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Medical Emergencies > Chapter 3 > Flashcards

Chapter 3 Flashcards

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USMLE® Step 1 flashcards
1
Q

True

A pulse can be felt in various locations in the body where an artery lies close to the skin surface and can be compressed over a hard structure, such as bone or muscle tissue

A

True

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2
Q

True or False

A person’s pulse indicates the speed and force of his or her heartbeat and the expansion and contraction of an artery as blood is forced out of the heart muscle.

A

True

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3
Q

Where are the most common areas to take a pulse?

A

Radial (wrist)
Brachial (arm)
Carotid (neck)

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4
Q

In an emergency situation, where is another site to take a pulse?

A

Femoral pulse (groin area)

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5
Q

Where is the most common place to take a pulse in a dental practice?

A

Radial

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6
Q

How do you determine the rate of the radial pulse?

A

Have the patient rest for 10 seconds
Place the tips of the index and middle fingers along the groove at the base of the thumb on the patient’s wrist
Press against the radial artery with your index and middle fingers to block the pulse
Gradually release the pressure until pulsation are felt (do NOT use your thumb)
Count the number of times a beat is felt for 30 seconds and then multiply by 2 in order to determine the number of heartbeats per minute.

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7
Q

What are the normal pulse rate in well-conditioned athletes?

A

40-60 beats per minute

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8
Q

What is the normal pulse rate for babies to age 1?

A

80-120 beats per minute

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9
Q

What is the normal pulse rate for children ages 1 to 10

A

70-130 beats per minute

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10
Q

What is the normal pulse rate for children age 10+ and adults?

A

60-100 beats per minute

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11
Q

What is a rapid pulse rate of more than 100 BPM called?

A

Tachycardia

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12
Q

A person’s heart rate normally increases in response to?

A 
Fever
Exercise
Nervous excitement
Medications
Stimulant type drugs
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13
Q

True or False

Tachycardia can also be a result of dizzy states such as heart failure, hemorrhage, or shock.

A

True

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14
Q

True or False

Tachycardia attempts to increase the amount of oxygen delivered to the cells throughout the body by increasing the amount of blood circulated through the blood vessels.

A

True

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15
Q

What occurs when the heart rate is less than 60 beats/minute?

A

Bradycardia

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16
Q

What drug is administered when bradycardia occurs?

A

Atropine (increases person’s heart rate)

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17
Q

An irregular pulse could be a sign of?

A

Arrhythmia

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18
Q

What is stroke volume?

A

Volume of blood pushing against the blood vessel walls with each heart contraction.

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19
Q

True or False

A strong pulse is an indication of increased stroke volume, which can be particularly dangerous if the patient has hypertension, which would increase her/his risk of cerebrovascular accident or stroke.

A

True

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20
Q

True or False

A weak pulse (thready pulse) indicates a decrease in the heart’s stroke volume.

A

True

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21
Q

What is respiration?

A

Process by which oxygen and carbon dioxide are exchanged within the body

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22
Q

What is external respiration?

A

Oxygen is taken into the body and carbon dioxide is eliminated via the lungs.

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23
Q

What is internal respiration?

A

Involves the use of oxygen, the production of carbon dioxide, and their exchange between cells and blood.

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24
Q

What is bradypnea?

A

Abnormally slow respiratory rate, less than 12 breaths/minute in an adult

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25
Q

What is tachypnea?

A

Abnormally fast respiratory rate above 20 breaths/minute

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26
Q

What is apnea?

A

Absence of respirations and is often described by the length of time in which no respirations occur

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27
Q

What happens if oxygen deprivation lasts 10 minutes or longer?

A

Brain damage and/or coma

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28
Q

What is the normal respiratory rate in newborns?

A

40-50 respirations/minute

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29
Q

What is the normal respiratory rate in infants?

A

20-40 respirations/minute

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30
Q

What is the normal respiratory rate in preschool children?

A

20-30 respirations/minute

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31
Q

What is the normal respiratory rate in older children?

A

15-25 respirations/minute

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32
Q

What is the normal respiratory rate in adults?

A

12-20 respirations/minute

33
Q

What are some abnormal respiratory patterns?

A

Biot’s respirations
Cheyne-Stokes respirations
Kussmaul respirations

34
Q

What are Biot’s respirations?

A

Cyclic breathing patterns characterized by periods of shallow breathing alternating with periods of apnea.
Seen in individuals with neurological problems, head trauma, brain abscesses, heat stroke

35
Q

What are Cheyne-Stoke’s respirations?

A

Cyclic breathing patterns characterized by periods of respirations of increased rate and depth alternating with periods of apnea.
Seen in individuals suffering from heart failure and drug overdose

36
Q

What are Kussmaul respirations?

A

Increased depth and rate of respirations of over 20 breaths/minute.
Seen in individuals with hyperventilation, metabolic acidosis, diabetic ketoacidosis, renal failure.

37
Q

True or False

Respirations should be quiet, automatic, and effortless.

A

True

38
Q

What is stridor?

A

Harsh sound made during inspiration that sounds like crowing, often associated with airway obstruction

39
Q

What is wheezing?

A

High-pitched sound that is usually heard on expiration but may be heard on inspiration as well.

40
Q

True or False

Stress can cause an increase in the strength and depth of respirations.

A

True

41
Q

True or False

Some medications such as narcotics, will decrease respiratory rates, whereas sympathomimetic drugs that mimic the effects of organ stimulation, such as albuterol, will dilate the bronchioles leading to an increase in the patient’s ability to breathe

A

True

42
Q

What is pyrexia?

A

Fever

Abnormal elevation in body temperature

43
Q

What can cause a fever?

A 
Infection
Neurological disease
Malignancy
Heart failure
Severe trauma
Drugs
Convulsions (may occur in children with extremely high fevers, and delirium is seen in children and adults with high fevers)
44
Q

What is hypothermia?

A

State in which an individual’s body temperature is reduced below his or her normal range, but not below 96 dg F

45
Q

What are the characteristics of hypothermia?

A

Mild shivering
Cool skin
Pallor

Illness, trauma, malnutrition, and medications may all cause hypothermia

46
Q

What is the definition of blood pressure?

A

Force exerted by the blood against the blood vessel walls
Read in millimeters of mercury (mmHg)
Systolic/Diastolic (120/80)

47
Q

What is systolic blood pressure?

A

Force of blood against the blood vessel walls during ventricular contraction (100-120 mmHg)

48
Q

What is diastolic blood pressure?

A

Force of blood against the blood vessel walls during ventricular relaxation (60-80 mmHg)

49
Q

What is pulse pressure?

A

The difference between systolic and diastolic

ex: 100 mmHg - 70 mmHg = 30 mmHg

50
Q

True or False

The higher the diastolic reading the greater the risk for myocardial infarctions, CVAs, and kidney failure.

A

True

51
Q

True or False

If left untreated, high systolic blood pressure can lead to a CVA, MI, heart failure, kidney damage, blindness, and other conditions

A

True

52
Q

True or False

Blood pressure in children varies based on gender, age, and height.

A

True

53
Q

What is normal blood pressure in children?

A

89th percentile or lower

ex: 89% of children of that gender, age, and height would have blood pressure below this level.

54
Q

What is prehypertension in children?

A

Indication of child’s average systolic or diastolic blood pressure is between 90th and 94th percentile.
Ages 12-18 blood pressure exceeds 120/80 mmHg

55
Q

True or False

Stage 1 hypertension in children indicates high blood pressure in which the average systolic and diastolic pressure ranges from the 95th percentile up to 5 mmHg above the blood pressure measurement at the 99th percentile.

A

True

56
Q

What is normal body temperature?

A

98.6 dg F

57
Q

What is Stage 2 hypertension in children?

A

Child’s average systolic or diastolic pressure is 5 mmHg or more above the 99th percentile for his or her gender, age, and height.

58
Q

What are some factors that affect blood pressure?

A

Blood volume
Cardiac output
Blood viscosity
Blood vessel resistance

59
Q

What is the relationship between blood volume and blood pressure?

A

Increase in blood volume causes increase in blood pressure and vice versa

60
Q

What is the relationship between stroke volume and blood pressure?

A

Increase in cardiac output causes increase in blood pressure and vice versa

61
Q

What is the relationship between blood viscosity and blood pressure?

A

Increase in blood viscosity causes increase in blood pressure and vice versa

62
Q

What is the relationship between blood vessel resistance and blood pressure?

A

Patients suffering from thickening and calcification of lumen of blood vessel tend to have higher blood pressure

63
Q

What is hypertension?

A

Common disorder characterized by elevated blood pressure exceeding 140/90 mmHg

64
Q

What is Stage 1 hypertension in adults?

A

Systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-99 mmHg

Advised to make lifestyle changes such as weight reduction, sodium reduction, appropriate physical activity, moderation of alcohol consumption

65
Q

What is Stage 2 hypertension in adults?

A

Systolic blood pressure of 160 mmHg or higher or diastolic above 100 mmHg

66
Q

True or False

Hypertension underlies most cardiovascular diseases.

A

True

67
Q

What are the two major categories of severe hypertension?

A

Hypertensive urgency
Hypertensive emergency

In each case the patient presents with extremely high blood pressure reading.

68
Q

What is the difference between hypertensive urgency and hypertensive emergency?

A

hypertensive emergency, the patient would experience some form of target end organ damage (aka malignant hypertension) - many of the patients did not recover
types of end organ damage: aortic dissection, cerebral infarction, hemorrhage, MI, renal insufficiency
Hypertensive urgency will not have any form of target end organ damage: usually newly diagnosed with hypertension

69
Q

What are some signs and symptoms or hypertensive urgency?

A 
Headache (moderate to severe)
Anxiety
Shortness of breath
Tinnitus
Edema
Epistaxis with a sudden changes in blood pressure greater than 180/110 mmHg
70
Q

What are some signs and symptoms of hypertensive emergency?

A 
Sudden increase in blood pressure greater than 180/110 mmHg, but often as high as 220/140 mmHg
Shortness of breath
Chest pain
Nocturia
Dysarthria (difficulty speaking)
Weakness
Altered consciousness
Seizures
Heart failure
Nausea
Vomiting
Coma
71
Q

True or False

Treatment for hypertensive urgency in the dental office wold begin by retaking the blood pressure to ensure that the first reading was accurate.

A

True

72
Q

True or False

A patient presenting a systolic blood pressure of 160 mmHg or diastolic pressure of 90-99 mmHg should not have dental procedures performed.

A

True

73
Q

True or False

Patients with a systolic rating of greater than 160 mmHg have a 30% greater risk of a CVA

A

True

74
Q

In a patient exhibiting hypotension, what would the treatment be?

A 
Position the patient in a supine position with feet raised
Assess the airway
Administer supplemental oxygen
Monitor vital signs
If patient does not improve, contact EMS
75
Q

What is orthostatic hypotension?

A

A sudden drop in systolic blood pressure caused by a change in body position

76
Q

True or False

Orthostatic hypotension may cause a patient to lose consciousness after being repositioned from a reclined position to an upright position in the dental chair

A

True

77
Q

What are the symptoms of orthostatic hypotension?

A

Dimming of vision
Decreased hearing
Lightheadedness

78
Q

True or False

The clinician should assess the patient’s gait, eyes, speech and skin color, as well as significant weight gain or loss.

A

True

changes in any of these could indicate a medical problem warranting emergency intervention, such as CVA or MI

Medical Emergencies (16 decks)

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