Block 4 Flashcards
Common effects of gag reflex stimulation include all of the following.
Tachycardia
Which of the following statements regarding anatomic dead space is correct?
1mL per pound
Wheezing is resolved with medications that.
Bronchodilate
Polycythemia is a condition in which
RBC’s are overproduced. Rare disease originating in a single stem cell or from CHF/HTN or living at high altitude for long periods. P.1256
In contrast to negative-pressure ventilation, positive-pressure ventilation
may impair blood return to the heart P.756-7
Difficulty with exhalation is MOST characteristic of
obstructive lung disease P.860
The by-product of cellular respiration is
carbon dioxide P.861
Respiratory alkalosis is the result of
too little CO2 in blood
Which of the following conditions would LEAST likely present with an acute onset of respiratory distress?
Pneumonia
Hepatomegaly and jugular venous distention are MOST suggestive of
R sided heart failure
A patient who is coughing up purulent sputum is MOST likely experiencing
a pulmonary infection
A sudden increase in end-tidal CO2 may be the earliest indicator of
ROSC
Pneumonitis is especially common in older patients with
chronic food aspiration
COPD is characterized by
changes in pulmonary structure and function that are progressive and irreversible
The primary treatment of bronchospasm is
bronchodilator treatment
A patient with status asthmaticus commonly presents with
Exhaustion and absent lung sounds
The hypoxic drive is a phenomenon in which
bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance.
Patients with decompensated asthma or COPD who require positive-pressure ventilation
may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly.
One of the hallmarks of a pulmonary embolism is
cyanosis that does not resolve with oxygen therapy.
Pickwickian syndrome is a condition in which respiratory compromise results from
extreme obesity
Patients with obvious respiratory failure require immediate
ventilatory support
Intubation of a patient with severe asthma
is often a last resort, because asthmatics are difficult to ventilate and are prone to Pneumothoraces
CPAP in the emergency setting is used to treat patients with certain obstructive airway diseases by
improving patency of the lower airway through the use of positive-end expiratory pressure.
You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During your assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. This patient is MOST likely experiencing
pneumonia
A 29-year-old woman is experiencing a severe asthma attack. Her husband reports that she was admitted to an intensive care unit about 6 months ago, and had a breathing tube in place. Prior to your arrival, the patient took 3 puffs of her rescue inhaler without effect. She is anxious and restless, is tachypneic, and has audible wheezing. You should
apply a CPAP unit, transport immediately, and attempt to establish vascular access en route to the hospital
A 21-year-old man experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. He is noticeably dyspneic, has an oxygen saturation of 93% on room air, and has diminished breath sounds to the upper right lobe. The MOST appropriate treatment for this patient involves
administering high-flow supplemental oxygen and transporting at once
You are transporting a patient with a long history of emphysema. The patient called 9-1-1 because his shortness of breath has worsened progressively over the past few days. He is on high-flow oxygen via non-rebreathing mask and has an IV of normal saline in place. The cardiac monitor shows sinus tachycardia and the pulse oximeter reads 89%. When you reassess the patient, you note that his respiratory rate and depth have decreased
begin assisting his ventilations with a bag-mask and 100% oxygen.
An elderly woman with COPD presents with peripheral edema. The patient is conscious but agitated. She is breathing with slight difficulty but has adequate tidal volume. During your assessment, you note that her jugular veins engorge when you apply pressure to her right upper abdominal quadrant. She tells you that she takes a “water pill” and Vasotec for high blood pressure. You should
suspect acute right heart failure and administer oxygen
You are transporting a middle-aged man on a CPAP unit for severe pulmonary edema. AnIV line of normal saline is in place. Prior to applying the CPAP device, the patient was tachypneic and had an oxygen saturation of 90%. When you reassess him, you note that his respirations have increased and his oxygen saturation has dropped to 84%
You should: remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him
You are dispatched to a residence for a young woman with difficulty breathing. When you arrive, you find the patient sitting in a tripod position, noticeably dyspneic and tachypneic. She tells you that she experienced a sudden sharp pain to the left side of her chest and then started having trouble breathing. She denies any past medical history and states that she only takes birth control pills. Based on this patient’s clinical presentation, you should be MOST suspicious for
acute pulmonary embolism
The peripheral nervous system is responsible for
Responsible for decreasing the activity of most visceral muscles, organs and glands and keeping the body functioning in its normal state
A person’s level of consciousness is regulated by the
reticular activating system
Chemicals that relay electrically conducted signals from one neuron to another are called
neurotransmitters
The MOST immediate and significant complication associated with a hemorrhagic stroke is
increased ICP
As intracranial pressure rises
cerebral herniation may occur
Hyperventilating a patient who has increased intracranial pressure (ICP) will
Constrict the cerebral vasculature and decrease cerebral perfusion
An adult who opens her eyes in response to verbal stimuli, is disoriented, and pushes your hand away when you palpate a painful area has a Glasgow Coma Scale score of?
A: 9
B:12
C: 11
D:10
B: 12
Common causes of trismus in an unresponsive patient include all of the following, EXCEPT
opiate toxicity
Ataxia Means
is a term used to describe changes in a person’s ability to perform coordinated motions, such as walking
A rhythmic contraction and relaxation of muscle groups that is commonly observed during a seizure is called___activity?
A: Clonic
B: Myoclonic
C: Tonic
D: Hypertonic
A: Clonic
A 39-year-old woman presents with signs and symptoms of an acute hemorrhagic stroke. She is responsive to deep painful stimuli only and has bilaterally dilated and sluggishly reactive pupils. Her respirations are slow and irregular, blood pressure is 80/50 mm Hg, and pulse is 40 and bounding. Initial treatment for this patient involves:
A: Rapid infusion of a crystalloid solution
B: High-flow oxygen via nonrebreathing mask.
C: Immediate transcutaneous cardiac pacing.
D: Positive pressure ventilatory support
D: Positive pressure ventilatory support
You are dispatched to a local pharmacy, where a 24-year-old woman experienced an apparent seizure. During your assessment, you note that the patient is conscious but combative. The patient’s supervisor states that she has a history of seizures and takes Tegretol. The patient’s blood pressure is 146/90 mm Hg, pulse rate is 110 beats/min and regular, and respiration’s are 24 breaths/min with adequate depth. The MOST appropriate treatment for this patient includes:
A: Administering oxygen, restraining her to protect her from further injury, placing a bite block in her mouth in case she seizes again, and transporting.
B: Establishing vascular access, administering diazepam or lorazepam to reduce her combativeness,and transporting to the closest hospital.
C: Administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren.
D: Giving her high-flow oxygen, inserting an IO catheter in her proximal tibia, transporting, and observing for further seizure activity.
C: Administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren.
You arrive at the scene shortly after a 7-year-old girl experienced a seizure. According to the child’s mother, she was sitting at the dinner table and then suddenly stopped speaking and started blinking her eyes very rapidly. The episode lasted less than 1 minute, after which the child’s condition rapidly improved. This clinical presentation is consistent with a(n) _____ seizure.
A: Tonic-clonic
B. Complex partial
C: Absence
D: Simple partial.
C: Absence
You are dispatched to a residence for a 44-year-old woman with a severe headache. You arrive to find the patient lying on her sofa with a wet washcloth on her forehead. She tells you that she has a history of migraine headaches and that this is one of her “typical” headaches. She also complains of nausea and photophobia. Her blood pressure is 170/94 mm Hg, pulse rate is 120 beats/min and regular, and respiration’s are 22 breaths/min with adequate depth. The MOST appropriate treatment for this patient includes:
A: Carefully assessing her pupils, administering oxygen,starting an IV and giving her morphine, and transporting.
B: Oxygen as tolerated, starting an IV line and administering ondansetron, and transporting without lights or siren.
C: Placing her in a fowlers position, administering oxygen, and transporting her to the hospital for definitive care.
D: Administering high-flow oxygen, establishing vascular access, and administering nitroglycerin to lower her blood pressure.
B: Oxygen as tolerated, starting an IV line and administering ondansetron, and transporting without lights or siren.
Increased intracranial pressure hydrocephalus occurs when
the movement of CSF decreases but production does not P.1080
Which of the following disease processes is characterized by an abnormal gait in which the patient places his or her feet very close together and shuffles while walking?
Parkinson’s disease
A poison is a substance that is?
A: Legal or illegal, and has the potential of causing permanent damage if it is ingested.
B: Toxic by nature, no matter how it enters the body or in what quantities it is taken.
C: Damaging to the tissues and cells, especially if injected or taken in large quantities.
D: Capable of making a person ill, at a minimum, and has a great chance of causing death.
B: Toxic by nature, no matter how it enters the body or in what quantities it is taken.
Clinical signs and symptoms following exposure to a toxin will manifest MOST rapidly if the patient
is exposed by the injection route
You would NOT expect a person using methamphetamine to present with
bradypnea
A middle-aged woman who has been taking 2 mg of clonazepam each day for 6 months finds that she now requires 4 mg each day to achieve the same effect. This is an example of
tolerance
Patients with alcoholism are prone to subdural hematomas and gastrointestinal bleeding because:
A: Their clotting mechanisms are impaired.
B: They fall more frequently than sober people.
C: Alcohol causes significant immunocompromise.
D: They are at higher risk for violent assault.
A: Their clotting mechanisms are impaired.
Which of the following is the MOST immediate danger to an unresponsive patient with acute alcohol intoxication?
Aspiration of vomitus
Which of the following interventions is influenced strongly by the amount of time that has elapsed since a patient ingested a toxic substance?
Gastric lavage
Appropriate prehospital treatment for a patient who has overdosed on a stimulant and is excessively tachycardic and violent includes all of the following,
beta-andrenergic agonists
Cardiac arrest following a narcotic overdose is usually the result of
respiratory arrest
Pulse oximetry will not provide a true assessment of arterial oxygenation in patients with carbon monoxide toxicity because
the device cannot determine whether carbon monoxide or oxygen is bound to hemoglobin
The MOST important prehospital treatment intervention for a patient with carbon monoxide poisoning is?
A: Cardiac rhythm monitoring.
B: Monitoring pulse oximetry
C: High flow oxygen
D: Establishing vascular access.
C: High flow oxygen
The hyperpnea and tachypnea associated with methyl alcohol intoxication is secondary to
metabolic acidosis
Common signs and symptoms of a tricyclic antidepressant overdose include
altered mental status and tachycardia P.1353
You are caring for an alcoholic patient who has been abstinent for about 2 days. The patient is confused, restless, and tells you that he sees snakes crawling on the walls. His blood pressure is 76/52 mm Hg, pulse rate is 140 beats/min and weak, and respirations are 24 breaths/min with adequate depth. In addition to administering oxygen, you should?
A: Treat his hypotension with crystalloid fluid bolus.
B: Administer 6 mg of adenosine to slow his heart rate.
C: Provide emotional support only and transport immediately.
D: Sedate him with 5 mg of Valium and transport at once.
A: Treat his hypotension with crystalloid fluid bolus.
A 29-year-old woman was found unresponsive by her husband. When you arrive at the scene and begin your assessment, you note that the patient’s respirations are slow and shallow, her pulse is slow and weak, and her pupils are markedly dilated. Your partner begins assisting the patient’s ventilations as you assess her blood pressure, which is 70/48 mm Hg. The patient’s husband hands you an empty bottle of phenobarbital, which was filled the day before, and tells you that his wife takes the medication for seizures. After establishing vascular access, you should?
A: Administer crystalloid fluid boluses to treat hypotension.
B: Instruct your partner to hyperventilate the patient at 24 breaths/min.
C: Give her up to 10 mg of naloxone to reverse the effects of the drug.
D: Begin a dopamine infusion at 10 ug/kg/min and titrate as needed.
A: Administer crystalloid fluid boluses to treat hypotension.
The structural and functional unit of the kidney is the:
A: Podocyte.
B: Medulla.
C: Renal cortex.
D: Nephron.
D: Nephron
The glomerular filtration rate is defined as the
Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR
Angiotensin II:
A: Decreases blood pressure.
B: Relaxes smooth muscle.
C: Decreases sodium reabsorption.
D: Is a potent vasoconstrictor
D: Is a potent vasoconstrictor
Most urinary tract infections:
A: Involve the lower urinary tract in males because the urethra’s large surface area can house more bacteria
B: Are asymptomatic and are diagnosed when a urinalysis is performed during a routine physical exam.
C: Are the result of viruses or fungi entering the external urethral opening secondary to poor personal hygiene.
D: Occur in women due to the relatively short urethra and its close proximity to the vagina and rectum.
D: Occur in women due to the relatively short urethra and its close proximity to the vagina and rectum.
The MOST important therapy the paramedic can administer to a patient with an isolated renal calculus is
analgesia P.1170
What is Septic shock
???
A common cause of intrarenal acute renal failure is
Decreased blood flow in the kidneys, Not enough fluid in the body (dehydration) also can harm the kidneys. (not 100% on this)
Unlike peritoneal dialysis, hemodialysis
involves the circulation of blood through a machine.
A young woman presents with left-sided flank pain, dysuria, and fever. She tells you that she has been experiencing pain and difficulty with urination for the past week, but did not see her physician. She called 9-1-1 when the flank pain and fever began. You should suspect
pyelonephronitis
You are dispatched to a residence for an elderly man with an altered mental status. As you are assessing the patient, his wife tells you that he goes to dialysis several times a week, but has missed his last three treatments because their car broke down. The patient’s skin is yellow, his blood pressure is 98/60 mm Hg, and his pulse rate is 118 beats/min. The ECG reveals sinus tachycardia with peaked T waves. You should be MOST concerned with the potential for:
A: Severe hypovolemia.
B: Lethal ventricular dysrhythmias.
C: Hypokalemia-induced cardiac arrest.
D: Acute bradycardia or heart block.
B: Lethal ventricular dysrhythmias
In the average female, the menstrual cycle lasts?
A: 24 days.
B: 21 days.
C: 28 days.
D: 35 days.
C: 28 days
Which of the following is a potential complication of pelvic inflammatory disease?
Ectopic pregnancy
Within a few days after having a therapeutic abortion, a 33-year-old woman presents with malaise, fever, constipation, and pelvic pain. Her blood pressure is 124/84 mm Hg, pulse rate is 104 beats/min and strong, and respirations are 22 breaths/min and regular. You should be MOST suspicious for?
A: Endometritis
B: Acute cystitis.
C: Pelvic inflammatory disease.
D: A ruptured ovarian cyst.
A: Endometritis
You are caring for a young woman with constant, diffuse abdominal pain, referred pain to both shoulders, and vaginal bleeding. She states that her last menstrual period was 2 months ago, but she adamantly denies being pregnant. Her blood pressure is 86/50 mm Hg, pulse rate is 120 beats/min and weak, and respirations are 24 breaths/min and regular. Which of the following interventions is NOT appropriate for this patient?
A: Narcotic analgesia.
B: Thermal management
C: IV fluid boluses
D: Cardiac monitoring
A: Narcotic analgesia.
The endocrine system comprises a network of ___that produce and secrete chemical messengers called___.
glands:hormone
Which of the following is an example of endocrine regulation via a negative feedback mechanism?
The neural regulating mechanism decreases its signals to the adrenal medulla, decreasing epinephrine release
If the body experiences a drop in volume or blood pressure
aldosterone secretion stimulates the kidneys to reabsorb sodium from the urine.
Diabetes is MOST accurately defined as
a metabolic disorder in which the body’s ability to metabolize simple carbohydrates is impaired.
Diabetic patients would MOST likely present with atypical signs and symptoms of
acute coronary syndrome
Which of the following would NOT cause hypoglycemia in the patient with type 1 diabetes?
Insulin underdose
Hyperglycemia is characterized by
High Blood sugar
Unlike the patient with hypoglycemia, the patient with severe hyperglycemia
is tachypneic and hyperpneic
Prehospital treatment for patients with hyperosmolar hyperglycemic non-ketotic coma focuses on
present with sever dehydration and neurologic deficits
Signs and symptoms of hypothyroidism include
bradycardic with sluggish reflexes
You receive a call to the county jail for a male inmate who is unresponsive. According to the jailor, the patient was arrested for being “drunk.” Your assessment reveals that the patient is profusely diaphoretic, and his respirations are rapid and shallow. His blood glucose level reads 30 mg/dL. As your partner assists the patient’s ventilations, you start an IV and administer 50% dextrose. Reassessment reveals that the patient is responsive to pain only and his blood glucose level is 46 mg/dL. You should
administer a second dose of dextrose and prepare for immediate transport
A 51-year-old man with type 2 diabetes presents with confusion, blurred vision, and signs of significant dehydration. According to the man’s wife, he has had a fever and flu-like symptoms for the past few days. She further tells you that he has “stuck to his diet” as advised by his physician. His blood pressure is 90/50 mm Hg, pulse is 120 beats/min and weak, and respirations are rapid and shallow. You assess his blood glucose level, which reads “high.” This patient is MOST likely
experiencing hyperosmolar non-ketotic coma
Which of the following clinical presentations is MOST consistent with thyrotoxicosis?
??
Red blood cell production is stimulated by erythropoietin, which is secreted by the
kidneys P.1245
You would expect a person’s hematocrit to be low if he or she
is hemorrhaging P.1245-46
Which of the following is NOT a major component of the hematologic system?
pancreas
In which of the following situations would a transfusion reaction MOST likely occur?
A person with type O blood receives type AB blood
Anemia would result from all of the following conditions except
an increase in iron
As multiple myeloma progresses, the patient would MOST likely experience
spontaneous fractures
You are transferring a 60-year-old man with COPD from a community hospital to a metropolitan hospital. The patient is mildly dyspneic, but is otherwise stable. He is receiving oxygen via nasal cannula, has an IV line of normal saline in place, and has an ECG applied. When reading his chart, you note that he has polycythemia, a history of a prior stroke, and hypertension. The patient tells you that he feels a fluttering sensation in his chest. You glance at the cardiac monitor and see a narrow complex tachycardia at a rate of 160 beats/min. The patient’s blood pressure is 116/70 mm Hg and he remains conscious and alert. You should
ensure adequate oxygenation and ventilation, administer 6 mg of adenosine, and reassess his cardiac rhythm
An abnormal immune response that the body develops when it is re-exposed to an allergen is called
allergic reaction
In contrast to cellular immunity, humeral immunity.
A: Is an acquired form of immunity that involves desensitization through the use of immunizations.
B: Is the result of the body production of leukocytes called T cells that attack and destroy invaders.
C: Protects the body against foreign substances by antibodies that are located exclusively in the lymph nodes.
D: Involves the use of antibodies dissolved in the blood plasma to fight off invading organisms.
D: Involves the use of antibodies dissolved in the blood plasma to fight off invading organisms.
Following the primary response to a foreign substance, the body
develops sensitivity and is able to recognize the substance following subsequent exposure P.1269
In contrast to acquired immunity, natural immunity occurs when
natural is not produced by immune response, acquired immunity is gained after birth as a result of the immune response
Histamine release causes all of the following effects except
increased cardiac contractility, which results in hypertension.
