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CFD Paramedic Course > NREMT Quizes III > Flashcards

NREMT Quizes III Flashcards

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1
Q

Pt was rear ended and got whip lash. Now complaining of weak/numb upper extremities. What’s wrong?

A

Central cord syndrome DT hyper flexion of the neck

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2
Q

Pt has weak/numbness in lower extremities DT a tumor on the spinal cord. What’s wrong?

A

Anterior cord syndrome

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3
Q

Regarding the heart, what is backwards failure vs forwards failure?

A

Backwards = L ventricle cant pump blood out fast enough = BACK flow into lungs

Forwards failure = L vent can’t pump enough pump out to rest of body

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4
Q

If afterload increases, what will happen to stroke volume?

A

It decreases

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5
Q

CO = ___ x ____

A

CO = SV x HR

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6
Q

What are normal bicarbonate (HCO3) levels?

A

22-26

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7
Q

Differentiate between the following antibodies:

IgM
IgD
IgA
IgG

A

IgM = produced first (*M= Me first)

IgD = lowest quantity

IgA = saliva/tears

IgG = Greatest memory

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8
Q

Explain the “Atrial kick”

A

Atria pumps blood into ventricles after ventricles are already full = greater ventricular contraction

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9
Q

In what arryhthmia would you see PR depression?

A

Pericarditis

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10
Q

R wave progression is a sign of what? When would you see the transition?

A

good R wave progression = healthy septum

Transition @ V3

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11
Q

What is “Mittlesmirtz”

A

Mittleshmirtz = middle pain (pn during ovulation in the middle of a period)

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12
Q

The egg that popped out of the ovary first is called the…

A

Graffian follicle

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13
Q

What is the ductus arteriosus?

A

Fetal artery that connects the pulmonary artery & aorta (bypassess the lungs)

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14
Q

Pt w/ bowel obstruction typically has hypotension & bradycardia. Why?

A

Pressure pushes on vagus nerve = bradycardia

Fluid swelling & inflammation = hypotension DT 3rd spacing

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15
Q

2 major classic signs of an addisonian crisis?

A

Hypotension & hypoglycemia DT no adrenal hormones (epi/norepi)

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16
Q

Would a person w/ Cushing’s disease be hyper or hypotensive? Why?

A

Hypertensive. Cushing = excess corticosteroid/cortisol hormones which are OPPOSITE of epi/norepi. They will instead have fluid retention issues

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17
Q

What is TORCH? What does it mean?

A

Mnemonic shows all diseases that cross placenta barrier & can infect fetus in utero

Toxoplasmosis
Other (syphilis, chicken pox)
Rubella
Cytomegalovirus 
Herpes infections
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18
Q

What’s Hanson’s disease?

A

AKA Leprosy = slow growing bacterial infections on skin hands, nerves, eyes, nose

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19
Q

What’s cytomegalovirus?

A

Herpes virus spread via body secretions. Similar SS like mono

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20
Q

What’s tularemia?

A

Infects animals & people, attacks skin, eyes, lymph nodes, lungs

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21
Q

What is wellen’s syndrome

A

ECG w/ deep inverted or biphasic T waves in V2-3 = critical LAD narrowing. High risk impending widow maker

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22
Q

What is the circle of Willis? What arteries feed it?

A

Circle of Willis = blood supply in brain, supplied by…

  1. Internal carotids
  2. Basilar arteries
  3. Vertebral arteries
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23
Q

Define status Epilepticus

A

2+ consecutive seizures OR seizure >5min

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24
Q

Obese pt SOB when supine DT heavy stomach pressing on diaphragm. What is this called?

A

Pickwickian syndrome

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25
Q

Elderly pt w/ dysphagia after eat. Pt complains tasting the same food she ate yesterday still. What’s the issue?

A

Zankers diverticulum (pouch forms in esophagus & traps old food)

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26
Q

On a 12-lead ECG, which lead is the only lead w/ a normally inverted P wave

A

AvR

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27
Q

What’s a fancy medical name for “headache”?

A

Cephalalgia

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28
Q

Pt w/ migraine Hx w/ aura has increased risk of what…

A

Hemorrhagic stroke DT defect in vascular walls.

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29
Q

Pt (usually a kid) stops everything they’re doing and freezes/stares for a couple seconds into space. What’s wrong?

A

Absence (petite mal seizures)

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30
Q

Pt suddenly becomes rigid, and starts spasming before becoming postictal. What kind of seizure is this?

A

Tonic-clonic (grand mal seizure)

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31
Q

How are pseudoseizures different from normal seizures?

A

Cause is psychiatric not physiological. (Ex. Traumatic emotional stress or pain)

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32
Q

Pt has tremors initially in their L hand. Tremors then move to L arm… then L shoulder… then R shoulder… what’s wrong?

A

AKA “Jacksonian March”. A partial seizure that moves from one body part to another

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33
Q

What nerve controls the intercostal muscles?

A

The intercostal

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34
Q

What nerve controls the scapula & helps lifts the ribs?

A

The thoracic nerve

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35
Q

What nerve controls the diaphragm

A

The phrenic nerve

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36
Q

What’s the graffian follicle and what hormone does it secrete?

A

Graffian follicle = first egg pop out of ovarian follicle. Secretes estrogen

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37
Q

What is inderal? What’s it used for?

A

Inderal = brand name for propranolol (beta blocker).

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38
Q

What’s amitriptyline?

A

Amitriptyline - tricyclic antidepressant

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39
Q

What happens when pt overdoses on a tricyclic antidepressant? What Rx?

A

Anticholinergic SS (mad hatter, red beat, dry bone, hot hare)

Cardiac: stretches out all QRS, QT, PRI until torsades.

Rx = sodium bicarb

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40
Q

A deficiency in Magnesium can result in what arrhythmia?

A

Torsades

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41
Q

What structure suspends the duodenum & separates upper from lower GI?

A

Ligament of trietz

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42
Q

Pt has bilateral calf pain w/ bilateral purple discoloration mid calf downwards. What’s wrong?

A

Venous stasis

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43
Q

Following an animal bite, pt has itching, fever, headache, confusion, hallucinations and insomnia. What’s wrong?

A

Rabies

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44
Q

What is rabies

A

neuro virus that spreads via saliva of animals

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45
Q

What respiratory disease has excessive mucus plugs in bronchioles?

A

1 = chronic bronchitis

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46
Q

What is the smallest functional unit of the liver?

A

Hepatocytes

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47
Q

What is the smallest functional unit of the lungs

A

Alveoli

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48
Q

What is the smallest functional unit of the kidneys?

A

Nephrons

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49
Q

What is the smallest functional unit of the brain

A

Neurons

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50
Q

What is the smallest functional unit of the heart?

A

Cardio yet

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51
Q

Explain, physiologically, why pt’s have chest pain from angina?

A

The cardiocytes are in anaerobic metabolism

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52
Q

How does Afib affect a persons cardiac output?

A

Knocks it by 20-25% DT loss of atrial kick

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53
Q

Pt has JVD when they breathe in. What’s this called and what does it mean?

A

AKA Kussmauls sign = obstruction to R ventricle outflow = backwards pumping of blood

Ex. Pericarditis, Pericardial tamponade, R ventricular failure, COPD

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54
Q

What is Prinzmetals angina? What causes it?

A

CP DT coronary artery spasms DT defect in Calcium channels

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55
Q

R side failure = peripheral edema. What is a “national registry” way of calling “peripheral edema”

A

Venous congestion

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56
Q

The lymphatic system empties into the…

A

Subclavian vein

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57
Q

West Nile virus causes ____ and is spread by ____

A

Encephalitis, mosquitos

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58
Q

When benzodiazepines are metabolized.. they become…

A

Active metabolites

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59
Q

Besides a blood clot. What are 3 other things that can cause Claudication?

A

Spinal problem, atherosclerosis, Diabetes mellitus

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60
Q

Of the following, which doesn’t have JVD?

Cardiac tamponade, hemothorax, tension pneumo, L side failure?

A

Hemothorax

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61
Q

Coumadin is a blood thinner that disables the action of which?

Vitamin K
Vitamin D
Vitamin E
Vitamin B1

A

Vitamin K

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62
Q

Pt has circumferential burn to leg from mid femur down. They’re at risk for what emergency?

A

Hyperkalemia & kidney damage, compartment syndrome

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63
Q

What’s a hypochondriac?

A

Someone way too stressed about their health

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64
Q

What ligament attaches your femur to your pelvis

A

Ligamentum teres

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65
Q

In which of the following is the O2 Torr pressure the highest?

  • Atmosphere
  • venules
  • alveoli
  • arteries
A

Alveoli

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66
Q

When RBCs can’t fold and get clumped together DT acidosis, this is called…

A

Rouleaux

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67
Q

What does terbutaline do?

A

B2 agonist = bronchodilation for asthma, bronchitis & emphysema

Slows uterine contractions

68
Q

How fast can an epidural bleed become fatal

A

Usually < 1hr

69
Q

Pt has SOB & hemoptysis during a rapid ascent from a dive. What’s wrong?

A

POPs = pulmonary overpressurization syndrome.

The alveoli rupture = pneumo, embolism, arterial gas embolism

70
Q

People w/ kidney disease tend to have which condition:

  • hypokalemia
  • cephalic neuralgia
  • hypotension
  • HTN
A

HTN

71
Q

Pt has chronic, intermittent condition of intense burning/stabbing pain at upper neck, back of head, face or behind ears. What’s wrong?

A

Neuralgia. Can be occipital, trigeminal hypoglossal depending on what cranial nerve is affected.

72
Q

What’s neuro glycogen is

A

Shortage of glucose in the brain usually DT hypoglycemia

73
Q

Which nerve plexus is next to the aorta?

A

The brachial plexus

74
Q

Which of the following metabolic disorders has abdominal pain:

  • DKA
  • Acromegaly
  • Dwarfism
  • hypoglycemia
A

DKA

75
Q

What is the parkland burn formula?

A

(BSA x 4ml x pt weight in kg) = X amount of fluids

50% of x in first 8 hours

50% of x in remaining 16 hours

76
Q

Pt is exposed to an allergen and develops sensitization only in the bronchioles (IgE attaches to mast cells). Pt has another exposure to antigen w/ adverse respiratory reaction. What is this condition called?

A

Asthma. Same mechanism as anaphylaxis except only in the lungs

77
Q

What happens in the blood when you hyperventilate?

A

Ph rises >7.45 = Calcium falls off receptor sites and attaches to albumins = temporary hypocalcemia

78
Q

What are the contraindications to epi?

A

Closed or open angle glaucoma; they can go blind

79
Q

Which of the following drugs can cause an intracerebral bleed?

  • Heroin
  • Fentanyl
  • cocaine
  • tricyclic antidepressant
A

Cocaine

80
Q

What’s your main concern in a pt w/ HONK?

A

Osmotic diuresis. Give them fluids

81
Q

Where is cortisol made and what does it do?

A

Cortisol = anti stress hormone made in the adrenal cortex.

  • think: cortex/cortisol
82
Q

Pt has numbness/less sensation in saddle area (groin butt inner thigh) following a traumatic accident. What is this called, what does it mean?

A

Positive saddle anaesthesia sign = Cauda equina syndrome (injury to lumbar/sacral nerve roots)

83
Q

What toxic substance do ppl usually “huff”? What medical concerns & SS would you have for them?

A

Hydrocarbons = cleaning supplies, chemicals, paint thinners, oils…

Neuro & cardiopulmonary injuries (ex. Seizure, hallucinate, pulm edema, dysrhythmias)

84
Q

26 YOM complains low back pain w/ low fever, dysuria & feeling need to pee. What’s wrong?

A

Prostitis (inflamed prostate).

85
Q

Which of the following causes ring worm?

  • fungi
  • bacteria
  • virus
  • parasite
A

Fungi

86
Q

Which infectious disease = night sweats, productive cough x many weeks, emaciation

A

Tuberculosis

87
Q

What is hyperpyrexia?

A

Extreme fever. Temp > 106.7 F

88
Q

Thermolysis vs thermogenesis

A

Thermolysis = heat removal (ex sweating)

Thermogenesis = heat production (ex. Shivering)

89
Q

Cyanide vs CO effect on oxygen

A

CO binds to hemoglobin prevents O2 binding

Cyanide enters all CELLS and prevents utilization of O2

90
Q

Best Rx for a jelly fish sting?

A

Hot water

91
Q

Which of the following requires no intervention except airway?

Sucking chest, flail chest, hemothorax, tension pneumo

A

Hemothorax. You can’t do anything for it specifically except support ABCs

92
Q

What is “first pass metabolism” and where does it occur?

A

Percentage of a drug doesn’t reach systemic circulation DT absorption/breakdown in LIVER (mostly)

93
Q

Of the main spider bites, which requires surgical debridement? Which requires calcium gluconate?

A

Brown recluse = surgical debridement

Black widow = calcium gluconate

94
Q

Pharmacokinetics vs pharmacodynamics

A

Pharmacokinetics = what BODY does to drug

Pharmacodynamics = what DRUG does to body

95
Q

Pt has SOB what should you check first?

A

Lung sounds

96
Q

When assessing pt ventilatory status, what is the most important thing to look for?

A

Respiratory rate high or low?

97
Q

Trauma pt has snoring respirations. What do you do?

A

Jaw thrust

98
Q

Pt has increasing Respiratory rate despite O2 administration. What do you do?

A

Bag them

99
Q

Your asthma pt is in respiratory distress. What O2 Rx would you do?

A

NRB 12-15lpm

100
Q

What is the earliest key signs of hypoxia in a pt?

A

Anxiety

101
Q

How can you tell if a pt has improvement in ventilatory status following your Rx?

A

Decreased respiratory rate

102
Q

You place a SOB pt on a NRB and he keeps pulling it off. Complains that its smothering him. What do you do?

A

If he wont tolerate it, use NC 1-6lpm

103
Q

Following an OD, pt resp rate is 8 & shallow. What do you do?

A

Intubate

104
Q

Best way to verify correct ETT placement?

A

ETCO2

105
Q

Pt w/ SOB and possible allergic reaction. You elect to use Epi. What are some considerations against using it?

A

If pt has cardiac Hx, be extra careful. Call MCP

106
Q

Which intercostals to use needle decompression?

A

2,3 mid clavicular

4,5 axillary

107
Q

Pt has a heat inhalation injury. What do you do?

A

Intubation w/ one size smaller ET tube

108
Q

Respiratory therapists often use what type of device on COPD pts?

A

Venturi mask = 24-50/60% FIO2

109
Q

Pt has abnormal lung sounds localized to one lobe. What do you think?

A

Pneumonia

110
Q

Your pneumonia pt has high fever with SOB despite O2 Rx. What do you do?

A

Albuterol & fluids

111
Q

Your OD pt is breathing 4x/min. What’s your biggest concern? What Rx?

A

Respiratory acidosis = intubate and assist ventilation

112
Q

Alcoholic OD w/ vomiting but no gag reflex. What airway would you use?

A

A supraglottic (combi-tube)

113
Q

You have successfully resuscitated a near drowning pt. What lung sounds would you expect to hear?

A

Crackles and then diminished lung sounds the next day

114
Q

17 YOF w/ fluttering feeling in chest. You note delta waves on her ECG. What Rx?

A

Probable WPW. Cardiovert

115
Q

When is it particularly important to ask for family medical hx?

A

When there is cardiac involvement

116
Q

Why would you avoid ASA in pts w/ hx ulcers

A

ASA = NSAIDS = more acid production

117
Q

Mainstay Rx of R side heart failure

A

Fluids

118
Q

Which is more important in SAMPLE: medical Hx or events leading up to emergency?

A

Medical Hx

119
Q

Aside from maintaining ABCs, what’s the only other intervention (not assessment) you could do for thoracic aneurysm?

A

Pn mgmt

120
Q

What is the field vs definitive Rx for pericardial tamponade?

A

Field = Fluids

Definitive = pericardial centesis

121
Q

When is the only time you can remove an impaled object?

A

Obstructs airway, CPR, or is through the cheeks

122
Q

Pt has injury to vertebral prominence (C7) what type of breathing would they have?

A

Belly/diaphragmatic breathing

123
Q

When would you give pn meds during a fracture trauma?

A

Prior to manipulation in order to relieve pain

124
Q

Pt CC: hot grease burn. What Rx?

A

Dry sterile dressing + pain mgmt

125
Q

Pt has CHF w/ cervical spine fracture. What Rx during extrication/transport?

A

KED (idk why)

126
Q

Pt has closed head injury with cushings reflex. What pharmacological Rx?

A

Mannitol (has hypertonic properties)

127
Q

Rule of nines in a kid vs infant

A

Head: I = 18, C = 12

Legs: I = 13.5, C = 16.5

  • everything else is the same as adults
128
Q

If a pt sustains a spinal cord injury, what temp would you expect to find below the injury site?

A

Warm and dry

129
Q

Pt in neurogenic shock should get what vasopressor at what dose?

A

Dopamine 2-20mcg/kg/min

130
Q

Multiple pts in nursing home w. Sudden onset of ab pn and nausea. What do you think?

A

Food poisoning

131
Q

Terminal cancer pt unresponsive, HR 44, BP 60, pinpoint pupils. What’s wrong?

A

OD on pn meds

132
Q

In a grand mal seizure pt, what should you always check first?

A

Airway for vomit

133
Q

Main SS of pheochromocytoma

A

Tachycardia and HTN

134
Q

Rx of cocaine OD

A

Benzos and O2

135
Q

Unresponsive hypoglycemic diabetic, what meds to give?

A

100mg thiamine & 25g d50

136
Q

What does it mean “extra pyramidal”

A

Think dystonic

137
Q

What’s the dose of diazepam

A

0.1-0.2mg/kg

138
Q

Pts with kidney stones usually have what SS

A

Hematuria

139
Q

Anyone in cardiogenic shock gets what med?

A

Dopamine

140
Q

What minimum MAP for perfusion?

A

70

141
Q

If breathing Rx ineffective in asthma pt, what next?

A

Epi

142
Q

Best airway for seizure pt?

A

NPA

143
Q

What defining assessment helps decide whether to intubate or not?

A

SPO2

144
Q

Max dose of lidocaine?

A

3mg/kg

145
Q

Kid has projective vomiting and diarrhea w/ a palpable mass on abdomen. What’s wrong?

A

Bowel obstruction

146
Q

How to secure airway in LEfort Fx?

A

Surgical cric

147
Q

Neonate CPR ratio

A

3:1

148
Q

Besides electrolytes, what medication helps with hyperkalemia? How?

A

Albuterol. Drives K back into cells

149
Q

Earliest signs of shock in infant?

A

Tachypnea, tachycardia

150
Q

Pt w/ recent Hx traveling can get what type hepatitis?

A

Hep A = oral/fecal route from contaminated shit

151
Q

On the O2 dissociation curve, a shift to the R or L means what?

A

Acidotic = shift to R = O2 falls off hemoglobin more easily

L = opposite

152
Q

What’s central cord syndrome

A

Whiplash or degenerative disease = weakness in upper extremities

153
Q

What’s anterior cord syndrome?

A

DT tumor or mass = upper and lower extremity weakness

154
Q

How does anaphylaxis affect the CNS

A

Depression

155
Q

What is the purpose of lactated ringers?

A

Good for slowing down acidosis (i.e. traumas)

156
Q

Mydriasis vs miosis

A

Mydriasis = dilated (has the D)

Miosis = pinpoint

157
Q

At what age do VS become adult like?

A

12

158
Q

How many drops in a ML?

A

10!

159
Q

Ectopic beats vs escape beats

A

Ectopic - early

Escape = late (next pacemaker sets in)

160
Q

How to guess pediatric weights (in Kg)

A

(Age + 4) x2 = wt (in kg)

161
Q

What is the Krebs cycle

A

How we make energy in a cell

162
Q

All stages of grieving process

A

Deny, anger, depression, bargain, accept

163
Q

What’s wellen’s syndrome

A

V2 &V3 (LAD) = biphasic T wave or deeply inverted T wave = imminent MI

164
Q

Name all stages of a blast injury

A

Primary = pressure

Secondary = shrapnel

Tertiary = body thrown

Quarternary = burns & all other

165
Q

What is dale’s method to give dopamine

A

W/ 1600mcg/ml concentration..

If you want to give 5mcgs/min, drop last number in pts weight (lbs) & minus 2

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