EMT244 Flashcards
What pathogens lead to bacterial meningitis?
Neisseria meningitidis (n. meningitis)
How is bacterial meningitis spread?
Airborne pathogens
What organs are responsible for increase in WBCs?
Lymph glands and bone marrow
Thymus
Spleen
What is the most common sign of infection?
Fever
Body system affected by tetanus?
CNS
Rabies virus carried by?
Saliva
Complications of hemodialysis?
Vascular access Hemorrhage Hypotension Chest pain Hyperkalemia Disequilibrium syndrome and more
S/S of CO poisoning?
Headache
Nausea/vomiting
Cherry red skin
Lethargy
Indicator of meningitis?
Stiff neck
Cells that HIV destroys?
T cells with CD4 on its surface
An illness caused by a specific germ is called ___?
Infectious
Disease passed from one person to another is ___?
Communicable
Most accidental poisonings in children from 1 to 3 years of age occur by means of:
Ingestion
The most common cardiovascular complications of poisoning by ingestion is:
Rhythm disturbances
Activated charcoal is most effective when the:
Poison was ingested less than an hour before the administration of charcoal
A contraindication to gastric lavage is:
Ingestion of gasoline or kerosene
You are called to treat a 2 y/o child who has just ingested lye. The child is conscious and cooperative. The poison control center may advise you to administer what oral solution?
Milk
Most pediatric lead poisonings occur as a result of:
Ingestion of paint chips
The most common route of mercury poisoning is:
Inhalation
You are called to a local park where several people attending a family reunion report stomach pain, nausea, and vomiting. Patients report that lunch was served 2 hours ago. This time frame would lead you to suspect that the cause of the food poisoning was:
Bacterial toxin
If the stinger is left in the wound after a honey bee sting, you should:
Scrape the stinger from the wound
What specific skills are typically required to prevent the escalation of a behavioral or psychiatric emergency?
Communication and support
A behavioral emergency is best defined as a:
Change in mood or behavior that cannot be tolerated by the involved person or others
In the U.S., mental health problems:
Affect 20% of the population
Typical causes of behavioral emergencies include:
Biological, psychosocial, and sociocultural behaviors
Your pt is a 15 y/o male who has been described as exhibiting bizarre behavior lately. The pt tells you that he hears voices. He is exhibiting delusional thinking and is extremely paranoid. You suspect:
Schizophrenia
Which of the following is true regarding schizophrenic patients’ ability to function in society?
If they are compliant with their medications, schizophrenics may function quite well
Your pt is a 28 y/o male complaining of severe panic attack. When you arrive, he informs you that he has a hx of panic attacks, and is currently experiencing chest pain and a feeling of doom. The most appropriate action is to:
Assess the pt for signs of myocardial infarction and transport him to the ED
28 y/o male, welfare check. When you arrive, pt states he has been depressed since the loss of his fiancee in an MVA that occurred while the pt was driving. Pt informs you he hasn’t slept well in weeks, expresses remorse and responsibility over the loss of his fiancee, saying it should have been he who died. He is suffering from:
Posttraumatic syndrome
Depression is characterized by an impairment of normal function and:
Is episodic, usually lasting longer than 1 month, with periods of remission
Your crew is called to a pt threatening suicide. Law enforcement on scene, pt is sitting on the hood of his car. During your interview with this pt, you should:
Try to ascertain whether the pt has a specific plan for the way he intends to commit suicide.
Your pt is a 43 y/o female who is despondent. Her coworkers inform you that she is normally a “bizarre” person and has acted out inappropriately in the past. They further inform you that the pt has been muttering to herself all morning, and shouting at inanimate objects. Pt does not respond to questioning, you should:
Speak in a quiet voice and allow her extra time to answer your questions
Any substance that produces harmful physiological or psychological effects is called a(n):
Poison
The absorption of toxins takes place primarily in the:
Small intestine
The preferred method of keeping a poison from entering the small intestine is:
Use of activated charcoal
The dosage of activated charcoal in a child is:
15-30 g
The antidote for benzodiazepine overdose is:
Flumazenil
The mnemonic SLUDGE helps you to remember the:
Signs of organophosphate poisoning
Drug therapy for patients with organophosphate poisoning should be administered when?
If the patient has 2+ symptoms of respiratory distress
The drug of choice for carbamate poisonings is:
Atropine
An employee in a pest-control business is found unconscious on a garage floor. He is drooling and diaphoretic. The most appropriate medication for this pt is:
Atropine
The drug of choice to treat an overdose of opiates is:
Naloxone (narcan)
Sedative-hypnotic drugs include:
Benzodiazepines and barbiturates
Cocaine is a(n):
CNS stimulant
Which of the following is an early sign of toxicity in reaction to a tricyclic antidepressant?
Blurred vision
The pharmacological management of choice for a symptomatic overdose of a TCA is:
Sodium bicarbonate
Among a patient’s prescription medications, you find a bottle of lithium, leading you to suspect that the patient has:
Bipolar disorder
The most commonly ingested NSAID in overdose is:
Ibuprofen
Acetaminophen overdose leads to toxicity of the:
Liver
What medication can you use to prevent exacerbation of Wernicke-Korsakoff syndrome?
Thiamine
Disulfiram is a medication taken by alcoholics to prevent:
Alcoholic intake
A “wet” patient presentation that includes tearing, emesis, and salivation would lead you to suspect what kind of toxicological syndrome?
Cholinergic
Thermoregulatory center in the body?
Hypothalamus
Poison absorption occurs mostly where?
Small intestine
Most common adverse drug reaction in the elderly is what?
Digitalis toxicity
What is a sign of a cocaine OD?
Dilated pupils
All types of blood cells are formed where?
Bone marrow
Codeine is what type of drug?
Narcotic
What occurs during the incubation period?
Pt is exposed to disease and has signs and symptoms
What organs are responsible for EPO production?
Kidneys
Coumadin blocks what?
Vitamin K production
What virus causes mono?
Epstein-Barre
Schizophrenia medication blocks what?
Action of dopamine
In what stage does chancre of syphilis develop?
Primary stage
A substance capable of producing an allergic reaction is a what?
Antigen
What three drugs are in the cyanide antidote kit?
Amyl nitrite
Sodium nitrite
Sodium thiosulfate
What is a crucial part of the inflammatory process?
Increased capillary permeability
Another name for multiple personality disorder?
Dissociative identity disorder
Scabies is caused by what?
Parasite
What is the universal blood recipient?
AB
What is an indicator of an early stage of Lyme disease?
Painless flat red lesions
Anemia is what?
A deficiency in RBC production
What is the best thing to do after a pt finishes seizing?
Roll pt on side
What system is affected by tetanus?
CNS
What organ will most likely show effects of poisoning first?
Heart
What is responsible for the blood clotting process?
Fibrinogen
How is Hepatitis C transferred to EMS providers?
Blood
What is the most common symptom of tetanus?
Trismus (stiff jaw)
What type of cells are destroyed by HIV?
T cell lymphocytes
What is an indication of Hodgkins’ disease?
Swollen lymph nodes
What happens in a heroine overdose?
Respiratory depression caused by the brain’s decreased response to CO2
What happens in fibrinolysis?
Plasmin dismantles blood clot
What is the normal hematocrit for a male?
35
CHAMP is used for?
Which hydrocarbons may benefit from gastric lavage
Hypothermic patients present with what?
Visible Osborne wave
What would we give for an aspirin OD?
Sodium bicarb and activated charcoal
Where does the majority of absorption take place in the body?
Small intestine
Most common overdose in the elderly population?
Digitalis toxicity
WBC responsible for body defense mechanisms, humoral, cell-mediated immunity?
Leukocytes
WBC responsible for phagocytosis, antibody-mediated defense against parasites?
Eosinophils
WBC responsible for phagocytosis, particularly during early phase of inflammation?
Neutrophils
WBC associated with allergic reactions and trauma?
Basophils
A compulsive, uncontrollable dependence on a substance, habit or practice to such a degree that cessation causes severe emotional, mental, or physiological reactions is called ___.
Addiction
A physiological response that requires that a drug overdose be increased to produce the same effect formerly produced by a smaller dose is ___.
Tolerance
A predictable set of signs and symptoms that occurs after a decrease in the usual dose of a drug or its sudden cessation is ___.
Withdrawal syndrome
Self-medication or self-administration of a drug in excessive amounts, resulting in physiological or physical dependence, functional impairment and deviation from approved social norms is ___.
Drug abuse
What type of antidysrhythmic is lidocaine?
Sodium channel blocker
What is the adult dose of thiamine?
100 mg slow IV or IM
What is the adult dose of D50?
12.5-50 g slow IV
What does marijuana affect?
Brain
Lungs
Respiratory system
What makes up the autonomic nervous system?
Sympathetic and parasympathetic systems
What organ produces erythropoietin (EPO)?
Kidneys
What 2 drugs are given for an organophosphate overdose?
2-PAM chloride and atropine
What is the most common tick-borne disease?
Lyme disease
Lyme disease caused by what?
Ixodes tick
Lyme disease treated how?
Removing tick (without squeezing body) and washing with soapy water
Four routes of exposure?
Inhalation, ingestion, injection, absorption
What is a virus transmitted by inhalation of rat urine and feces?
Hantavirus
How strong is the bonding of CO to hemoglobin?
240 times stronger than oxygen
Define trismus
Stiffness of the jaw caused by tetanus
Proteins that cause the formation of an antibody and react specifically to that antibody are called ___.
Antigens
Substances that can produce hypersensitivity reactions in the body are called ___.
Allergens
Substances produced by the body that destroy or inactivate a specific antigen are called ___.
Antibodies
How long do red blood cells live?
80-120 days
Maladaptive behavior involving major distortions with reality is the definition of ___.
Psychosis
What is easily confused with multiple personality disorder?
Schizophrenia
What is the most severe type of high-altitude sickness?
High altitude cerebral edema
What causes scabies?
Sarcoptes scabiei var. hominis
What is the universal blood donor?
Type O negative
What is the universal recipient?
Type AB
Which medication blocks H1 and H2 receptors?
Benadryl
What is phenobarbital used for?
CNS depression and anticonvulsive
What causes the SLUDGE symptoms?
Inhibition of acetylcholinesterase, resulting in buildup of acetylcholine and overstimulation of receptors
Which organ causes an increase in RBC production?
Kidneys secrete EPO which stimulates RBC production in the bone marrow
What are the components of TB testing?
A positive skin test indicates past exposure and reaction of antibodies
Requires chest x-ray and sputum culture to confirm
Difference between dementia and delirium?
Dementia pts will not have hallucinations
Latent period is…?
Begins with invasion, ends when the agent can be shed
Incubation period is…?
Begins with invasion, ends when the disease process begins
Communicability period is…?
Begins at end of latent period, continues as long as agent is present and can spread to others
Disease period is…?
Follows incubation period, variable duration
How long can HIV survive outside the body?
Minutes to hours
How long can HCV survive outside the body?
16 hours - 4 days
How long can HPV survive outside the body?
7 days
Difference between bacterial and viral infection?
Bacterial = doesn't need a cell for host Viral = needs a cell for host
Strains involve?
Tendons
Sprains involve?
Ligaments
What is kyphosis?
Hunchback
What is scoleosis?
Lateral curvature
What is lordosis?
Lumbar curvature
Which hemophilia is also known as Christmas disease?
B
Hemophilia A clotting factor?
8
Hemophilia B clotting factor?
9
Leukopenia is?
Low WBC count
Thrombocytopenia is?
Low platelet count
92% of plasma is ___.
Water
Hemophilia affects which gender more?
Males
What is the most plentiful plasma protein?
Albumin
Methemoglobinemia is?
Elevated serum hemoglobin level
What are the 4 stages of alcohol dependence?
1 = tolerance 2 = memory lapses 3 = lack of control over alcohol 4 = prolonged binges of intoxication
What % of alcohol is absorbed within 30 min?
80-90%
What % of alcohol is absorbed in the small intestine?
20%
What causes Wernicke-Korsakoff syndrome?
Reduction of intestinal and thiamine absorption
What are the 2 stages of Wernicke-Korsakoff syndrome?
Wernicke’s encephalopathy
Korsakoff’s psychosis
Signs and symptoms of Wernicke’s encepalopathy?
Ataxia, nystagmus, poor speech/gait, neurophathy, stupor
Signs and symptoms of Korsakoff’s psychosis?
Apathy, memory loss, retrograde amnesia, confabulation, and dementia
What is the cause of hepatic encephalopathy?
Accumulation of toxic waste that’s normally detoxified by a healthy liver
Alcohol withdrawal: minor reactions start when?
6-12 hours after cessation
Alcohol withdrawal: minor reactions peak when?
24-36 hours
Alcohol withdrawal: minor reactions may last how long?
10-14 days
Alcohol withdrawal: hallucinations start when?
12-24 hours after cessation
Alcohol withdrawal: withdrawal seizures start when?
24-48 hours
What are withdrawal seizures also known as?
Rum fits
What are withdrawal seizures?
Grand mal seizures of short duration
Alcohol withdrawal: when do delirium tremens start?
48-72 hours, though can be delayed up to 14 days
Alcohol withdrawal: delirium tremens last how long?
1-3 days
Medications that can treat withdrawal symptoms?
Benzodiazepines
Why is disulfiram prescribe to alcoholics?
Keeps them from drinking by inhibiting ethanol metabolism
How is a behavioral emergency best defined?
Change in mood or behavior that cannot be tolerated by the involved person or others
A dual diagnosis means a pt has a mental illness and which other condition?
Substance-related disorder
What is the definition of maladaptive behavior?
Actions that interfere with well-being and ability to function
What are typical causes of behavioral emergencies?
Biological, psychosocial, and sociocultural behaviors
Schizophrenia is often confused with ___.
Multiple personality disorder
What is the DSM-IV?
Classification system for psychiatric disorders
Delirium and dementia are classified as which type of disorder?
Cognitive
Unlike dementia, delirium possesses which characteristic?
Is often associated with delusions and hallucinations
While EMS is gathering a medical history, the patient reports that she takes Zoloft, leading the paramedic to consider which condition?
Depression
Paramedics are called to the home of a 67 year-old male. The patient’s wife tells EMS that her husband has progressively lost awareness of his surroundings and cannot recall events such as breakfast. These findings are indicative that this patient may be suffering from which condition?
Dementia
Paramedics are called to assess a 15 year-old male who has been described as exhibiting bizarre behavior lately. The patient tells EMS that he “hears voices.” He is exhibiting delusional thinking and is extremely paranoid. What is likely occurring?
Schizophrenia
Medication designed to treat schizophrenia includes antipsychotic drugs and agents that block the action of which brain chemical?
Dopamine
Can schizophrenics function in society?
Yes, if they are compliant with their medications
Paramedics are called to the home of a 27 year-old male who refuses to come out of his bathroom. Through the door, he explains that he saw a large spider on the wall of his bedroom and is deathly afraid of spiders. He ran in the bathroom, stuffed a towel under the door, and got in the bathtub. This is a classic demonstration of which disorder?
Phobia
A person who washes her hands five times after every patient contact, even though she realizes that once is sufficient, is an example of what disorder?
Obsessive-compulsive disorder
One particular manifestation of depression is the inability to derive pleasure from events or experiences that ordinarily are pleasurable. This is what?
Anhedonia
The mania phase of bipolar disorder is characterized by ___.
Perceived personal grandeur
The first step in assessing a behavioral emergency is assessing which portion?
Scene for hazards
Paramedics are called to the home of a 34 year-old female for a nonspecific abdominal complaint. She informs them that she has had many abdominal surgeries that have not resolved her complaints. Which of the following disorders is a condition in which an individual has complaints (lasting several years) of various physical problems for which no physical cause can be found?
Somatization
A factitious disorder in which the patient makes habitual pleas for treatment and hospitalization for a symptomatic but imaginary acute illness is known as which condition?
Munchausen syndrome
What is another term for multiple personality disorder?
Dissociative identity disorder
What substance is most commonly used by patients with a substance-abuse disorder?
Alcohol
What is the minimum number of capable individuals necessary to restrain a physically violent patient?
Four
Which of the following drugs would be appropriate for chemically restraining a violent patient in the prehospital setting?
Lorazepam
Lithium is commonly taken by patients with which disorder?
Bipolar disorder
When the decision has been made to restrain a patient, which force should be implemented?
Reasonable
When paramedics arrive on the scene, police have physically subdued a 27 year-old patient. He has a history of schizophrenia and became violent in a restaurant after screaming about the voices that were commanding him to destroy the world. He is struggling and shouting profanity. His vital signs are within expected values for his agitated state. Which intervention would be most appropriate for this patient?
Administer lorazepam 2 mg IM before moving him to the cot
