EMT224(2) Flashcards
Foreign body airway obstruction is defined as a problem with ___.
Ventilation
The process of air moving into and out of the lungs is ___.
Ventilation
Chronic bronchitis can be defined as:
Inflammatory changes and excessive mucus production in the bronchial tree
Clinical diagnosis of chronic bronchitis is made by the presence of:
A cough with sputum production occurring for at least 3 months of the year for at least 2 consecutive years
Emphysema is described as:
Permanent abnormal enlargement of the air spaces and destruction of alveoli
An elevated hematocrit level secondary to chronic hypoxia is known as:
Polycythemia
Patients with emphysema have increased airway resistance during:
Expiration
Drugs like albuterol help asthma patients by:
Dilating the bronchi
You are treating a patient who reports that she has COPD. If she has emphysema, you would expect:
A thick, barrel-chested appearance
Asthma exacerbation results in:
Bronchial smooth muscle contraction
Excessive positive intrathoracic pressure during an asthma attack may lead to:
Pulsus paradoxus
The current cornerstone of asthma treatment in the U.S. is:
Albuterol
Asthma that doesn’t resolve with repeated doses of bronchodilators is called:
Status asthmaticus
Status asthmaticus is commonly triggered by:
Viral respiratory infection
A local preschool has closed because of an epidemic of pneumonia among the children. The most common cause of children’s pneumonia is:
Influenza A
Days after a seizure and a period of unconsciousness, a patient develops pneumonia. This patient is at high risk for:
Aspiration pneumonia
One factor that may help differentiate pneumonia from COPD is the presence of:
Fever
A condition that exists when the capillaries in the lung have greater permeability, which leads to rales and stiff alveoli, is known as:
ARDS
PEEP is used to:
Keep alveoli open
A bleb is a:
Weakened area of the lung
What type of patients are predisposed to spontaneous pneumothorax?
Tall, thin males with a narrow chest
The resultant respiratory alkalosis associated with hyperventilation syndrome is due to an excessive loss of:
CO2
A pt who appears anxious, tachypneic, clear lung sounds, complaining that his fingers are numb and tingling, is most likely suffering from:
Hyperventilation syndrome
The most appropriate tx for a pt with hyperventilation syndrome is:
Calming the pt and supplying O2 as necessary
If arterial blood gases were drawn on a pt suffering from hyperventilation syndrome, they would most likely reveal:
Respiratory alkalosis
Your pt is a 75 y/o woman with a hx of diabetes and atherosclerosis, chief complaint is heartburn. You suspect:
This may be a cardiovascular problem because women and pts with diabetes often present with atypical symptoms
The hallmark of atrial fibrillation is:
An irregularly irregular rhythm
You have determined that your pt with a-fib is unstable and requires electrical therapy. You will perform ___ countershock with ___ joules.
Synchronized; 120
If a-fib presents for more than 48 hours, conversion of this pt’s rhythm may lead to:
Release of emboli
Prinzmetal angina occurs when:
Coronary arteries spasm
The first medication a paramedic should administer to a pt with angina is:
Oxygen
Most MIs are caused by:
Acute thrombotic occlusion
The majority of acute MIs involve the:
Left ventricle
Chest pain associated with an MI:
Is constant
The position of comfort for a patient with left ventricular failure is usually:
Sitting with legs dependent
Which of the following is most indicative of right ventricular infarct?
Peripheral edema
A drug that may improve the symptoms of cardiogenic shock patients in the field is:
Dopamine
Signs of cardiac tamponade include:
Muffled heart tones
While assessing a pt, you note a pulsatile mass in the abdomen. Suddenly this mass is no longer palpable, and the patient’s blood pressure begins to drop. You suspect:
The patient’s aneurysm has ruptured
You are called to the local airport to evaluate a 40 y/o obese woman who is complaining of pain in her lower left leg. She has just completed a 12-hour flight, and the pain developed as she got off the plane. The leg is warm, swollen, and painful. You suspect:
Deep-vein thrombosis
The organs most at risk in a hypertensive crisis include the:
Kidneys
Pt has a bp of 200/140, initially complained of headache and nausea. During your 3-hour transport, the pt began to seize and is now unresponsive to any stimulus. You suspect the pt has:
Hypertensive encephalopathy
Tx for hypertensive encephalopathy includes:
Diazepam
When performing CPR on an adult, you would compress the chest to a depth of ___ inche(s).
At least 2”
The sound heard when the AV valves close during ventricular systole is:
S1
A single elongated projection of a neuron that transmits impulses away from the cell body is called a(n):
Axon
Afferent neurons transmit impulses:
Toward the brain
Nodes of Ranvier occur on myelin sheaths of axons, allowing impulses to:
Jump from one node to the next
The spacing between the axon of one neuron and the dendrites of another is called a:
Synapse
The circle of Willis is a(n):
Safeguard to ensure continued blood supply to the brain
If a pt is hyperventilating, you would expect blood flow to the brain to:
Decrease
Cushing’s triad consists of:
Elevated bp, decreased pulse and respiratory rate
The single best indicator of a serious neurological condition is:
Rapidly worsening level of consciousness
A mnemonic device that is helpful for remembering the common causes of coma is:
AEIOU TIPS
Administration of thiamine should be considered if the cause of coma is suspected to be:
Alcoholic
Why would a comatose patient regain consciousness after the administration of naloxone?
It competes with narcotics at the receptor sites
The two major events that occur to cause a stroke are:
Occlusion and hemorrhage
Your patient complains of the abrupt onset of the worst headache she has ever felt in her life. This is indicative of:
Hemorrhagic stroke
A TIA is different from a stroke in that:
The signs and symptoms of a TIA resolve within 24 hours
The arm drift in the Cincinnati Prehospital Stroke Scale is abnormal if:
One arm drifts down compared to the other
The most important action a paramedic can take in the tx of a stroke patient is to:
Rapidly transport the patient to an appropriate facility
Epilepsy is a seizure disorder:
With no known correctable or avoidable causes
Your partner suddenly falls to the floor and becomes very rigid, with occasional relaxation of the muscles. His temperature is normal. He is apneic and incontinent of urine. This type of seizure activity is best described as:
Tonic-clonic
Your 4 year-old son stares off into space and doesn’t respond to your repeated questioning about whether he is all right. He displays no movement and remains in a standing position. This type of seizure activity is best described as:
Petit mal
Your patient reports having an auditory aura. This is a warning sign that she may have a:
Seizure
You have been on the scene with a patient who is experiencing a grand mal seizure. As soon as the seizure resolves, your priority in her management will be to:
Assist her in maintaining her airway and provide high-flow oxygen
Status epilepticus is defined as:
Repetitive seizures without any period of awakening
A Jacksonian seizure is a type of:
Partial seizure
Diazepam has which of the following significant side effects?
Respiratory depression
Headaches that are precipitated by constriction and dilation of blood vessels and cause intense throbbing on one side of the head are called:
Migraine headaches
A brain abscess is a(n):
Accumulation of pus
An inherited disease that causes slow but progressive degeneration of muscle fibers and usually causes the patient to die by the age of 12 is:
Muscular dystrophy
Parkinson’s disease is caused by damage to or degeneration of nerve cells in the:
Basal ganglia
Amyotrophic lateral sclerosis is:
Usually fatal within 2 to 4 years of diagnosis
Spina bifida is a birth defect in which:
A portion of the spinal cord is left exposed
What type of tissue generates heat?
Muscle
What are renal calculi?
Kidney stones
What is the first tx for renal calculi?
Hydration
What is paroxysmal nocturnal dyspnea indicative of?
Left-sided heart failure
What is the dosage of epinephrine for anaphylaxis?
0.3 - 0.5 mg, 1:1000
In a pt with PVC’s, how many per minute make it a concern?
> 6 per minute
For PVC’s, what medication is appopriate?
Lidocaine (secondary: amiodarone)
What is a late sign of left-sided heart failure?
Pulmonary edema
What is pylonephritis?
UTI, spread into inflammation of the kidneys
What is pain in the deep loin on deep percussion over the kidney, even when pressure causes no pain?
Lloyd’s sign
What is esophageal tearing as a result of chronic vomiting known as?
Mallory-Weiss syndrome
What are some signs and symptoms of kidney stones?
Acute, excruciating pain in R/L lower quadrant, groin, testes (in males) Restlessness Nausea/vomiting Urinary urgency/frequency Sweating Fever
What might help collateral circulation in the heart during ischemia/infarct? How do these form?
Anastomoses (collateral circulation)
We get more developed as we age
Hepatitis B is most commonly spread how?
Through blood and serum
What is uremic frost? What does it indicate?
Fine white powder on the skin of a pt with kidney failure
Tenderness midway between the anterior-superior iliac spine and the umbilicus is what?
McBurney’s sign
What does McBurney’s sign indicate?
Can indicate acute appendicitis
How is an MI diagnosed on an ECG?
ST segment elevation in 2 or more contiguous leads
What is the most common cause of non-traumatic pain in women?
UTI
A yellow discoloration of the skin, mucous membranes, and sclerae of the eyes caused by a greater than normal amount of bilirubin in the blood is called what?
Jaundice
What is the cause of esophageal varices?
Portal hypertension
What is cholecystitis?
Inflammation of the gallbladder, most often associated with the presence of gallstones
What is your priority in multi-system trauma?
Tx of life threats
Would a 3-lead be of much use in a multi-system trauma situation?
No
What is cor pulmonale caused by?
Increased pulmonary pressure
What is hematochezia?
Bright red blood in the stools
What is melana?
Tarry, black stools
Cause of hematochezia?
Lower GI bleed
Cause of melana?
Upper GI bleed
What type of pt is most at risk for a hypertensive emergency?
A pt with a hx of hypertension
What would you suspect in a pt who is taking beta blockers and ACE inhibitors?
Hx of hypertension
A technique used to normalize blood chemistry and remove excess fluid in patients with acute or chronic renal failure is called what?
Renal dialysis
Pain during menstrual cycle is known as what?
Dysmenorrhea
An allergic reaction is what?
An overly sensitive immune response
An allergen can be defined as a(n):
Antigen causing an allergic response
The primary antibody affecting an anaphylactic reaction is:
IgE
Anaphylactoid reactions are treated how?
In the same way as anaphylactic reactions
Localized allergic reactions are best managed with:
Antihistamines
In sensitized individuals, the risk of anaphylaxis increases most with:
Frequency of exposure
The chemical released in an anaphylactic reaction that causes rapidly increased vascular permeability and capillary and venule dilation is:
Histamine
Histamines promote the contraction of nonvascular smooth muscle, especially muscles in the:
Bronchial tree
The most life-threatening result of an anaphylactic reaction is:
Airway compromise
During an anaphylactic reaction, urticaria may be noted on the skin, and swelling may be noted in the ___.
Face and tongue
Angioedema results from the swelling of the:
Subcutaneous tissue
A pt calls 911 because he fears that the cookie he has just eaten may have contained peanuts, which he is highly allergic to. He ate the cookie 1 hour ago. You tell him:
Anaphylaxis usually occurs within 30 minutes of the introduction of the antigen
Your pt is a 28 y/o female complaining of a rash on her abdomen and tightness in her chest. She ate shellfish 2 hr ago. The symptoms first appeared approx 1 hour ago and have not worsened. Her vitals are normal, lungs clear, with good tidal volume. Pt is without any further complaint. You suspect she is experiencing:
A mild allergic reaction
Expect that a fluid bolus of up to ___ may be needed to restore BP in anaphylactic patients.
4 L
Your pt is in cardiac arrest following a severe anaphylactic reaction. The pt’s face and neck are severely swollen. Administration of epi should be:
The normal does of 1 mg 1:10,000 IVP
The standard subq dose of epi used in treating an adult with severe anaphylaxis is:
0.3 - 0.5 mg of 1:1000 solution
The primary treatment for hypotension resulting from anaphylaxis is:
IV fluids
Urticaria is:
Caused by increased capillary permeability and the leaking of fluid into the interstitial spaces
Your pt is a 28 y/o male, attacked by swarm of bees. Pt is unconscious with swelling and uticaria. Lung sounds = diminished tidal volumes and wheezes, stridor with respirations. BP 70/40. After administering O2 and securing the airway, initial tx should be:
IV epinephrine 0.3 - 0.5 mg, 1:10,000 solution
SQ or IM epi may not be effective for a pt having severe anaphylaxis because of:
Decreased peripheral perfusion
H. pylori can cause what?
Chronic gastroenteritis
Small intestine order?
Duodenum
Jejunum
Ileum
Visceral pain assoc. with?
Hollow organs
Bluish periumbilical color is?
Cullen’s sign
Cullen’s sign indicates?
AAA rupture
Pancreas rupture
Peritoneal hemorrhage
Thrill in a fistula is?
Indicative of unobstructed circulation
Def of cardiogenic shock?
Systolic bp of less than 90 for 30 minutes secondary to myocardial dysfunction
How to tx hypotension with dialysis?
Small fluid bolus 200-300 mL
Most common cause of GI bleed in older pts?
Diverticulitis
Diverticulitis can lead to…?
Sepsis
Most common cause of upper GI bleed is?
Peptic ulcers
Syndrome occurring during or after dialysis, symptoms/signs including loss of consciousness, hypotension, neuro deficits, increased ICP, seizures/coma?
Disequilibrium syndrome
Lloyd’s sign indicates what?
Kidney stones
What is Kehr’s sign?
Left shoulder pain, referred from ruptured spleen or ectopic pregnancy
Circulation disorders that affect blood vessels outside of the heart and brain, typically arteries/veins that supply limbs and organs below stomach?
Peripheral vascular disease
Inflammation of the tube at the back of the testicle that stores and carries sperm is called what?
Epididymitis
Rohypnol is a drug used in what circumstance?
Date rape
D/C stands for? Used when?
Dilation and curettage
Ectopic pregnancy
Endometrial tissue occurring outside of the uterus is called ___?
Endometriosis
Inflammation of the lining of the uterus is called ___?
Entometritis
Normal menstruation amount?
25-60 mL
Right or LLQ pain occurring mid-menstrual-cycle, lasting 24-36 hours with slight bleeding and a low fever?
Mittelschmerz
Pelvic inflammatory disease caused by?
STDs
What type of substances cross the blood brain barrier?
Lipid soluble
1 month abdominal pain with dark tarry stools can indicate?
Chronic gastritis
Gastroenteritis occurs via which route?
Oral/fecal
