NREMT Quizes I Flashcards

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1
Q

What are the layers of the heart (from outside to inside)

A
  • Epicardium (surrounded by pericardium)
  • Myocardium
  • Endocardium
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2
Q

What is the cardiac sulcus

A

Groove in heart separates atrium from ventricles

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3
Q

Where does all venous blood empty into before it dumps back into the R atrium?

A

The coronary sinus

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4
Q

Parasympathetic NS controls heart via the…

A

Vagus nerve

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5
Q

What does estrogen do?

A

Sex development

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6
Q

What are papillary muscles? Where are they and what do they do?

A

Located in heart, attach to chordae tendineae, which attach to the AV valves.

They contract during ventricular systole = prevent AV valves from back flowing into the atria

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7
Q

Ectopic pregnancies present with lower belly pain & referred pn to what area?

A

Trapezoids

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8
Q

Alveoli can resist collapse DT presence of what substance?

A

Surfactant

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9
Q

What is parenchyma?

A

The functional parts of a gland or solid organ

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10
Q

The narrowest part of laryngeal airway in kids is the….

A

Cricoid cartilage

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11
Q

PEA is a rhythm? True or false

A

False. It is a condition

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12
Q

What pea-shaped gland regulates calcium by releasing hormones to increase Ca++ blood levels?

A

Parathyroid gland

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13
Q

What anatomical feature marks the beginning of the hypopharynx?

A

The hyoid bone

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14
Q

What is the hypopharynx?

A

Aka larngopharnx = lowest part of pharynx

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15
Q

What is Murphy’s eye. What does it do?

A

Murphy’s eye = side hole at end of ET tube.

Enables airflow even if end of tube occluded

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16
Q

What’s kehr’s sign

A

Ab pn w/ referred pn to L shoulder = spleen rupture

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17
Q

Parietal vs visceral pericardium?

A

Parietal = outside, touches chest wall

Visceral = inside, touches heart (epicardium)

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18
Q

What’s a colles fracture

A

Fracture of forearm and wrist

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19
Q

What is it called when the odontoid process is fractured?

A

Hangman’s fracture.

Odontoid process (aka dens) = connects C1 & C2.

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20
Q

Atlas vs axis?

A

Atlas = C1

Axis = C2

think: you swivel on an axis

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21
Q

Pt complains cramping pn in calves when walking, but relieved w/ rest. What’s this called?

A

Claudication (DT ischemia from clot)

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22
Q

12 YOF CC flu SS x4-5days. Pt given ASA for her fever. Now in comatose. What happened?

A

Reye’s syndrome = brain swelling from giving ASA to pediatrics

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23
Q

Following a blunt force to the head, pt now reports seeing a curtain coming down over his vision. What’s wrong?

A

Retinal detachment

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24
Q

Pt reports having sudden painless loss of vision in one eye. What’s wrong

A

Central retinal artery occlusion

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25
Q

What does the hyoid bone do?

A

Anchors the tongue

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26
Q

Which resp disease causes distortion in alveolar surface area and decreases alveolar/capillary interface?

A

Emphysema

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27
Q

The terminal end & functional units of the lower airway are the…

A

Alveolar sacs

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28
Q

What do Alpha 1 sympathetic receptors do?

A

Vasoconstriction

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29
Q

What do Alpha 2 sympathetic receptors do?

A

Glucagon secretion, insulin/norepi INHIBITION

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30
Q

What do beta 1 sympathetic receptors do?

A

Heart receptors: HR, contractility, conduction

Renin

  • think Beta 1 (one heart), Beta 2 ( two lungs*
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31
Q

What do beta 2 sympathetic receptors do?

A

Bronchus/bronchiole relaxation

Insulin

Uterine relaxation

  • think Beta 1 (one heart), Beta 2 ( two lungs*
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32
Q

What do beta 3 sympathetic receptors do?

A

Shivering, goosebumps, heat conservation

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33
Q

Chronotropic vs inotropic vs dromotropic effects on the heart

A

Chronotropic = more HR

Inotropic = more contractility

Dromotropic = more conduction

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34
Q

Finish the sentence: the AV valves open to allow ventricular filling when the intra-atrial pressure…

A

Exceeds the intraventricular pressure

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35
Q

What does ACE stand for? What are they?

A

ACE= angiotensin-converting enzyme

Changes angiotensin I to angiotensin II in the lungs = peripheral artery constriction

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36
Q

What is propranolol?

A

Propranolol (inderal) = sympathetic beta blocker

Slows HR

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37
Q

Briefly explain brown sequard syndrome

A

Penetrating trauma or ischemia = hemisection of spinal cord = ipsilateral & contralateral neuro deficits below injury site

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38
Q

What are the neuro deficits involved with a brown-sequard injury?

A

Ipsilateral motor loss below injury

Contralateral pn sensation/temp sensation loss below injury

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39
Q

Bruit vs thrill

A

Both = narrowed artery from turbulent blood flow

You HEAR a bruit, FEEL a thrill

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40
Q

What’s a transmural infarct

A

MI involves full thickness of myocardium

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41
Q

What’s the main role of Epi in a cardiac arrest

A

To increase SVR (BP) & improve perfusion.

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42
Q

Football player struck on top of head. Became paralyzed below neck for several days before regaining normal motor sensory function. What happened?

A

Spinal shock (temporary paralysis following a spinal cord injury)

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43
Q

King coral diamond rattle snake. Which is the least harmful?

A

King snake = non venomous

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44
Q

Which type of snakes have neurotoxins in their venom?

A

Coral snakes

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45
Q

Pit viper vs coral snake venom

A

Pit viper = necrosis

Coral snake = neurotoxin SS

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46
Q

What snakes are part of the “Crotalinae” family

A

Pit viper

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47
Q

What type of snakes are in the “Elapidae” family

A

Coral snakes

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48
Q

What the different types of pit vipers?

A

Rattle, cottonmouths, diamondbacks

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49
Q

Besides neurotoxin effects, what is the other main danger of snake bites?

A

Infection

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50
Q

You have a CHF pt w/ pink frothy sputum. What is the frothiness caused by?

A

Plasma washes surfactant from alveoli

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51
Q

Which type of cholesterol is the bad kind? LDL or HDL

A

LDL

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52
Q

Which system doesn’t have ANY organs in the thorax?

A

The renal system

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53
Q

Which bone is located on the medial aspect of the forearm

A

Ulna

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54
Q

Hemothorax vs Pneumothorax SS

A

Both can have absent breath sounds.

But hemothorax = flat jugular veins w/ dull/hyporesonance

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55
Q

What effect does dopamine have at only 2 uq/kg/min?

A

Increase in vasoconstriction

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56
Q

We know epidermis = superficial skin layer.

But what structures found in dermis?

A

Nerve endings, Blood vessels, Sweat glands, hair follicles, Sebaceous glands

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57
Q

What are the functions of the skin?

A
Temp regulation
Immunity/protection
Sensation
Blood reservoir
Vitamin D synthesis
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58
Q

Burn shock = protein & fluids leave damaged blood vessels into surrounding tissue = ?

A

Reduced intravascular oncotic pressure

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59
Q

Pt burned after gas ignited= circumferential 2nd & 3rd degree burns to both arms, hands, face, chest and abdomen. What BSA?

A

40.5%

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60
Q

Adult has burns to anterior thorax & all R leg. What BSA?

A

27% (thorax = chest)

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61
Q

How do we recover fluids from interstitial space during microcirculation?

A

Circulating albumins (from liver) attracts Na back into the vessels = followed by fluids

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62
Q

Where in our bodies is the Torr pressure of Co2 the highest?

A

The venules

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63
Q

If pt has severe diarrhea x3 days, what will their pH be?

A

Below 7.35 (metabolic acidosis)

64
Q

Explain rouleaux. Why is it a big deal

A

When RBCs stack on one another DT clotting, infection, inflammation, diabetes….

Detrimental because prevents diffusion of O2 in capillaries (they can only accept singular flowing RBCs

65
Q

A person w/ a circumferential extremity burn is at risk for developing what other emergency later?

A

Compartment syndrome

66
Q

What’s one way to stop premature uterine contractions during child birth?

A

Fluid bolus.

ADH & oxytocin (stimulates contractions) secreted together. Stop the ADH (by adding fluids) = stop the contractions

67
Q

17 YOF hit in head w/ soft ball. Immediate LOC x5min, regains and CC severe headache N, dizziness. Enroute to hosp pt LOC again, now pn responsive w/ decorticate posturing. What’s wrong?

A

Epidural Hematoma

68
Q

With decompression sickness, nitrogen bubbles out of the blood. What gas law is this?

A

Henry’s law

69
Q

What is Henry’s law

A

Gas pressure in fluid directly related to same gas partial pressure above the fluid

70
Q

What’s boyles law?

A

Volume gas inverse to pressure

71
Q

What’s Dalton’s law?

A

All partial pressures totaled = 100%

72
Q

When your heat control center loses function DT high temperatures. Body cant expel heat. What’s wrong?

A

Heat stroke

73
Q

What is sensitization

A

When exposed to an allergen, the body forms antibodies

74
Q

What do H1 vs H2 receptors do?

A

H1 = Vasodilation, bronchoconstriction, more motility

H2 = gastric acid secretion, more mucus, vascular permeability

75
Q

What’s acromegaly

A

Too much HGH from pituitary gland

76
Q

What does the pineal gland do?

A

Secretes melatonin = sleep wake patterns

77
Q

What are normal PaCO2 levels?

A

35-45 mmHG (like ETCO2)

78
Q

What are normal PAO2 levels?

A

75-100mmHG

79
Q

How does hyperventilation affect blood calcium’s levels

A

Hyperventilation = rise in blood pH = Calcium in blood ionize s = acute hypocalcemia = carpal spasms & numbness

80
Q

What does Calcium do in the body?

A

Assists w/ electrical impulses & muscle contraction. Stabilizes the cell membrane during depolarization

81
Q

HYPOcalcemia SS

A

Increased neuro/cardiac excitation: cramps, spasms, seizures, dysrhythmias (long QT)

82
Q

HYPERcalcemia SS

A

Weak, nausea, constipation, polyuria

83
Q

Pineal gland is directly connected to which nerve?

A

Cranial nerve II (optic nerve)

84
Q

What’s the circadian cycle and what is it controlled by?

A

Circadian cycle = sleep cycle, regulated by pineal gland through melatonin secretion

85
Q

Where can you find cyanide? How does it affect the body?

A

Cyanide = cellular asphyxiant that prevents O2 perfusion

Found in pesticide, insecticide, flax seed, fires

86
Q

What does cyanide smell like? How do you treat it?

A

SS = almond/burning smell

Rx = amyl nitrite, sodium nitrite, sodium thiosulfate

87
Q

Adrenal medulla vs adrenal cortex hormones?

A

Medulla = middle (aldosterone, epi/norepi)

Cortex = covering (corticosteroids)

88
Q

What is carboxyhemoglobin? What Rx?

A

When CO binds with hemoglobin during CO poisoning

Rx = High flow O2 & hyperbaric chamber

89
Q

How does diabetes insipidus affect the endocrine system?

A

Not enough ADH from posterior pituitary gland, or bad kidneys

90
Q

Pt has electrolyte imbalance, dehydration, polyuria, polydipsia, with no urine glucose. What’s wrong?

A

Diabetes insipidus

91
Q

What is Paget’s disease?

A

Bone disorder w/ calcium issue

92
Q

What is HCO3 and normal blood levels?

A

HCO3 = bicarbonate

Normal levels = 22-26 mEq/L

93
Q

Where do T-cell lymphocytes mature?

A

The thymus

94
Q

SS of epididymitis?

A

Male version of PID = infection SS w/ inflammation

95
Q

What’s a classic tricyclic antidepressant name?

A

Amitriptyline

96
Q

What group of meds are tricyclic antidepressants? What OD Rx

A

Sodium channel blocker

Rx = sodium bicarb

97
Q

How can you tell if pt has tricyclic OD

A

Metabolic acidosis SS (hypo, flushed, dysrhythmia, CNS depression)

Dominant R wave in aVR & long QT

98
Q

Pt has persistent cough >3wks, night sweats, hemoptysis, low income SNF area. What’s wrong?

A

TB

99
Q

TB transmission & infection rate?

A

Airborne, not super contagious . use surgical mask

100
Q

Varicella zoster (chickenpox) transmission & infection rate?

A

Super contagious, airborne

101
Q

Measles (rubeola) transmission & infection rate?

A

Super contagious, airborne

102
Q

Rubella (German measles) vs rubeola (measles)

A

Rubella = droplet precaution

RubEOLa = airborne, way more contagious

103
Q

What’s a fancy way to say fever/?

A

Hyperpyrexia

104
Q

Explain “thermal gradient”

A

Your temp vs outside temp

105
Q

Why are infants susceptible to hypothermia?

A

Less mass, more BSA

106
Q

How do organophosphates work on the body?

A

Block acetylcholinesterase in synapse = constant impulse = paralysis

107
Q

How does hydrofluoric acid affect the body? What Rx?

A

Leaches cations from cells (10% BSA = lethal)

Rx = cations (calcium gluconate) & submerge limb in nice cold water

108
Q

What is Creutzfeldt Jakob disease?

A

Degenerative brain disorder DT protein malformation = spongiform encephalitis

Ex. Eating infected meat

109
Q

What is Lou Gehrig disease

A

Aka amyotrophic lateral sclerosis

Stephen hawking had this

110
Q

What is stokes Adam’s syndrome?

A

Sudden transient LOC DT major decrease in CO. Found in older ppl = transit 3rd degree heart blocks

111
Q

What is sick sinus syndrome

A

SA node malfunction = rapid change from tachy to brady

112
Q

Grey turner vs Cullens sign

A

Grey turner = flank bruise

Cullen = belly button bruising

think: turn to your FLANK

113
Q

What is biotransformation and where does it occur

A

Biotransformation = substances/meds turn into active or inactive metabolites

Occurs mostly in liver (some skin, kidney, GI, lungs)

114
Q

With radiation list the types of rays from weakest to strongest

A

Alpha, beta, then gamma radiation

115
Q

What protection for alpha radiation?

A

Easily stopped by skin

116
Q

What protection against beta radiation

A

Clothing

117
Q

What protection against gamma radiation

A

Several inches of lead or concrete

118
Q

What is Cassions disease?

A

Aka decompression sickness, aka the bends

119
Q

What happens to the body with both HAPE and HACE

A

Hypoxia = vasoconstriction = HTN = vessels leak (HAPE in lungs, HACE in brain)

120
Q

Rx for hace

A

Dexamethasone (corticosteroid for anti-inflammatory)

121
Q

What is osteogenesis imperfecta? What’s the significance

A

Born w/ weak bones. Possible reason for pedi Femur Rx, instead of child abuse

122
Q

What is Otitis media? Why can it be serious?

A

Otitis media = inner ear infection in kids. Associated with brain abscess

123
Q

Placenta abruptio vs previa. Which is painful/painless

A

Previa / painLESS

Abruptio = pain FULL

124
Q

What is spondylosis

A

Degenerative vertebral disk disease occurs with age

125
Q

What is it called by pt’s belly is flat/inwards? What does this indicate?

A

Scaphoid belly = diaphragmatic hernia

126
Q

What is spina bifida?

A

Born w/ spinal cord outside body DT lack of follic acid during gestation

127
Q

What are the stages of a seizure

A
  • LOC
  • Tonic phase (all rigid)
  • Hypertonic phase (rigid + arched back)
  • Clonic phase (twitching)
  • post seizure phase (eyes moving)
  • postictal phase
128
Q

What is Ludwig’s angina?

A

Molar/tooth infection = abscess under jaw = airway compromise

129
Q

When do the coronary veins empty?

When do the coronary arteries fill?

A

Veins empty during systole

Arteries fill during diastole

130
Q

What does the hyoid bone do?

A

Anchors the tongue

131
Q

What is phenol? How to remove it?

A

Phenol = tar junk from transformer

Requires alcohol to remove

132
Q

Pt has an uncontrollable tick, smacking lip, beer face… what’s wrong? Why is this serious

A

Tardive dyskinesia from OD on phenothiazines (antipsychotics). Can progress to dystonia & torsades

133
Q

What does digitalis do?

A

(Cardiac glycoside) Increases cardiac contractions & treats Afib, SVT. Has narrow therapeutic index = high toxicity risk

134
Q

SS & Rx for digitalis/digoxin OD

A

SS = NV, lethal hyperkalemia

Rx = Calcium chloride

135
Q

What are the stages of syphilis

A

Primary, secondary, latent, tertiary stages

136
Q

Pt has painless sores/chancres on body on genitals… what stage of syphilis are they in?

A

Primary phase

137
Q

Pt has a rash throughout body, & on palms of hands, soles of feet, w/ patchy hair loss, swollen lymph nodes, fever, weight loss, stiffness, and neuro ss. What stage of syphilis is this?

A

Secondary

138
Q

Pt w/ syphilis previously broke out in a rash that went away. What stage of syphilis is this? How long does this last?

A

Latent (hidden) stage. Lasts 1 -20 years

139
Q

Pt w/ syphilis has large sores in/outside body, heart and neuro complications. What stage is this?

A

Tertiary (late) stage

140
Q

What are intercalated discs and what do they do?

A

They connect cardiomyocytes together and speed conduction signals

141
Q

What is an Ostia?

A

Entrance to coronary arteries found in aorta

142
Q

When does pre-eclampsia become eclampsia

A

When seizures begin

143
Q

Besides tissue necrosis, what is a big risk associated with brown recluse spider bites

A

MRSA infection risk

144
Q

What is the medical fancy name for croup?

A

Laryngotracheobronchitis

145
Q

What separates bronchiolitis vs asthma?

A

Both = wheezing

Bronchiolitis = <1-2yrs DT RSV virus

Asthma = >1-2yrs

146
Q

What is a major complication of a massive PE?

A

R sided heart failure

147
Q

What is normal QT interval duration?

A

0.30-0.45s

148
Q

Neurogenic shock SS

A

Hypotension w/ Bradycardia, hypothermia

149
Q

In WPW, what classic ECG marking would you see?

A

Delta waves (ramp between p wave & QRS)

150
Q

In hypothermia what ECG signs would you see

A

Long QT w/ Osborn/J waves (hump following QRS)

151
Q

With hyperkalemia, what ECG signs would you see?

A

Tall peaked T waves w/ Long QT interval

152
Q

With ICP what ECG signs would you see?

A

Deep, symmetric, inverted T waves (aka cerebral T waves)

153
Q

What ECG changes would you see in a PE?

A

new RBBB, Rightward shift of QRS axis, ST elevation in V1 & aVR

154
Q

What is Von Willebrand disease

A

No willebrand factor = platelets can’t sick = no clotting

155
Q

What is Marfrans syndrome

A

Connective tissue issue in tall lanky people = aneurysm risk

156
Q

What is bainbridge reflex

A

AKA atrial reflex, when HR increases DT rise in atrial pressure (during inspiration)