Dale's Paramedic Pearls Flashcards
A build up of blood or other fluid in the pericardial sac that puts pressure on the heart, which may prevent it from pumping correctly.
Cardiac Tamponade
S/S- Dyspnea and orthopnea, clear lung sounds, rapid and weak pulse, decrease in systolic BP, pulsus paradoxus, narrowing pulse pressure, muffled heart tones.
Cardiac Tamponade
S/S- Acute onset of chest pain or SOB, altered mental status or unconsciousness, general weakness, restlessness, confusion, coma, dyspnea, productive cough, labored breathing, paroxysmal nocturnal dyspnea, tripoding, tachycardia.
Cardiogenic Shock
Treatment for flailed chest?
Stabilize flail segment with a bulky dressing. Do not use a sandbag.
Treatment for a sucking chest wound?
Occlusive dressing sealed on 3 sides. Monitor for loss of compliance while bagging.
High HR, Low BP, think?
Bleed or dehydration
Flat jugular veins when supine?
Bleed, dehydration, or HHNK
Hot skin in a shock patient, think?
Septic Shock
Female patient on birth control and/or smoking with SOB, think?
Pulmonary Embolism
Hives and laryngeal edema, think?
Allergic reaction or Anaphylactic Shock
Cool, clammy skin, think?
Shock
Sudden onset of vomiting or diarrhea, think?
Allergic reaction or Anaphylactic Shock
S/S- Cool, clammy skin above, warm dry skin below, low BP, low HR.
Neurogenic Shock
Difference between Neurogenic Shock and Spinal Shock?
Spinal Shock is temporary
Hives? Think?
Allergic reaction or Anaphylactic Shock
Person on ACE inhibitor with laryngeal edema and stridor, think?
Allergic reaction or Anaphylactic Shock
Black, tarry stools, think?
Lower GI bleed
Bright red blood in stool (hematochezia), think?
Hemorrhoid
Patient states “My heart is beating out of my chest”, think?
SVT
Most common cause of SVT?
Wolff-Parkinson White Syndrome (WPW)
Crushing substernal chest pain, think?
Myocardial Infarction
Treatment for MI?
MONA Morphine 2-4mg IVP Oxygen Nitro .3-.4mg sublingual Aspirin 160-325mg PO
Sudden onset of SOB?
Pulmonary Embolism
Patient has JVD, think?
Right side failure
Any female of child bearing age with abdominal pain, think?
Ectopic pregnancy
Tall, skinny males with sudden onset of SOB, think?
Spontaneous Pneumothorax
Tall, skinny people affected. Genetic disease that presents with weakness in arterial walls. Often aneurysm history, think?
Marfrans Syndrome
1 cause of pulmonary edema?
Left side failure
1 cause of left side failure?
Myocardial Infarction
1 cause of right side failure?
Left side failure
Only reason not to disrobe a trauma patient?
The environment
S/S- Vaginal bleeding with pain, sudden sharp, tearing pain, stiff, boardlike abdomen, massive hemorrhage, 3rd trimester.
Abruptio Placentae
S/S- Lightheadedness, breathlessness, weakness, headache, nausea, vomiting, @6600ft.
Acute Mountain Sickness
S/S- Progressive weakness, fatigue, decreased appetite, weight loss, hyper pigmentation of the skin, vomiting or diarrhea.
Addison’s Disease (Hypoadrenalism)
S/S- Short term memory loss, shuffling gait, stiffness of body muscles, aphasia, psychiatric disturbances, decorticate.
Alzheimers
Angina caused by artery spasm?
Prinzmetals angina
S/S- Sudden onset of chest discomfort, radiating pain, epigastric pain, SOB, elevated BP during episode, pain lasting 3-5 minutes as long as 15 minutes.
Angina Pectoris
Angina that occurs with activity and is relieved by rest?
Stable angina
Angina that occurs with rest and lasts beyond 15 minutes?
Unstable angina
S/S- dyspnea, wheezing, cough, one or two word dyspnea, pulsus paradoxus, tachycardia, decreased O2 saturation, agitated, anxious?
Asthma
2 stages of asthma?
Stage 1- Bronchospasm
Stage 2- Inflammatory response
Treatment for asthma?
Albuterol
Oxygen
Epinephrine
S/S- Localized bite, redness, swelling, muscle spasms of large muscle groups, nausea and vomiting, sweating, seizures, paralysis, decreased LOC?
Black Widow spider bite
Treatment for muscle spasms in Black Widow bite?
Diazepam (Valium) 2.5-10mg IVP
Calcium Gluconate .1-.2mg/kg of 10% solution IV
Anti venom if available
S/S- Painless, small erythematous macula surrounded by a white ring, chills, fever, nausea and vomiting, joint pain, tissue necrosis days, to weeks after bite?
Brown Recluse spider bite
S/S- Headache, nausea and vomiting, confusion, tachypnea, agitation, loss of coordination, chest pain, LOC, seizure, cyanosis, bright cherry red skin?
CO poisoning
S/S- Wenckebach and PVC’s on monitor, blunt trauma to the sternum?
Cardiac Contusion
S/S- Respiratory symptoms, malaise, low grade fever, rash that starts on the face and trunk?
Chicken Pox
S/S- Produces considerable quantities of sputum, productive cough for at least 3 months per year for 2 or more years, overweight, cyanotic, rhonchi, right heart failure if they JVD,
Chronic Bronchitis
Classic sign of right sided heart failure?
JVD and peripheral edema
S/S- Localized numbness, weakness, drowsiness, ataxia, slurred speech and excessive salivation, paralysis of tongue and larynx, drooping of eyelids, double vision, dilated pupils, abdominal pain, nausea and vomiting, LOC, seizure, respiratory failure, hypotension?
Coral snake bite
Red on yellow will kill a fellow? Type of snake.
Coral snake bite
S/S- GI bleeding, recent weight loss, intermittent abdominal cramping, pain, nausea, and vomiting, diarrhea and fever?
Crohns Disease
S/S- Loud seal bark cough, tachypnea, grunting while breathing, wheezing, acute respiratory distress during the night?
Croup
S/S- Burning sensation in the mouth and throat, headache, confusion, combative behavior, hypertension, tachycardia, seizures, coma, pulmonary edema?
Cyanide Poisoning
S/S- Joint and abdominal pain, fatigue, paresthesis, CNS disturbances, associated with diving?
Decompression Illness, “The Bends”
S/S- Slow onset, diuresis, dry, warm skin, excessive hunger and thirst, malaise, tachycardia, feelings of physical weakness, kussmaul respirations, fruity or acetone like smell, hyperglycemia, acidic pH, hypokalemia, decreased mental function, coma?
Diabetic Ketoacidosis (DKA)
Caused by the body burning fat instead of sugar?
DKA
3 classic signs of diabetes mellitus type 1?
Polyuria (Excessive Urination)
Polydipsia (Excessive Thirst)
Polyphagia ((Excessive Hunger)
S/S- Lower left side pain, low grade fever, colicky pain, nausea and vomiting, tenderness on palpation, cool, clammy skin, tachycardia, diaphoresis, hematochezia?
Diverticulitis
S/S- Barrel chest, decreased chest excursion with prolonged expiratory phase, rapid resting respiratory rate, thin, pink in color, hypertrophy of accessory muscles, pursed lips, clubbing of fingers, right heart failure (JVD, peripheral edema, or hepatic congestion). Severe signs include: confusion, agitation, somnolence, one to two word dyspnea, use of accessory muscles, pink puffers?
Emphysema
Kussmaul Sign?
JVD upon inspiration/Pulsus paradoxus
S/S- Decreased LOC, fever, headache, drowsiness, coma, tremors, stiff neck and back, seizures?
Encephalitis
Cushings Reflex?
BP up, pulse same or down, erratic breathing
S/S- Muffled voice or cry, sore throat, pain with swallowing, difficulty swallowing, drooling, stridor?
Epiglottitis
S/S- Agitation, emotional changeability, insomnia, poor heat tolerance, weight loss despite increased appetite, weakness, dyspnea, tachycardia?
Graves Disease (Hyperthyroidism)
S/S- Cramps in fingers, arms, legs, or abdominal muscles, mentally alert, weakness, dizziness, moist and warm skin?
Heat Cramps
S/S- Increased body temp, cool and clammy skin, rapid and shallow breathing, weak pulse, possible diarrhea, muscle cramps, weakness, headache, anxiety, paresthesia, impaired judgement?
Heat Exhaustion
S/S- >105 temp, cessation of sweating, hot skin that is dry or moist, very high core temp, deep respirations that become shallow, rapid at first but may slow, rapid full pulse may slow later, hypotension with low or absent diastolic reading, confusion or disorientation, unconscious, seizures?
Heat Stroke
S/S- Blunt or penetrating chest trauma, signs and symptoms of shock, dyspnea, dull percussive sounds over site collecting blood?
Hemothorax
Treatment for hemothorax?
O2
2 large bore IVs
Monitor breath sounds
S/S- Weight gain, moon face appearance, buffalo hump, thinning or transparent skin, mood swings, impaired memory or concentration. Too much cortisol?
Hyperadrenalism (Cushings Syndrome)
S/S- Diaphoresis, increased skin temp, flushing, altered LOC?
Hyperthermia
S/S- Altered mental status, bizarre behavior, diaphoresis, tachycardia, seizure, quick onset, blood sugar <90?
Hypoglycemia
S/S- Temp between 90-95, lethargy, shivering, lack of coordination, pale, cool dry skin, early rise in BP, heart and resp?
Mild Hypothermia
S/S- Temp <90, no shivering, dysrhythmias, loss of voluntary muscle control, hypotension, undetectable pulse and respirations, J-waves on ECG?
Severe Hypothermia
S/S- Fatigue, decreased mental function, lethargy, cold intolerance, constipation, decreased appetite with increased weight gain?
Hypothyroidism (Myxedema)
S/S- Altered mental status, one or two word dyspnea, cyanosis, hemoptysis (coughing up blood), hypoxia, cough, hoarseness, vague chest pain, fever, chills, pleuritic chest pain, crackles, wheezes, diminished breath sounds heard in affected lung, profound wait loss (severe)?
Lung Cancer
Treatment for marine animal injection?
Establish and maintain airway
Apply light constricting band between wound and heart to occlude lymphatic flow
Apply heat or hot water
Inactivate or remove stinger
S/S- Full body rash, hacking cough, runny nose, high fever, watery red eyes, kopliks spots (red spots with blue-white centers that appear in the mouth). Viral disease?
Measles
S/S- High fever, headache, stiff neck, nausea and vomiting, discomfort looking into bright lights, confusion, sleepiness, seizure. Classic sign is high fever. 6 year old kid with high temp for 2 days?
Meningitis
S/S- Chest pain, elevated BP during episode, chest pain that last more than 30 minutes, pain radiates to arms, neck, or back. Acute onset of nausea and vomiting, nitro and rest offer no relief, feeling of impending doom?
MI
Classic sign of MI?
Crushing substernal chest pain
Most heart attacks occur where?
Left ventricle
S/S- Fever, headache, loss of appetite, pain and swelling in parotid gland, viral?
Mumps
S/S- Altered level of consciousness, impaired judgement, drunkedness, also know as “rapture of the deep”?
Nitrogen Narcosis
S/S- Penetrating chest trauma, sucking chest wound, frothy blood at wound site, dyspnea, hypovolemia. Has to be 3mm or larger to be a problem?
Open Pneumothorax
Treatment for Open Pneumothorax?
High flow O2
Cover opening with sterile occlusive dressing taped on 3 sides
S/S- Tremor, rigidity, bradykinesia (slow movement), postural instability. Caused by lack of dopamine in the brain?
Parkinson’s Disease
Treatment for Pit Viper bite?
Keep patient supine Immobilize limb with splint Maintain extremity in neutral position Do not apply constricting band O2 IV Crystalloid Fluids Transport
1 cause of bleeding in 3rd trimester?
Placenta Previa
S/S- Painless, bright red vaginal bleeding. Takes place in 3rd trimester?
Placenta Previa
What is Becks Triad?
JVD
Narrowing Pulse Pressure
Muffled Heart Sounds
S/S- Substernal chest pain, irregular pulse, abnormal heart sounds, low BP, narrow pulse pressure, change in voice?
Pneumomediastinum
S/S- Chills, deep productive cough, yellow to brown sputum often streaked with blood, pleuritic chest pain. More prone to get disease if on steroids?
Pneumonia
S/S- Trauma to the chest, chest pain on inspiration, hyperinflation of chest, diminished breath sounds to affected side?
Pneumothorax
Treatment for Pneumothorax?
Chest Decompression
Difference between Pneumothorax and Tension Pneumothorax?
Tension has:
JVD
Tracheal Deviation
Sometimes narrowing pulse pressure
Treatment for Open Pneumothorax?
First, cover with gloved hand and place occlusive dressing over the wound
S/S- Excessive salivation, lacrimation, diaphoresis, abdominal cramps, nausea and vomiting, diarrhea, decrease LOC, eventually coma?
Poisonous Plant or Mushroom ingestion
What is SLUDGE?
Salivation Lacrimation Urination Defecation Gastrointestinal Upset Emesis
What is Hemoptysis?
Coughing up blood
S/S- Blunt or penetrating chest trauma, increasing dyspnea, hypoxia, increasing crackles, diminishing breath sounds, hemoptysis, signs and symptoms of shock?
Pulmonary Contusion
S/S- Sudden onset of severe unexplained dyspnea, possible pleuritic chest pain, possible cough, labored breathing, tachypnea, tachycardia?
Pulmonary Embolism
Treatment for PE?
High flow O2 and Transport
What is a Thrombus?
Blood Clot
When someone is hyperventilating, what metabolic disorder are they in?
Respiratory Alkalosis
S/S- Sore throat, rhinorrhea, chills, myalgia, headache, diarrhea, cough, sputum production, respiratory stress, respiratory failure?
Severe Acute Respiratory Syndrome (SARS)
S/S- Thrombosis in the brain, gradual onset, often occurs after periods of rest?
Occlusive Stroke
S/S- Facial drooping, headache, confusion, dysphasia, aphasia, dysarthria, vision problems, hemiparesis, hemiplegia, paresthesia, inability to recognize touch, gait disturbances, uncoordinated fine motor movements, dizziness, incontinence, coma?
Stroke
S/S- Complains of worst headache of their life?
Hemorrhagic Stroke
Treatment window for suspected Occlusive Stroke?
3-4.5 Hours
Most common emboli?
Thrombi
S/S- Chest trauma, severe dyspnea, vent/perfusion mismatch, hypoxemia, hyperinflation of affected side of chest, diminished then absent breath sounds, cyanosis, diaphoresis, altered mental status, JVD, hypotension, hypovolemia, narrowing pulse pressure?
Tension Pneumothorax
S/S- High fever (106 or higher), irritability, delirium or coma, tachycardia, hypertension, vomiting, diarrhea. Usually as the result of ingestion of thyroid product?
Thyrotoxic Crisis or Thyroid Storm
S/S- Dry mouth, blurred vision, urinary retention, constipation, confusion, hallucinations, hyperthermia, respiratory depression, seizures, tachycardia, hypotension, cardiac dysrhythmias?
Tricyclic Antidepressant Toxicity
Treatment for Tricyclic Antidepressant overdose?
Sodium Bicarb
S/S- Nausea, weakness, fatigue, rapid weight loss, fever, night sweats, cough, chest pain, hemoptysis?
Tuberculosis
When caring for TB patients what BSI precaution must you wear?
N95 Respirator
What is the division of the Upper and Lower GI System?
Ligament of Treitz
S/S- Abdominal discomfort, upset stomach, gas pain, tearing pain in upper quadrants, nausea and vomiting, hematemesis, melena, tachycardia?
Upper GI Bleed
What is myalgia?
Muscle pain
S/S- fever, chills, myalgias, fatigue, usually viral?
Upper Respiratory Infection
S/S- Coarse tremor of hands, tongue, eyelids, nausea and vomiting, general weakness, increased sympathetic tone, tachycardia, sweating, hypertension, orthostatic hypotension, anxiety, irritability, hallucinations, poor sleep?
Withdrawal Syndrome
Normal vital signs at birth?
Resp- 30-60
HR- 100-180
Systolic BP- 60-90
Normal vital signs for preschool age (3-5)?
Resp- 22-34
HR- 70-110
Systolic BP- 95-110
Normal vital signs for Adolescence?
Resp- 12-26
HR- 60-90
Systolic BP- 112-128
What does APGAR stand for?
Activity Pulse Grimace Appearance Respiration
How often after birth do you evaluate the APGAR score?
1 and 5 minutes following birth
Name 5 components of the Initial Impression?
- Form a general impression
- C-spine control as needed
- Assess baseline mental status
- ABC’s
- Determine priority
The way we evaluate oxygenation of blood in the body?
Fick Principle
Normal PaCO2 level?
35-45mmHg
Normal PaO2 level?
80-100mmHg
Rhonchi?
Mucus in the airway
Crackles?
Fluid in the lower airway, pulmonary edema
Stridor?
Upper airway obstruction, FBAO, epiglottitis in children older than 3-4
Wheezing?
Fluid in lower airways, bronchoconstriction, associated with asthma
What causes snoring respirations?
Soft tissues in back of the throat, usually tongue
Best way to determine good respirations?
End tidal CO2 detector or Capnogram
Least advised way to insert ET tube?
Digitally
Right side hypertrophy brought on by long term hypertension?
Cor Pulmonale
What is Pulsus Paradoxus?
Drop in pulse and 10mmHg BP during inspiration
What is the most frequent infection that affects smokers?
Bronchitis, then pneumonia
A liquid protein substance that coats the alveoli in the lungs?
Surfactant
Alveolar collapse that prevents the use of that portion of the lung for ventilation and oxygenation?
Atelectasis
What is the exchange of gases between a living organism and the environment?
Respirations
What is air movement in and out of the lungs? Does not guarantee respirations.
Ventilation (Mechanical)
What is the average volume of gas inhaled and exhaled in one respiratory cycle?
Tidal Volume (500ml)
What gives you the best seal when using BVM?
E-C, 2 person BVM
Nasal intubation is contraindicated in the presence of what?
Apnea
Primary concern of Cheyne-Stokes respirations?
Minute volume
Treatment for Pulmonary Edema?
Nitro
Lasix
Morphine
CPAP
A selective Beta-2 agonist that can be used as a breathing treatment? Can also stop contractions.
Terbutaline
What is Kussmaul’s Sign?
Rise of jugular vein upon inspiration
What is Succinylcholine and its dose?
Used for Rapid Sequence Intubation, 1-1.5mg/kg
Any abnormal condition that effects the hearts arteries that produces various effects, especially reducing the flow of O2 and nutrients to the myocardium?
Coronary Artery Disease (CAD)
Most common form of CAD?
Atherosclerosis
Occlusion of arteries with fatty deposits and cellular debris?
Atherosclerosis
Calcification of the arteries causing loss of elasticity?
Arteriosclerosis
S/S- Pedal edema, ascites, pulmonary edema, dyspnea, orthopnea, cough, decreased BP, nausea and vomiting, pitting edema, anxiety, confusion, JVD, weak pulse, decreased urine output?
CHF
Backwards left sided heart failure presents with what?
Pulmonary Edema
Forwards left sided heart failure presents with what?
Hypotension
Right sided heart failure presents with what?
Peripheral edema
Wheezing in cardiac patient caused by left sided failure and fluid in the lungs is know as what?
Cardiac asthma
S/S- Weak, strong, weak, strong, pulse quality alteration?
Pulsus Alterans
Monitor shows varying amplitude of weak, strong, weak, strong?
Electrical Alterans
A condition involving sudden fainting which usually lasts for less than a minute and may include seizures. Before the attack patient becomes pale and during recovery the patient often feels hot and flushed. Fainting occurs due to a lack of O2 in the brain due to heart rhythm problems involving slowing of the heart.
Stokes Adams Syndrome
Anti-hypertensive that blocks the cellular uptake of calcium. Causes a decrease in SA and AV node automaticity. Examples are Verapamil, Cardizem. Chief side effects are hypotension and bradycardia.
Calcium Channel Blocker
Blocks Beta-1 and Beta-2 receptor sites. Decreases HR and BP. Examples are Propranolol, Acebutolol, Esmolol, Metoprolol, Atenolol.
Beta Blockers
Beta Blocker overdose treatment?
Glucagon
What is the separation of the tunica medica from the tunica adventitia, causing referred pain to the left shoulder, upper back, and chest?
Aortic Aneurysm
S/S- Pain referred to lower back, possible pulsating mass in abdomen and feeling of impending bowel movement?
Abdominal Aortic Aneurysm
S/S- Tearing chest pain that radiates to the back or shoulder blades, radial pulse discrepancy?
Thoracic Aneurysm
What is a common cause of an idioventricular rhythm?
AAA
Role of ASA in the patient with chest pain?
ASA is a platelet aggregate. It makes platelets slippery keeping the clot from getting larger.
What is the S1 sound?
Mitral and Tricuspid valves closing
What is the S2 sound?
Aortic and Pulmonic valves closing
When is the S3 and S4 sound heard?
CHF, elderly with heart disease, indicative of valve failure
The heart is what kind of pump?
Sodium Potassium Pump
Cardiac Output=
Stroke Volume x Heart Rate
What law states the greater the volume of blood entering the heart during diastole, the greater the volume of blood ejected during systolic contraction?
Starlings Law
A nerve plexus of the autonomic nervous system supplying the heart and neighboring structures?
Cardiac Plexus
Blood and IV fluids have what kind of osmolarity?
Isotonic
Rhythm Hallmarks- Chaotic and irregular, no pulse/breathing?
V-Fib
Rhythm Hallmarks- Long PRI
1st degree heart block
Rhythm Hallmarks- PRI grows then drops a beat, usually grouped beats.
2nd degree, type 1 (Wenckebach)
Rhythm Hallmarks- PRI constant with conducted beats, dropped beats present.
2nd degree, type 2 (Classical)
Rhythm Hallmarks- No correlation between P’s and QRS’s?
3rd degree heart block, complete block
Rhythm Hallmarks- No P wave or inverted P wave?
Junctional Rhythm
Treatment for Stable V-Tach?
150mg Amiodarone IV, given over 10 minutes. Repeat as needed to a max dose of 2.2g in 24 hours.
Treatment for Unstable V-Tach?
Synchronized Cardioversion
You see Asystole on the monitor, what is your next step?
Check in another lead
Asystole on the monitor, what is first drug of choice?
Epinephrine 1mg IV/IO every 3-5 minutes. Could also use Vasopressin 40u for 1st or 2nd dose of Epi.
Vagal or Valsalva maneuvers will only work on what type of rhythms?
SVT’s
What is the treatment for a patient with stable SVT?
Vagal maneuver first, then
Adenosine 6mg, 12mg, 12mg
What is the most common reperfustion rhythm?
2nd degree, type 1 (Wenckebach)
When ST elevation is seen across all leads, think?
Pericarditis
Treatment for patient with atrial flutter?
IV
O2
Supportive care
Transport
When does the relative refractory period begin?
At the apex of the T wave
What does Nitro do?
Dilates coronary arteries, reducing the workload on the heart.
Treatment for Morphine overdose?
Narcan 2-4mg IVP
What causes heart blocks and yellow vision?
Digitalis Toxicity
Treatment for a hypertensive emergency?
IV at TKO
O2
Transport
What is a decrease in arterial perfusion at the calf muscle, causing pain?
Claudication
Angiotensin causes what to the blood vessels?
Constriction
Good cholesterol?
HDL
Bad cholesterol?
LDL
Low levels of calcium in the blood that may lead to dysrhythmias?
Hypocalcaemia
The law that the volume flow of an incompressible fluid through a circular tube is equal to pie/8?
Poiseuille’s Law
This is the difference between systolic and diastolic pressures?
Pulse Pressure
Mean Arterial Pressure (MAP)=
1/3 pulse pressure+ diastolic
Beta-1 response to Epi does what?
Increase HR
This part of the brain controls higher thought and judgement, sight, memory and cognitive function?
Cerebrum
This part of the brain controls fine motor control?
Cerebellum
What is the Parasympathetic Neurotransmitter?
Acetycholine
What is the Sympathetic Neurotransmitter?
Norepinephrine
Brain can last how long without perfusion?
3-6 seconds
SVT is considered when the HR is over how many BPM?
160
What is the short period immediately after depolarization in which myocytes are not yet repolarized and are unable to fire or conduct an impulse?
Absolute Refractory Period
This period is between the effective refractory period and the end of the refractory period; a period of a few milliseconds following the absolute refractory period during which the excitation threshold of neural tissue is raised and a stronger than normal stimulus is required to initiate an action potential?
Relative Refractory Period
What is Becks Triad, and what is it associated with?
JVD
Muffled Heart Tones
Narrowing Pulse Pressure
Seen in Cardiac Tamponade
What type of overdose can cause numbness, tingling, and seizures?
Lidocaine OD
Dose for Dopamine drip?
2-10mcg/kg/min
What system is designed to keep blood pressure up?
Renin/Angiotensin
IV flow is least affected by the length of the catheter as opposed to its?
Diameter
What is the Beta-1 response to Epi?
Increased HR
At what MAP is the brain profused?
60mmHg
Norepinephrine works on what receptor sites?
Alpha, Beta, Dopaminergic Receptors
What nerve does acetycholine work on?
Vagus Nerve
What contains 50% of of the sugar volume in the entire body?
Cerebral Spinal Fluid (CSF)
Also known as the oculomotor nerve, this nerve allows for pupil constriction and eye movement?
3rd Cranial Nerve
With a head injury and brain swelling you will sometimes see constricted pupils, this is due to pressue on the tentorium of the brain on which cranial nerve?
3rd Cranial Nerve
Also called the trigeminal nerve, this never is responsible for most facial sensations?
5th Cranial Nerve
Also called the facial nerve, when this nerve swells it can cause facial paralysis or Bells Palsy which can be confused for a stroke?
7th Cranial Nerve
Also called the vagus nerve, this nerve is the connection between the brain and numerous organs?
10th Cranial Nerve
Stages of Seizure?
Aura Tonic Clonic Postseizure Postictal
A sensation the patient gets before a seizure? Also the first stage of seizure.
Aura
This phase of seizure includes body wide rigidity?
Tonic Phase
This phase of seizure involves rhythmic contractions of major muscle groups?
Clonic Phase
This phase of seizure is when all the muscle relax, the eyes may roll back?
Postseizure
The phase of seizure is the reset period for the brain? May last several minutes or several hours.
Postictal
This type of seizure involves the whole body?
General Seizure
This type of seizure just involves part of the body?
Partial Seizure
These are also known as “fake” seizures?
Pseudoseizures
Also called Tonic/Clonic, this type of seizure leaves the patient unconscious and involves shaking and jerking the entire body?
Grand Mal Seizures
This seizure, also called an absence seizure, involves 10-30 seconds of seizure activity marked by starring episodes or loss of motor control?
Petit Mal Seizure
This type of seizure lasts longer than 4-5 minutes or
Status Epilepticus
Treatment for Status Epilepticus?
Vailum
A common chronic neurologic disorder that is characterized by recurrent unprovoked seizures?
Epilepsy
Sedative hypnotic drugs that provide muscle relaxation and mild sedation, includes Diazepam (Valium), and Medazolam (Versed)?
Benzodiazepines
Sustained contractions of both agonist and antagonist muscles. Twisting movements which when prolonged may produce abnormal postures?
Dystonia
Treatment for Dystonic Seizures?
Benedryl 25-50mg
A movement disorder which consists of effects including diminished voluntary movements and the presence of involuntary movements, similar to tics or chorea?
Dyskinesia
Involuntary movements of the tongue, lips, face, trunk, and extremities? Generally caused by extended use of Halodol.
Tardive Dyskinesia
A delayed stress reaction?
Post Traumatic Stress Disorder (PTSD)
S/S- Hallucinations and delusions.
Schizophrenic Patient
Suicide is most likely to occur at what age and condition?
40-50 with terminal disease
A condition in which a person is overly concerned with physical health and appearance to the point that it dominates his or her life?
Somatoform Disorder
Periods of apnea and rapid breaths? Usually involved with a head injury and increased intracranial pressure?
Biot’s Respirations
Respirations caused by stroke and intracranial pressure?
Cheyene-Stokes Respirations
Treatment for patient with Cheyne Stokes respirations?
Ventilate at 20BPM
Elevated BP, Slow or normal HR, erratic respirations?
Cushings Syndrome/Triad/Reflex
Best sign of Intracranial Pressure?
High BP
Why is the patients skin pink distal to the injury in neurogenic shock?
A lack of Sympathetic response
A rare and usually fatal disease of the brain, characterized by progressive dimentia and gradual loss of muscle control, that occurs most often in middle age and is caused by a slow virus?
Mad Cow Disease (Creutzfeldt-Jakob disease)
Tumors of the adrenal gland which produce excess adrenaline?
Pheochromocytoma
Damages the motor neurons in the brain and spinal cord?
Lou Gehrigs Disease (ALS-Amyotrophic lateral sclerosis)
A syndrome that results when the pituitary gland produces excess growth hormones? Includes abnormal and and feet growth.
Acromegaly
Inadequate cellular perfusion?
Shock
Shock causes what type of acidosis?
Metabolic
Types of Shock?
Cardiogenic Hypovolemic Neurogenic Anaphylactic Septic
Type of shock where there is an impaired pumping power of the heart
Cardiogenic Shock
Treatment for Cardiogenic Shock?
Dopamine 5-10mcg/kg/min
Type of shock where there is a decrease in blood/water volume? Cool, pale, clammy skin, BP low, HR up?
Hypovolemic Shock
Earliest sign of hypovolemia?
Anxiety and restlessness
First organ affected by lack of O2?
Brain
Type of shock with an injury to the brain or spinal cord that disrupts communication between nerves and arteries causing relative hypovolemia? Warm, dry, red skin, low BP, slow HR?
Neurogenic Shock
Type of shock with a quick onset, allergic reaction, stridor is an ominous sign? Low BP, pulmonary or laryngeal edema?
Anaphylactic Shock
Treatment for Anaphylactic Shock?
Epinephrine 1:1000 IM
What does the CNS due in Anaphylaxis?
Widespread vasodilation
The antibody responsible for Anaphylaxis?
IgE- Immunoglobulin E
Type of shock with an infection that enters the blood stream and is carried throughout the body? Fever, skin flushed, maybe have breathing issues. History of infection or fever.
Septic Shock
In lead II, which lead is positive?
LL-Left Lower
Bacteria produce what to harm our body?
Endo/Exotoxins
PE mimics what?
Right Side Failure
Addison’s Disease?
Hypoadrenalism
How does asthma display on ETCO2?
Shark Fin
1 cause of chronic bronchitis?
Smoking
Somnolence means?
Sleepiness
Too many RBC’s, called?
Polycythemia
Graves’ disease also called?
Hyperthyroidism
Cushing’s syndrome, also called?
Hyperadrenalism
Myxedema, also called?
Hypothyroidism
Best position to evaluate JVD on patient?
45 degree angle
What kind of drug is verapamil?
Calcium channel blocker
Cancer patient in a nursing home is cold and clammy with a fever of 101. Recently returned from the hospital for surgery, has a non-healing sore, suspect?
Septic Shock
Abnormal distribution and return of the blood as seen in Anaphylaxis, Sepsis, or Neurogenic Shocks?
Distributive Shock
3 stages of shock?
Compensated
Decompensated
Irreversible
In this stage of shock, the body has teh ability to maintain its metabolic demands. Normal BP, possible skin mottling, heart rate up, and contractility is normal.
Compensated Shock
In this stage of shock, the body is unable to meet metabolic demands. Hypotensive, bradycardia. Heart rate moving from tachy to brady?
Decompensated Shock
