Medical Flashcards

1
Q

Trousseau sign may be encountered in patients with which of the following conditions

A

Hypocalcemia

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2
Q

By which of the following mechanisms does cyanide cause hypoxia?

A

It prevents the metabolism of oxygen

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3
Q

An elderly man is not acting right, according to his daughter. He becoes agitated when you attempt to assess him and tells you that you are not taking him anywhere. What should you do?

A

Calmy talk to him and try to obtain a glucose reading

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4
Q

Signs and symptoms of insecticide poisoning include which of the following?

A

Excessive salivation and severe bradycardia

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5
Q

Disequilibrium syndrome manifest with signs and symptoms of?

A

increased intracranial pressure

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6
Q

Which of the following disease processes is characterized by myoclonic jerking, major cognitive deterioration, visual impairment, and ataxia?

A

Creutzfeldt-Jakob disease

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7
Q

A woman is found unresponsive by her roomate. According to the roomate, the patient, who has type I diabetes, was fine 30 minutes ago.

A

Blood glucose level less than 60 mg/dl

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8
Q

a 24-year-old woman presents with a headache, fever, and photophobia. She is disoriented and slow to answer your questions. Your assessment reveals a positive Brudzisnki sign. What should you suspect?

A

Meningitis

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9
Q

Which of the following is a class of lymphocyte that matures in the bone marrow and produces antibodies?

A

B Cell

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10
Q

The clinical presentation of thyroid storm resembles which of the following conditions?

A

Amphetamine use

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11
Q

Which of the following hormones stimulates the kidneys to reabsorb sodium and excrete potassium?

A

Aldosterone

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12
Q

A woman with a history of hypertenson presents with an acute onset of tearing abdominal pain. She is conscious and alert, but restless. Her BP is 86/56 mm Hg, pulse rate is 120 beats/min, and respirations are 28 breaths/min. What should you do?

A

Determine if her femoral pulses are of equal strength

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13
Q

Which of the following complications would likley occur if a patient missed several dialysis treatments?

A

Pulmonary edema

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14
Q

A 30-year-old male is in cardiac arrest after he overdosed on heroin. What should you do after initiating CPR?

A

Assess his cardiac rhythm and establish vascular access

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15
Q

Which of the following statements regarding hypoglycemia is correct?

A

With severe hypoglycemia, the patient’s response to treatment may be delayed or short-lived.

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16
Q

In contrast to an anaphylactic reaction, an anaphylactoid reaction:

A

can occur without prior exposure to an offending agent

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17
Q

Four hours after starting a new prescription of Zoloft, a woman presents with delirium, tachycardia, and hpyertension. Her muscles are rigid, she has trimus, and she is diaphoretic. What should you suspect?

A

Serotonin syndrome

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18
Q

You are setting up a norepinephrine infusion to run at 5 mcg/min. You add 8 mg of norepinephrine to 500 mL of normal saline. How many milliliters per hour will be delivered?

A

19

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19
Q

A 60-year-old woman, who has been taking high doses of prednisone for several months to treat her rheumatoid arthritis, presents with weakness and fatigue that has progressively worsened. On appearance, her face appears swollen, What should you suspect?

A

Cushing syndrome

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20
Q

Which of the following conditions would produce the MOST rapid loss of consciousness?

A

Insulin shock

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21
Q

Polycythemia is a condition that results in

A

Increased oxygen-carrying capacity of the blood

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22
Q

You would expect to encounter trismus with which of the following conditions?

A

Tetanus

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23
Q

A man is confused and has slurred speech after working in the heat for several hours. His skin is hot and moist, his pulse is rapid and weak, and his respirations are rapid and shallow. What should you do?

A

Remove his clothes and apply ice packs to his goin and axillae

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24
Q

A 26-year-old female who overdosed on amitriptyline is responsive to pain only. Her BP is 70/40 mm Hg and her heart rate is 140 beats/min. A 12-lead ECG reveals wide QRS complexes and prolonged QT interval. What should you do?

A

Give 20-ml/kg crystalloid fluid boluses

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25
Q

A patient presents with a diffuse petechial rash. What should you suspect?

A

Thrombocytopenia

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26
Q

A 60-year-old male presents with acute onset of confusion and slurred speech. His family states that the episode began while he was watching TV, and that he was normal all morning. Which of the following assessments would be the most likley to reveal a possible cause of his altered mental status?

A

Blood glucose level

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27
Q

A 39-year-old man is in cardiac arrest and has a core body temprature of 81F. which of the following standard resuscitation interventions may require modification?

A

Vasoactive medications

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28
Q

A woman complains of a burning sensation in her abdomen but is unable to describe exactly where it hurts. How would you describe this type of pain?

A

Visceral

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29
Q

A 74-year-old woman with a recent urinary tract infection has an altered mental status.

A

Give a 30-mL/kg crystalloid bolus

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30
Q

A patient with blood glucose level of 650 mg/dl would be expected to present with:

A

hyperpnea, dehydration, warm skin, and tachycardia

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31
Q

Which of the following patient presentations meet all the components of the quick Sepsis-related Organ Failure Assessment criteria for sepsis?

A

GCS, 14; respiratory rate, 24 breaths/min; systolic BP, 90 mm Hg

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32
Q

Which of the following findings is the most clinically significant when assessing a patient with a headache?

A

An unsteady gait

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33
Q

Shortly after his dialysis treatment, a 66-year-old man presents with confusion, a headache, and nausea. What should you suspect?

A

Disequilibrium Syndrome

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34
Q

A 71-year-old woman with renal disease presents with confusion, severe weakness, shortness of breath, and peripheral edema. She is unable to tell you when she had her last dialysis treatment. Her BP is 140/84 mm Hg, pulse is 55 beaths/min and weak, and respirations are 22 breaths/min. Her 12-lead ECG reveals a first-degree AV block with wide QRS complexes. What should you do?

A

Give 1 g calcium chloride

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35
Q

A man was working in his shed when he experienced a sudden, sharp pain in his leg. Assessment of the area reveals a small area of redness, but no visible marks. He is disoriented and complains of intense abdominal pain. What should you suspect?

A

Black widow spider

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36
Q

A 34-year-old woman presents with acute dyspnea and anxiety. Her skin is pale and diaphoretic, her heart rate is 130 beats/min, and her end-tidal CO2 is 14. You are unable to obtain a signal on the pulse oximeter. What should you suspect?

A

Pulmonary embolism

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37
Q

A 39-year-old woman is confused, is experiencing hallucinations, and is repetitively smacking her lips. What should you suspect?

A

Complex partial seizure

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38
Q

Which of the following occurs when the blood glucose level falls, such as during strenous exercise?

A

The pancreas secretes glucagon, which stimulates the liver to convert glycogen to glucose.

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39
Q

a 30-year-old man has been having a seizure for the past 15 minutes. What drug/dose combination should you give?

A

5 to 10 mg diazepam

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40
Q

The act of marking a foreign microbe or antigen for phagocytosis is called which of the following?

A

Opsonization

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41
Q

A woman has a rash and severe itching to her trunk and arms that began a day after she started taking penicillin. Her breath sounds are clear to ausculation bilaterally, she denies shortness of breath, her oxygen saturation is 96%, and her BP is 114/64 mm Hg. What should you do?

A

Give 25 mg diphenhdramine IM

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42
Q

A woman was bitten on the ankle by a rattlesnake. She is conscious and alert, but anxious. Her BP is 144/72 mm Hg. Her pulse is 116 beats/min and strong, and her respirations are 16 breaths/min and unlabored. What should you do?

A

Splint the entire lower extremity

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43
Q

A 54-year-old woman presents with acute onset of confusion, generalized weakness, and slurred speech. Her BP is 114/60 mm Hg, pulse is 64 beats/min, respirations are 20 breaths/min, and oxygen saturation is 95%. What should you do?

A

Assess her blood glucose

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44
Q

A patient presents with polyuria and a blood glucose reading of 412 mg/dl. Treatment should include which of the following.

A

Fluid rehydration with an isotonic crystalloid

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45
Q

Which of the following ECG abnormalities is associated with hypothermia?

A

Osborn wave

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46
Q

A woman swallowed a lot of pills. Which of the following should you inquire about FIRST?

A

What kind of pills were taken

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47
Q

A man is under the influence of an unknown substance. He is agitated, his BP is 180/100 mm Hg, his pulse rate is 150 beats/min, and his skin is hot to the touch. What should you suspect?

A

Cocaine

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48
Q

Which of the following paramters is included in the quick sequential organ failure assessment score for sepsis?

A

Mental status

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49
Q

A 39-year-old woman has been taking corticosteriods medications for a long time. She complains of chronic weakness and fatigue and states that she has gained a lot of weight, mainly in her abdomen. Assessment reveals that her face is swollen, and she has multiple skin tears on her arms and legs. What should you suspect?

A

Cushing disease

50
Q

A man presents with an acute onset of left-sided weakness, right-sided facial droop, and slurred speech. What should you suspect?

A

Right-side ischemic stroke

51
Q

A man ingested a bottle of extra strength acetaminophen. He presents with malaise and palpable tenderness to the right upper quadrant of his abdomen. He is conscious and alert, his BP is 136/66 mm Hg, his pulse is 100 beats/min and regular, his respirations are 16 breaths/min, and oxygen saturation is 95%. Which of the following treatments is indicated for him?

A

IV saline lock

52
Q

You are assessing a young female and are trying to determine if she experienced a seizure or syncopal episode. Which of the following findings is MOST consistent with a seizure?

A

Her heart rate is 120 beats/min

53
Q

Diarrhea, marked bradycardia, miosis, and hypersalivation are consistent with which type of toxidrome?

A

Cholinergic

54
Q

Overdose of which of the following drugs would likley respond favorably to naloxone?

A

Meperidine

55
Q

A 27-year-old female overdosed on an unknown type of drug. Her skin is hot and flushed and her breathing is rapid and deep. Her BP is 98/64 mm Hg and her heart rate is 120 beats/min. What should you suspect?

A

Aspirin

56
Q

Signs of myxedema may include which of the following?

A

Hypothermia

57
Q

A 55-year-old male who is an alcoholic stopped drinking 4 days ago. He is confused and restless. His skin is hot to the touch, he is diaphoretic, and his hands are shaking. His BP is 180/90 mm Hg, pulse is 120 beats/min, respirations are 24 breaths/min, and oxygen saturation is 98%. What should you do?

A

Assess his blood glucose and establish vascular access

58
Q

A woman with a history of Graves disease presents with an altered mental status. Her skin is hot to the touch and her pulse rate is 160 beats/min. What should you suspect?

A

Thyrotoxic crisis

59
Q

Which two cranial nerves are responsible for eye movement?

A

Oculomotor and trochlear

60
Q

A 59-year-old male with a history of hypertension and diabetes presents with dark, tarry stools. He is confused; his blood pressure is 84/62 mm Hg and his pulse rate is 74 beats/min and weak. His medications include propranolol and Glucophage. Which of the following would MOST likley explain his heart rate?

A

The prescribed adrenergic blocking agent to treat his hypertension

61
Q

An IV has been established on a woman who complains of abdominal pain. During transport, she pegins complaining of chills, a backache, and nausea. What should you do?

A

Discontinue the IV fluid

62
Q

An unresponsive woman, who is a known IV drug abuser, has slow, shallow breathing and a slow, weak pulse. After initiating bag-mask ventilation, what intervention should be performed next?

A

0.4 to 2 mg naloxone IM or IV

63
Q

Which of the following is consistent with hyperglycemic ketoacidosis?

A

Hyperpnea

64
Q

A woman was stung by a scorpion. Within a few minutes, she developed nausea and abdominal pain. She is confused, her skin is pale, and her BP is 80/50 mm Hg. What should you do?

A

Give 0.3 to 0.5 mg epinephrine IM

65
Q

A woman presents with abdominal cramping, nausea, vomiting, and diarrhea. She is conscious and alert and is lightheaded. BP is 110/70 mm Hg, pulse is 120 beats/min, and respirations are 18 breaths/min, Her temperature is 87.7F orally and her oxygen saturation is 95%. What should you do?

A

Give a 500-mL fluid bolus and 4 mg ondansetron

66
Q

A man presents with a sudden painless loss of vision in one eye. He has no other symptoms. What should you suspect?

A

Central retinal arterial occlusion

67
Q

A 29-year-old man is agitated and refuses to give you any information because his roommate told him not to trust anyone. His small apartment clearly indicates that he is the sole occupant. Your partner finds a prescription for Zyprexa, which is prescribed to the patient. What should you suspect?

A

Schizophrenia

68
Q

Forty-five minutes after being stung by a hornet, a woman presents with diffuse uticaria and itching. Her BP is 124/72 mm Hg, pulse is 88 beats/min and strong, respirations are 16 breaths/min and unlabored, and oxygen saturation is 94%. What should you do?

A

Administer 25 mg diphenhydramine IM

69
Q

A man had a syncopal episode after several hours of vigorous exercise in the heat. He is responsive to pain only, and his skin is flushed, hot, and moist. What should you do?

A

Begin rapid cooling measures

70
Q

A patient with diabetic ketoacidosis would be expected to present with which of the following clinical signs?

A

Hyperglycemia and Dehydration

71
Q

Which of the following patients is at greatest risk of Hypothermia?

A

55-year-old woman with hypothyroidism

72
Q

A 68-year-old man returned to a skilled nursing facility 3 days ago after having his Foley catheter changed. Today, he is found to be confused. His BP is 70/40 mm Hg, pulse is 110 beats/min and weak, respirations are 28 breaths/min, and his skin is cold to the touch. What should you do?

A

Give a 30-mL/kg crystalloid bolus

73
Q

You are assessing a patient who presents with a melena and abdominal pain. Which of the following medical history findings is the MOST clinically significant?

A

von Willebrand disease

74
Q

Following prolonged dehydration, a 67-year-old man presents with hypotension, tachycardia, and oliguria. He has no past medical history. What should you suspect?

A

Prerenal acute renal failure

75
Q

Increased parasympathetic tone, bradycardia, shunting of blood to the brain, and hypotension describes which of the following?

A

The diving reflex

76
Q

A 65-year-old obese female has experienced a change in behavior over the past several days, according to her husband. She initially seemed forgetful, but today she is confused. Her BP is 90/50 mm Hg, pulse is the 50 beats/min, and respirations are 10 breaths/min. Her skin is cold and dry. Her husband is not aware of any medical problems that she has, but remarks about her weight gain over the past few months. What should you suspect?

A

Decreased thyroid hormone production

77
Q

What components of the immune system release the body’s chemical mediators in anaphylaxis?

A

Basophils and mast cells

78
Q

Which of the following medications is classified as a tricyclic antidepressant?

A

Nortriptyline hydrochloride

79
Q

A 66-year-old man presents with acute aphasia, facial droop, and left-side paralysis. He is ignoring the left side of his body as though it does not exist. His BP is 144/84 mm Hg, pulse is 76 beats/min, and respirations are 14 breaths/min. What should you suspect?

A

Large vessel occlusive stroke

80
Q

Which of the following assessment findings is indicative of peritoneal irritation?

A

A decrease in pain when drawing the knees into the abdomen

81
Q

A man has a severe headache and vomiting that has progressively worsened over the past 36 hours. Which of the following questions would be MOST important to ask him initially?

A

Have you experienced a recent head injury?

82
Q

A man is unresponsive and has cool, clammy, pale skin. His wife states that he has diabetes and that he wears an insulin pump. His respirations are rapid and shallow and his blood glucose level reads 22 mg/dL. What should you do?

A

Deactivate his insulin pump

83
Q

What does a high level of thyroid-stimulating hormone in the blood indicate?

A

Hypothyroidism

84
Q

Which of the following describes the typical sequence of events that precedes cardiac arrest in a drowning episode?

A

Laryngospasm, hypoxia, dysrthmias

85
Q

At 2:30 AM, you respond to a crowded homeless shelter for a 52-year-old male who is sick. The patient complains of intense itching to his hands and axillae. Assessment of these areas reveals the presence of a rash. The patient denies any medical problems, but states he was stung by a hornet 2 days ago. What should you suspect?

A

Scabies

86
Q

Which of the following analgesic medications would be appropriate when there is a concern for inducing respiratory depression or hypotension?

A

Ketorolac tromethamine

87
Q

A 60-year-old male with chronic alcoholism presents with an acute onset of the hematemesis. His BP is 80/40 mm Hg, pulse is 130 beats/min and weak, and respirations are 28 breaths/min and shallow. What should you suspect?

A

Abnormally enlarged esophageal veins secondary to impaired blood flow to the liver

88
Q

What are the therapeutic effects of epinephrine when administered to a patient with anaphylaxis?

A

Constricts the blood vessels and dilates the bronchioles

89
Q

A woman complains of chills, muscle aches, and a headache that began a few days ago. Her blood pressure is 130/72 mm Hg, pulse is 118 beats/min and strong, and respirations are 16 breaths/min and unlabored. She is conscious and alert and denies any past medical history. What additional findings would you expect to encounter?

A

Fever

90
Q

When scoring deep tendon reflexes, a grade of 2+ indicates which of the following?

A

Active

91
Q

A 71-year-old female presents with confusion and slurred speech. According to her husband, she was recently diagnosed with a urinary tract infection. She has type II diabetes and hypertension and currently takes Glucophage, zestril, and bactrim. Her blood glucose level reads “high” her pulse is 120 beats/min, and her respirations are 20 breaths/min and regular. What should you suspect?

A

Hyperosmolar hyperglycemic syndrome

92
Q

Which of the following is a defining factor in the transition from human immunodeficiency virus infection to acquired immunodeficiency syndrome?

A

Development of opportunistic infections

93
Q

A man with type I diabetes has not taken his insulin in 3 days. Which of the following would you expect to encounter?

A

Dehydration; deep, rapid breathing; warm, dry skin

94
Q

A woman presents with a severe migraine headache and nausea. Her vital signs are stable. What should you do?

A

Ask her if she has taken anything for her headache

95
Q

A patient, who is conscious and has a pulse, has a core body temprature of 92.8 F. Which of the following treatments is correct?

A

Passive rewarming only

96
Q

A 70-year-old male presents with an altered mental status and severe weakness. According to his wife, he has had lower back pain and a fever for the past few days. His BP is 82/44 mm Hg, pulse is 160 beats/min, and respirations are 22 breaths/min. Which of the following treatments is indicated for him?

A

Normal saline boluses and norepinephrine

97
Q

Which of the following drugs are indicated for a patient with copious bronchial secretions, marked bradycardia, and profuse diaphoresis following exposure to an industrial pesticide?

A

Atropine and pralidoxime chloride

98
Q

Which of the following signs are consistent with severe anemia?

A

Pallor and shortness of breath

99
Q

Which of the following statements regarding lightning injuries is correct?

A

Lightning injuries tend to resemble blast injuries more than they do high-voltage injuries

100
Q

Following long-term antibiotic therapy, an older man presents with watery diarrhea, nausea, anorexia, and abdominal pain. His vitals signs are stable, although he is slightly tachycardic. What should you suspect?

A

Clostridoides difficile

101
Q

Easy bruising, lymph node enlargement, and splenomegaly are clinical signs of:

A

leukemia

102
Q

A 70-year-old woman complains of tinnitus and difficulty concentrating. She tells you that she has consumed six cups of ice over the past hour. What should you suspect?

A

Chronic anemia

103
Q

Which of the following is a distorted sense of smell, in which the person perceives unpleasant odors that do not exist?

A

Dysosmia

104
Q

Which of the following can be assessed without talking to a patient?

A

Affect

105
Q

A woman develops hives on her chest and arms after being stung by a scorpion. She is conscious and alert and tells you that it is difficult to swallow. Her heart rate is 110 beats/min and her oxygen saturatin is 94%. Which of her signs or symptoms is the MOST concerning?

A

Difficulty swallowing

106
Q

Which of the following occurs when the blood glucose level falls, such as during strenous exercise?

A

The pancreas secretes glucago, which stimulates the liver to convert glycogen to glucose.

107
Q

Which of the following assessment findings helps distinguish envenomation due to a black widow spider bite from an acute abdominal condition?

A

Abdominal rigidity without palpable tenderness

108
Q

A 34-year-old man is in anaphylactic shock. You have administered two doses of epinephrine 0.3 mg via the intramuscular route; however, the patient is still hypotensive and has labored breathing. What should you do?

A

Establish vascular access and begin an epinephrine infusion

109
Q

A man reports burning in his throat and a severe headache after being rescued from his burning house. His BP is 180/90 mm Hg, pulse is 120 beats/min, and respirations are 28 breaths/min and labored. What treatment is indicated from him?

A

Amyl nitrite inhaled in 20-second increments

110
Q

A man complains of difficulty breathing and a fever. He is emaciated, is coughing, and has purple blotches on his trunk. What should you suspect?

A

HIV/AIDS

111
Q

What cranial nerve is assessed by asking the patient to shrug their shoulders and turn their head from side to side?

A

Spinal accessory

112
Q

A woman complains of severe neck pain. Her head is turned to the side and appears locked in that position. You also note that her eyes are clenched shut. She is conscious, but agitated. She started taking lithium the day before after being diagnosed with bipolar disorder. Which of the following medications is indicated?

A

Diphenhydramine

113
Q

An older woman presents with severe weakness, hypotension, lower back pain, and vomiting. Her husband tells you that she has not taken her prednisone in several days because she has not been feeling well. What should you suspect?

A

Addisonian crisis

114
Q

A 30-year-old man collapsed at a local park. He is disoriented, his skin is hot and moist, and his respirations are rapid and shallow. What should you suspect?

A

Heatstroke

115
Q

Which of the following describes the pathophysiology of multiple sclerosis?

A

Autoimmune disorder in which the body attacks the myelin sheath of the neurons in the brain and spinal cord

116
Q

Which of the following regulates a person’s level of consciousness?

A

Reticular activating system

117
Q

What is the correct dose and route of diphenhydramine for a patient experiencing an allergic reaction?

A

1 to 2 mg/kg IM or IV

118
Q

A man has a headache and visual disturbances that have progressively worsened over the past 3 months. What should you suspect?

A

Cerebral neoplasm

119
Q

Which of the following statements regarding sickle cell disease is correct?

A

In sickle cell disease, misshapen red blood cells can lodge in the spleen, causing it to swell and rupture.

120
Q

Treatment for a black widow spider bite includes which of the following?

A

2.5 to 10 mg diazepam