?

A

SCARBOSA: Scarbosa pattern is a characteristic ECG pattern in patients with myocardial infarction involving the left circumflex artery, presenting as ST-segment elevation in leads I, aVL, V5, and V6, and ST-segment depression in leads II, III, and aVF. On a 12-lead ECG, you can spot it by the presence of the Scarbosa pattern.

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86
Q

What is HEMOPHILIA?

A

Genetic bleeding disorder with IMPAIRED blood CLOTTING.

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87
Q

What is LEUKEMIA?

A

Cancer of the BLOOD CELLS.

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88
Q

What are the symptoms of PANCREATITIS?

A

Mid epigastric PAIN radiating to the back.

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89
Q

What are the symptoms of APPENDICITIS?

A

Periumbilical PAIN progressing to RLQ pain with McBurney’s POINT tenderness.

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90
Q

What are the symptoms of CHOLECYSTITIS?

A

RUQ pain following ingestion of fatty food

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91
Q

What are the symptoms of ESOPHAGEAL VARICES?

A

Bright red HEMATEMESIS due to portal vein hypertension.

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92
Q

What are the symptoms of HEPATITIS/CIRRHOSIS?

A

RUQ pain and JAUNDICE.

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93
Q

What are the symptoms of PEPTIC ULCER?

A

Mid epigastric PAIN, commonly associated with chronic NSAID use.

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94
Q

What are the symptoms of BOWEL OBSTRUCTION?

A

Hematochezia, pain, bloating, N&V, fecal EMESIS.

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95
Q

What are the symptoms of KIDNEY STONES?

A

Flank/back PAIN and dysuria (Renal Lithiasis/Calculi).

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96
Q

What are the symptoms of UTI?

A

Dysuria, polyuria, and PAIN.

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97
Q

What are the symptoms of TESTICULAR TORSION?

A

Sudden UNILATERAL PAIN, often after heavy lifting (Kehr’s sign).

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98
Q

What are the symptoms of HEMORRHOIDS?

A

Painful swelling, itching, and BLEEDING around the anus.

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99
Q

What are the symptoms of SPLENIC INSULT?

A

LUQ PAIN, nausea, vomiting, and left shoulder PAIN.

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100
Q

What are the two types of DISTRIBUTIVE SHOCK?

and treatment

A

Anaphylactic Shock,
Septic Shock

Fluids, Anti-histamines, Anti-biotics

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101
Q

What can cause HYPOVOLEMIC SHOCK?

A

Hemorrhage, dehydration

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102
Q

What can cause CARDIOGENIC SHOCK?

A

MI, heart injury, infection, and dysrhythmia.

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103
Q

What can cause OBSTRUCTIVE SHOCK?

A

Pulmonary embolism, tamponade, and tension pneumothorax.

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104
Q

What causes NEUROGENIC SHOCK?

A

Spinal injury above T6 level.

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105
Q

What type of shock is caused by a FLUID/GAS problem?

A

Distributive Shock.

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106
Q

What type of shock is caused by VESSEL DILATION?

A

Obstructive Shock.

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107
Q

What are the stages of shock?

A

Compensated, Decompensated, and Irreversible.

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108
Q

What are the signs of COMPENSATED shock?

A

Low blood pressure, increased heart rate (100-120 bpm).

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109
Q

What are the signs of DECOMPENSATED shock?

A

Very low or undetectable blood pressure, irreversible tissue damage.

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110
Q

What are the signs of IRREVERSIBLE shock?

A

Inability to restore normal blood pressure, severe tissue damage.

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111
Q

What is Beck’s Triad
and in what condition do we see it?

A

Three signs - low BP, muffled heart sounds, jugular vein distention.

Seen in CARDIAC TAMPONADE.

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112
Q

What is Cushing’s Triad
and when is it observed?

A

Triad of hypertension, bradycardia, and irregular respirations.

Seen in INCREASED INTRACRANIAL PRESSURE.

Hyperventilate at 20 bpm BVM

(normal is 10-12)

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113
Q

What is Kehr’s Sign
and what does it indicate?

A

Pain radiating to the LEFT SHOULDER,

indicates ABDOMINAL SPLEEN injury.

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114
Q

What does the Babinski Test assess and how is it performed?

A

Assess corticospinal tract integrity.
Performed on the BOTTOM OF THE FOOT.

A positive (bad) Babinski test is indicated by the upward and OUTWARD movement (extension and fanning) of the toes.

good is inward, opposite for neonate

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115
Q

What is Decorticate Posturing and what does it indicate?

GCS Score?

A

GCS motor score of 3. Flexed arms, clenched fists to CORE, extended legs.

Indicates BRAIN INJURY.

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116
Q

What is Decerebrate Posturing
and how does it differ from Decorticate Posturing?

GCS Score?

A

GCS motor score of 2. Extended arms OUTWARD and legs, clenched fists.

Indicates SEVERE BRAINSTEM INJURY.

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117
Q

What is Cullen’s Sign and what does it suggest?

A

Ecchymosis (bruising) around the UMBILICUS.

Suggests INTRA-ABDOMINAL BLEEDING.

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118
Q

How is heat transferred through RADIATION?

A

Transfer of heat via electromagnetic waves

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119
Q

What is CONDUCTION?

A

Transfer of heat through DIRECT CONTACT between objects.

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120
Q

How does heat transfer through CONVECTION?

A

Heat transfer through the MOVEMENT OF FLUIDS or GASES.

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121
Q

How does heat transfer through EVAPORATION?

A

Transfer of heat through the CONVERSION OF LIQUID TO GAS.

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122
Q

What should you do when DEFIBRILLATING a HYPOTHERMIC patient?

A

DEFIBRILLATE ONCE until the patient is REWARMED.

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123
Q

What does the CENTRAL NERVOUS SYSTEM consist of?

A

BRAIN and SPINAL CORD

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124
Q

What are the two components of the PERIPHERAL NERVOUS SYSTEM?

A

SOMATIC and AUTONOMIC NERVOUS SYSTEM.

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125
Q

How do HEMORRHAGIC and ISCHEMIC STROKES differ?

A

Hemorrhagic causes INCREASED INTRACRANIAL PRESSURE, (BLEED)

while ischemic occurs due to BLOCKAGE. (CLOT)

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126
Q

What are the different types of SEIZURES?

A

Generalized (GRAND MAL and PETIT MAL) and Partial (SIMPLE and COMPLEX).

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127
Q

What distinguishes ALS from MS?

A

MS comes and goes, while ALS PROGRESSES and affects breathing.

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128
Q

What are the different types of HEADACHES?

A

Tension, migraine, cluster, and sinus headaches.

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129
Q

What is the normal range for a BRADYCARDIC heart rate?

A

<60 beats per minute.

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130
Q

What is the rate range for IDIOVENTRICULAR ESCAPE rhythm?

A

20-40 beats per minute.

no P wave

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131
Q

What is the rate range for JUNCTIONAL ACCELERATED JUNCTIONAL rhythm?

A

100-120 beats per minute.

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132
Q

What are the different types of PREMATURE atrial contractions?

A

PAC - early P;
PJC - early wide QRS;
PVC - early wide QRS.

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133
Q

How can you identify ATRIAL FLUTTER on an ECG?

A

Sawtooth pattern. between QRS’s

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134
Q

How can you identify ATRIAL FIBRILLATION on an ECG?

A

Chaotic, irregular squiggles. between QRS’s

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135
Q

What is the characteristic of VENTRICULAR TACHYCARDIA on an ECG?

A

Fast, wide, bizarre QRS.

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136
Q

What is the significance of P WAVES on an ECG?

A

Indicate atrial depolarization.

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137
Q

What is the normal range for PR INTERVAL on an ECG?

A

less than <200 milliseconds.

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138
Q

What is the characteristic of a SECOND-DEGREE TYPE II block on an ECG?

A

P wave without a QRS complex (random dropped QRS).

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139
Q

What are the characteristics of RIGHT BUNDLE BRANCH BLOCK (RBBB) on an ECG?

A

Bunny ears in V1, slurred S wave in I/V6.
Wide QRS (>112ms)

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140
Q

What are the characteristics of LBBB (Left Bundle Branch Block) on an ECG?

A

Wide QRS (≥120ms), mostly negative QRS in V1.

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141
Q

What is the recommended treatment for Stable Bradyarrhythmia?

A

Atropine

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142
Q

What is the recommended treatment for Unstable Tachyarrhythmia?

A

Synchronized Cardioversion (over 150 bpm).

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143
Q

What is the recommended treatment for Stable Tachyarrhythmia?

A

Adenosine (6mg, 12mg, 12mg) or consider vagal maneuvers.

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144
Q

What is the recommended treatment for V-Tach with a Pulse?

A

Amiodarone (150mg, 300mg)

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145
Q

What is the recommended treatment for V-Fib or Pulseless V-Tach?

A

Defibrillate (200J, 300J), Epi (1mg) and Amiodarone (300mg).

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146
Q

What is the recommended treatment for AFib and Aflutter?

A

Cardizem or Diltiazem.

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147
Q

What is the recommended treatment for ROSC (Return of Spontaneous Circulation)?

A

Secure airway, check ETCO2, give 10 breaths per minute. Active rewarm, lift 30 degrees

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148
Q

What is the recommended treatment for Asystole or PEA (Pulseless Electrical Activity)?

A

Do not shock, initiate high-quality CPR.

Give Epi

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149
Q

What are the common causes of cardiac arrest represented by H and T?

A

Hypovolemia, Hypoxia, Hydrogen Ion (Acidosis), Hypo/Hyperkalemia, Hypothermia, Tension pneumothorax, Tamponade, Toxins, Thrombosis (Coronary/Pulmonary).

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150
Q

What is the recommended treatment for Pulseless VFib or Pulseless VTach?

A

Defibrillate immediately (200J, 300J), then administer Epi (1mg) and consider Amiodarone (300mg).

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151
Q

What are the drug dosages for Epi (Epinephrine) and Dopamine in cardiac arrest?

A

Epi: 1mg every 3-5 minutes, Dopamine: 5-20mcg/kg/min.

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152
Q

How do you confirm electrical capture during transcutaneous pacing?

A

Check femoral pulse and observe electrical capture on the monitor.

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153
Q

What is the recommended treatment for stable wide-complex tachycardia?

A

Consider Amiodarone 150mg over 10 minutes.

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154
Q

What is the recommended treatment for defibrillation of pulseless VTach/VFib?

A

Immediately shock at 200J, then escalate to 300J, and consider administering Amiodarone (300mg).

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155
Q

What are the normal ranges for PRI (PR interval) and QRS duration on an ECG?

A

PRI: 0.12-0.20 seconds (4-5 small squares), QRS: 0.06-0.11 seconds (1-3 small squares).

156
Q

What is Guillain-Barre Syndrome?

A

Body’s immune system attacks its own MYELIN, causing peripheral nerve dysfunction and weakness progressing to PARALYSIS.

157
Q

What is Meningitis?

A

Inflammation of the MENINGES via FECAL/oral or respiratory viral or bacterial infection.

158
Q

What is Poliomyelitis?

A

VIRAL infection attacking motor neurons, causing muscle weakness and PARALYSIS.

159
Q

What is Bell’s Palsy?

A

Unilateral facial nerve paralysis post-trauma or VIRAL INFECTION.

160
Q

Morphine

A

0.1mg/kg max initial dose of 20mg (2nd dose 0.05mg/kg max 10mg)

opioid analgesic

for severe pain

contra - allergic, resp distress, bp >90

161
Q

Fentanyl

A

1 mcg/kg max dose of 200mcg

opioid analgesic

for severe pain

contra - bp >90, allergic, resp distress

162
Q

What is the initial dose of IV fentanyl for pain management?

A

1 mcg/kg max of 150 mcg

163
Q

Q waves are significant if:

A

They are ≥ 0.03 seconds (one little block) wide
B.

They are deeper than ⅓ the height of the R wave.

164
Q

What does the T Wave Represent

A

Ventricular Repolarization

165
Q

Where would you see a U wave?

A

The U wave is a small, flat wave seen after the T wave and before the next P wave.

166
Q

What is a physiologic block?

A

it is a normal slowing or delay of the impulse as it moves from the atria to the ventricles via the AV node. This slowing is critical to coordinate the mechanical contraction of the atria with the ventricles. Without the physiologic block, the atria and ventricles would contract simultaneously.

167
Q

What fires during the PR interval?

A

The atria, AV node, bundle of His, bundle branches, and Purkinje system all fire.

168
Q

Whats the difference between Physiological Q wave and Pathological Q wave

A

Physio is NORMAL variant (less that .04)

PATHOLOGICAL is wider (greater than .04)
or depth is 1/3 x

169
Q

Limb leads look at the ____________

Precordial (Chest) leads look at the ___________

A

Frontal plane

Horizontal plane

170
Q

Define Einthoven’s triangle

what type of limb lead view is it

A

Bi-Polar limb leads

I, II, III

171
Q

What kind of leads are V1 - V6

A

precordial (chest)

unipolar

positive electrodes

172
Q

What lead groups look at the:

Septal Wall

A

V1, V2 (chest leads).
+ electrodes are sternum

173
Q

1 and avL, V5 and V6 looks at what part of the heart

A

Lateral Wall

+ electrode is at the left arm (1, avL)

left lateral chest ( v5, v6)

174
Q

Which leads are NOT anatomically contiguous?

A

I and II

avr and avf

v1 and v4

175
Q

Define Polarization

A

When electrical charges are balanced and ready for discharge

176
Q

What are the 3 Inherent rates of the conduction system

A

SA Node 60-100 bpm
AV Junction 40-60 bpm
Ventricles 20-40 bpm

177
Q

Which nervous system slows the heart

Which nervous system speeds the heart up

A

Slows DOWN the heart - Parasympathetic

Speeds - Sympathetic

178
Q

What are two interventions that start or squeeze the heart

A

start - epi

squeeze - defib

179
Q

Interventions to SPEED up the heart

A

TCP

Atropine
Epi infusion
Dopamine infusion

180
Q

Treatment for Hypovolemia

(low blood)

A

IV Fluid (20mL per kg)
Vasopressors (Dopamine, Epi)

181
Q

Treatment for Hydrogen Ion (Acidosis)

A

Sodium BiCarb

airway management
CPR

182
Q

what do you do with the energy level if….

you go from a perfusing to a NON perfusing rhythm

A

never decrease the energy level

from defi to SVT stay at 300

183
Q

What is the dose of Atropine for Bradycardia

A

Atropine 1mg every (q) 3-5mins max of 3mg

184
Q

For Brady what is the quick treatment atde

A

All
Trained
Dogs
Eat

Atropine
TCP
Dopamine
Epinephrine

185
Q

What are signs of unstable TACHY

A

hypotension below 90/60
AMS
Shock
CP

186
Q

What are the DEFIBRILLATION shocks

A

200j, 300j, 360j

187
Q

Explain depolarization vs Contraction

A

Depolarization = electrical activity only

Contraction = mechanical squeeze of the heart

188
Q

What lead are we looking at when placing PADs

A

Lead 2

189
Q

how many small boxes is a 6 second strip

A

150

190
Q

My underlying rate is 70. My PRI is .22s. I have P, QRS & T waves which all look the same.

A

Sinus with 1st degree Heart block

191
Q
A

Atrial Fibrillation (controlled) with 2 unifocal PVC’s

192
Q

how much time is between the two heavy lines on a graph

A

0.20 seconds

193
Q

What is the atrial rate in a-flutter

A

250-350 bpm

194
Q

What is the drug dose of Diltiazem

when do you give

A

0.25mg/kg

2nd dose
0.35mg/kg

For afib and aflutter

Calcium channel blocker

Do not give chf or 3rd degree block

195
Q

What is the drug dose of Lidocaine

and when do you give?

A

0.5-0.75mg/kg

Tachy

196
Q

What is the drug dose of Atropine

when do you give

A

1mg

Brady

197
Q

what is the drug dose of cardizem

when do you give

A

afib or aflutter

(0.25 then 0.35)

198
Q

What is happening during a

QRS

A

Ventricle Depolarization

199
Q

Define Absolute refractory period

A

heart cannot fire, not ready,

has not reached halfway up t-wave

200
Q

Where does blood flow through the heart

A

Superior/Inferior VC -> R Atria -> Tricuspid valve -> R Ventricle -> Pulmonary artery ->

Lungs ->

Pulmonary veins -> L Atria -> Mitral valve -> L Ventricle -> Aorta

201
Q

Steps for Sync Cardio Vert

A

For unstable Tachy

  • Press Sync
  • Marker over every R wave
  • Settings
    A-fib: 120-200J -> 200J -> 300 -> 360J

A-flutter: 100J -> 200J -> 300J -> 360J

SVT w/narrow QRS: 100J -> 200J -> 300J -> 360J

V-tach: 100J -> 200J -> 300J -> 360J

202
Q

Depression in aVr indicates

A

Pericarditis

203
Q

Limb leads look at the heart from a __________ plane

A

frontal

204
Q

What lead is the positive lead in aVr?

A

right arm +

205
Q

Leads II, III, and aVf look at the _______ _______

A

Inferior wall

206
Q

R wave is the _____ _______________________ in the QRS complex

A

1st positive deflection

207
Q

What makes a Q wave pathologic? (2 things)

A

> or = to .04 seconds (greater than or equal to 1 small box)

If Q wave depth is > 1/3 height of R wave

208
Q

What lead is the positive lead in aVf?

A

left leg +

209
Q

Leads II, III, and aVf look at the _______ _______

A

Inferior wall

210
Q

Left Coronary Artery starts as the Left main, then bifurcates into the _________ and the ___________.

A

-left circumflex
-left anterior descending artery

211
Q

Right Coronary Artery wraps around the heart and becomes the _______________________

A

posterior descending artery

212
Q

Left Anterior descending artery feeds the (3 things):

A

-anterior septal wall
-anterior left ventricular wall
-apex

213
Q

AHA definition of a STEMI

A

> or equal to 1mm ST elevation in 2 or more anatomically contiguous leads

214
Q

Which leads look at the LATERAL wall of the heart?

A

I, aVL, V5, and V6

215
Q

What is bifascicular heart block?

A

a blockage of 2/3 pathways to contract the ventricles in an organized fashion

216
Q

How do you calculate LVH?

A

“Rule of 35”

Pick the deepest negative deflection of QRS between leads V1 and V2, and add the # of small boxes to the tallest positive QRS deflection in V5 and V6

217
Q

LVH confirmation _____________ the 12 lead for AMI discrimination

A

negates

218
Q

How do you identify pericarditis on an ECG? (3 things - only need 1 to confirm)

A

-diffuse ST segment elevations
-no reciprocal changes
-PR interval depressions

219
Q

avR T wave inversion is _______, in v1 and v2 it is ________ and other leads its a sign of _________

A

normal (because of how leads are)

a normal variant

a sign of ischemia

220
Q

Low blood sodium is called ____________

A

Hyponatremia

221
Q

Whats a normal platelet count?

A

150,000-300,000

222
Q

Normal range for WBCs

A

4,500 - 10,000

223
Q

normal hematocrit levels

A

Male: 45%-52%
Female: 37-48%

224
Q

Normal potassium levels (K)

A

3.5-5.0 mEq/L

225
Q

Creatinine levels

A

0.6-1.2 mg/dL

226
Q

Normal INR range

A

0.9 - 1.1 sec

227
Q

Normal BUN levels

A

8-22 mg/dL

228
Q

Low creatinine levels suggest _______ and/or ________ disease

A

Heart and/or liver

229
Q

Normal chloride (Cl) levels

A

95-102 mEq/L

230
Q

Low BUN can indicate _______

A

Liver disease

231
Q

Depression in aVr is indicative of _________

A

Pericarditis

232
Q

When do you run a V4r

A

EVERY time an ST elevation in INferior Wall (II, III, avf)

233
Q

What is the most common AMI

A

Inferior Wall MI is 80%

234
Q

What does Nitro and morphine do to the RV

A

reduce preload

235
Q

Where anatomically is v5r, v6r placed

A

v5r - 5th ics anterior axillary (right)
v6r - 5th ics mid axillary (right)

236
Q

What are clues of RV involvement

and what are you looking for in v4r

A

J-point elevation in III is > than II
J-point elevation in V1
J-point depression in V2

v4r - greater than 1 mm j-point elevation

237
Q

What are the symptoms of Inferior/RV AMI

A

Weakness and nausea - angianal equivalents

urge to defecate

JVD
Hypotension

CP

238
Q

Anatomically where do V8 and v9 go

(and v7)

A

v8 - 5th ics mid scapula (L) (under shoulder blade)

v9 - paravertebral border (L) (near spine)

v7 - posterior axillary line (L) (near arm pit)

239
Q

Obtain v8 and v9 when

A

v1- v4 show st depression (two or more anatomically contiguous)

240
Q

What does the QT interval represent

A

The amount of time it takes ventricle to depolarize and repolarize

241
Q

What are the bi-polar leads

A

I II III

242
Q

What the augmented leads

A

avr avL avf

243
Q

How much time is

1 small box
1 large box
5 large blocks
30 large blocks

A

1 small box - 0.04
1 large box - 0.20
5 large blocks - 1 second
30 large blocks - 6 seconds

244
Q

What BB’s does a hemi block indicate

A

it specifically indicates LBB

Anterior hemiblock - Pathological left (-30/-90)
and
Posterior -Right Axis (90/180)

245
Q

When you find a block, hemi block what do you do next

A

PUT Pads on them to DEFIB or PACE

246
Q

How do you confirm LBBB after turnsignal in V1

(with qrs over 120 & supra rhythm)

A

look at I and/or v6 for:

FAT/BROAD R Waves

247
Q

What is ejection fraction

A

% of blood pumped out by the left ventricle, compared to how much it holds (usually 70-75%)

BBB with QRS 170ms, ejection fraction can’t be more than 50% (chf or MI) can compensate

248
Q

What are the rates of Junctional Rhythms

and difference between junc brady and idiovent

A

Junctional Tachy Over 100
Accel Junctional 60 -100
Junctional (Escape) 40-60
Junctional Brady Below 40 (narrow QRS)

(idioventricular = wide QRS over 0.120s, below 40)

249
Q

If you find a Bi-Fascicular Block what should you be prepared for?

A

To Pace and or Defibrillate (put on the PADS)

250
Q

Which axis comes with a Anterior hemiblock

A

Pathological Left

251
Q

What the 3 categories for ECG

A

Non-Diagnostic - acute coronary
Ischemia - st depress, t wave inversion
STEMI

252
Q

In avR where is the positive electrode?

A

Right shoulder

253
Q

If you have elevation in II III and avF where might you see reciprocal change

A

I, avL, v leads

254
Q

Pump Failure would cause what type of shock?

A

Cardiogenic Shock

255
Q

Shock secondary to an INFECTION in the blood is ______________ shock

A

Distributive shock

256
Q

Fentanyl

class / dose / for / contra

A

Opioid

dose: 1mcg/kg (max 200mcg)

for: severe pain

contra: allergic, uncorrected resp distress, hypo 90

257
Q

Morphine

class / dose / for / contra

A

Opioid

dose: 0.1mg/kg (max initial dose 20mg)
2nd dose: 0.05mg/kg (max of 10mg)

for: severe pain

contra: allergic, uncorrected resp distress, hypo 90

258
Q

Ketamine

class / dose / for / contra

A

Sedative-hypnotic; analgesic

for PAIN:
dose: 0.2mg/kg (over 1-2 mins) max dose 20mg
2nd dose: same as above 0.2/max20

for SEDATIVE:
dose: 1mg/kg (max 100mg) IV,
4mg/kg IM (max 400)

contra: Eye injury, CP, AB pain, Headache, Pregnant/Breastfeed, hypersensative

259
Q

Epinephrine 1:1 (for allergic)

class / dose / for / contra

A

Adrenaline

dose: 1mg in 1ml

for: severe allergic reaction with resp dis, severe asthma

contra: none during anaphylaxis

260
Q

Name one of the primitive reflexes

A

Moro (startle)

261
Q

If your patient is hypoventilating, what will happen to their ETCO2 levels?

A

ETCO2 will increase

262
Q

Mild Abdominal Pain Radiating to the back is a sign of what organ affected?

A

Pancreas

263
Q

Define Afterload

A

the force the heart must overcome to pump blood out to the body. (Pressure of vascular resistance).

264
Q

What are the different types of burns?

A

thermal, chemical, and electrical.

265
Q

What is the difference between “hypovolemic” and “hemorrhagic” shock?

A

Hypovolemic shock - is caused by a loss of fluid,

hemorrhagic shock - is caused by a loss of blood.

266
Q

What is the difference between a simple and a comminuted fracture? (Not compound)

A

A simple fracture is when the bone breaks but does not penetrate the skin, while a comminuted fracture is when the bone is broken into multiple pieces.

267
Q

What is the difference between a hematoma and an ecchymosis?

A

A hematoma is a collection of blood outside the blood vessels, while an ecchymosis is a bruise.

268
Q

What is the difference between a partial-thickness and a full-thickness burn?

A

A partial-thickness burn - affects the outer layer of the skin and may cause blistering, while a

full-thickness burn - affects all layers of the skin and may cause charring.

269
Q

What are the symptoms and treatment of neurogenic shock? Besides can’t feel legs.

A

Symptoms: Bradycardia, hypotension, and warm/dry skin.

Treatment: Vasopressor support, fluid resuscitation, and spine immobilization.

270
Q

What are the signs and symptoms of a basilar skull fracture, and how should it be managed?

A

Signs and symptoms include raccoon eyes, Battle’s sign, CSF leakage from the ears or nose, and vertigo.

Management involves maintaining a patent airway and transporting the patient to the hospital for further evaluation.

271
Q

What is the difference between arterial and venous bleeding?

A

Arterial bleeding is bright red, spurting, and rapid,

venous bleeding is dark red, oozing, and slower.

272
Q

What are the signs of decompensated shock?

A

Vital signs: Hypotension, tachycardia, tachypnea, decreased urine output

Symptoms: Weakness, altered mental status, cool and clammy skin, decreased peripheral pulses, delayed capillary refill, decreased skin turgor, oliguria

273
Q

What are the signs of irreversible shock?

A

Vital signs: Profound hypotension, bradycardia, respiratory failure, hypoxia

Symptoms: Unresponsive, dilated and fixed pupils, absent peripheral pulses, cool and mottled extremities, anuria, metabolic acidosis

274
Q

What is the difference between a coup and contrecoup injury?

A

coup injury - occurs at the site of impact,

contrecoup injury - occurs on the opposite side of the brain due to the brain bouncing off the skull.

275
Q

What is the difference between an epidural and subdural hematoma?

A

An epidural hematoma - occurs between the skull and dura mater

subdural hematoma - occurs between the dura mater and brain.

276
Q

What is the hallmark sign of a third-degree burn?

A

Charring or white, leathery skin.

277
Q

Cheyne-Stokes
Biots,
and
Apneustic,

symptoms

A

Cheyne-Stokes - gradual increase and decrease with periods of apnea
(brain inj)

Biot’s - ABNORMAL, equal depth, with regular apnea
(brain stem inj)

Apneustic - prolonged inspire with prolonged expire (ICP)

278
Q

What are the signs and symptoms of heat stroke?

A

Confusion, altered mental status, hot and dry skin, and rapid pulse.

aggressive cooling and hydration, along with supportive care. This may include moving the patient to a cool environment, removing excess clothing, applying cool water to the skin, and using ice packs or cooling blankets. Intravenous fluids may be given to maintain hydration, and medications such as benzodiazepines or muscle relaxants may be used to control seizures or muscle rigidity. In severe cases, intubation and mechanical ventilation may be necessary.

279
Q

What are the 6 types of shock

A

Cdd hon

Cardiogenic
Distributive
Dissociative

Hypovolemic
Obstructive
Neurogenic

280
Q

Battle signs vs Raccoon Eyes are a sign of fractures where?

A

Battle - basilar skull
Raccoon - anterior cranial fossa

281
Q

What class of medication is diltiazem?

A

Class IV, antiarrhythmic

282
Q

What is the contraindicated Sedative for low Bp and Trauma bleeds

and dose

A

Versed - benzo, lowers bp

(0.05 - 0.1mg/kg)

283
Q

What does TXA do?

A

It SLOWS the break down of clots and fibrin

284
Q

What is the dose of TXA?

A

1g

285
Q

In MD, TXA can be administered how many hours after the injury?

A

1 Hour in MD, 3 hours Nat Reg

286
Q

How many collisions does a patient suffer in an MVC?

A

3

287
Q

BP 188/101, and a hx of blood thinners. Sudden severe headache, blurry vision, and AMS.

Subdural hematoma

epidural hematoma

intracranial hematoma

A

intracranial hematoma

288
Q

Parkland Burn Formula

A

4mL x TBSA x kg, given over 24 hours

289
Q

Calculate the TBSA using the rule of 9s (1st degree burns – entire back, entire left arm, back of leg)

A

0%

290
Q

Calculate the TBSA using the rule of 9s (3rd degree and 2nd degree burns – entire back, entire left arm, back of leg)

A

36%

291
Q

How much blood can the abdominal cavity hold?

A

Over 3000mL

292
Q

A patient fell from a roof and has normal pink skin, BP 98/62, HR 70, RR 18, and is unable to move or feel legs. What type of shock is this?

Not decomp comp irreversible

A

Neurogenic- Spinal

293
Q

In the rule of 9s how much is the patients palm?

A

1%

294
Q

A patient fell from a roof and is presenting with flushed skin, BP 80/42, HR 54, RR 0, and absent reflexes. What shock are they suffering from?

Not comp decomp irreversible answer

A

Neurogenic shock

295
Q

TBI patient without suspicion of herniation syndrome should be ventilated at a rate of ___.

A

10-12 bpm (ETCO2 35-45)

296
Q

How would you most likely treat flail chest if the pt was found to be unresponsive?

High flow O2

BVM ventilations

Pain management and O2

A

BVM ventilations

297
Q

Bleeding or swelling occurs within a compartment in a patient with which of the following conditions?

cardiac tamponade

crush injury

compartment syndrome

commotio cordis

A

compartment syndrome

298
Q

In a Near Drowning patient what might you consider for treatment

A

Airway, C-Spine, Rescue Breathing

Then on land:
02 pulse, abc, CPR, suction, IV

Poss: PEEP, if ET - nasogastric tube
place on side

299
Q

for High Altitude PE (HAPE) what is contra indicated

A

Signs - pulmonary hypertension

No Nitro
No Furosemide

poss CPAP and lower altitude

300
Q

A partial thickness burn is also known as ____________ and ________ degree burns (2)

A full thickness burn is also known as?

A

First and second - partial

3rd - Full - every layer - needs skin graft

301
Q

What is a 4th Degree burn

A

burn to bone, mostly chem burns

full thickness past muscle and tissues, all

302
Q

What chart does the hospital use for burns?

A

Lund and Browder Chart

303
Q

What is Boyles Law

A

Gas Pressure decrease as volume increase (and vice versa)

304
Q

What are signs of High Alt Cerebral Edema (HACE)

A

Headache, ATAXIA, ams

305
Q

How long do you Irrigate chem burns

A

atleast 15-20 mins

306
Q

What are the 3 forms of radiation and which is most harmful

A

Alpha
Beta
Gamma- Most dangerous

also note:
Ionizing - most dangerous
nonionizing - safe

307
Q

What are the 5 blast injuries

A
  1. primary - blast wave
  2. secondary - blast force
  3. Tertiary - impact with object
  4. Quaternary - burns, inhalation
  5. Qunary - long term damage
308
Q

Define
Hematuria
Hematachezia
Hematocrit

A

Hematuria - blood in urine
Hematachezia - bright red stool
Hematocrit - red blood cells in total blood volume

309
Q

The body cannot tolerate blood loss of _____

it is a class III hemorrhage

A

30-40%

310
Q

What is it called, a person lacking blood clotting factors

A

hemophilia

311
Q

Define Epithelialization

A

Formation of fresh tissue to heal a wound

312
Q

For a severe burn patient which step is first Intubate or Vitals?

A

Put out fire
Open airway
O2
INTUBATE
nasogastric tube stomach
IV
VITALS
remove clothes
Determine burn %
Dress burns, sterile

313
Q

Define Joule’s Law

A

The relationship between heat, current and resistance

314
Q

Difficulty swallowing

A

DysphaGIA

315
Q

Name the organs in the RUQ and LUQ

A

RUQ - Gall bladder, Intestine, Liver

LUQ - Pancreas, Intestine, Spleen, Stomach

316
Q

Define Cauda Equina Syndrome

A

compression of the spinal nerve roots, resulting in motor and sensory deficits

caused by a herniated disk, tumor, trauma, or spinal stenosis.

317
Q

What are the signs of Neurogenic Shock and not
Herniation or TBI

and how do we treat?

A

Neuro-
low bp
low hr
Flush RED skin
loss of sympathetic tone

give epi drip and pressors

318
Q

What drug to you give for Torsades?

A

Mag Sulfate 2g over 2mins

319
Q

What is the dose of Mag Sulfate for asthma?

A

2 grams of magnesium sulfate in 100 mL of normal saline to be administered intravenously over 20 minutes for the treatment of acute severe asthma.

320
Q

Describe GCS pneumonic you use

A
321
Q

What type of shock is Pericardial Tamponade?

A

Obstructive shock

322
Q

Accended 5 mins later mild chest pain, dysnea, and then goes unresponsive what is the cause?

A

Arterial gas emboli

323
Q

What type of shock and treatment?

A 30-year-old male who has been in a car accident and is experiencing mild shock. His blood pressure is 110/70 mmHg, heart rate is 110 beats per minute, respiratory rate is 20 breaths per minute, and he has mild diaphoresis.

A

Compensated

Treatment: oxygen via non-rebreather mask and IV fluids.

in compensated shock, the body’s compensatory mechanisms are able to maintain adequate organ perfusion, and the patient’s vital signs are relatively stable. The patient may have an elevated heart rate and respiratory rate, but their blood pressure is maintained within normal limits, and they do not have signs of inadequate organ perfusion.

324
Q

Define Endometriosis?

A

the tissue that normally lines the uterus grows OUTSIDE the uterus.

325
Q

Define Menarche
and Tanner Stages

A

Menarche - the FIRST menstrual period

Tanner Stages - physical changes that occur during PUBERTY (both boys and girls)

326
Q

Define Premenstrual Syndrome

what are the signs?

A

is a group of symptoms that occur in women BEFORE their menstrual periods, such as mood swings, bloating, and breast tenderness. (PMS)

327
Q

Define Mittelschmerz?

A

is a PAIN that some women experience during ovulation when the EGG IS RELEASED from the OVARY.

328
Q

Whats the difference between:
Dysmenorrhea
Menorrhagia
Amenorrhea
Mittelschmerz

A

Dysmenorrhea is painful menstrual cramps

Menorrhagia is heavy menstrual bleeding,

Amenorrhea is the absence of menstrual periods

Mittelschmerz is pain during ovulation.

329
Q

Define

Bartholin Abscess
Vaginitis
Pelvic Inflammatory Disease (PID)
Cystitis
STDs
Dyspareunia

A

Bartholin Abscess is an infection of the Bartholin gland

Vaginitis is an inflammation of the vagina

PID is an infection of the female reproductive organs

Cystitis is a bladder infection

STDs are sexually transmitted diseases.

Dyspareunia is PAIN during SEX in women.

330
Q

Define
Syphilis
HSV
Trichomoniasis
Gonorrhea
HPV
Cervictitis

A

Syphilis is a bacterial infection,

HSV is the herpes simplex virus,

Trichomoniasis is a parasitic infection,

Gonorrhea is a bacterial infection,

HPV is the human papillomavirus, and

Cervicitis is an inflammation of the cervix.

331
Q

Define these Ovarian Disorders

Ovarian Cyst
Ovarian Torsion
Tubo-Ovarian Abscess

A

Ovarian Cyst is a fluid-filled SAC that develops on the ovary,

Ovarian Torsion is when the ovary TWIST on its blood supply

Tubo-Ovarian Abscess is an INFECTION that affects the ovary and fallopian tube.

332
Q

Define these Uterine Disorders
Endometritis
Endometriosis
Uterine Prolapse

A

Endometritis is an inflammation of the endometrium,

Endometriosis is the growth of endometrial tissue outside the uterus,

Uterine Prolapse is when the uterus descends into the vaginal canal.

333
Q

Define GTD, Gestational Trophoblastic Disease

A

GTD is a rare condition in which tumors develop inside the uterus from tissue that normally forms during pregnancy.

334
Q

Define DUB, Dysfunctional Uterine Bleeding

A

DUB: Dysfunctional Uterine Bleeding is abnormal vaginal bleeding that occurs BETWEEN menstrual periods or during menopause.

335
Q

What are some signs and causes of Ectopic Pregnancy

A

a fertilized egg implants OUTSIDE of the uterus, causing abdominal pain, vaginal bleeding.

Causes include scarring from previous surgeries, infections, and certain medical conditions.

336
Q

Define Menopause

A

when woman’s menstrual periods stop, occurring ages 45-55

337
Q

Explain the menstrual cycle

A

A monthly hormonal cycle in women that prepares the uterus for pregnancy.

It includes several phases, including the: follicular phase,
ovulation,
and the luteal phase.

338
Q

Identify female reproductive anatomy (5)

A

the ovaries,
fallopian tubes,
uterus,
cervix,
and vagina.

339
Q

Define Gravita and Preventa

A

Gravita refers to the NUMBER of pregnancies a woman has had.

Preventa refers to the number of LIVE births a woman has had.

340
Q

Define Amenorrhea

A

Amenorrhea refers to the absence of menstruation.

341
Q

Ture or False: Arteries carry to mom from baby

A

True
The uterine arteries carry oxygenated blood to the uterus and placenta to nourish the developing fetus.

342
Q

What is Naegele’s Rule

A

formula used to estimate the due date of a pregnant woman

adding 7 days to the first day of her last menstrual period,
subtracting 3 months,
and adding 1 year.

343
Q

Define Round ligament pain

A

Caused by stretching and pulling of the round ligaments that support the uterus.

344
Q

What is the pregnancy time line

A

Three trimesters, each lasting approximately 12-13 weeks.

345
Q

Define Supine Hypotensive syndrome

A

pregnant woman lying flat on her back can compress the INFERIOR vena cava,

causing a drop in blood pressure.

346
Q

What is Effacement and Dialating?

A

Effacement refers to the thinning and shortening of the cervix during labor.

Dilating refers to the opening of the cervix during labor.

347
Q

Define
Placenta Implantation
Accreta
Increta
Percreta

A

Placenta implantation - the placenta attaches ABNORMALLY to the uterine wall.

Accreta - placenta ATTACHING too deeply into the uterine wall,

Increta - placenta growing INTO the uterine wall

Percreta - placenta growing THROUGH the uterine wall and potentially invading nearby organs.

348
Q

What is HELLP Syndrome?

A
349
Q

Define Pre-Eclampsia and Eclampsia

A

Pre-eclampsia - pregnancy with high blood pressure and signs of damage to other organ systems, often the kidneys.

Eclampsia is a severe form of pre-eclampsia with seizures.

350
Q

Define Antepartum, Intrapartum, and Postpartum

A

Antepartum refers to the period of time BEFORE labor and delivery.

Intrapartum refers to the period of time DURING labor and delivery.

Postpartum refers to the period of time AFTER delivery.

351
Q

When do you (and dont) give Oxytocin and how much?

A

Oxytocin is used to induce labor in the hospital only.
Used by paramedics post delivery as a last resort to stop hemorrhaging.

10 units

352
Q

How many trimesters are there?

A

There are 3 trimesters in a pregnancy,

each lasting approximately 12-13 weeks.

36-39 weeks total

353
Q

Define RH factor and when Rogam Shots are needed?

A

RH factor is an antigen on red blood cells.

Rogam shots are needed if the mother is RH-negative and the baby is RH-positive.

354
Q

What are the 3 stages of childbirth?

A

First stage: onset of labor to complete cervical dilation

Second stage: delivery of the BABY

Third stage: delivery of the placenta.

355
Q

Define Prolapsed cord and treatment?

A

When the umbilical cord precedes the baby through the birth canal.

2 fingers positioned to relieve pressure on the cord.

356
Q

Define Ruptured uterus

A

A tear in the uterine wall.

357
Q

Define Placenta Previa and Abruption

A

Previa is when the placenta COVERS the cervix.

Abruption is when the placenta SEPARATES prematurely.

358
Q

Define Breech Delivery

A

Baby presents feet or buttocks first.

359
Q

Define Shoulder Dystocia and treatment

A

Baby’s shoulder is stuck behind mother’s pubic bone.

Treatment includes repositioning mother (mcroberts), suprapubic pressure

360
Q

Define McRoberts

A

A maneuver to relieve shoulder dystocia. Flexing the mother’s legs to the chest.

361
Q

Define Precipitous

A

Labor that lasts less than 3 hours from onset to delivery.

362
Q

Define Apgar Score

A

A measure of the newborn’s physical condition assessed at 1 and 5 minutes after birth.

Newborns typically don’t have a perfect APGAR at 1 min due to cynosis in arms.

363
Q

What is the targeted SPO after birth? 1min and 5mins

A

1 min: >60%,

5 min: >95%

364
Q

Define MRSOPA and what is it used for?

A

A scoring system used to assess the newborn’s physical condition and determine the need for resuscitation.

365
Q

What is the hr to start CPR for neonate?

A

If heart rate is <60 bpm, start CPR.

366
Q

What is the dose of EPI for a 3kg neonate?

A
367
Q

What is the dose of Magnesium Sulfate when is it used?

A

mothers with pre-eclampsia (seizures)

368
Q

What is the dose of Calcium Gluconate, when do you give?

A

hyperkalemia or calcium channel blocker overdose.

369
Q

What is the dose of Terbutaline, and when do you give

A
370
Q

What is the dose of Vallium, when do you give?

A
371
Q

If the mother is a drug user do you give the baby narcan?

A

No

372
Q

What is considered a premie?

A

A baby born before 37 weeks of gestation.

373
Q

What is low BGL for a neonate?

A

under 40-45 BGL

374
Q

Define Pitocin titration

A

adjusting the dose of Pitocin (synthetic oxytocin) to induce labor.

375
Q

Define Braxton Hicks

A

mild uterine contractions that occur intermittently during pregnancy, often described as “practice contractions.”

may stop with position change

376
Q

What is the #1 cause of Amenorrhea?

A

Pregnancy

absence of period

377
Q

Define Cephalic Delivery

A

Cephalic delivery refers to the delivery of a baby in a HEAD DOWN position, which is the

most common and PREFERED position for a vaginal delivery.

378
Q

What are the 4 phases of a womans monthly cycle?

A

Day 1-5: Menstrual - discharge

Day 6-13: Preovulatory

Day 14: Ovulation

Day 15-28: Postovulatory

379
Q

What is the correct rate to Bag a Neonate?

A

40-60 breaths/min

380
Q

What is the dose of fluids for a neonate?

A

10mL/kg

381
Q

For Pre Eclampsia (which causes protein in urine and HTN)

when do you give Mag Sulfate?

A

When the bp is 160/110 it is severe watch patient carefully for seizures (have IV, give fluids, lay on left side)

Give mag (4mg over 10mins) when patient has Seizures (AFTER Versed 5mg IM)

Note: Eclampsia (seizure) can happen postpartum

382
Q

Define HELLP Syndrome

A

H-emolysis - anemic
E-levated
L-iver
L-ow
P-latelets

worse then pre-eclampsia, blood values are off.

383
Q

What do you do before you give Versed? and

What is the IM dose of Versed?

A

Check BGL

Versed 5mg IM or
0.1mg/kg in 2mg inc SLOW IV

reduce dose to 50% if patient is 69 or older

384
Q

What is the BVM rate for:

Neonate

Ped

Adult

A

Neonate 30-40 (every 2 secs)

Ped 12-20 (every 3 secs)

Adult 10-12 (every 6 secs)

385
Q

If you were to give a pregnant patient the following:

Fluids, TXA, Epi Drip

What is the dose for each?

A

FLUIDS - 20mL/kg of LR IV max of 2,000mL

TXA - 1g in 100mL in Lac Ringers over 10mins

EPI Drip - 1mg in 100mL (60gtts/mL) use 20g IV (give fluids first)

386
Q

What are the contra-indications for TXA

A

Patient less than 15 y/o
Allergy
PE or DVT
More that 1 hour from injury

Paramedic (24 decks)

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