Paramedic State Test 2023 pt 3 Flashcards

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1
Q

What are the symptoms of pericardial tamponade?

A

Chest tenderness, dyspnea, JVD, clear lung sounds, tachycardia, and hypotension

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2
Q

What is Grey-Turners sign?

A

Brusing of the flanks

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3
Q

What can Grey-Turners sign indicate?

A

Retroperitoneal hemorrhage, ruptured ectopic pregnancy, and acute pancreatitis
Retroperitoneal hemorrhage most likely- based on patients’ gender, hx, and lack of blood in the urine.

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4
Q

What is common when a patient has CHF?

A

Pink, frothy sputum

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5
Q

65 y/o pt with COPD presents with sudden onset of right-sided chest pain and SOB after coughing vigorously.
Neck veins are flat, trachea is midline, lung sounds are absent on the right side, normal on the left.
Assessment reveals no fever or hemoptysis
Vitals signs are as follows—
BP: 132/78
Pulse: 110
RR: 30 and shallow
SPO2: 92%
What should your initial theory be?

A

Spontaneous pneumothorax

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6
Q

What is cullen’s sign?

A

Ecchymosis (bruising) around umbilicus

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7
Q

What can cullen’s sign indicate?

A

Bleeding in abdominal cavity

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8
Q

What is murphy’s sign?

A

Right upper quadrant pain

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9
Q

what can murphy’s sign indicate?

A

Cholecystitis

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10
Q

What is kehr’s sign?

A

Referred pain to shoulder

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11
Q

What can kehr’s sign indicate?

A

Ectopic pregnancy, spleen injury, blood under diaphragm

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12
Q

What is homan’s sign?

A

Pain in calf on dorsiflexing foot while leg is straight

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13
Q

What an homan’s sign indicate?

A

DVT

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14
Q

What is clubbed fingers caused by?

A

Chronic hypoxia

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15
Q

What is clubbed fingers suggestive of?

A

Pulmonary diseases such as COPD

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16
Q

What is visceral pain?

A

Damage or injury of internal organs that can be hard to localize

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17
Q

What is referred pain?

A

Pain that is felt in a location other where the pain originates

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18
Q

What is somatic pain?

A

Pain that originates from skeletal muscles, ligaments, joints, or peritoneal lining
Sharp localized throbbing pain and may increase upon inspiration

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19
Q

What is cellular respiration?

A

Cellular processes that convert energy from nutrients into adenosine triphosphate (ATP) and the release waste products

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20
Q

What is exhalation?

A

The passive part of breathing

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21
Q

What is external respiratory?

A

Oxygen exchange between the lungs and the circulatory system

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22
Q

What is hypoxia?

A

Oxygen deficiency

23
Q

What is inhalation?

A

The active part of breathing

24
Q

What is internal respiration?

A

Oxygen exchange between blood and cells of the body

25
Q

What is minute ventilation?

A

Volume of gas inhaled or exhaled per minute
RR x TV

26
Q

What is oxygenation?

A

Delivery of oxygen to blood

27
Q

What is ventilation?

A

The physical movement of moving air in and out of the lungs

28
Q

What makes up the upper airway?

A

Nose/mouth, nasopharynx, oropharynx, epiglottis, and larynx (above the vocal cords)

29
Q

What makes up the lower airway?

A

Larynx (below the vocal cords), trachea, left and right mainstem bronchi, bronchioles, alveoli

30
Q

What are the early signs/symptoms of hypoxia?

A

Restlessness, anxiousness, irritability, tachycardia, and tachypnea

31
Q

What are the late signs/symptoms of hypoxia?

A

Decreased level of consciousness, severe dyspnea, cyanosis, bradycardia

32
Q

What does a primarily respiratory problem present like?

A

Presents w/ PaCO less than 35mmhg (alkalosis) or greater than 45 mmHg (acidosis)

33
Q

What does a primarily metabolic problem present like?

A

Presents with HCO3 below mmHg (acidosis) or greater than 26 mmHg (alkalosis)

34
Q

When does a ventilation perfusion mismatch occur?

A

Occurs when the lungs receive oxygen, but not adequate blood flow or when the longs receive blood flow, but not adequate oxygen.
AKA pulmonary embolism

35
Q

What is the time suction cannot exceed for adults?

A

15 seconds

36
Q

What is the time suction cannot exceed for peds?

A

10 seconds

37
Q

What is the time suction cannot exceed for infants?

A

5 seconds

38
Q

When do you use an OPA?

A

Unresponsive patient with no gag reflex

39
Q

When do you use an NPA?

A

Patients with decreased level of consciousness but not unresponsive

40
Q

What is BLS for foreign body airway obstruction?

A

Conscious adults and children= Abdominal thrusts
Unconscious (all ages)= CHEST COMPRESSIONS
Conscious infants= Back blows and chest thrusts

41
Q

What is ALS for foreign body airway obstruction?

A

When BLS interventions are ineffective
Attempt to remove foreign body with laryngoscope and McGill forceps
Attempt ET insertion to try passing tube through obstruction or forcing it into right mainstem

42
Q

What are the advantages of ETT intubation?

A

Isolates the trachea, eliminates gastric distension from ventilation, no mask seal needed, improved suction ability, route for medication administration;
L: Lidocaine
E: Epinephrine
A: Atropine
N: Naloxone

43
Q

What are the disadvantages of ETT intubation?

A

Extensive training required
Direct visualization of vocal cords required
Many serious complications
Not been shown to increase survival rates

44
Q

When is a surgical cricothyrotomy indicated?

A

In acute life-threatening situations when use of less invasive airway techniques are ineffective

45
Q

What are the indications for RSI?

A

Respiratory failure
Inability to protect airway
Combative patient
Suspected TBI
Persistent hypoxia

46
Q

What are the contraindications for RSI?

A

Respiratory and cardiac arrest
Anticipated difficult airway (relative)
Short transport time (relative)
Neuromuscular disease (e.g. ALS, muscular dystrophy)

47
Q

What are the predictors of difficult advanced airway insertion?

A

Mouth does not fully open
Hypersecretion
Obesity
Pulmonary edema
Airway burns
Facial trauma

48
Q

What is class 1 on the Mallampati score?

A

Entire tonsil clear

49
Q

What is class 2 on the Mallampati score?

A

Upper half of tonsil visible

50
Q

What is class 3 on the Mallampati score?

A

Soft and hard palate visible

51
Q

What is class 4 on the Mallampati score?

A

Only hard palate visible

52
Q

What is the LEMONS mnemonic?

A

L: look externally
E: Evaluate 3-3-2 rule
M: Mallampati score
O: Obstruction
N: Neck mobility
S: Saturations

53
Q

What is the LEMONS mnemonic used for?

A

Difficult airway