2434 Exam Flashcards
Amyl nitrate, sodium nitrate, and sodium thiosulfate are what kind of drugs?
Used for hydrogen cyanide poisoning.
What drug for acute hydrogen cyanide poisoning must be used first?
Amyl Nitrate
What is SLUDGEM and what is it used for?
Salivation
Lacrimation
Urination
Deification
Gastrointestinal hypermotility with emesis
Used to describe the signs and symptoms of acute organophosphate poisoning.
How do you treat organophosphate poisoning in the pre-hospital setting?
Atropine 2-5mg and Pralidoxime Chloride
What does a Mark 1 Kit consist of?
Two autoinjectors containing Atropine Sulfate and Pralidoxime Chloride (2-PAM)
How is Hepatitis A spread?
fecal matter
How are Hepatitis B, C, and D spread?
Blood to blood contact, IV drug use.
Can oral glucose be given to someone with a known diabetic hx and is altered?
Yes, if they can tolerate it. Benefits outweigh the consequences.
What should be checked if a patient is unresponsive or has altered LOC, snoring respirations, and high BP?
check sugar, do CSS.
Can antibiotics be used for a viral STD such as Herpes?
no
Gonorrhea and Syphilis are examples of what kind of STD?
bacterial. can be treated with antibiotics
When giving a patient report to the hospital, what should you make sure to include?
Pain, signs/symptoms, and time of onset.
What are renal calculi?
Kidney stones, also called renal calculi, nephrolithiasis, or urolithiasis, are hard deposits made of minerals and salts that form inside your kidneys.
What is the order of operations for a patient with severe anaphylaxis?
oxygen - Epi - benadryl - steroids.
What medication can be used for a patient with a localized allergic reaction?
Benadryl
What is McBurney’s point?
Tenderness over the RLQ. Indicative of appendicitis. It is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus. This is near the most common location to the appendix.
What abdominal quadrant is the gallbladder in?
RUQ
What is Murphy’s sign?
indicative of cholecystitis. crampy visceral pain in the RUQ.
Where is the pancreas and what are common symptoms of pancreatitis?
LUQ and pain after eating/drinking alcohol.
What abdominal quadrant is the liver in and what are common signs/symptoms of hepatitis?
RUQ with constant pain, radiating to the shoulder.
What abdominal quadrant is the spleen in and what are the common signs/symptoms of an inflamed spleen?
LUQ. Constant pain with radiation of pain to the left shoulder.
What is another name for addison’s disease?
adrenal insufficiency
This disease is an uncommon disorder that occurs when your body does not produce enough of certain hormones. The adrenal glands produce little cortisol and often too little aldosterone.
Addison’s disease
What is the treatment for addison’s disease and what populations are affected by it?
Hormone replacement. Disease occurs in all age groups and both sexes.
What causes hemorrhoids?
chronic hypertension in the renal portal. Increases blood flow and creates swelling.
What is the first drug given with cardiac chest pain when not having shortness of breath?
aspirin.
What test must be done for patients complaining of headache?
cincinnati stroke scale
Anytime we are exposed to something that can induce an immune response is called a???
antigen
How many/what percentage of the population end up having appendicitis?
5-10%
15-30 million people
What is the name of the disease that causes constant inflammation of the stomach and intestines?
Crohn’s
What is the name of an acute episode of stomach inflammation? (also known as a stomach bug)
Gastroenteritis
What is more prevalent, strokes or parkinsons?
Strokes
strokes affect 500,000 and parkinsons 50,000
What is more prevalent, Epilepsy or stroke/parkinsons?
Epilepsy
How is a person with a history of psychiatric illness treated differently when complaining of something not psych related like abdominal pain?
They are not. Psych patients are treated normally when complaining of something not related to the mental illness
What medication are people experiencing an acute psychiatric crisis given?
Haldol or Versed
Anytime we have upper GI bleeding, it is going to be separated from lower GI bleeding by:
the ligament of Treitz
what is the ligament of treitz and where is it located?
thin band of tissue that connects and supports the end of the duodenum and the beginning of the jejunum.
what is the most common sign or symptom of an acute myocardial infarction/heart attack?
chest pain/pressure. can also have nausea and vomiting and pallor
What is the biggest possible issue with TCP?
not getting mechanical capture
People with angina typically also have ___
Coronary artery disease
Why are ketones produced in diabetic ketoacidosis?
Catabolism of fatty acids. Body switching from burning sugar for energy to fatty acids which causes the creation of ketones
What are you likely to hear when listening to the lungs of someone with congestive heart failure?
Rales, pulmonary edema causing crackles
When someone is having a heart attack, sometimes the heart rate will ___ to reduce cardiac output and reduce oxygen demand to the heart.
slow
How is someone with a hx of renal failure and acute fluid retention and hyperkalemia treated?
oxygen and consider sodium bicarb for hyperkalemia. Dialysis for definitive care.
Retention of blood volume
vascular system
What is the reason we maintain volume in the vascular system?
plasma proteins pull fluid in the vascular area and help retain it.
Anytime we have someone on prednisone, atroven, betamethasome, inhalers, most are used for ???
asthma treatment
In the event of a stoke, transport the patient on the ____ or ____ side up.
paralyzed side down or brain side up
When a patient has lower back pain radiating to genetalia, what would you be concerned for?
kidney stone. ask the patient if they have had this pain before.
What is myxedema?
doughy edematous skin with very thin hair. Most likely have a history of hypothyroidism.
What is the main mechanism of hyperthyroidism.
increases, speeds everything up.
If someone is paralyzed on their right side from a stroke, how would you transport them?
put them on their right side to protect it.
What is usually caused by parasites in the epidermis layer of the skin with intense itching and pimply rash?
scabies
What is mild alteration that is of sudden onset called?
acute psychosis
If examining a patient that has back pain, jaw pain, and irregular heartbeat that is considered a critical finding of _____
ischemia or cardiac events. patients may go into cardiac arrest and may require CPR
Patients with lower right abdominal pain do not want to palpate over it due to ____?
positive mcburney’s point tenderness indicative of appendicitis. palpating too hard can cause the appendix to rupture.
How much more affinity does CO have to hemaglobin than oxygen?
200-300x
Right sided MI such as inferior wall MI preload is ???
hypotensive
What percent of diabetes is type 2 vs type 1?
type 2 - 90% type 1 - 10%
CHF with ____ cannot tolerate CPAP, nitro, morphine, and lasix.
hypotension
Anytime a medical assessment is being completed, what can you use to help you figure out what is going on?
context clues. look around the house for things relevant to the patients current illness such as a bucket to vomit in to.
What types of abdominal assessments are performed/helpful pre-hospital?
palpation and percussion. listening to bowel sounds is not helpful pre-hospital and wont give much info.
What can percussion of the abdomen tell you?
blood in the abdomen.
CHF patients when they have trouble breathing when they lay flat have ____?
paroxysmal nocturnal dyspnea
What is paroxysmal nocturnal dyspnea?
sudden onset of SOB at night usually indicative of CHF.
What does a patient likely have if the only way poop can come out is through vomit? Looks like M&M’s in vomit.
Severe bowel obstruction
What is the most common cause of seizures?
idiopathic
What is a critical sign of dehydration in a patient having an endocrine emergency?
dry skin. If a patient has dry skin, they are extremely dehydrated.
Inflammation of the pancreas is called
pancreatitis
inflammation of the appendix is called
appendicitis
inflammation of the gallbladder is called
cholecystitis
Inflammation of the liver is
hepatitis
What happens with an aspirin overdose?
causes metabolic acidosis.
What is another name for aspirin?
acetyl salicilic acid.
What is the antidote for metabolic acidosis from aspirin overdose?
sodium bicarb
What is the name for swollen veins in the rectum or anus?
hemorrhoids
Anytime someone has compensatory mechanism with cardiogenic shock they are going to try and improve
preload
What is our main goal with managing cardiogenic shock?
improve respiratory efficiency and try to give pressor to increase peripheral vascular resistance
What do you do when you have a patient with a toxic exposure?
contact poison control
What signs and symptoms will you see with anaphylaxis
urticaria (hives), tachycardia, hypertension
What is one of the last symptoms in severe anaphylaxis that indicates decompensation?
bradycardia
What are the signs and symptoms of cushings triad?
bradycardia, irregular respirations, hypertension
What is cushing’s triad a sign of?
increased ICP
What can long term tylenol administration or acute OD cause?
liver failure after 6-8 hours and gets worse over several days
What population is more likely to have an aortic aneurysm?
tall, thin, males
What are the signs and symptoms of aortic aneurysm?
Hypotension with severe lower abdominal pain. Treat the same as hemorrhagic shock
What does fulminant mean?
Severe sudden onset (typically with sickness) infections
What is the universal blood donor?
O-
What is the universal blood recipient?
AB+
What usually causes flank pain radiating to the groin?
renal calculi
What is the number 1 goal with treating sexual assault?
treat the patient
What should you be concerned about if several people in a building are complaining of headache, confusion, and/or AMS?
CO poisoning. get everyone out.
What is the treatment for CO poisoning?
Hyperbaric chamber
Pain as a result of previous brain/spine injury developed after the fact is known as?
Central pain syndrome or phantom pain
Productive cough with green sputum and one sided congestion are signs of what disease pathology?
Pneumonia
Trace a drop of blood through the heart
Vena cava - RA - tricuspid valve - RV - Pulmonary arteries - Lungs (exchange CO2 and O2) - pulmonary veins - LA - bicuspid (mitral) - LV - aortic valve
If someone is extremely tachycardic and has an MI, what drug do you consider?
Lebetalol (beta blocker) will help as it relaxes the blood vessels by lessening oxygen demand.
What is the BGL goal for a diabetic adult?
80
What is the BGL goal for a diabetic kid?
60
What is the BGL goal for a diabetic infant?
40
What type of poisoning would you suspect with a person exposed to pesticide/cleaning solution?
organophosphate poisoning
What is the dose for treating OP poisoning with atropine?
2-5mg till secretions stop
Can kidney stones be hereditary?
yes
What is the antidote for atropine overdose?
physostigmine (#74 pick D)
What do peaked T waves on a 12 lead indicate?
hyperkalemia
what is the treatment for hyperkalemia?
calcium chloride and bicarb
True or false, most people do not end up with rectal foreign bodies unintentionally
true
What is the treatment for somebody with a rectal obstruction, foreign body insertion?
Position of comfort and transport
Multiple seizures in a row without consciousness indicates?
The patient is critical, status epilepticus.
What is the treatment for status epilepticus?
stop the seizure then find out what caused it
_____ is considered acute elevation of BP requiring intervention within 1 hour.
hypertensive emergency
Distal portion of GI system is external anal rectal sphinctor and gives control over ____
pooping
What is important to remember when instructing family members about seizures?
Do not put anything in the patients mouth. Can cause teeth to break and airway obstruction
What could be the cause for a person suddenly gaining a lot of weight and lethargy?
thyroid gland issue.
What is the most common endocrine gland to have issues?
thyroid gland
Fever, headache, stiff neck (torticollis), and light sensitivity are all signs of what disease pathology?
Meningitis
What is usually the problem if the patient has pain in the RUQ after eating?
Choleycycstitis
What is an important piece of equipment to prepare prior to intubating a patient?
Suction
What is a late sign of anaphylaxis?
drop in blood pressure
What is an important thing to remember when treating someone who is developmentally delayed?
take more time to explain what is going on so everybody has a clearer understanding.
What is an anaphylactic reaction to an antigen that the person has never been exposed to before called?
anaphylactoid
Where does a bundle branch indicate a problem in the heart?
Left anterior decending
What vessel in the heart is usually the issue when problems with the SA node or right ventricle are seen on a 12 lead?
RCA
What are risk factors for an ischemic stroke?
Afib, DM, HLD, genetics
What are risk factors for hemorrhagic stroke?
HTN.
What is a TIA?
ischemic stroke that essentially fixes itself within 24 hours with no deficits
What is the difference in onset between ischemic and hemorrhagic strokes?
Ischemic is usually slow and hemorrhagic is fast
What is the treatment for diverticulitis?
diet change by eating high fiber food
What organs cause visceral pain?
hallow organs
What organs cause somatic pain?
solid organs
What are the differences between somatic and visceral pain?
Visceral is crampy and somatic is pin point solid structure pain.
What causes Cushing’s syndrome?
Too much cortisol for a long period of time. Can result from taking oral corticosteroid medication or the body might just produce too much cortisol.
What is the treatment for Cushing’s syndrome?
oxygen and transport
What is hyperthermia?
increased temp
What are the signs/symptoms of hypothyroidism?
low temp, low HR, decreased metabolism, thinning hair
What are the signs of thyroid medication OD/toxcicity?
high temp and tachycardia
What is the most common cause of a seizure?
idiopathic
