NREMT Quizes II Flashcards
1
Q
What is Dahl’s sign?
A
Discoloration/thickening of elbows & skin above knees DT chronic tripod position (COPD)
*think: strippers on their KNEES for DAHLers
2
Q
What’s the Leopold maneuver?
A
Palpate belly to understand imminent birth
3
Q
What’s pulmonary shunting?
A
Lung cycles non oxygenated blood around bad alveoli to good ones to pick up O2
4
Q
What’s McMurray’s sign?
A
Systematically rotate knee to locate where a meniscus/cartilage tears are at
5
Q
What is joffroy’s sign. What disease does it indicate
A
Forehead skin cant wrinkle DT underlying edema (grave’s disease)
6
Q
What’s it called when a hyperthyroid pt has bulging eyes?
A
exophthalmos
7
Q
What’s whipples triad?
A
SS indicate hypoglycemia DT insulin a (tumor on pancreas makes excess insulin)
- low BGL <55
- hypoglycemia SS
- resolution of SS following administration glucose
8
Q
What’s waddell’s triad
A
Injury pattern in kids hit by car: broken femur, abdominal/ chest injuries
*think: kids WADDLE like ducklings across the street (cars)
9
Q
What is tic delaru?
A
Aka trigeminal neuralgia = facial nerve disease = severe stabbing face pain
10
Q
Pt complains of sharp stabbing pn on one side of the face that occurs in episodes lasting weeks to months. What’s wrong?
A
Tic Delaru (trigeminal neuralgia)
11
Q
What is the corpus luteum and what hormones does it make?
A
Ovarian follicle that pops out an ovary. Continues to produce progesterone to support pregnancy
12
Q
Antidote for a beta blocker OD?
A
Glucagon 1-15mg infusion per hour.
13
Q
How does glucagon reverse effects of a beta blocker OD?
A
It has inotropic & chronotropic effects that bypass Beta 1 receptors
14
Q
Where on the cardiac conduction system does an impulse have the greatest velocity?
A
Purkinje fibers (fastest at the end)
15
Q
A person with chronic HTN is at risk for developing what type of stroke?
A
Hemorrhagic
16
Q
Pt has the “worst headache” of their life. What type of stroke is this?
A
Hemorrhagic
17
Q
Pt has a thunderclap headache. What type of stroke is this?
A
Subarachnoid hemorrhage
18
Q
Any middle aged person who wakes up w/ a seizure (new onset), what is the likely issue?
A
A brain tumor
19
Q
What is the dopamine dosage for cardiac vs vasoconstrictive?
A
Cardiac = 5-10mcg/kg/min
Vasoconstrictive = 10-20 mcg/kg/min
20
Q
What is the antidote for a cocaine OD?
A
Benzodiazepines
21
Q
What is hepatojugular reflux and what does it mean?
A
JVD when you press on the liver = heart failure (R side) or heart issue (pericarditis, tamponade)
22
Q
What is portal hypertension and what is it caused by? What will it eventually cause
A
HTN of vessels connecting liver to GI DT chronic alcoholism or Hep C. Will eventually cause esophageal varices
23
Q
What is anosmia
A
Loss of sense of smell
24
Q
What is Barrett’s esophagus?
A
Damage to lower esophagus DT GERD (chronic exposure to stomach acid). Can lead to cancer
25
Pt has AMS, resp depression, burning in throat, & hypoxia following a house fire. What’s wrong?
Cyanide poisoning
26
Trace the arteries from the heart going downwards (ex. Aorta to…)
Aorta to L & R common iliac artery bifurcates to External iliac and femoral artery. Femoral artery turns into popliteal artery (knee).
27
What vertebrae controls the diaphragm?
C3-C5
28
Which vertebra is at the nipple line?
T4
29
Which vertebra is at the umbilicus
T10
30
What skin condition is connected with AIDS?
Kaposi sarcoma
31
What are the layers of a blood vessel from inner to outermost? Which layer constricts?
Tunica intima, tunica media, tunica Adventitia
Tunica media has the smooth muscle to constrict
32
What is glycogen and where is it stored?
Glycogen = larger units of glucose. Stored in muscles and liver
33
What is MAT
Multifocal atrial tachycardia = faster version of WAP >100bpm. Common in pts w/ terminal pulmonary diseases (ex. End stage emphysema)
34
What is a “pyrogenic reaction”
Pt gets a fever w/ chills DT an infusion of contaminated solution (ex. Dialysis pts getting infused w/ contaminated water)
35
___ = to continuously measure and adjust a drug dosage vs physiological effect
Titrate
36
Tendons vs Ligaments
Tendons = muscle to bone
Ligaments = bone/cartilage to bone/cartilage
37
Where are the “atlas & axis” in the body?
Atlas = C1
Axis = C2
38
What is the dens?
Projection from C2 that goes up into C1, allowing the head to swivel. AKA odontoid process
39
Child has poor feeding, nuchal rigidity, fever, w/ rash & inconsolable cry. What’s wrong?
Meningitis
40
What is “subluxation”
An incomplete dislocation
41
What is a comminuted fracture
Bone broken in two or more places
42
What chemoreceptors are located in the medulla? What do they do?
Regulate CO2 & pH levels of CSF
43
How many units of crystalloids make up for 1 unit of blood loss?
3 L fluids = 1 L of blood
44
How do alkaline and acidic burns differ
Acidic burns don’t burn as deep DT the eschars (dead scabbing tissue)
45
What organelle in a cell makes the energy?
Mitochondria
46
The cell membrane is also known as the _____
Phospholipid bilayer
47
What is the brain of the cell called?
The nucleolus (stores DNA)
48
Cilia vs flagella
Cilia moves shit across cell
Flagella moves the CELL
49
What is a cellular lysosome?
It’s the organelle in cell that cleans bad parts & destroys invaders
50
What’s the dosage of mag sulfate for Eclampsia?
4-5g IV followed by 1-2g/hr
51
Pt has cyanotic head, upper extremeties & upper torso following massive compression to chest. What’s wrong?
Traumatic Asphyxia
52
What’s pulsus paradoxus?
SBP falls > 10 mm HG w/ inspiration DT AMI, cardiogenic shock, cardiac tamponade, constrictive pericarditis.
53
Pt has SS anxiety, impending doom, extremity weakness, AMS & shock SS. He has unequal BP readings in both arms. What’s wrong?
Thoracic dissecting aneurysm
54
Pt has JVD, narrowing pulse pressure, tracheal deviation, & unilateral hyperresonance on thorax. What is wrong?
Tension pneumothorax
55
What dysrhythmia shows a Prolonged PRI with every QRS wave?
1st degree heart block
56
What dysrhythmia shows a constant PRI for every QRS with several intermittent dropped beats (P wave but no QRS)
2nd degree type II heart block (Mobitz II)
57
What dysrhythmia shows a Progressively increasing PRI before dropping a beat (P wave but now QRS)
Second degree Heart block type I
58
What SS of pericardial tamponade
Becks triad (Muffled heart tones, narrowing pulse pressure, JVD) WITH pulsus paradoxus
59
What’s the difference between vtach vs idioventricular rhythms
They look similar, except idioventricular rhythms are 20-40bpm. Vtach is >100 but usually 110-250bpm
60
What happens when a pt misses dialysis appointments
Hyperkalemia & muscle weakness w/ fluid retention
61
Peritoneal vs hemodialysis
Peritoneal = inject fluid into abdominal cavity and suck it out
Hemodialysis = blood filtered through machine and returned
62
Which has the most dangerous infection risk: laceration, avulsion, puncture, road rash
Puncture. It pushes anaerobic pathogens deep into the tissues
63
What blood loss % and mL is Class I, II, III, IV shock
```
I = <750ml (<15%)
II = 750-1500 (15-30%)
III = 1500 - 2000 (30-40%)
IV = >2000 (>40%)
```
64
Trauma pt has HR 110. What class of shock is he in?
Class II (100-120 HR)
65
Trauma pt has HR 135
Class III (120+ HR)
66
Pt lost 500 mL blood w/ normal BP & slightly elevated HR. What class of shock is he in?
Class I = <750mL blood, normal HR & BP
67
At what class of shock (I, II, III , IV) does a pt’s cap refill start to get delayed?
Class II maybe, class III definitely
68
Pt has 18respirations following a trauma. What class of shock is she in?
Class I (14-20)
69
At what class of shock does a pt’s SBP drop (decompensated)
Class III
70
What class of shock does a pt become anxious AND confused? What about lethargic?
Class III = confused
Class IV = lethargic
71
Trauma pt has cool pink skin. What class of shock are they in?
Class I
72
Trauma pt has cool moist skin. What class of shock are they in?
Class II
73
Trauma pt has cold pale moist skin. What class of shock are they in?
Class III
74
Trauma pt has 20-24 resp, what class of shock are they in?
Class II
75
At what class of shock do a pt’s respirations become extremely rapid?
Starting at class III
76
At what class of shock would you begin infusing blood along w/ the normal saline?
Blood starts at class III
77
At class of shock does pulse pressure start to narrow? When does it get very narrow?
Class II = narrow
Class IV = very narrow
78
What are the PHASES (not classes… i know stupid) of shock
Compensated, decompensated, irreversible
79
At what class of shock does urine output get diminished
Class III
80
What does your skin look like in decompensated shock
Ashen, mottled, cyanotic
81
Pt has cool moist clammy skin during compensated or decompensated shock
Compensated shock
82
Pt’s pulse is weak rapid and thready. Is this compensated or decompensated shock
Compensated shock
83
Pt has impending sense of doom. Is this compensated or decompensated shock
Compensated shock
84
What happens to your mental status when you progress from compensated to decompensated shock
Compensated = agitation, anxiety, restless
Decompensated = altered/lethargic
85
What’s Cushing’s triad/reflex
Bradycardia, ataxic respirations, HTN
86
How does Cheyenne stokes lead to hypoxia?
It causes a lack in minute volume
87
What percentage of blood loss minimum = narrowing pulse pressure
When 12-25% (25%)
88
Pt has lost about 500mL blood what class shock
Class I (<750)
89
Pt lost about 1200 mL blood. What class of shock is he in?
Class II (750-1500)
90
Pt lost 1500mL of blood. What class of shock is he in?
Class III
91
Pt has lost 2500mL of blood. What class of shock is he in?
Class IV (>2000mL)
92
What are the three layers of the meninges from outer most to inner most
Dura mater, arachnoid mater, pia mater
93
__ = Cell decreases in size
Atrophy
94
___ = reversible adaptation where one cell type replaced by another
Metaplasia
95
___ = cell increases in size
Hypertrophy
96
___ = cell changes size, shape, and organization
Dysplasia
97
___ = cell increases in NUMBER
Hyperplasia
98
Surfactant. Where does it come from, what does it do?
Surfactant made by Type II alveoli. Decreases surface tension to keep alveoli open
99
What is atelectasis
Collapse of alveoli
100
What causes a U wave on an ECG?
U wave comes after T wave = HYPOkalemia/calcaemia/magnesaemia/ thermia
LVH, ICP, phenothiazines, digoxin,
101
How phases in an action potential?
Five (0,1,2,3,4)
102
What happens during stage 0 of action potential?
Depolarization = Na influx w/ Ca
103
What happens during phase I of an action potential
Channels close and cells start to repolarize
104
What happens during phase 2 of an action potential
Plateau phase, Ca prolongs contraction
105
What happens during phase 3 of action potential
Final phase of repolarization
106
What happens during phase 4 of action potential
Resting phase
107
What constitutes as a low dose of dopamine? What does it do?
Low = 1-5 mcg/kg/min = increase urine output & renal perfusion
108
What constitutes a medium dose of dopamine? What does that do?
Medium = 5-15 mcg/kg/min IV = increase kidney perfusion & Beta 1 actions
109
What’s a high dose of dopamine? What does that do?
High = 20-50mcg/kg/min = vasocontriction & BP
110
What’s the Parkland Burn formula?
Total fluid requirement in first 24 hours of a burn
4ml x TBSA x weight (kg) = x
50% of X = first 8 hours
50% of X = next 16 hours
111
What drip set do you need for a dopamine infusion? How do you mix it for what concentration?
Always 60gtts set (60gtts = 1mL)
Mix 800mg in 500 mL NS = 1600 mcg/mL concentration
112
What’s the required concentration of dopamine? How do you calculate appropriate drip rate for pt?
Always use 1600mcg/mL
2 methods: clock method & Dale’s way
113
What is the drip rate formula?
X = (desired dose x drip set) / drug concentration
114
Using the drip rate formula, calculate drip rate for 10mcg/kg/min of dopamine in a 100kg pt
X = (10mcg x 100kg x 60 drop/mL) / 1600 mcg/mL
X = 60000/1600
X = 37.5 Gtt/min
115
What’s the bolus dose of lidocaine
1-1.5mg IVP
Repeat PRN at 0.5 - 0.75 mg/kg IV/IO over 5-10min until max of 3 mg
116
What is the IV infusion dose of lidocaine? What is the infusion concentration
1-4mg using a 60 gtts set
Concentration = 4mg/mL
117
What’s the infusion concentration of lidocaine? How do you mix lidocaine to get that concentration?
Concentration = 4mg/1mL
Mix 2g in 500mL NS = 4mg per mL
118
What is lidocaine used for?
Antiarrhythmic used as alternative to Amiodarone for VF/pulseless VT
119
Your medical kit only has 1000 mL bag of NS & you need to mix lidocaine. How much to inject to get 4mg/mL concentration?
2g in 500 ml, so 4g in 1000mL
120
What’s the lidocaine clock formula?
1mg = 15drops/min
2mg = 30 drops/min
3mg = 45 drops/min
4mg= 60drops/min
121
What is inderal
Aka propranolol = beta blocker
122
Antidote to mag sulfate
Calcium gluconate
123
Antidote to beta blocker OD
Glucagon
124
Medicine for HACE
Dexamethasone (steroid for inflammation)
125
Hyper vs hypotonic solution
Hypertonic = thicker/more concentrated than other fluid
Hypotonic = thinner, less concentrated than other fluid
126
Colloid vs Crystalloid solutions
Colloid = has molecules (proteins) too big to pass through capillaries. They stay in the blood vessels. Good for reducing edema
Crystalloid = dissolved crystals (ex. Salt) in water. Can cross cell membranes
127
Osmolarity vs osmolality
Osmolarity = number particles of solute per liter of solution
Osmolality = number particles of solute per kilogram of solvent
128
What’s the main intracellular and extracellular cation?
Main Intracellular = K (potassium)
Main extracellular = Na (sodium)
129
What are ascites?
Fluid build up in belly DT liver cirrhosis. Pressure of portal veins so high, they seep out
130
A virus is an ___ ____ parasite
Obligate intracellular parasite
131
Define oliguria
Peeing <500 mL per day
132
Histamines are released by which cell?
Mast cells & basophils
133
Which antibody is associated with memory?
IgM, IgD, IgE, IgG
IgG
134
Which antibody is made first:
IgM, igD, IgE, IgG
IgM
135
Which heart arrhythmia is associated with 600bpm in the upper heart chambers?
A-Fib
136
External vs internal respiration?
External = alveoli & lungs (aka pulmonary respiration)
Internal = in capillaries of the tissues (aka cellular respiration)
137
What’s the fick’s principle?
Fick’s principle = all the reasons why someone is SOB
- Environment O2 % & torr
- Ventilation
- Pulmonary respiration
- Transport (heart, blood, vessels)
- Cellular respiration
138
How do organophosphates affect the body?
They disable acetylcholinerase = excess acetylcholine accumulate in synapse = parasympathetic over stimulation
139
Which is more positive: inside or outside cell during resting potential
Inside = less positive
140
Sprain vs strain
Sprain = injured ligament
Strain = injured muscle
141
What’s spondylosis?
Degenerative disk disorder of vertebra
142
Which spinal condition fucks with tidal volume?
Kyphosis
143
What is the most commonly fractured bone in the body?
The clavicle
144
Which vertebra is AKA the vertebral prominence?
C7
145
What’s the fancy medical word for strep throat?
Streptococcal pharyngitis
146
Which can be SVT: atrial tach, sinus tach, Junctional tach, or all?
All of them
147
Normal QT interval is what fraction of the previous R-R interval
1/3
148
What is zankers Diverticulum
Outpouching of connection between lower throat and upper esophagus = dysphagia
149
Pt has regurgitation, weight loss, bad breath, choking and states tasting a previously eaten meal. What’s wrong?
Zankers Diverticulum
150
What is the ligament of treitz located?
Attached to the small intestine
151
What organ initiates the fight or flight response
The autonomic NS
