General Paramedicine III

Question 1

Crush Injury Syndrome (CIS) can also be called ___.

Answer 1

1. Traumatic Rhabdomyolysis (TR);

Question 2

The opposite of ___ (toward the tail) is ___ (toward the head).

Answer 2

1. Caudal;
2. Cephalad;

Question 3

What is the AHA recommended weight-based NS fluid bolus to deliver to a pediatric patient in cardiogenic shock?

Answer 3

1. 5-10 mL/kg;

Question 4

The most common form of distributive shock is ___. The next most common form of distributive shock is ___.

Answer 4

1. Sepsis (or septic shock);
2. Anaphylaxis (or anaphylactic shock);

Question 5

A ___, colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis.

Answer 5

1. Thrombus;

Question 6

Discomfort from false labor (aka ___) commonly presents in the ___ abdomen, while discomfort from true labor presents in the ___ abdomen.

Answer 6

1. Braxton-Hicks contractions;
2. Lower;
3. Upper;

Question 7

Erectile dysfunction medications are ___ inhibitors.

Answer 7

1. Phosphodiesterase;

Question 8

A ___ is an area of skin that is mainly supplied by a single spinal nerve. There are ___ cervical nerves, ___ thoracic nerves, ___ lumbar nerves and ___ sacral nerves. Each of these nerves relays sensation from a particular region of skin to the brain.

Answer 8

1. Dermatome;
2. 8;
3. 12;
4. 5;
5. 5;

Question 9

___ is a discomfort below the rib and above the ilium, generally beginning at the back or in the midaxillary line and resulting from the stimulation of specialized nerve endings upon distention of the ureter or renal capsule.

Answer 9

1. Flank pain;

Question 10

What process can be used in the field to determine whether nasal secretions contain CSF?

Answer 10

1. Test the fluid with a glucometer (CSF should have glucose in it, whereas this is unlikely in normal nasal secretions);

Question 11

The presence of moist crackles along with tachycardia, poor perfusion and increased liver size are typical findings in patients with ___ shock.

Answer 11

1. Cardiogenic;

Question 12

The two most-commonly injured organs due to blunt force trauma.

Answer 12

1. Spleen;
2. Liver;

Question 13

Le Fort ___ fracture (horizontal), otherwise known as a floating palate, may result from a force of injury directed low on the maxillary alveolar rim, or upper dental row, in a downward direction.

Answer 13

1. I;

Question 14

___ is a condition in which damaged skeletal muscle tissue breaks down rapidly. Breakdown products of damaged muscle cells are released into the bloodstream. Some of these, such as the protein ___, are harmful to the ___ and may lead to ___ failure.

Answer 14

1. Rhabdomyolysis;
2. Myoglobin;
3. Kidneys;
4. Kidney;

Question 15

Common causes of ___ shock include congenital heart disease, myocarditis, cardiomyopathy.

Answer 15

1. Cardiogenic;

Question 16

___ occurs when a blood clot develops in a blood vessel and reduces the flow of blood through the vessel.

Answer 16

1. Thrombosis;

Question 17

A ___ is an incision into the pleural space of the chest. It is performed by surgeons to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine

Answer 17

1. Thoracotomy;

Question 18

What are the four types of distributive shock?

Answer 18

1. Neurogenic shock;
2. Psychogenic shock;
3. Septic shock;
4. Anaphylactic shock;

Question 19

What are the three major categories of shock?

Answer 19

1. Hypovolemic shock;
2. Distributive shock;
3. Cardiogenic shock;

Question 20

What is the definition of a “flail chest”? What type of movement may it exhibit with relation to the chest wall?

Answer 20

1. Two or more adjacent ribs which are fractured in more than one place along their length;
2. Paradoxical movement;

Question 21

A raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys.

Answer 21

1. Uremia;

Question 22

What does tPA stand for?

Answer 22

1. Tissue plasminogen activator;

Question 23

What does PETCO2 stand for?

Answer 23

1. Postapneic End-Tidal Carbon Dioxide Pressure;

Question 24

A woman’s blood pressure commonly ___ during pregnancy due to the hormone ___ relaxing the walls of blood vessels. This blood pressure change is most often seen during the ___ and ___ trimesters.

Answer 24

1. Decreases;
2. Progesterone;
3. First;
4. Second;

Question 25

The AHA states that for patient's suffering from acute ischemic stroke and for whom the risks of fibrinolytic therapy are unacceptable, healthcare providers may administer ___ and continue further stroke management.

Answer 25

1. Aspirin;

Question 26

\_\_\_ shock exists when there is inadequate blood flow to some tissue beds, while there is too much blood flow to others. It is typically associated with vaso\_\_\_, some capillary leak, and decreased heart function.

Answer 26

1. Distribuitive; 2. Dilation;

Question 27

The skull, especially the part enclosing the brain.

Answer 27

1. Cranium;

Question 28

What does ARDS stand for?

Answer 28

1. Acute Respiratory Distress Syndrome (occurs when fluid builds up in the alveoli);

Question 29

What process can be used in the field to determine whether bloody otorrhea contains CSF?

Answer 29

1. Look for the Halo Sign (Dab some of the blood on a tissue. If there is CSF mixed with the blood, it will move by capillary action further away from the center than the blood will, forming a ring.);

Question 30

IV ___ remains the first-line therapy for acute ischemic stroke.

Answer 30

1. rTPA;

Question 31

The third stage of labor begins right after ___ and ends with the \_\_\_.

Answer 31

1. Birth of the baby; 2. Delivery of the placenta;

Question 32

A discharge of the internal ear.

Answer 32

1. Otorrhea;

Question 33

If ___ or more indicators from the Cincinnati Prehospital Stroke Scale is abnormal, probability of a stroke is 72%.

Answer 33

1. One;

Question 34

CSF otorrhoea results from a combination of a ruptured ___ membrane and nearby ___ fracture.

Answer 34

1. Tympanic; 2. Basilar skull;

Question 35

What are the three phases of the progression of shock?

Answer 35

1. Compensated Shock; 2. Decompensated Shock; 3. Irreversible (Terminal) Shock;

Question 36

The first stage of labor begins when ___ and ends when \_\_\_.

Answer 36

1. Contractions start; 2. The cervix is fully dilated;

Question 37

In ___ shock, cariac output is impaired by physical obstruction to blood flow into or out of the heart. Obstructions may be caused by air (e.g. tension pneumothorax), fluid (e.g. cardiac tamponade), blood clots (e.g. pulmonary embolus) or congenital heart defects (e.g. ductal dependent lesions).

Answer 37

1. Obstructive;

Question 38

Le Fort ___ fracture (pyramidal) may result from a blow to the lower or mid maxillary​ area. The key component of these fractures beyond the pterygoid plate fractures is involvement of inferior orbital rim. When viewed from the front, the fracture is classically shaped like a pyramid.

Answer 38

1. II;

Question 39

Name two (of three listed) signs of imminent delivery.

Answer 39

1. Rectal pressure; 2. Strong urge to push; 3. Crowning;

Question 40

The term ___ is commonly used to indicate a nonnecrotizing inflammation of the skin and subcutaneous tissues, a process usually related to acute bacterial infection that does not involve the fascia or muscles. This disease is characterized by localized pain, swelling, tenderness, erythema, and warmth.

Answer 40

1. Cellulitis;

Question 41

Raccoon eye(s) (panda eyes or periorbital ecchymosis) following trauma are a sign of \_\_\_. They may not appear until ___ after the injury.

Answer 41

1. Basilar skull fracture (Bilateral raccoon eyes are highly suggestive of basilar skull fracture, with a positive predictive value of 85%. They are most often associated with fractures of the anterior cranial fossa.); 2. 2-3 days;

Question 42

How many full turns are allowed when tightening a CAT tourniquet?

Answer 42

1. Three;

Question 43

A(n) ___ is anything that travels through the blood vessels until it reaches a vessel that is too small to let it pass.

Answer 43

1. Embolus;

Question 44

A sudden blocking of an artery.

Answer 44

1. Embolism; (An embolism is the lodging of an embolus, a blockage-causing piece of material, inside a blood vessel.)

Question 45

Where on the patient should needle chest decompression be performed in the field?

Answer 45

1. Immediately superior to the third rib (between the second and third rib/second intercostal space) at the midclavicular line, on the affected side of the chest;

Question 46

Following trauma, Battle's Sign (mastoid ecchymosis) is an indication of a(n) ___ fracture, and may suggest underlying brain trauma. Note that this sign will take at least ___ to appear after the initial fracture.

Answer 46

1. Basilar skull (specifically the middle cranial fossa); 2. One day;

Question 47

The ___ formula is used to estimate the amount of replacement fluid required for the first 24 hours in a burn patient so as to ensure they remain hemodynamically stable. The formula is: \_\_\_

Answer 47

1. Parkland; 2. V = 4 x m (A x 100) (where mass is in kg, area is a percentage of total body surface area with 2nd degree burns, and volume is in mL);

Question 48

Needle ___ is used to decompress the chest when a patient is deteriorating because of a tension pneumothorax.

Answer 48

1. Thoracostomy;

Question 49

The second stage of labor begins when the ___ and ends with \_\_\_.

Answer 49

1. Cervix is fully dilated; 2. The birth of the baby; (Sometimes referred to as the "pushing" stage.)

Question 50

Le Fort ___ fracture (transverse), otherwise known as craniofacial dissociation, may follow impact to the nasal bridge or upper maxilla. The salient feature of these fractures, beyond pterygoid plate involvement, is that they invariably involve the zygomatic arch, or cheek bone.

Answer 50

1. III;

Question 51

A ___ fracture is a fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist and hand. This fracture is sometimes referred to as a dinner fork or bayonet deformity due to the shape of the resultant forearm.

Answer 51

1. Colles';

Question 52

A ___ fracture of the skull is a classic transfacial fracture of the midface, involving the maxillary bone and surrounding structures in either a horizontal, pyramidal or transverse direction.

Answer 52

1. Le Fort;

Question 53

Condition where both eyes move differently to each other.

Answer 53

1. Dysconjugate gaze;

Question 54

The functional tissue of an organ as distinguished from the connective and supporting tissue

Answer 54

1. Parenchyma;

Question 55

Epidemiological data for WA show that incidence of heart attack increases at this age.

Answer 55

1. 55 years old (\>= 55);

Question 56

The production of abnormally small amounts of urine.

Answer 56

1. Oliguria;

Question 57

The progressive impairment of two or more organ systems from an uncontrolled inflammatory response to a severe illness or injury.

Answer 57

1. Multiple Organ Dysfunction Syndrome (MODS);

Question 58

What does MODS stand for?

Answer 58

1. Multiple Organ Dysfunction Syndrome;

Question 59

What does SIRS stand for?

Answer 59

1. Systemic Inflammatory Response Syndrome;

Question 60

An inflammatory state affecting the whole body. It can be the body's response to an infectious or noninfectious insult.

Answer 60

1. Systemic Inflammatory Responde Syndrome (SIRS);

Question 61

What are the six Rights of Medication Administration?

Answer 61

1. Right patient; 2. Right medication; 3. Right dose; 4. Right route; 5. Right time; 6. Right documentation;

Question 62

When an air bubble enters a vein, it's called a(n) \_\_\_. When an air bubble enters an artery, it's called a(n) \_\_\_. These air bubbles can travel to your brain, heart, or lungs and cause a heart attack, stroke, or respiratory failure.

Answer 62

1. Venous air embolism; 2. Arterial air embolism; _- https://en.wikipedia.org/wiki/Air\_embolism_

Question 63

In what position should a patient suffering from a venous air embolism be placed?

Answer 63

1. Immediately place the patient in the left lateral decubitus (Durant's maneuver) and Trendelenburg position.

Question 64

1. Human case reports suggest that injecting more than ___ of air into the venous system at rates greater than ___ can be fatal.

Answer 64

1. 100 mL; 2. 100 mL/s; Note: Hence, it is nearly impossible to inject air through a peripheral IV at a dangerous rate. *- https://en.wikipedia.org/wiki/Air\_embolism#cite\_note-13*

Question 65

What are the water flow rates of the following catheters: 1. 14G 2. 16G 3. 18G 4. 20G

Answer 65

1. 240 mL/min; 2. 180 mL/min; 3. 90 mL/min; 4. 60 mL/min; * - https://www.pedagogyeducation.com/Correctional-Healthcare-Campus/Resource-Library/Infusion/Peripheral-IV-Catheter-Chart.aspx*

Question 66

What does ODT stand for, with regards to medication administration?

Answer 66

1. Orally disintegrating tablet;

Question 67

In what two general locations are chemoreceptors said to be found? In what two general locations are baroreceptors said to be found?

Answer 67

1. Aortic arch (more specifically, the aortic bodies); 2. Carotid arteries (more specifically, the carotid bodies); 3. Aortic arch; 4. Carotid arteries (more specifically, the carotid sinus);

Question 68

\_\_\_ is the initial stretching of ___ prior to \_\_\_. It is related to ventricular filling. ___ is the force or load against which the heart has to contract to eject the blood.

Answer 68

1. Preload; 2. The cardiacmyocytes of the wall of a particular heart chamber (when speaking of preload in a general sense, the left ventricle is assumed); 3. Contraction (systole); 2. Afterload;

Question 69

In medical diagnosis, test ___ is the ability of a test to correctly identify those with the disease (true positive rate), whereas test ___ is the ability of the test to correctly identify those without the disease (true negative rate).

Answer 69

1. Sensitivity; 2. Specificity;

Question 70

\_\_\_ (and its indirect measurement \_\_\_) describes the amount of oxygen bound to hemoglobin in arterial blood. The term "saturation" likens hemoglobin to a sponge that becomes saturated with oxygen. The measurement is given as a percentage. ___ describes the amount of oxygen dissolved in arterial blood plasma.

Answer 70

1. SaO₂; 2. SpO₂; 3. PaO₂;

Question 71

Name the indicated parts of a thoracic vertebra.

Answer 71

Question 72

\_\_\_ consists of placing a patient in the left lateral decubitus position in order to prevent a ___ air embolism from lodging in the \_\_\_. The air will rise and stay in the ___ side of the heart until it slowly absorbs. Similarly, placing a patient in the Trendelenburg position (head down) helps prevent ___ air embolism from traveling to the \_\_\_.

Answer 72

1. Durant's maneuver; 2. Venous; 3. Lungs (causing "air lock"); 3. Right; 4. Arterial; 5. Brain (causing a stroke); * - https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/durants-maneuver*

Question 73

Chest pain while lying down.

Answer 73

1. Angina decubitis; ## Footnote *- https://en.wikipedia.org/wiki/Lying\_(position)*

Question 74

What is the maximum size gastric sump tube that may be utilized with iGels size 3, 4 and 5?

Answer 74

1. 12 French; 2. 12 French; 3. 14 French; * https://www.youtube.com/watch?v=YuG6k6ndBpM*

Question 75

Bruises, contusions, ecchymosis, purpura and petechiae are all varieties of \_\_\_.

Answer 75

1. Hematoma; ## Footnote *https://en.wikipedia.org/wiki/Hematoma*

Question 76

A ___ is a variety of hematoma that measures \< ___ mm and which may result from numerous and diverse etiologies such as adverse reactions from medications (e.g., warfarin), straining, asphyxiation, platelet disorders and diseases (e.g., cytomegalovirus).

Answer 76

1. Petechia (plural: petechiae); 2. 3; * https://en.wikipedia.org/wiki/Bruise* * https://en.wikipedia.org/wiki/Hematoma*

Question 77

A ___ is a variety of hematoma that measures \_\_\_-\_\_\_ mm and indicates various pathologic conditions such as thrombocytopenia.

Answer 77

1. Purpura; 2. 3; 3. 10; Note: Purpura may be classified as palpable purpura or non-palpable purpura. *https://en.wikipedia.org/wiki/Bruise*

Question 78

An ___ is a varity of hematoma that measures \> ___ cm and is caused by blood dissecting through tissue planes and settled in an area remote from the site of trauma or pathology.

Answer 78

1. Ecchymosis; 2. 1; * https://en.wikipedia.org/wiki/Bruise*

Question 79

The terms "bruise," "contusion" and "ecchymosis" can often be used interchangeably. However, in careful usage, what differentiates a bruise or contusion from an ecchymosis?

Answer 79

1. Bruises are always caused by trauma, while ecchymosis may be caused by disease; ## Footnote *https://en.wikipedia.org/wiki/Ecchymosis*

Question 80

An abscess is not the same thing as a cyst. Both are fluid-filled lumps, but an ___ is infected while a ___ is not.

Answer 80

1. Abscess; 2. Cyst; * https://www.emedicinehealth.com/abscess/article\_em.htm*

Question 81

Although frequently described as a collapse of lung tissue, ___ is not synonymous with a pneumothorax, which is a more specific condition that *features* \_(1.)\_. It is a condition where the ___ are deflated down to little or no volume, and may occur as a post-operative complication or as a result of ___ deficiency.

Answer 81

1. Atelectasis; 2. Alveoli; 3. Surfactant; * https://en.wikipedia.org/wiki/Atelectasis*

Question 82

The ___ of the eye are one of the first tissues to change color as bilirubin levels rise in \_(condition)\_. The yellowing of the "white of the eye" is properly termed \_\_\_, however it is also commonly refered to as \_\_\_.

Answer 82

1. Conjunctiva; 2. Jaundice; 3. Conjunctival icterus; 4. Scleral icterus; * https://en.wikipedia.org/wiki/Jaundice*

Question 83

An adjective for "occuring after a meal."

Answer 83

1. Postprandial; ## Footnote *https://www.lexico.com/en/definition/postprandial*

Question 84

Bipolar disorder is a mood disorer in which episodes of ___ fluctuate with episodes of \_\_\_. For this reason, Bipolar disorder has also been called "\_\_\_."

Answer 84

1. Mania 2. Depression; 3. Manic depression; * FireRescue1 Academy, Depression and Suicide, 2020*

Question 85

\_\_\_ is one of the most widely used and studied medications for treating bipolar disorder.

Answer 85

1. Lithium (Eskalith, Lithobid); ## Footnote *https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-lithium#1*

Question 86

What temperature range constitutes mild hypthermia?

Answer 86

1. 33-35 degrees C; ## Footnote *EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 87

What temperature range constitutes moderate hypthermia?

Answer 87

1. 29-32 degrees Celsius; ## Footnote *EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 88

What temperature range constitutes severe hypthermia?

Answer 88

1. 22-28 degrees Celsius; ## Footnote *EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 89

What condition is caused when active external rewarming of a hypothermic patient causes periperhal vasodilation, increased blood return to the heart, a decrease in core temperature and cardiac arrhythmias resulting from toxins generated by peripheral cell death?

Answer 89

1. Rewarming Shock; ## Footnote *EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 90

Which classification(s) of hypothermia feature shivering?

Answer 90

1. Mild hypothermia; ## Footnote *EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 91

Which classification(s) of hypothermia feature cardiac dysrhythmias?

Answer 91

1. Moderate hypothermia (e.g., Atrial Fibrillation); 2. Severe hypothermia (e.g., Ventricular Fibrillation); * EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 92

Which classification(s) of hypothermia do(es) not feature shivering?

Answer 92

1. Moderate hypothermia; 2. Severe hypothermia; * EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*

Question 93

With regard to traumatic hip injuries, an externally rotated and shortened lower extremity is indicative of a \_\_\_, while an internally rotated and flexed lower extremity is indicative of a \_\_\_.

Answer 93

1. Fracture; 2. Dislocation; * EMS Connect: Hypothermia / Falls & Anticoagulants (https://www.emsconnect.org/members/courses/95)*