AEMT - STUDY

Question 1

Signs of Intercranial Pressure

Answer 1

Cushing’s Triad - Hypertension, Bradycardia, and Abnormal respirations

Question 2

Breathing Patters - Ataxic (Biot), Agonal, Kussmaul, Cheyne-Stokes

Answer 2

Biot / Ataxic - irregular breathing, which varies in depth and rate with intermittent periods of apnea. (ICP, stroke, head trauma)

Agonal Breathing - agonal gasps - is characterized by slow irregular or occasional gasping breaths - seen for a short period of time after a patients heart has stopped; this is especially true with sudden cardiac arrest caused by VFIB - requires PPV support and potentially advanced airway management.

Kussmaul - DKA - deep, rapid pattern.

Cheyne-Stokes - respirations increase and then decrease with intermittent periods of apnea

Question 3

Excitability, Automaticity, Conductivity, Contractility

Answer 3

Excitability - refers to the cardiac cells’ ability to respond to electrical impulses.
Automaticity - Not found in any other cells (only cardiac) this allows cardiac muscles to contract spontaneously without a stimulus from a nerve cell.
Conductivity - the ability to conduct electrical impulses.
Contractility - the force of the muscle contraction.

Question 4

how to calculate 1-10 year old systolic

Answer 4

age x 2 and then add 70

Question 5

normal ph

Answer 5

7.35-7.45

Question 6

Partial Pressure

Answer 6

Pressure of oxygen in the blood plasma - measured in millimeters of mercury (mm Hg), or torr.

Question 7

Fraction of inspired oxygen (FiO2) is defined as the:

Answer 7

Percentage of oxygen in inspired air; it is documented as a decimal (1=100%, 0.9=90%, and so forth).

Question 8

hypoxic vs hypoxemic

Answer 8

hypoxic is inadequate o2 supply at the tissue and hypoxemia is deficiency of o2 in arterial blood (hypoxemia is measured with the pulse oximetry)

Question 9

describe Tonic-clonic seizures VS absence seizures

Answer 9

Tonic-clonic seizures are characterized by an aura (a warning sign of an impending seizure that may include an odd taste or a high-pitched sound); loss of consciousness; a tonic phase (body-wide rigidity); a hypertonic phase (arched back and rigidity); and a clonic phase (rhythmic contraction of major muscle groups, lip smacking, trismus, rapid eye movement). Most tonic-clonic seizures are followed by a postictal phase, during which time the patient seems dazed, confused, or can even be combative. The postictal phase can last from several minutes to an hour, after which time the patient’s level of consciousness returns to normal.
VS:
an absence seizure presents with little or no movement. The patient, classically a child, presents with staring episodes (absence spells), during which physical activity ceases. Loss of motor control is uncommon, although rapid eye blinking and lip smacking are common. Absence seizures are not followed by a postictal period; the patient’s level of consciousness immediately returns to normal.

Question 10

Left Sides Heart Failure vs Right Sided Heart Failure

Answer 10

LEFT: Hypertension and Tachycardia in addition to pulmonary edema.

RIGHT: JVD, Peripheral Edema, and ascites (fluid accumulation in the peritoneum)

Question 11

How to Calculate MAP and Normal Range

Answer 11

Mean arterial pressure (MAP) is the average arterial pressure during a single cardiac cycle.

MAP = DBP + ⅓ (SBP - DBP)
or
MAP = systolic BP + (diastolic BP × 2) / 3

70 and 100 mmHg

Question 12

Describe the steps of placing a King LT airway

Answer 12

The King LT airway is inserted until the base of the connector is aligned with the teeth or gums.

After inserting the device, inflate both cuffs with the recommended amount of air (varies, depending on the King LT size). The cuffs are inflated simultaneously using a common inflation port; the amount of air used is dictated by the size of the airway device. It is normal to see the King LT airway retract slightly out of the mouth during inflation of the cuffs.

After inflating the cuffs, attach the bag-mask device and begin ventilating the patient. If you meet resistance and/or the patient’s chest does not rise, slowly withdraw the King LT (without deflating the cuffs) until ventilation is successful. You can consider placing a bite block in between the patient’s molars.

Question 13

Name some Beta Blockers and what they do

Answer 13

Beta-blocking medications (atenolol [Tenormin], metoprolol [Lopressor], propranolol [Inderal], or esmolol [Brevibloc]) inhibit sympathetic nervous system discharge, thereby reducing the amount of epinephrine and norepinephrine that is secreted.

Question 14

Define Hypocarbia and Hypercarbia and what causes it

Answer 14

Hypocarbia - too little CO2 <35mm Hg (breathing too rapidly)

Hypercarbia - too much CO2 >45mm Hg (inadequate ventilation)

Question 15

Hemorrhagic stroke

Answer 15

With a hemorrhagic stroke, you would expect the patient to present with signs and symptoms of increased intracranial pressure, such as altered mental status, hypertension, bradycardia, and abnormal breathing. In addition, the patient with a hemorrhagic stroke typically complains of a sudden severe headache.

Question 16

Ischemic Stroke

Answer 16

Ischemic strokes typically present with confusion; unilateral weakness (hemiparesis); a facial droop; and dysarthria (slurred or poorly articulated speech).

Question 17

Right Hemisphere Stroke

Answer 17

They can understand language and speak but they may slur their words. Dysarthria - inability to pronounce speech clearly. May also be oblivious to their deficits - might not recognize their arm (neglect)

Question 18

Left Hemisphere Stroke

Answer 18

PT may exhibit inability to understand speech. Aphasia - they cant understand you but have clear speech. Expressive aphasia - they cant speak.

Question 19

Arteriosclerosis

Answer 19

A thickening of the arterial walls, which causes a loss of elasticity (hardening of the arteries) and a subsequent reduction in blood flow.

Question 20

Atherosclerosis

Answer 20

is a process in which cholesterol and other fatty substances build up and form a plaque inside the walls of blood vessels, which obstructs blood flow and interferes with their ability to dilate or contract

Question 21

Prinzmetal angina

Answer 21

also called variant or vasospastic angina, occurs when the coronary arteries constrict and significantly decrease blood flow to the heart

Question 22

Vertibre

Answer 22

C
T
L
C

Question 23

Adventitious breath sounds

Answer 23

abnormal sounds that are heard over a patient’s lungs and airways and include fine and coarse crackles (also called rales), wheezes (or rhonchi), pleural rubs, and stridor. They indicate pathologies such as bronchitis, pneumonia, congestive heart failure, or atelectasis.

Question 24

Bronchial breath sounds

Answer 24

hollow, tubular sounds that are lower pitched than vesicular ones. They can be auscultated over the trachea, where they are considered normal.

Question 25

Vesicular breath sounds

Answer 25

the most commonly auscultated breath sounds, usually heard over most of the lung surface as soft and low-pitched during inspiration.

Question 26

Bronchovesicular breath sounds

Answer 26

normal sounds in the mid-chest area or in the posterior chest between the scapula and are a combination of normal bronchial and vesicular sounds.

Question 27

Per NREMT the correct newborn shock fluid bolus

Answer 27

The correct dose for a fluid bolus of a crystalloid solution for shock in the newborn is 10 mL/kg

Question 28

Grey Turners Sign

Answer 28

Ecchymosis in the lower abdominal and flank regions -result of intraabdominal bleeding, such as liver, kidney, pancreas, or spleen, typically appearing 12-24 hours post-injury.

Question 29

Cullen sign

Answer 29

ecchymosis in the umbilical region - result of intraabdominal bleeding, such as liver, kidney, pancreas, or spleen, typically appearing 12-24 hours post-injury.

Question 30

Kehr sign

Answer 30

referred shoulder tip pain from retroperitoneal bleeding, typically from a splenic laceration, irritating the phrenic nerve of the diaphragm.

Question 31

Alveolar minute volume

Answer 31

the volume of air moved through the lungs in one minute, less dead space; it is calculated by multiplying tidal volume (minus dead space) and respiratory rate.

Question 32

Hyphema

Answer 32

is bleeding into the anterior chamber of the eye and results from direct ocular trauma.

Question 33

Anisocoria

Answer 33

Anisocoria is uneven pupil size and can occur naturally or as a sign of stroke, traumatic brain injury, or other pathology.

Question 34

Le Fort fractures

Answer 34

Le Fort fractures are specific maxillary fractures based on anatomic location.

Question 35

Cor pulmonale

Answer 35

Cor pulmonale is right side heart failure due to respiratory disease.

Question 36

Pulsus paradoxus

Answer 36

Pulsus paradoxus is an exaggerated drop in blood pressure with inspiration.

Question 37

Melena vs. Hematochezia

Answer 37

Melena is black, foul-smelling, tarry stool that contains digested blood. It typically indicates upper GI bleeding, but bleeding from a source in the small bowel or right colon can also be the cause.

Hematochezia is the passage of gross blood from the rectum and usually indicates lower GI bleeding but may result from vigorous upper GI bleeding with rapid transit of blood through the intestines.

Question 38

Normal blood Ph levels

Answer 38

pH measures how acidic, base, or neutral the patient’s blood is. pH specifically measures the concentration of hydrogen ions in the bloodstream. Any value less than 7.35 is considered acidic, while any value of 7.45 is considered base. Any value between 7.35 and 7.45 is considered normal.

Question 39

Beta blockers

Answer 39

Beta blockers, also known as beta-adrenergic blocking agents, are medications used to treat hypertension. Beta blockers work by blocking the effects of the sympathetic nervous system.

Question 40

Angiotensin-Converting Enzyme (ACE) inhibitors

Answer 40

Angiotensin-Converting Enzyme (ACE) inhibitors are medications that help relax the veins and arteries to lower blood pressure.

Question 41

Diuretics

Answer 41

Diuretics remove fluid from the body, which decreases the amount of fluid in blood vessels. This reduces blood pressure.

Question 42

Sodium channel blockers

Answer 42

Sodium channel blockers are used to slow heart rate or reduce nerve impulse transmission. They are not used to treat hypertension.

Question 43

Adrenal Medula does…

Answer 43

adrenal glands are located on the superior pole of each kidney and consist of two layers: the cortex and the medulla. The inner layer, the medulla, synthesizes and secretes catecholamines (epinephrine and norepinephrine), which regulate the “fight or flight” syndrome and affect heart rate, blood pressure, and other aspects of the sympathetic nervous system

Question 44

drug schedules

Answer 44

As the drug schedule number goes up, the abuse potential goes down

Schedule I: Heroin, LSD, marijuana (cannabis), peyote, and MDMA (Ecstasy)

Schedule II: Hydromorphone, methadone, meperidine, oxycodone, fentanyl, methylphenidate, codeine, and hydrocodone

Schedule III: Codeine-mixed ingredient products with <90mg per dose unit (e.g., acetaminophen with codeine), dronabinol, buprenorphine, ketamine, anabolic steroids

Schedule IV: Zolpidem, Librium, fenfluramine, Darvon, benzodiazepines (e.g., alprazolam, clonazepam)

Schedule V: Pregabalin, cough preparations containing less than 200 milligrams of codeine per 100 milliliters or per 100 grams, and ezogabine

Question 45

Abdominal quadrant pains

Answer 45

Flank pain radiating from the back to the groin is a sign of kidney stones.

Left upper quadrant pain, radiating to the shoulder tip, is a sign of spleen or liver bleeding.

Right lower quadrant pain is a sign of appendicitis.

Question 46

what are the MSK trauma categories?

Answer 46

Minor, Moderate, Serious, Severe, and Critical.

Question 47

What is myoclonus ?

Answer 47

Myoclonus is a condition of hyperactive reflexes and occurs during severe preeclampsia.

Question 48

Oxygen Cylinder Volumes

Answer 48

D: 350 L
Jumbo D: 500 L
E: 625 L
M (MM): 3,000 L
G: 5,300 L
H, A (M4), K: 6,900

Question 49

Signs of hypocalcemia

Answer 49

include abdominal cramps, hypotension, carpopedal spasms, and vasoconstriction.

Question 50

Signs of hyperkalemia

Answer 50

include chest pain, cardiac arrhythmias, nausea and vomiting, and muscle weakness.

Question 51

Signs of hyponatremia

Answer 51

include nausea, headache, confusion, muscle weakness, and seizures.

Question 52

Hypercalcemia

Answer 52

Hot, flushed skin is a sign of hypercalcemia. Other signs include ataxia and skeletal muscle weakness. The vasodilation associated with high levels of calcium causes warm, flushed skin. This can be the definitive sign to help identify hypercalcemia.

Question 53

the Hering-Breuer reflex

Answer 53

As the chest expands, mechanical receptors, known as stretch receptors, in the thoracic cavity and bronchioles send a signal to the apneustic center via the vagus nerve to inhibit the inspiratory center; this results in exhalation. This feedback loop, a combination of mechanical and neural control, is called the Hering-Breuer reflex and terminates inhalation to prevent overexpansion of the lungs.

Question 54

Gonorrhea

Answer 54

Gonorrhea is caused by a bacterium that can grow and multiply rapidly in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women and in the urethra in women and men. Women may be infected with gonorrhea for months but may not experience symptoms until the infection has spread to other parts of the reproductive system. When symptoms do appear in women, they generally manifest as dysuria (painful urination), with associated burning or itching; a yellowish or bloody foul-smelling vaginal discharge; and bleeding after intercourse.

Question 55

Chlamydia

Answer 55

Chlamydia is also caused by a bacterium; symptoms include lower abdominal or back pain, nausea, fever, pain during intercourse, and bleeding between menstrual periods.

Question 56

Syphilis

Answer 56

Syphilis is also caused by a bacterium; however, it classically presents with an open lesion on the genitals called a chancre. Fever, vaginal discharge, and abdominal pain are not common with syphilis.

Question 57

Genital herpes

Answer 57

Genital herpes, caused by a virus, is characterized by small clusters of painful blisters in the genital area; fever, vaginal discharge, and abdominal pain are typically not associated with genital herpes.

Question 58

Petechiae are…

Answer 58

Petechiae are purplish, red spots on the skin caused by intradermal or submucous hemorrhage. The presence of petechiae indicates abnormal blood clotting and may be seen in patients with sepsis, such as what may occur with meningitis

Question 59

Newborn and Infant hypovolemia fluid bolus…

Answer 59

When signs of hypovolemia are present in a newborn (weak central pulses, pallor, tachycardia, and so forth), crystalloid fluids, such as normal saline or lactated Ringer’s solution, should be administered at a rate of 10 mL/kg over 5 to 10 minutes. Do not give rapid fluid boluses to a newborn as this can cause acute volume overload and pulmonary edema. Children older than 1 month of age should receive 20 mL/kg fluid boluses.

Question 60

Epi Dose Anaphylaxis

Answer 60

When signs of hypovolemia are present in a newborn (weak central pulses, pallor, tachycardia, and so forth), crystalloid fluids, such as normal saline or lactated Ringer’s solution, should be administered at a rate of 10 mL/kg over 5 to 10 minutes. Do not give rapid fluid boluses to a newborn as this can cause acute volume overload and pulmonary edema. Children older than 1 month of age should receive 20 mL/kg fluid boluses.