Medical OB Gynecology

Question 1

Kernig sign

Answer 1

when a patient is unable to extend their leg at the knee when the thigh is flexed because of severe pain or resistance.

Kernig’s sign is a good indication that the patient is suffering from meningitis.

Question 2

An average-weight adult has approximately 5-6 L of total blood in their body. Of the total body weight, blood accounts for what percentage?

Answer 2

Blood accounts for approximately 8% of the total body weight. Blood is comprised of plasma and formed elements.

Question 3

Brudzinski’s sign

Answer 3

an indication of meningitis.

It involves the involuntary flexion of the knees when the head is bowed to the chest.

Question 4

Babinski’s sign

Answer 4

is an abnormal plantar reflex.

Question 5

Hamman sign

Answer 5

a crunching sound heard over the heart

sign of a pneumomediastinum.

Question 6

Cullen’s sign

Answer 6

bruising around the umbilicus, secondary to intra-abdominal hemorrhage.

Question 7

Which of the following medications is the first-line treatment for anaphylaxis in a patient with no contraindications?

Toradol (Ketorolac)

Epinephrine (Adrenalin)

Diphenhydramine (Benadryl)

Methylprednisolone (Solumedrol)

Answer 7

Correct answer: Epinephrine (Adrenalin)

Epinephrine is the first-line treatment for anaphylaxis. It acts rapidly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and increasing heart rate and blood pressure.

Diphenhydramine (Benadryl) may be used as an adjunct therapy to relieve itching and hives but should not replace epinephrine as the primary treatment for anaphylaxis.

Toradol (Ketorolac) is a non-steroidal anti-inflammatory drug (NSAID) used for pain relief but is not indicated for the treatment of anaphylaxis.

Methylprednisolone (Solumedrol), a corticosteroid, may be used in managing an allergic reaction but is not appropriate for the acute phase of anaphylaxis.

Question 8

The primary location for the body’s cell production?

Answer 8

Bone marrow

Question 9

What organ is responsible for producing the blood’s coagulation factors?

Answer 9

Liver

The body’s clotting factors are produced within the liver.

The liver is also responsible for filtering the blood.

The liver breaks down old red blood cells and turns them into bile.

Question 10

Which of the following relates to increased intracranial pressure (ICP)?

A
Bernoulli’s Principle

B
Monro-Kellie doctrine

C
Fick Principle

D
Frank-Starling Law

Answer 10

Correct answer: Monro-Kellie doctrine

The cranial vault is 100% filled by the brain, cerebrospinal fluid (CSF), and blood.

In response to an expanding intracranial mass, the body attempts to reduce ICP by expelling CSF and venous blood from the cranial vault.

During the early stages, this mechanism successfully creates more space for the mass and keeps ICP within normal limits.

Question 11

What condition is most likely to cause an adult female patient to present with non-traumatic lower abdominal quadrant pain reported as severe, agonizing, and often radiating to the patient’s shoulders?

Splenic rupture

Renal calculi

Ovarian cyst rupture

Ectopic pregnancy rupture

Answer 11

Correct answer: Ectopic pregnancy rupture

Adult females who present with non-traumatic lower abdominal quadrant pain reported as severe, agonizing, and often radiates to the patient’s shoulders should be suspected of having an ectopic pregnancy, especially when other factors point to the possibility.

Question 12

Which of the following is responsible for the production and release of albumin, fibrinogen, globulins, and clotting factor?

Pancreas

Liver

Bone marrow

Plasma

Answer 12

Correct answer: Liver

The liver is the main line of defense against many by-products of metabolism that become toxic if allowed to accumulate in the body. The blood proteins, albumin, fibrinogen, globulins, and clotting factor are also made and released into the general circulation by the liver.

Question 13

IV solutions can be categorized by their tonicity. Which IV solutions are correctly categorized below?

Select the 2 answer options which are correct.

3% saline is hypertonic

5% dextrose in water is hypertonic

0.9% sodium chloride is hypotonic

Lactated Ringer’s solution is isotonic

Answer 13

Correct answer: 3% saline is HYPERTONIC and Lactated Ringer’s are ISOTONIC.

Isotonic solutions include 0.9% sodium chloride (normal saline) and lactated Ringer’s solution (LR).
-Used for fluid replacement and volume expansion.

3% saline is considered hypertonic.
- Commonly used to reduce edema and facilitate fluid removal in the urine.

5% dextrose in water (D5W) is a unique solution that is isotonic in the bag but, when administered, becomes hypotonic in the body.
- Commonly used to dilute medications for IV administration.

Question 14

What’s Unique about DW5 (5% Dextrose)?

Answer 14

It is ISOTONIC in the bag but,
- when administered,
= becomes HYPOTONIC in the body.

Question 15

What is the Tonicity of 3% Saline and what is it used for?

Answer 15

to reduce edema and facilitate fluid removal in the urine.

Question 16

What type of solution is 0.9% sodium chloride (normal saline) and lactated Ringers and what are they used for?

Answer 16

fluid replacement and volume expansion

Question 17

What are these blood sample tubes primarily used for at the Hospital?

Lavender top

Red top

Green top

Light blue top

Answer 17

A light blue top blood sample tube contains sodium citrate.
- This tube is used primarily for blood coagulation studies.

The lavender (or purple) top blood sample tube contains the anticoagulant ethylenediaminetetraacetic acid (EDTA). I
- It is used for blood cell counts, hemoglobin, hematocrit, erythrocyte sedimentation rate, glycohemoglobin, and HIV testing. These tubes are used for whole-blood hematology testing.

Red top blood sample tubes do not contain any additives or preservatives.
- They are used primarily for serum electrolytes, liver enzymes, therapeutic drug levels, and blood bank procedures.

Green top blood sample tubes contain the anticoagulant heparin.
- They are primarily used to test electrolytes, glucose, and cardiac enzymes.

Question 18

What is a naturally occurring steroidal hormone produced by the adrenal cortex to help regulate the sodium/potassium balance in the blood?

Answer 18

Aldosterone

a naturally occurring steroidal hormone produced by the adrenal cortex.

It is used by the body as a means to regulate the essential balance of sodium and potassium in the blood.

Question 19

Gravida (Gravidity)

Answer 19

The total number of confirmed pregnancies a woman has had, including current pregnancies and those that did not result in a live birth.

Question 20

Para (Parity)

Answer 20

The number of live births a woman has carried full term.

Question 21

Hemothorax

Answer 21

Blood into thoracic cavity.

Diminished lung sounds
flat neck veins
dull to percussion

Question 22

Tension Pneumothorax

Answer 22

absent lung sounds
distended neck veins
hyper resonant to percussion

Question 23

HELLP Syndrome

Answer 23

a severe form of preeclampsia

H-EL-LP

H - Hemolysis (the breakdown of red blood cells)
EL - Elevated liver enzymes
LP - Low Platelet count.

PE-RF-PH-S
Pulmonary Edema
Renal failure
Postpartum Hemorrhage
Stroke

Question 24

Hemolysis

Answer 24

Breakdown of red blood cells

Question 25

What are the signs and symptoms of a thyroid storm?

Answer 25

Tachycardia,
tachypnea,
hyperthermia,
palpitations
delirium

The acute hyperfunction thyroid event is known as thyroid storm and is a true medical emergency that can quickly lead to death if medical intervention is not initiated quickly.

Patients with thyroid storm often present with often severe tachycardia, tachypnea, hyperthermia, palpitations, and often, delirium or coma.

Question 26

Major or critical burn criteria requiring a burn center?

Answer 26

Adults = Burn greater than >25% of TBSA
Children/Elderly = Greater than >20%
Full-thickness burn that involves greater than 10% TBSA.

Critical burns also involve all burns to the face, neck, torso, and genitalia.

Caustic agent as well as inhalation burns of all types are critical and considered major burns.

Major burns should be transported to a burn center.

Question 27

Flat neck veins

Answer 27

Hypovolemia

Question 28

Spontaneous Pneumothorax

Answer 28

A spontaneous pneumothorax (SP) occurs when “blebs” or weak spots on the surface of a patient’s lung burst.

Commonly occurs from coughing against a closed glottis.

It is described as a “snap, crackle, pop” sensation under the skin when palpated.

Question 29

Dunphy sign

Answer 29

Sharp pain in the RLQ elicited by a voluntary cough
= possible Appendicitis/Peritonitis

Question 30

Homan sign

Answer 30

DVT test

Dorsiflexion of foot with positive pain behind knee or calf
= positive DVT

Question 31

Burn damage from chemical agent: 4 factors

Answer 31

1. The CONCENTRATION and quality of the agent
2. The chemical state or TEMPERATURE of the agent
3. The LENGTH of EXPOSURE
4. The DEPTH of burn PENETRATION

Question 32

Causes of false pulse oximetry readings

Answer 32

Carbon monoxide and Cyanide poisonings

Question 33

Treatment for PreEeclampsia-induced hypertension

Answer 33

Hydralazine (Apresoline)
Nifedipine (Adipine)
Labetalol (Trandate).

Question 34

8 D’s of stroke care?

Answer 34

Detection
Dispatch
Delivery
Door
Data
Decision
Drug/Device
Disposition

Question 35

At least how many responders are needed based on resuscitation guidelines?

Answer 35

6

Team leader
Compressor
Airway manager
AED/Monitor/Defibrillator
IV/IO medication provider
Time recorder

Question 36

Your 55-year-old patient is suspected of having a myocardial infarction. He is complaining of substernal chest pain that came on during rest. His heart rate is 88 beats per minute, and his respirations are 20. His skin is cool, pale, and diaphoretic with a blood pressure of 110 systolic.

What does the presence of pale, diaphoretic skin typically indicate during a cardiac event?

A
The heart has lost the ability to be an effective forward pump

B
Peripheral vasoconstriction and sympathetic nervous system stimulation

C
Central vasodilation and parasympathetic nervous system stimulation

D
Inadequate cardiac output due to myocardial ischemia

Answer 36

B).

PERIPHERAL VASOCONSTRICTION and SYMPATHETIC NERVOUS SYSTEM STIMULATION

Patients experiencing a myocardial infarction often suffer from peripheral vasoconstriction, tachycardia, pale cool skin, and diaphoresis as part of the sympathetic nervous system stimulation.

Question 37

What medication is indicated for a pt with symptoms of a thyroid storm?

Answer 37

Propanolol (Inderal)

Question 38

Your 69-year-old patient awoke with severe dyspnea and is only able to talk in two- to three-word bursts. Her skin is cool, pale, and diaphoretic with labored respirations at 30 with an SPO2 of 80% on room air. She has audible wheezes and rales with pitting edema peripherally. She has an irregular heart rate of 100 to 110 bpm, and her ECG shows A-fib with no obvious pathological ST elevation or depression. Her blood pressure is 160/100 in an upright sitting position. She has a history of COPD, hypertension, and congestive heart failure.

Which of the following would be a first-line medication for this patient?

a. Morphine

b. Albuterol

c. Furosemide

d. Nitroglycerin