NREMT P General Prep Flashcards
What system is used to identify the class or division of substances?
Placard system
What colors are on the placard system? What do they mean?
Blue=Health Hazard, Red=Flammability Hazard, Yellow=Instability Hazard, White=Special Hazard
What is ADH? And what is its purpose? (Also known as Vasopressin)
Antidiuretic hormone (ADH) is a hormone released from the pituitary gland that signals the kidneys to release less water, also causing a decrease in urine production.
What is Addison’s Disease and the signs and symptoms.
Where the adrenal glands do not produce enough cortisol and aldosterone do to destruction of these glands. Causing fatigue, nausea, dizziness upon standing, darkening of the skin, and low blood pressure.
Purpose of cortisol?
A type of glucocorticoid hormone which is a type of steroid hormone. It suppress inflammation in all of your bodily tissues and control metabolism in your muscles, fat, liver and bones. Glucocorticoids also affect sleep-wake cycles (circadian rhythm)
What does aldosterone do?
Is a steroid hormone that is released by adrenal glands. Its purpose is to help control balance of water and equalize the amount of salt retained and potassium excreted.
What is Graves disease? What are some signs & symptoms?
Immune system disorder causing overproduction of thyroid hormones. S&S are weight loss, enlarged thyroid gland, bulging eyes, and thick red skin found on the shins and top of the feet.
What does “goiter” mean?
Irregular growth/enlargement of thyroid gland.
Typical signs of Cushing’s syndrome
Buffalo back and Moon face (Get these extra fat deposits do to cortisol relation with how fat is stored throughout body)
What is Cushing’s syndrome
Cushing’s syndrome is caused when the body produces or has to much cortisol over long periods of time.
When you pass the tip of an ET tube through the vocal cords during intubation, how much farther should you advance the tube before inflating the cuff?
1-2 cm
Name 3 electrolyte disorders that could cause muscle cramping.
Hypocalcemia, Hypokalemia, Hyperkalemia.
Explain what defines “Crush Syndrome”
A crush injury occurring over 4 hours and is paired with Rhabdomyolysis.
What is “Rhabdomyolysis”?
When muscle tissue begins to breakdown and releases proteins and electrolytes, specifically myoglobin which can harm the kidneys.
Discuss the treatment plan for a Crush Injury patient.
IV NS, Sodium Bicarbonate will balance the pH of the blood do to its alkalotic pH, Calcium Chloride will help stabilize the large amounts of potassium being leaked out, and Nebulizer with albuterol will help the cells uptake the large quantities of potassium as well.
Normal Vitals for a neonate?
Neonate 120-160 HR, 30-60 RR, 50-75 systolic BP
Describe the physiology of left and right CHF
LS CHF will usually hear Rales when patient breathes and RS CHF will usually have sacral and pedal edema.
What is the most common upper airway obstruction?
The Tongue
3 Upper Airway sounds?
Gurgling, Snoring and Stridor
Which is worse? Hodgkins or Non-Hodgkins Lymphoma
Non-Hodgkins Lymphoma
Medical term for “kidney stones”
Nephrolithiasis or renal calculi
What main medication should be administered to a patient suffering from Wernicke Encephalopathy?
Thiamine
What does “ataxia” mean
Poor coordination
What is “ophthalmoplegia”?
Paralysis or weakness of the eye muscles
What is the main cause for Wernicke Encephalopathy?
Alcohol Abuse
What is the McGinn-White Sign
The S1Q3T3 pattern seen on an EKG during an acute pulmonary embolism. (A large S-wave in lead l, a Q-wave in lead lll, inverted T-wave in lead lll)
What is Beck’s triad?
3 clinical signs that are associated with Cardiac tamponade which are low BP, muffled heart tones, JVD
What is Cardiac Tamponade?
Compression of the heart caused by fluid collecting in the sac surrounding the heart
What is the most definitive and secure advanced airway?
Endotracheal tube
What supraglottic airway is the most common?
King LT
What is Status Epilepticus?
A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes.
What is a “dystonic reaction”? and what is the treatment?
seizure like symptoms that occur within hours or days of exposure to a dopamine blocking drug (ex:Haldol). Would give 50mg of benadryl or some form of anti-histamine.
What does diastole and systole represent?
Diastole represents the filling of the heart and systole represents the ejection of fluid from the heart
What is Brown-Sequard Syndrome
A neurological syndrome caused by trauma that affects sensation and movement of both sides of the body. One side will have loss of pain, temperature and sensation while the other side will have loss of vibration , motor function and touch.
What is the purpose of the epiglottic vallecula?
These “spit traps” collect saliva so that the swallowing reflex is not initiated.
What is diverticulitis?
An inflammation or infection in one or more small pouches in the digestive tract.
Difference between ventilation, oxygenation, and respiration?
Ventilation is the physical movement of air in and out of the lungs. Oxygenation is the loading of O2 onto the hemoglobin. Respiration is the exchange of O2 and CO2 at the alveoli and the tissues of the body.
What liquid found in the lungs ensures that the alveoli do not collapse at end-expiration?
Surfactent
What is the main neurotransmitter for the parasympathetic nervous system?
Acetycholine
What is the main neurotransmitter for the sympathetic nervous system?
Norepinephrine (Catecholamines in general)
Least to Most systemic effect for medication routes?
Intradermal, subcutaneous, intramuscular, intravenous
Does inhaling or exhaling cause negative pressure in the thoracic cavity?
Inhaling
What do you check when administering magnesium sulfate?
Deep Tendon Reflexes
What type of brain bleed causes in and out of consciousness?
Epidural bleeds
What is the average volume of air per breath?
500ml and 6L in one minute
What is “First pass metabolism”? Where is this metabolism mainly occurring?
Metabolism of a drug before it reaches the systemic circulation. Metabolism mainly occurs in the Liver.
How to calculate size of ET Tube for pediatrics?
Uncuffed: 4+(age/4)
Cuffed: 3.5+ (age/4)
What is the maximum pressure for an O2 tank?
2000-2200 psi
What are Schedule l drugs and what are some examples?
drugs with no currently accepted medical use and a high potential for abuse. (heroin, LSD, marijuana, ecstasy)
What are Schedule ll drugs and what are some examples?
Drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. (hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid)
What medication will help reduce the affects of a cyanide inhalation or overdose?
Sodium Thiosulfate (this is bc it will convert cyanide to thiocynate which will be easier for the kidneys to break down)
Lead l of an EKG is looking where?
Left arm to right arm
Lead ll of an EKG is looking where?
Left leg to right arm
Lead lll of an EKG is looking where?
Left leg to left arm
What does capnometry monitor?
The amount of carbon dioxide in the exhaled air.
What type of injury from a blast has the most mortality?
Pulmonary
ST Elevation imposters
Wolf Parkinson White, Left Bundle Branch Block, Left Ventricular hypertrophy, benign early repolarization
How many stages of the labor process are there? When does each one commence?
There are 3 stages. Stage 1 (contractions) happens when labor begins and ends in full cervical dilation. Stage 2 (Childbirth) ends with the full delivery of the fetus. Stage 3 (Afterbirth) involves the placenta being delivered and ends when the mother is bonding with the child.
When a pregnant woman begins to have tonic-clonic seizures, what medication should you administer and what dosage?
Magnesium Sulfate at 2-4 grams.
What is a prolapsed cord? How would you manage this?
A prolapsed cord is when the umbilical cord is out of the birth canal before the baby. You would insert your hand into the vagina and try to lift the baby’s head off the cord.
What type of blade is recommended for infants during intubation
Miller blade
Intrapartum vs Antepartum
Intra= during delivery
Ante= after delivery
What is the leading cause for cardiac arrest in neonates?
Hypoxia
What is the main sign for the classification of respiratory failure?
Decrease in heart rate
How much is a normal amount of blood loss during childbirth?
500ml or less (1 pint or less)
How do you calculate fluid resuscitation amount for pediatrics?
20ml x kg
What is placenta previa?
When the placenta is covering the opening of the cervix.
What does APGAR stand for?
Appearance, Pulse, Grimace, Activity, Respirations
What is Hyperemesis Gravidarum?
intractable vomiting during pregnancy, leading to weight loss and volume depletion (this is more severe than morning sickness)
Pediatric dosage for Versed?
0.1mg/kg up to the adult dosage
Most common reason for pediatric seizures?
Fever/Febrile Seizures. Other reasons could be hypoglycemia and hypoxia.
Pediatric 10% Dextrose dosage?
0.2g/kg
Describe the RULE OF 9s
Describes the amount of surface burn area on a patient
Parkland Formula
4ml x BSA % x pts weight in kg / 2
What does “Mittelschmerz” mean?
Ovulation pain
What does “Menarche” mean?
The first occurrence of menstruation.
What child age is most likely to choke on foreign objects?
Younger than 4.
What is RAAS? What is its function? (THINK BLOOD PRESSURE!)
Renin-angiotensin-aldosterone system (RAAS). Regulator of blood pressure (BP) and determinant of target-organ damage. It controls fluid and electrolyte balance through coordinated effects on the heart, blood vessels, and Kidneys.
Discuss how the kidneys are affected during a CHF Exacerbation?
When a CHF Exacerbation occurs, the heart becomes weaker and causes blood to not be pumped out through the body as well. Bc of this, your kidneys believe that your body has low volume and releases renin to create systemic vasodilation.
Normal BGL for an adult and neonate
Adult = 80-130
Neonate = ensure its higher than 45.
You cant have Hepatitis D without…..
HEPATITIS B!
What is the safest supraglottic advanced airway for a pediatric?
Laryngeal airway mask
What does “Exophthalmos” mean?
Bulging eyes
What does “Dysmenorrhea” mean?
Pain during menstruation
When should you first suction a newborn?
When their head pops out the womb.
How low does a pediatric pts HR have to be to begin chest compressions?
60 beats per minute
What does Diabetic Ketoacidosis (DKA) and Hyperosmolar hyperglycemic syndrome (HHS) have in common? What is the MAIN difference between them?
THE 3 Ps! (Polyuria, Polydipsia, Polyphasia) The MAIN difference between them is HHS has altered mental status!
What is “Hirsutism”? What is it commonly found in?
It is when dark, thick hair is found around a woman upper lip/general facial hair. Most commonly found in polycystic ovary syndrome.
What does “Aphagia” mean
Lack of ability to swallow
What does “Dysarthria” mean?
Mouth muscles are weakness, leading to difficulty speaking.
Tracheitis vs Croup symptoms
Both will have a bark like cough, but Tracheitis will have a HIGH grade fever and Croup will have a LOW grade fever.
What does your cerebrum control?
Speech, thought, emotions
What is Brudzinsksis Sign?
A test for meningitis. A positive
What does Geodon do?
Treats mental health conditions like schizophrenia and bipolar disorder by balancing the levels of dopamine and serotonin in your brain.
What is Olanzapine used for?
Mainly used for antipsychotic, specifically schizophrenia.
What is Kernigs Sign?
A sign of menigitis where you have someone lay supine and lift their leg. If they are unable to straighten or have resistance doing so, that is a positive Kernigs sign.
What type ambulance do we use the most?
Type 1
Einthovens Triangle
An imaginary formation of three limb leads in a triangle used in the electrocardiography, formed by the two shoulders and the pubis.
What Vitamin is ESSENTIAL for the clotting cascade?
Vitamin K
What does “Dysphasia” mean?
Difficulty Speaking
What are Androgens?
Sex hormones (Hyperandrogensim can cause male pattern baldness, acne, abnormal hair growth)
What is the main function of the thyroid?
To control the speed of your metabolism/metabolic rate
What is the main function of calcitonin?
Main job is to lower calcium levels in your blood (not your bones). It does this in two main ways: Calcitonin inhibits (blocks) the activity of osteoclasts, which are cells that break down bone. When osteoclasts break down your bone, the calcium from your bone is released into your bloodstream
What is Myxedema coma? How is it caused? What are some signs and symptoms?
Severe hypothyroidism leading to decreased mental status, slow RR and hypothermia. It is a medical emergency with a high mortality rate. Its is caused do to chronic, untreated hypothyroidism and can be triggered when stress (sepsis, CHF, Acute MI, Stroke, Gi bleed) occur.
What size should a BP cuff be?
2/3 of the upper arm
Epinephrine dosage for adults and pediatrics in anaphylaxis?
0.3mg-0.5mg for adults, 0.15mg for pediatrics
Epinephrine dosage for cardiac arrest in adults and pediatrics?
1mg in adults every 3-5 minutes and 0.01mg/kg in pediatrics
What is a Thyroid Storm? Signs and Symptoms?
(Also called thyroid crisis and thyrotoxic crisis) Happens when your thyroid gland releases a large amount of thyroid hormone in a short amount of time. It’s a rare complication of hyperthyroidism. S&S would include high fever, agitation, delerium and LOC.
What is Rhonchi indicative of?
Mucus which may be do to CHF or an infection
What are three things you want to ensure are good before giving a patient CPAP?
- Can maintain their own airway
- Are NOT altered mental status
- Have a systolic BP of at least 100
What are the 4 stages of shock? What begins to happen to your body during each stage?
Stage 1 (Initial Stage) - Have lost about 750ml of blood, HR and BP will be normal, increase thirst
Stage 2 (Compensatory Stage) - 750 - 1500ml of blood lost, HR and RR begin to increase
Stage 3 (Progressive Stage) - 1,500 - 2000mL of blood lost, BP drops and HR + RR increase more. Urine production will decrease
Stage 4 (Refractory Stage) - Lost over 2000mL of blood, BP low and will begin to AMS, HR high as well.
When in doubt do…..?
ABC , VITALS , SECONDARY ASSESSMENT!
When we see the term, “Insulin Disorder” which type of Diabetes should we suspect?
Type 1 Diabetes
What BGL amount defines DKA and HHS?
250-450 BGL will be considered DKA and above 500 BGL is HHS
What are the degrees for Normal deviation, Left axis, Right axis, and Extreme axis deviation?
Normal = between -30 and 90
Left = Less than -30
Right = greater than 90
Extreme = Between -90 and 180
What coronary artery perfuses V1 - V4
Left Anterior Descending (LAD)
What coronary artery perfuses Lead ll , lll , AVF
Right Coronary Artery (RCD)
What coronary artery perfuses Lead l , AVL , V5 , V5
Left Circumflex (LCX)
What is the dose of Epinephrine in bradycardia that is refractory to atropine
2-10mcg/min
Take 1mg of Epi and mix with 500ml of NS or D5W and infuse.
What can ACE inhibitors cause to new users or people who have been using for a long time?
the “ACE Cough” and Angio edema. Back pain can be common as well
What can you give a patient experiencing angio edema?
50mg of Benadryl (Diphenhydramine)
Catabolic vs anabolic?
Catabolic is the break down of molecules and anabolic is the creation of molecules. (Both Catabolism and Anabolism are required for metabolism!)
What is Varicella known as….? How would you treat it?
Chicken pox! And would give anti-viral medications (anything ending in -vir).
What is a tracheobronchial disruption? How would you best manage this?
It is a major tear in the trachea that has very high mortality rates. The best way to manage this is by maintaining airway and suctioning any blood/secretions
When geriatric overdose occurs, what is the first thing you should ask?
Ask the intentions of the overdose? Was it an accident? Was it on purpose? Or was it bc she was altered and not aware of how much she took. (Geriatrics make up for 1/5 suicides) :(
The initiating cause of a myocardial infarction is…?
A tear of the tunica intima
What is “Eschar”?
Dead tissue that forms over healthy skin and then, over time, falls off (sheds). It is caused by a burn or cauterization
Multiple Casualty vs Mass Casualty?
With mass casualties, resources for each patient are limited, whereas with multiple casualties, full resources can be brought to bear on each individual patient.
What is “Atherosclerosis”?
Atherosclerosis is the thickening/hardening of arteries
What is “Arteriosclerosis”?
Arteriosclerosis is the build up of plaque inside arteries, and this can ultimately cause a tear in the tunica intima.
