General Paramedicine II Flashcards
Audible sonorous (snoring) respirations from an unconscious patient are an indication of an airway ___ problem.
- Positioning (consider using a head-tilt/chin-lift or jaw thrust maneuver to lift the tongue from the back of the throat);
Audible gurgling or bubbling respirations from an unconscious patient are an indication that there is ___ or ___ in the airway. Consider ___ immediately.
- Blood; 2. Vomitus; 3. Suctioning;
Another word for esophagus.
- Gullet;
How to measure a soft suction line for bronchotracheal suctioning.
- Measure from the sternal notch, around the back of an ear, and to the corner of the patient’s mouth.
“GCS < 8, ___”
- Intubate;
Endotracheal tube depth at the teeth is commonly ___ cm for adult males and ___ cm for adult females.
- 25 cm; 2. 23 cm;
The standard for maintaining passive oxygenation throughout intubation attempts.
- Apneic oxygenation at 15 lpm O2 via NC;
The angled tip of the bougie is called the “___” tip.
- Coude;
When passing an ET tube over a bougie into the trachea, in what direction should the bougie be rotated when it “catches” on the right arytenoid cartilage?
- Counter-clockwise;
The first heart sound (S1), “lubb” (aka “lub”), is produced by ___.
- The closing of the AV valves (tricuspid and mitral) at the beginning of systole;
The second heart sound (S2), “dupp” (aka “dub”), is produced by ___.
- The closing of the semilunar valves (aortic and pulmonic) at the end of systole;
What does the “U” in U Wave stand for?
- Unknown;
The QT interval should be <= ___ the ___ interval.
- 1/2; 2. RR;
During CPR chest compressions, pushing downward on the chest perfuses the ___, while lifting the hands back up off the chest (to allow full chest recoil) perfuses the ___.
- Brain; 2. Heart;
___ is defined as an alteration in the structure and function of the right ventricle (RV) of the heart caused by a primary disorder of the respiratory system. Pulmonary hypertension is often the common link between lung dysfunction and the heart in this disease.
- Cor Pulmonale;
- Partial pressure of CO2 in the alveoli: __CO2
- Partial pressure of CO2 in arterial blood: __CO2
- Partial pressure of CO2 at the end of expiration: __CO2
- Arterial to end-tidal CO2 tension/pressure difference or gradient: __CO2
- Partial pressure of CO2 in mixed venous blood: __CO2
- Fraction of inspired oxygen (the percentage of oxygen in inhaled breath);
- Fraction of exhaled oxygen (the percentage of oxygen in exhaled breath);
- PACO2;
- PaCO2;
- PETCO2;
- (a-ET)PCO2;
- PvCO2;
- FiO2;
- FeO2;
* - https://www.capnography.com/capnography-introduction/definitions*
A person suffering from pulmonary embolism will present with respiratory ___.
- Alkalosis;
In about 50% of cases, patients with a PE will present with ___ on their ECG.
- Sinus Tachycardia;
The names of Angiotensin Receptor Blockers commonly end in -___.
- -sartan (e.g. Losartan);
The names of ACE Inhibitors commonly end in -___.
- -pril (e.g. Lisinopril);
The names of Beta Blockers commonly end in -___.
- -olol (e.g. Metoprolol);
The names of Calcium Channel Blockers commonly end in -___. Two common Calcium Channel Blockers with alternate suffixes include ___ and ___.
- -dipine (Dihydropyridine Calcium Channel Blockers; (e.g. Nifedipine);
- Verapamil (Non-Dihydropyridine Calcium Channel Blocker);
- Diltiazem (Benzothiazepine Calcium Channel Blocker);
What are the six classes of anti-hypertensive medications (ABCDEs)?
A - ACE Inhibitors; Angiotensin Receptor Blockers; Alpha1 Receptor Blockers; B - Beta Blockers; C - Calcium Channel Blockers; D - Diuretics; E - Endothelin Receptor Antagonists;
Within the kidneys and the cells of the body, water tends to follow ___.
- Sodium;
___, is the rapid swelling (edema) of the dermis, subcutaneous tissue, mucosa and submucosal tissues. It is very similar to ___, but _(same)_, occurs in the epidermis and upper dermis.
- Angioedema; 2. Uticaria (hives);
Edotracheal tube sizes refer to what measurement?
- Inner diameter (e.g. “ID 6.0”);
Generally speaking, how can myocardial ischemia, injury and infarction be identified on an ECG tracing?
- Ischemia - ST Segment depression or T Wave inversion;
- Injury - ST Segment elevation;
- Infarction - Pathologic Q Waves;
Be vigilant for evidence of a posterior MI in any patient with a(n) ___ or ___ STEMI. Evidence of ST segment depression in leads ___-___ should heighten your suspicion of posterior involvement. Posterior infarction is confirmed by the presence of ST elevation and Q waves in the ___ leads (___-___).
- Inferior;
- Lateral;
- V1-V3;
- Posterior;
- V7-V9;
* - https://litfl.com/posterior-myocardial-infarction-ecg-library/*
___ is a rare congenital condition in which the apex of the heart is located on the right side of the body.
- Dextrocardia (leads and defib pads must be placed in reversed positions);
What are the recommended angles of entry for medication delivery by 1. IM and 2. SQ?
- IM: 90 degrees (directly into muscle tissue); 2. SQ: 45 degrees (pinch the skin and inject below the epidermis/dermis and into the subcutaneous layer);
A substance that kills bacteria is called bacterio___, while one which prevents it from growing is called bacterio____.
- -cidal; 2. -static;
What is the most sensitive and specific sign of a pseudo-seizure?
- Eyes tightly shut during the seizure-like activity;
Does a patient’s shellfish allergy mean that iodine should not be used on them for IV preparation?
- No;
What is the medical term for Battle’s Sign?
- Mastoid ecchymosis;
What is the medical term for “butt crack?”
- Intergluteal cleft;
What is the medical term for “raccoon eyes?”
- Periorbital ecchymosis;
What is the medical term for “pooping?”
- Defecating;
What is the medical term for “blood in the stool?”
- Hematochezia;
Name one (of two listed) medical terms for “pseudo seizure.”
- Psychogenic Non-Epileptic Seizure (PNES); 2. Non-Epileptic Attack Disorder (NEAD);
What does “euvolemic” mean?
- Having a normal amount of body water (neither hypovolemic, nor “volume up”);
What does “orthopnea” mean?
- Difficulty breathing while lying down;
What is a “nosocomial” disease?
- One which has originated in a hospital;
What does DIC stand for?
- Disseminated Intravascular Coagulation;
___ (literally translated means “normal head”) is a medical term referring to a person whose head and all major organs of the head are in a normal condition and without significant abnormalities.
- Normocephalic;
The first letter of ___ medication names should be capitalized, while the first letter of ___ medication names should not be capitalized.
- Brand name; 2. Generic;
___ sign is sometimes used as a sign of deep vein thrombosis (DVT). A positive sign is generally considered present when there is pain in the ___ on ___. (Other positive signs include “increased resistance” and “involuntary flexure of the knee.”)
- Homans’; 2. Calf; 3. Forceful and abrupt dorsiflexion of the patient’s foot at the ankle while the knee is extended;
Although ___ effects predominate at low doses, nitroglycerin produces a dose-related dilation of both arterial and venous beds. Venodilation promotes ___ pooling of blood and decreases venous return to the heart, reducing ___.
- Venous; 2. Peripheral; 3. Left ventricular end-diastolic pressure (preload);
If you can palpate the pulse at the carotid artery, you can be confident the patient’s BP is roughly at least ___. Radial artery? Femoral artery?
- 60/S; 2. 80/S; 3. 70/S;
How is a patient’s Shock Index (SI) calculated?
- SI = HR/SBP;
A Shock Index > ___ indicates acute hypovolemia in the presence of normal heart rate and blood pressure, and is a marker of injury severity and mortality. A healthy Shock Index range is ___.
- 0.9; 2. 0.5-0.7;
What does ABG stand for, with respect to blood tests?
- Arterial Blood Gas;
What does VBG stand for, with respect to blood tests?
- Venous Blood Gas;
What does CBC stand for with respect to blood tests?
- Complete Blood Count;
Regarding intravenous cannulation, an ___ is an inadvertent administration of a nonvesicant into the surrounding tissue. ___ is defined as an inadvertent delivery of a vesicant into the tissues. Vesicants cause blistering, severe tissue damage, and even necrosis if extravasated.
- Infiltration; 2. Extravasation;
___ is the quantity of base (HCO3-, in mEq/L) that is above or below the normal range of buffer base in the body (22 -28 mEq/L).
- Base Excess (or Base Deficit);
Chemoreceptors are found in the ___ arteries, and detect levels of ___, ___ and ___.
- Carotid; 2. O2; 3. CO2; 4. pH;
The arched opening at the back of the mouth leading to the pharynx.
- Fauces;
Crackles are any _(more specific than simply “adventitious”)_ noises heard during auscultation of the lungs and are caused by the popping open of air spaces (___ crackles) or the movement of fluid or secretions in the larger airways (___ crackles).
- Discontinuous; 2. Fine; 3. Coarse;
“Rales” is an old term for what we now call ___. These sounds are usually heard in the lung ___ at the end of ___.
- High-pitched crackles; 2. Bases; 3. Inspiration;
Rhonchi is an old term for what we now call ___ caused by secretions in the ___ airways.
- Low-pitched crackles; 2. Larger;
Strider harsh, high-pitched sound heard during ____, and indicates narrowing, usually as a result of ___.
- Inhalation; 2. Swelling (laryngeal edema);
___ is a noun for “the action or process of vomiting.” ___ is a synonym for the noun “vomit.”
- Emesis; 2. Vomitus;
What does SOAP ME stand for?
S - Suction; O - Oxygenation (before, during, and after); A - Airways (ET, supraglottic, OPAs, NPAs); P - Positioning (patient and rescuer; ramping, sniffing); M - Medications/Monitoring; E - EtCO2;
Generally speaking, heart sounds are produced by ___.
- The closing of heart valves;
What heart sounds are heard when heart valves open?
- No audible sounds occur when the valves open;
What does the mnemonic APe To Man stand for?
A - Aortic; P - Pulmonic; T - Tricuspid; M - Mitral;
Where should aortic valve heart sounds be auscultated?
- Second intercostal space, to the right of the sternum;
Where should pulmonic valve heart sounds be auscultated?
- Second intercostal space, to the left of the sternum;
Where should tricuspid valve heart sounds be auscultated?
- Fourth intercostal space to the left of the sternum;
Where should mitral valve heart sounds be auscultated?
- Fifth intercostal space, midclavicular line;
QTc = ___
- QT / (square root of RR);
What are the three components of the Trauma Triad of Death?
- Hypothermia; 2. Acidosis; 3. Coagulopathy; (The Trauma Triad is commonly seen in patients who have sustained severe traumatic injuries and results in a significant rise in the mortality rate.);
A chloride level that’s above normal means there’s too much chloride in your blood, which is called ___.
- Hyperchloremia;
Partial pressure of oxygen at sea level in arterial blood (PaO2) is normally between ___ and ___.
- 75 mmHg; 2. 100 mmHg;
Pulse pressure is the difference between ___. If resting blood pressure is 120/80 mm Hg, then the pulse pressure is ___.
- Systolic and diastolic blood pressure; 2. 40 mmHg;
Medical term for the noun “itch.”
- Pruritis;
What type of acute edema can occur due to allergic reaction and is often accompanied by pain and tenderness, while it may or may not be itchy?
- Angioedema;
What type of acute edema can occur due to allergic reaction and is usually associated with an itch, while pain and tenderness are uncommon?
- Uticaria (hives);
_(term)_ is the amount of pressure needed to maintain cerebral blood flow.
- Cerebral perfusion pressure (CPP);
Mean Arterial Pressure (MAP) = _(equation)_
- [(2 x diastolic)+systolic] / 3; Or Diastolic Pressure + 1/3 Pulse Pressure
Cerebral Perfusion Pressure (CPP) = _(equation)_
- Mean Arterial Pressure (MAP) - Intracranial Pressure (ICP);
Intracranial Pressure (ICP) is usually ___-___ mm Hg.
- 10-15;
What approximate percentage of the intracranial space do blood, CSF and the brain fill?
- Brain: 80%; 2. Blood: 10%; 3. CSF: 10%;
Hypercarbia leads to ___ in cerebral blood vessels and ___ ICP due to ___ blood volume.
- Vasodilation; 2. Increased; 3. Increased;
A region in an organ or tissue that has suffered damage through injury or disease, such as a wound, ulcer, abscess, tumor, etc. synonyms:
- Lesion;
What does PEG stand for with respect to feeding tubes?
- Percutaneous Endoscopic Gastrostomy;
http://www.tube-feeding.com/What-is-Tube-Feeding/
Before a disastrous head bleed occurs from a ruptured aneurysm, a patient will often develop an intense “warning” headache (known as a ___ headache) due to a tiny leak in the brain (known as a ___). The eventual rupture is likely to cause a “___” headache. In the time between the initial small leak and the large bleed there is an opportunity to make a difference in a patient’s life.
- Sentinel;
- Sentinel bleed;
- Thunderclap;
* https://www.emedicinehealth.com/symptoms_of_a_brain_aneurysm/article_em.htm#what_are_brain_aneurysm_symptoms*
* https://en.wikipedia.org/wiki/Thunderclap_headache*
A ___ is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs. These are usually caused by injury or surgery, but they can also result from an infection or inflammation.
- Fistula;
https://en.wikipedia.org/wiki/Fistula
___ is the failure of passage of enteric contents through the small bowel and colon that are not mechanically obstructed. Essentially it represents the paralysis of intestinal motility.
- Adynamic ileus;
https://radiopaedia.org/articles/adynamic-ileus?lang=us
Another name for quadriplegia.
- Tetraplegia;
https://en.wikipedia.org/wiki/Tetraplegia
What is the purpose of creating an AV Fistula for dialysis?
- An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong. The larger vein provides easy, reliable access to blood vessels. Without this kind of access, regular hemodialysis sessions would not be possible. Untreated veins cannot withstand repeated needle insertions, because they would collapse the way a straw collapses under strong suction.
https://surgery.ucsf.edu/conditions–procedures/vascular-access-for-hemodialysis.aspx
Examples of surgical ___ are:
- Arteriovenous fistula (an opening created between an artery and vein) for dialysis
- Colostomy (an opening created between the bowel and the skin of the abdominal wall)
- Intestinal, in which two ends of intestine are sewn together
- A connection between a graft and a blood vessel to create a bypass
- Anastomoses (singular: anastomosis);
https://medlineplus.gov/ency/article/002231.htm
Anastomoses that are abnormal, whether congenital or acquired, are often called ___.
- Fistulas;
https://en.wikipedia.org/wiki/Anastomosis
Skin ___ is a reflection of the skin’s elasticity, measured by monitoring the time it takes for the skin of the ___ to return to position after it is lightly pinched between the examiner’s thumb and forefinger. Normal _(1.)_ is a return to normal contour within ___ seconds; if the skin remains elevated (tented) more than _(3.)_ seconds, turgor is decreased.
- Turgor;
- Forearm;
- Three;
* https://medical-dictionary.thefreedictionary.com/turgor*
In addition to low fluid volume, consider ___ when treating suspected dehydration.
- Electrolyte abnormalities;
Lexipol FireRescue1 Academy - Dehydration, 2019
What does HHNS stand for with respect to diabetes? HHS?
- Hyperosmolar Hyperglycemic Nonketotic Syndrome;
- Hyperosmolar Hyperglycemic State;
* https://en.wikipedia.org/wiki/Hyperosmolar_hyperglycemic_state*
HHNS and HHS feature blood glucose measurements greater than ___ mg/dL.
- 600;
https://en.wikipedia.org/wiki/Hyperosmolar_hyperglycemic_state
DKA features a blood glucose level greater than ___ mg/dL.
- 250;
https://en.wikipedia.org/wiki/Diabetic_ketoacidosis
The average adult with DKA has a total body water shortage of about ___ liters.
- 6;
https://en.wikipedia.org/wiki/Diabetic_ketoacidosis
When assessing skin turgor in an older patient, use the skin of the___, a more reliable location for assessing skin turgor in the adult patient.
- Upper chest;
Lexipol FireRescue1 Academy - Dehydration, 2019
