Practice Exam Questions Flashcards
What are the features which relate to the generation, regulation, and detection of a pulse?
Structures involved: heart (specifically left ventricle [LV]), the aorta, arteries
Pathophysiology: during ventricular systole the LV contracts and ejects 50-100mls blood. The impulse of this blood through the aorta and then arteries causes a high pressure wave which can be detected as a pulse
Pulse regulation: speed = HR, strength could be affected by things like degree of vasodilation, stroke volume, etc. Pulse pressure is often used as a guide for fluid therapy rather than SV but studies have shown it isn’t directly related to SV.
Detection: can be felt best at locations where arteries approach the surface, i.e. carotid, brachial, femoral, pedal, ulnar, popliteal, posterior tibial
discuss the features and paramedic implications of normal labour and delivery
a) any pregnancy of 20 weeks or more is considered viable
b) the second stage of labour involves the complete expulsion of the baby
c) the purpose of clamping the cord is to force the baby to draw breath instead of relying on maternal oxygenated blood
d) once the amniotic sac has been ruptured it is important the baby be delivered promptly (within an hour)
answer: B
labour is divided into 3 stages
stage 1: dilation of the cervix and movement of the baby down the birth canal
stage 2: birth of the baby
stage 3: delivery of the placenta
Discuss the features of vascular anatomy
a) The venous system contains around 70% of total blood distribution of the cardiovascular system
b) Valves are a feature unique to only the coronary arteries and the veins located in the legs
c) Unlike arteries, veins contain no tunica media, making them unable to dilate or constrict
d) Capillary blood flow is constant and pulsations directly mimic each left ventricular contraction
Answer : A
Discuss the pathophysiology, clinical features, and the pre-hospital management principles of CVA’s
a) A patient’s stroke symptoms are influenced by the location and size of the insult
b) Prehospital management of a CVA should focus on lowering systolic blood pressure and rapidly transporting the patient to the closest hospital
c) During a haemorrhagic CVA there is a raised ICP unlike an ischaemic CVA where there is a decreased ICP
d) CVA signs and symptoms are very specific to the condition and seldom misinterpreted for other conditions
Answer: A
Each lobe or region of the brain has specific functions. When an insult occurs and reduces blood flow to a region, the cells and tissues there will not function appropritately. Therefore, the tasks that the affected region performs will not function properly. E.g. occipital lobe = vision
Discuss the pharmacodynamics, pharmacokinetcs and pre-hospital use of Midazolam
a) Midazolam blocks the excitatory neurotransmitter GABA from binding to GABAA receptors
b) Midazolam’s effect on postsynaptic chloride channels results in decreased neuronal excitability
c) Midazolam has a half life of between 24-48 hours so single dose administration is expected to have lasting effects
d) Midazolam directly causes a decrease in all excitatory neurotransmission
Answer: B
Midazolam works by increasing GABA receptors affintity for GABA binding. When opened, these receptors allow an influx of chloride, a negatively charged ion. This decreases the electrical charge of the cell, bringing its resting membrane potential further away from the threshold potential and therefore making it more difficult to fire
which of the following is the usual location of language centres in the brain?
a) right hemisphere
b) hypothalamus
c) left hemisphere
d) brainstem
Answer: C
