Quiz 17 - Abdominal / GI / Gynecologic Flashcards
The conversion of glycogen to glucose occurs in the:
A. liver.
B. spleen.
C. blood.
D. pancreas.
A. liver.
You are caring for a middle-aged man with severe abdominal pain and dark, tarry stools. He is conscious but very restless. His blood pressure is 78/52 mm Hg, pulse rate is 130 beats/min and weak, and respirations are 24 breaths/min and shallow. Further assessment reveals that his skin is cool and clammy and his radial pulses are weakly present. You should:
A. administer high-flow oxygen, start a large-bore IV line, administer a 20-mL/kg normal saline bolus, and give 1 μg/kg of fentanyl for pain.
B. administer high-flow oxygen, start two large-bore IV lines, and administer 20- mL/kg normal saline boluses until his radial pulses strengthen.
C. apply a nasal cannula in case he vomits, start at least one large-bore IV line, and administer up to 3 liters of normal saline solution.
D. apply supplemental oxygen, establish vascular access, and give isotonic crystalloid boluses until his systolic BP is at least 110 mm Hg.
B. administer high-flow oxygen, start two large-bore IV lines, and administer 20- mL/kg normal saline boluses until his radial pulses strengthen.
You receive a call to a residence for a 60-year-old man who is bleeding from his dialysis shunt. When you arrive, the patient’s wife, who has been properly trained on the use of the dialysis machine, tells you that she panicked and called EMS. The dialysis cannula has loosened from the needle, which is still in the shunt.
Your initial action should be to:
A. immediately clamp off the cannula and apply direct pressure.
B. attempt to tighten the connection between the needle and cannula.
C. remove the dialysis needle from the shunt and apply direct pressure.
D. apply direct pressure over the shunt and carefully remove the needle.
B. attempt to tighten the connection between the needle and cannula.
Which of the following is NOT characteristic of the secondary stage of syphilis?
A. Mucous membrane lesions
B. Fever and swollen lymph glands
C. The presence of a skin rash
D. A single or multiple chancres
D. A single or multiple chancres
It is important for the paramedic to consult with medical control prior to administering analgesia to a patient with severe flank pain and suspected acute renal failure because:
A. patients with renal failure often require high doses of analgesia.
B. most patients who are given analgesia will experience hypotension.
C. renal failure may cause analgesics to accumulate to toxic levels.
D. analgesia will mask the patient’s pain and skew further examination.
C. renal failure may cause analgesics to accumulate to toxic levels.
The presentation of Mallory-Weiss syndrome is linked to _________ and is caused by _________.
A. eating spicy foods, erosion of the lining of the gastrointestinal tract
B. blunt trauma, rupture of hollow organs with resultant peritoneal inflammation
C. spastic coughing, rupture of esophageal veins due to portal hypertension
D. severe vomiting, a tear at the junction between the esophagus and stomach
D. severe vomiting, a tear at the junction between the esophagus and stomach
The MOST common cause of amenorrhea is:
A. stress.
B. exercise.
C. pregnancy.
D. anorexia nervosa.
C. pregnancy.
As the filtrate passes through the rest of the nephron, tubular reabsorption and tubular secretion convert it to:
A. water.
B. urine.
C. salt.
D. glucose.
B. urine.
A 38-year-old man presents with an acute onset of severe right upper quadrant abdominal pain, pain to his right shoulder, and nausea. He is conscious and alert, but is restless from the pain. His blood pressure is 150/86 mm Hg, pulse rate is 120 beats/min and strong, and respirations are 22 breaths/min and regular. In addition to administering supplemental oxygen, you should:
A. establish vascular access with a large-bore catheter, administer a 500-mL normal saline bolus, and avoid analgesics due to the potential for intra-abdominal bleeding.
B. encourage him to remain supine to relieve his pain, monitor his oxygen saturation level, and administer 10 to 20 mg of Nubain via the IM route.
C. start an IV with normal saline and set it to keep the vein open, place him in a position of comfort, and administer 4 mg of morphine and 12.5 mg of promethazine.
D. perform a comprehensive abdominal exam, start at least one large-bore IV line, infuse normal saline at 125 mL/hr, and consider giving him an antiemetic medication.
C. start an IV with normal saline and set it to keep the vein open, place him in a position of comfort, and administer 4 mg of morphine and 12.5 mg of promethazine.
Chronic use of nonsteroidal anti-inflammatory drugs would MOST likely result in:
A. esophageal varices.
B. acute gastroenteritis.
C. diverticulitis.
D. peptic ulcer disease.
D. peptic ulcer disease.
A ruptured ovarian cyst typically presents with:
A. a sudden onset of abdominal pain that can be related to the menstrual cycle.
B. chronic waxing and waning abdominal cramping between menstrual periods.
C. a sudden onset of upper abdominal pain and nausea without vomiting.
D. dull or aching epigastric pain that radiates to the shoulders or lower back.
A. a sudden onset of abdominal pain that can be related to the menstrual cycle.
In contrast to somatic pain, visceral pain:
A. is difficult to localize.
B. indicates peritonitis.
C. increases with movement.
D. is well localized.
A. is difficult to localize.
A 62-year-old man presents with an acute onset of bright red vomiting. According to his wife, he ingests excessive amounts of alcohol each day. As you are assessing the patient, you note that his level of consciousness has decreased markedly. His mouth is full of blood, and his skin is pale and moist. You should:
A. assist his ventilations for 2 to 3 minutes, insert a Combitube, suction his airway for up to 15 seconds, start two large-bore IV lines with normal saline, and administer a 1-L fluid bolus.
B. turn him on his side and suction his oropharynx, intubate his trachea if the oral bleeding continues, establish at least one large-bore IV with normal saline, and administer enough fluids to maintain adequate perfusion.
C. suction his mouth for up to 20 seconds, insert a nasopharyngeal airway, ventilate him at a rate of 20 breaths/min, consider endotracheal intubation, start a large-bore IV line, and run the IV wide open until signs of improvement are noted.
D. perform immediate tracheal intubation, insert a nasogastric tube, establish IV or IO access, and administer 10- to 20-mL/kg normal saline or lactated Ringer’s boluses to maintain a systolic blood pressure of at least 90 mm Hg.
B. turn him on his side and suction his oropharynx, intubate his trachea if the oral bleeding continues, establish at least one large-bore IV with normal saline, and administer enough fluids to maintain adequate perfusion.
There is evidence that a 21-year-old woman was given Rohypnol before being raped. She presents with alcohol on her breath, drowsiness, and memory loss. Her blood pressure is 98/68 mm Hg, pulse is 58 beats/min and weak, and respirations are decreased and shallow. You attempt to administer high-flow oxygen, but she resists. What should you do now?
A. Recognize that because the patient is of legal age, she can refuse EMS treatment.
B. Consider administering naloxone in case she was also given a narcotic drug.
C. Administer a sedative medication to facilitate her acceptance of the oxygen.
D. Start an IV line and administer 1 to 2 liters of an isotonic crystalloid solution.
B. Consider administering naloxone in case she was also given a narcotic drug.
Esophageal varices are a direct result of:
A. esophageal erosion.
B. portal hypertension.
C. alcohol consumption.
D. cirrhosis of the liver.
B. portal hypertension.
A 30-year-old woman complains of an “achy” pain to both lower abdominal quadrants, which she states is made worse by walking. She further tells you that she recently finished her menstrual period. She has a fever of 101.9°F. Her blood pressure is 122/62 mm Hg, pulse rate is 84 beats/min and strong, and respirations are 14 breaths/min and unlabored. After gathering the rest of her medical history, you should:
A. provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.
B. establish vascular access and give her a 250-mL normal saline bolus, consider analgesia for her pain, and transport.
C. visually inspect her vagina for bleeding or discharge, start an IV line and set it to keep the vein open, and transport.
D. advise her that she can probably go to the hospital via personal vehicle since she is not showing signs of shock.
A. provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.
You are dispatched to a residence for a 33-year-old woman with excruciating pain to the right lower quadrant of her abdomen. She is conscious and alert and tells you that she has been experiencing pain to the same area for the past few days. Her blood pressure is 110/66 mm Hg, pulse rate is 118 beats/min and strong, and respirations are 22 breaths/min with adequate depth. Her skin is warm and moist. The MOST appropriate treatment for this patient involves:
A. high-flow oxygen, two large-bore IV lines, a 20-mL/kg normal saline bolus, and rapid transport to an appropriate medical facility.
B. oxygen via nonrebreathing mask, an IV of isotonic crystalloid set to keep the vein open, morphine or fentanyl, and prompt transport.
C. supplemental oxygen via nasal cannula, 25 mg of Phenergan IM, an IV of normal saline set to keep the vein open, and prompt transport.
D. ventilation assistance with a bag-mask device, immediate transport, and establishment of vascular access en route to the closest hospital.
B. oxygen via nonrebreathing mask, an IV of isotonic crystalloid set to keep the vein open, morphine or fentanyl, and prompt transport.
If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods:
A. one of her ovaries is probably grossly enlarged.
B. you should suspect disseminated gonococcemia.
C. it is likely that she has an ectopic pregnancy.
D. she most likely has pelvic inflammatory disease.
D. she most likely has pelvic inflammatory disease.
Azotemia is defined as:
A. an accumulation of uric acid in the blood.
B. excess potassium excretion by the kidneys.
C. increased nitrogenous wastes in the blood.
D. electrolyte disturbances in the blood.
C. increased nitrogenous wastes in the blood.
The Candida albicans fungus is the causative agent in:
A. bacterial vaginosis.
B. gardnerella vaginitis.
C. vaginal yeast infections.
D. gonorrhea and chlamydia.
C. vaginal yeast infections.
