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ALS/Paramedic Course > Final Review > Flashcards

Final Review Flashcards

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1
Q

Perfusion is a function of:

A

BP, HR, CO, SV, SVR

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2
Q

___ is a state of collapse & failure of the cardiovascular system

A

Shock

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3
Q

The time just before or just after cardiac arrest

A

Peri-arrest period

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4
Q

Conditions that preceded the onset of a disease

A

Premorbid conditions

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5
Q

Premorbid conditions that affect healthy adults

A

Drug toxicity, electrolyte imbalance, pulmonary embolus

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6
Q

Chosen from a differential list used to base a treatment plan

A

Working diagnosis

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7
Q

M in “M-T SHIP”

A

Medication issues, metabolic causes

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8
Q

T in “M-T SHIP”

A

Trauma, tumor, toxins

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9
Q

S in “M-T SHIP”

A

Seizure, stroke

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10
Q

H in “M-T SHIP”

A

Hypoxia, hyper/hypothermia, hyper/Hypoglycemia, hypertensive crisis, hypovolemia, hyper/hypokalemia

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11
Q

I in “M-T SHIP”

A

Infection & uremia

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12
Q

P in “M-T SHIP”

A

Psychiatric/behavioral disorders

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13
Q

Tendency to gather & rely on information that confirms existing views

A

Confirmation bias

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14
Q

Allowing initial viewpoints to distort your estimates

A

Anchoring bias

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15
Q

Operational practice designed to enhance communication & teamwork

A

Crew resource management

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16
Q

Concept describing the relationship between myocardial contractility & cardiac output

A

Frank-Starting mechanism

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17
Q

Resistance to blood flow within all vessels except pulmonary vessels

A

SVR

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18
Q

The blood pressure required to sustain organ perfusion

A

Mean arterial pressure

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19
Q

MAP is roughly ___ in the average person

A

60

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20
Q

MAP formula

A

MAP = DBP + 1/3 (SBP-DBP [pulse pressure])

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21
Q

Pulse pressure is found by this formula

A

SBP - DBP

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22
Q

Control of the cardiovascular system is a function of the:

A

Autonomic nervous system

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23
Q

A decrease in SBP below 80 mmHg stimulates the ___ to increase arterial pressure through vasoconstriction

A

Vasomotor center of the medulla oblongata

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24
Q

Time that a tissue can be deprived of oxygen before it starts to die

A

Warm ischemic time

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25
Q

Major cause of death following septic, traumatic, and burn injuries

A

MODS
Multi-organ dysfunction syndrome

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26
Q

Group of plasma proteins that functions to eliminate invading bacteria

A

Complement system

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27
Q

Pediatric patients can compensate for blood loss up to as much as:

A

30%-35%

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28
Q

Fluid challenge volume for an adult with moderate or severe hypotension

A

250 mL followed by reevaluation of BP, up to 4 doses

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29
Q

Shock classification that divides types of shock into central or peripheral shock

A

Weil-Shubin classification

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30
Q

Beck triad of cardiac tamponade

A

JVD
Narrowing pulse pressures
Muffled heart tones

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31
Q

___ occurs when the heart is unable to sufficiently circulate blood to sustain peripheral perfusion

A

Cardiogenic shock

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32
Q

2 main causes of obstructive shock:

A

Cardiac tamponade & tension pneumothorax

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33
Q

If the septic patient is normotensive after initial fluid therapy, administer ___ to maintain BP & renal precision

A

Dopamine

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34
Q

If the septic patient is hypotensive & vasodilators in “watml shock, administer:

A

Norepinephrine

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35
Q

If the septic patient is hypotensive in “cold” shock, administer:

A

Epinephrine

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36
Q

Fluid bolus dose for septic patients:

A

30 mL/kg

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37
Q

Neurogenic shock usually results from:

A

Spinal cord injury

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38
Q

A characteristic sign of neurogenic shock is:

A

Absence of seating below the level of the cord injury

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39
Q

Disruption or loss of normal GI motility

A

Ileus

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40
Q

___ occurs when there is widespread dilation of resistance or capacitance vessels (arterioles & venules)

A

Distributive shock

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41
Q

___ medications initiate or alter cellular activity by binding to receptor sites and promoting a response

A

Agonist

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42
Q

___ medications prevent chemicals from reaching receptors and initiating or altering particular cellular activity

A

Antagonist

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43
Q

Binding of ___ receptors causes vasoconstriction, while ___ receptor binding causes vasodilation

A

Alpha; beta

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44
Q

Concentration of a medication required to initiate cellular response

A

Potency

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45
Q

Ability of a medication to initiate or alter cell activity therapeutically

A

Efficacy

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46
Q

___ antagonists temporarily bind with receptor sites, displacing other chemicals

A

Competitive

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47
Q

___ antagonists permanently bind with receptors and block activation by agonist chemicals

A

Noncompetitive

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48
Q

___ bind to receptors but do not initiate as much cellular activity or change as others

A

Partial agonists

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49
Q

Careful titration of medication doses may be required in:

A

Pediatric or geriatric patients

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50
Q

Medication metabolism in the liver is affected by the:

A

Cytochrome P-450 system

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51
Q

Patients at extremes of age are prone to ___ medication reactions

A

Paradoxical

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52
Q

Ideal body weight formula for men:

A

50+(2.3 X height in inches over 60”)

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53
Q

Ideal body weight formula for women

A

45.5+(2.3 X height in inches over 60”)

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54
Q

Risks associated with meds in pregnancy class __ outweigh any potential benefits to the mother

A

X

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55
Q

Possibility of fetal harm in 1st trimester from meds in pregnancy class __ are remote

A

A

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56
Q

Meds in pregnancy class __ have not been studied thoroughly enough to determine risks to the fetus in the first trimester

A

B

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57
Q

Meds in pregnancy class __ should only be given if the potential benefits outweigh the risks to the fetus

A

C

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58
Q

Meds in pregnancy class __ have known fetal risks, but benefits to the woman may be acceptable if the benefits outweigh the risks

A

D

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59
Q

Several smaller doses of a med may be capable of producing the same effects of a single larger dose

A

Cumulative action

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60
Q

Completely unexpected adverse reactions not known to occur with a particular med

A

Idiosyncratic reactions

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61
Q

Reduction of available receptors for a particular drug resulting in tolerance

A

Down-regulation

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62
Q

Decreased efficacy of a drug due to frequent usage

A

Tolerance

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63
Q

Condition in which repeated doses of a medication within a short time frame may cause tolerance/decreased efficacy

A

Tachypnylaxis

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64
Q

Physical tolerance and psychological dependence on a medication

A

Habituation

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65
Q

Physical, emotional, or behavioral need for a particular substance

A

Dependence

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66
Q

Undesirable medication interactions

A

Interference

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67
Q

Med combination that produces a greater effect than the sum of the individual effects

A

Synergism

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68
Q

Enhancement of the effects of a medication by another

A

Potentiation

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69
Q

Two medications binding together creating an inactive substance

A

Neutralization

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70
Q

Percentage of unaltered medication that reaches systemic circulation

A

Bioavailability

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71
Q

Insulin restriction, glucagon secretion, and inhibition of norepinephrine release are the agonist effects of what type of receptors?

A

Alpha 2

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72
Q

Agonist binding of ___ receptors causes vasodilation of mesenteric arteries

A

Dopaminergic

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73
Q

The ___ of a medication is lower for medications with a higher potency

A

threshold dose

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74
Q

% Of RBC’s in the intravascular space

A

hematocrit

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75
Q

A drug’s bioavailability is altered by all administration routes except:

A

IV

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76
Q

In addition to GI motility, pH, and presence of food/liquid, GI medications are subjected to ___

A

first pass metabolism

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77
Q

GI medications pass from the GI tract into the ___ and then to the ___

A

Portal vein; liver

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78
Q

Alteration of a medication via metabolism within the GI tract before it reaches systemic circulation

A

first-pass effect

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79
Q

___ is the amount of time needed in an average Person to metabolize or eliminate 50% of a substance in plasma

A

half-life

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80
Q

All Beta agents have a ___ effect on the heart.

A

stimulant

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81
Q

In the lungs, alpha agents cause:

A

Minor bronchoconstriction

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82
Q

Parasympathetic blocker that opposes the vagus nerve to speed up the heart after excessive vagal stimulation/firing has caused bradycardia

A

atropine

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83
Q

Parasympathetic agent used primarily to induce vasoconstriction & increase bp

A

Norepinephrine

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84
Q

Sympathetic agent used to increase renal perfusion, increase HR & myocardial contractility, and constrict peripheral vessels

A

dopamine

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85
Q

___ blockers will reduce HR & BP

A

Calcium-channel

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86
Q

Clopidogrel (plavix) is a ____

A

platelet inhibitor

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87
Q

Ach binds with ___ receptor sites

A

Nicotinic

88
Q

Onset/duration time of succinylcholine:

A

30-60 sec/ 3-8 min

89
Q

Rare, but immediately life-threatening side effect of succinylcholine

A

Malignant hyperthermia

90
Q

Onset/duration of rocuronium

A

1-3 min/15-60 min

91
Q

___ antagonizes muscarinic receptors to Cause bronchodilation and decreased mucus production

A

Ipratropium bromide

92
Q

Antidysrhythmic meds are classified using;

A

Vaughan-Williams classification scheme

93
Q

___ is used to treat desthythmias, but not included in VW classification

A

Adenosine

94
Q

During Cardiac cycle phase __, cardiac cells are at rest

A

4

95
Q

Na and Ca+ slowly enter the cell during phase __

A

2

96
Q

Depolarization occurs after/during phase ___ of the cardiac cycle

A

0

97
Q

During phase ___, sodium ions rapidly enter the cell thru sodium channels in cardiac cells

A

0

98
Q

___ exits the cardiac cell during phase 1

A

Potassium

99
Q

Period during which cardiac myocytes are unable to fire or conduct an impulse

A

Refractory period

100
Q

Class __ antidesrhythmics slow movement of sodium thru ion channels in certain cardiac cells

A

1

101
Q

___ is a class 1 antidesrhythmic that blocks sodium channels in the purkinje fibers & ventricles

A

Lidocaine

102
Q

antidysrhythmics Class ___ is composed of beta-adrenergic blocking agents

A

2

103
Q

Antidysrhythmic Class ___ medications increase the duration of phases 1,2,3 of the cardiac cycle

A

3

104
Q

Class __ antidysrhythmics are comprised of calcium channel blockers

A

3

105
Q

Calcium channel blockers slow conduction at the ___

A

AV node

106
Q

___ causes marked reduction in the cardiac conduction velocity

A

Adenosine

107
Q

Patients taking alphanadrenergic receptor agonist meds at home are often more prone to ___

A

Orthostatic hypotension & tachycardia

108
Q

Alpha-blockers generally work to _____

A

Lower BP & decrease systemic vascular resistance

109
Q

Ach activates receptors in the heart to produce:

A

Bradycardia & conduction delays

110
Q

Competitive muscarinic receptor agonist

A

Atropine sulfate

111
Q

___ is used to treat bradycardia caused by vagal stimulation

A

Atropine

112
Q

Stimulation of alpha-2 receptors suppresses:

A

Release or norepinephrine

113
Q

First sign of IV occlusion:

A

Decreasing drip rate or presence of blood in tubing

114
Q

The ___ contains epithelial cells that form a continuous barrier to medication absorption

A

Urinary tract

115
Q

___ is an anticholinergic drug derived from plant sources

A

Atropine

116
Q

You should suspect altered medication metabolism in a pt with:

A

HX of Chronic alcoholism

117
Q

IM administered medications have a bioavailability of:

A

75-100%

118
Q

Administration of ___ is indicated in eclampsia when seizures do not respond to Mag sulfate

A

Diazepam (valium)

119
Q

AKA Diazepam

A

Valium

120
Q

___ can be administered to suppress preterm labor, which may be necessary in case of cord prolapse

A

Terbutaline

121
Q

___ is useful in treating hyperemesis gravidarium

A

Diphenhydramine

122
Q

Brain damage is irreversible after _ _ _ minutes without adequate oxygenation

A

10

123
Q

Clinical state characterized by increased RR and work of breathing

A

Respiratory distress

124
Q

Normal resting minute ventilation volume of an average person

A

6 L/min

125
Q

Resting alveolar minute volume is approximately:

A

4 L/min

126
Q

Pulmonary artery blood flow is approximately:

A

5 L/min

127
Q

Average v/q ratio is:

A

4:5 L/min, or 0.8 L/min

128
Q

Most Common airway obstruction in an unresponsive patient:

A

The tongue

129
Q

Hypoventilation is typically directly linked to

A

PaCO2 levels in the blood

130
Q

___ occurs when Carbon dioxide elimination exceeds carbon dioxide production

A

Hyperventilation

131
Q

Condition caused by blood bypassing the alveoli and returning to the left side of the heart unoxygenated

A

Intrapulmonary shunting

132
Q

Pulmonary edema is related to __

A

Left sided heart failure

133
Q

Peripheral edema is a result of __

A

Right sided heart failure

134
Q

Positive pressure ventilation increases ___

A

Afterload

135
Q

The resistance against which the ventricle must contract

A

Afterload

136
Q

Increased afterload causes decreased ___

A

Cardiac output

137
Q

The greater the pressure used to ventilate a patient, the greater the decrease in ___

A

Preload

138
Q

Low levels of oxygen in arterial blood

A

Hypoxemia

139
Q

Clinical finding in which SBP drops 10 mmHg during inhalation

A

Pulsus paradoxus

140
Q

Irregular rate, rhythm, and depth of breathing resulting from increased ICP

A

Ataxic respirations

141
Q

Softer, muffled breath sounds

A

Vesicular

142
Q

Low-pitched, continuous breath sounds that indicate mucus or fluid in airways

A

Rhonchi

143
Q

Loud high-pitched breath sounds upon inspiration

A

Stridor

144
Q

A caprograph with a prolonged alveolar plateau is indicative of:

A

Bradypnea

145
Q

A capnograph with a short alveolar plateau is typically a result of

A

Hyperventilation

146
Q

Point on a capnograph that best reflects alveolar Carbon dioxide levels

A

Point d. Alveolar plateau

147
Q

An up-sloping, “shark fin” capnograph is characteristic of:

A

Bronchospasm/ prolonged expiratoryphase

148
Q

An inspiration downstroke that fails to reach 0 and increases gradually, indicates:

A

Rebreathing/ air trapping

149
Q

Ability of alveoli to expend during ventilation

A

Compliance

150
Q

Oxygen tank duration of flow is calculated by:

A

Current tank psi - safe residual pressure x cylinder constant / flow rate in Lpm

151
Q

Cylinder constant for a D tank

A

0.16 LPM

152
Q

Cylinder constant for a M tank

A

1.56 LPM

153
Q

Cylinder constant for a H tank

A

3.14 LPM

154
Q

NRB mask can deliver up to ___% oxygen concentration

A

90%

155
Q

Positive pressure ventilation impairs venous return, namely by:

A

Decreasing preload

156
Q

Generally accepted therapeutic pressure range forCPAP

A

5-10 cmH2O

157
Q

10 Rights of med administration

A

Right patient
Right medication
Right dose
Right route
Right time
Right documentation
Right assessment
Right to refuse
Right evaluation
Right patient education

158
Q

Parasympathetic blocker that opposes the vagus nerve

A

Atropine

159
Q

___ is contraindicated for sedation in PTs with possible TBI

A

Ketamine

160
Q

___ have potent anti-seizure, anxiolytic, and sedative properties

A

benzodiazepines

161
Q

At high doses, benzo’s cause ___

A

hypotension

162
Q

Diazepam, lorazepam, and midazolam are pregnancy class ___, because they have demonstrated potential fetal harm

A

D

163
Q

benzodiazepines should bbe administered to pregnant PT’s when ___

A

there is no safer alternatives available

164
Q

___ is a competitive benzodiazepine antagonist

A

Flumazenil

165
Q

Succinylcholine is a ___ paralytic

A

competitive nondepolarizing

166
Q

Albuterol can promote cellular uptake of ___

A

potassium

167
Q

Lidocaine is a class ___ antidysrhythmic

A

1B

168
Q

Lidocaine is a ___ channel blocker, and works primarily in the ___

A

sodium; ventricles

169
Q

Potassium channel blockers work in the:

A

atria & ventricles

170
Q

Amiodrone is a ___ channel blocker

A

Potassium

171
Q

___ channel blockers may be used to increase myocardial oxygen delivery

A

calcium

172
Q

___ and ___ are calcium channel blockers commonly used prehospital

A

Verapimil & diltiazem

173
Q

___ is a alpha-2 receptor agonist (blocks epi & norepi) used to treat HTN

A

Clonidine

174
Q

___ is unlikely to be effective in treating bradycardia caused by blocked cardiac conduction

A

Atropine

175
Q

Nebulized epinephrine is used to treat ___

A

airway edema & bronchospasm

176
Q

Norepinephrine is indicated in conditions that involve ___

A

loss of vasomotor tone

177
Q

Dopamine is the primary prehospital medication for ___

A

hypotension refractory to fluid resuscitation

178
Q

Dopamine dosage for chronotropic & inotropic effects

A

5-10 mcg/kg/min

179
Q

Dopamine dosage for vasoconstriction effects

A

10-20 mcg/kg/min

180
Q

Recommended dose of TXA:

A

1 gram IV drip over 10 minutes

181
Q

When drawing blood samples, tubes should be filled in this order:

A

Red, blue, Green, Lavender

182
Q

“10% dextrose” means there are ___ grams per mL

A

100
(10,000 mg/100 mL = 100 mg/mL)

183
Q

Formula for calculating flow rate for IV med administration

A

Volume to be infused X drip set rate ‘/, infusion time in minutes

184
Q

failure to match ventilation & perfusionn

A

V/Q mismatch

185
Q

Airway assessment LEMON stands for:

A

Look externally
Evaluate 3-3-2
Mallampati
Obstruction
Neck mobility

186
Q

Analgesic dose for Ketamine

A

0.2-0.3 mg/kg

187
Q

Sedation dose for Ketamine

A

2 mg/kg

188
Q

Standard dose for Succinylcholine

A

1-2 mg/kg

189
Q

Standard dose for Vecuronium

A

0.1-0.2 mg/kg

190
Q

Standard dose for Rocuronium

A

0.6-1.2 mg/kg

191
Q

Infection of the larynx, trachea, and bronchi

A

Laryngotracheobronchitis

192
Q

Laryngotracehobronchitis is a common cause of:

A

Croup

193
Q

___ is characterized by stridor, hoarseness, and a barking cough

A

Croup

194
Q

__ is a more common underlying cause of croup

A

Viral infection

195
Q

Severe, rapidly progressive inflammation of the epiglottis & surrounding tissues

A

Epiglottitis

196
Q

S&S of Epiglottitis

A

sore throat, fever, drooling, hoarseness

197
Q

__ & __ are collectively classified as COPD

A

Chronic bronchitis & Emphysema

198
Q

Triad of airway alterations found in asthma

A

Bronchospasm, ^ mucous production, peripheral airway edema

199
Q

An ill looking PT who reports recent illness with chest pain, productive cough, fever, and who presents with a “vibration” sensation when palpating the chest as the PT breathes is likely suffering from:

A

Pneumonia

200
Q

Inhalation of ___ causes acute upper respiratory irritation

A

Ammonia

201
Q

The effects of inhaling __ depend on the concentration and amount/length of exposure

A

Chlorine

202
Q

Inhalation of ___ has a delayed onset of pulmonary edema

A

Phosgene

203
Q

Lung sounds caused by fields of wet alveoli popping open as the lungs inflate

A

Crackles

204
Q

Trauma triad of death:

A

hypothermia, coagulopathy, acidosis

205
Q

Titration of BP to __ -__ mm Hg may be preferred for hemmorhagic shock patients

A

80-90

206
Q

A __ scar does not extend past the borders of the wound margins, & tends to form in ppl with lighter skin

A

Hypertrophic

207
Q

A ___ scar grows over the wound margins & can be larger than the wound area

A

keloid

208
Q

Dead tissue

A

gangrene

209
Q

Wet gangrene can cause ___ and lead to death

A

sepsis

210
Q

Death of tissue from bacterial infection

A

necrotizing fasciitis

211
Q

Topical burn injury

A

scalding

212
Q

The presence of ___ may be a sign of impending upper airway compromise

A

stridor

213
Q

PTs with burns greater than __% of TBSA will need fluid resuscitaiton

A

20

214
Q

Consensus/Parkland formula for fluid resuscitation of burn PTs

A

2-4 mL X weight (kg) X TBSA burned

215
Q

When using the Parkland/Consensus formula, __% of the fluid should be given in the first __ hours

A

50; 8

216
Q

Acid & alkali burns should initially be treated with:

A

flushing

217
Q

Indications for morphine in ACS

A

Symptoms that are refractory to, or not relieved by nitrates

ALS/Paramedic Course (10 decks)

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