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ACP Entrance Exam > RS Notes > Flashcards

RS Notes Flashcards

1
Q

What are the four types of brain bleeds?

A

Epidural bleed
Subdural bleed
Subarachnoid bleed
Intracerebral hemorrhage

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2
Q

Define Epidural hematoma.

A

Accumulation of blood between dura mater and the cranium.

Usually associated with a laceration or tear of the middle meningeal artery.

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3
Q

Define Subdural hematoma.

A

A collection of blood between the dura and the surface of the brain in the subdural space.

This injury usually results from bleeding of the veins in that bridge the subdural space.

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4
Q

Define subarchnoid hematoma.

A

A collection of blood in the subarachnoid space.

Bleeding into the cerebrospinal fluid.

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5
Q

50% of patients with BLANK hematoma have a transient loss of consciousness, followed by a lucid interval (6-18 hours) in which neurological status returns to normal.

A

Epidural hematoma.

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6
Q

Signs and symptoms of BLANK hematoma are similar to those of BLANK hematoma and include headache, nausea and vomiting, decreasing level of consciousness, coma, abnormal posturing, paralysis, and, in infants, bulging fontanelles.

These findings are maybe subtle because of the slow development of the hematoma location and chronic phases.

A

Subdural hematoma.`

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7
Q

Characteristics of BLANK hematoma

sudden and severe HA
dizziness
neck stiffness
unequal pupils
vomiting
seizures
LOC
A

subarachnoid hematoma

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8
Q

Define intracerebral hematoma

A

an accumulation of blood or fluid within the tissue of the brain. More than 5 mL

Common causes penetrating trauma, MVC, ICP as a result of compression

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9
Q

Define Virchow’s Triad.

A

As it is has come to be known today, the triad consists of stasis, vessel damage, and hypercoagulability, and is used to describe the etiology and assess the risk of thrombosis, especially of deep vein thrombosis (DVT.)

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10
Q

S+S of DVT

A 
pain
edema
warmth
erythmea or bluish discoloration
tenderness
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11
Q

Risk factors for DVT?

A 
Recent lower extremity trauma
recent surgery
advanced age
recent MI
inactivity
confinement to bed
CHF
Cancer
previous thrombosis
oral contraceptive therapy
sickle cell disease
obesity
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12
Q

What is Beck’s Triad?

A

3 D’s

Decreased heart sounds (muffled)
Distended Jugular Veins
Decreased BP

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13
Q

Rule of Nines

A

A method to estimate burn injury that divides the total body surface area into segments that are multiples of 9%.

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14
Q

Using the rule of nines what is the adult body (or child greater than 9 years old) percentage look like?

A 
Head 9
Upper chest 9
Abdomen 9
Upper Back 9
Lower back 9
L arm 9 
R arm 9
Groin 1
L thigh 9 around
L calf around 9
R thigh 9 around
R calf around 9
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15
Q

What does Nitroglycerin do?

A

Reduce preload.

NTG dilates arterioles and veins in the periphery (and coronary arteries in high doses). The resultant reduction in preload, and to a lesser extent in after load, decreases the workload of the heart and lowers myocardial oxygen demand. NTG is lipid soluble and is thought to enter the body from the GI tract through the lymphatics rather than the portal blood.

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16
Q

Contraindications for the use of Nitroglycerin?

A

Hypo tension

Erectile dysfunction drug use

Allergy

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17
Q

Define gestational hypertension

A

Hypertension that occurs during the latter stages of pregnancy (>20 weeks) without any other features of preeclampsia, and resolves during postpartum period’ recognized by BP greater than 140/90.

Thought to result from rejection of the pregnancy by the immune system and can be an early indication of preeclampsia.

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18
Q

Define preeclampsia

A

an abnormal disease disease of pregnancy characterized by the onset of acute hypertension associated with proteinuria after the twentieth week of gestation.

Can be mild or severe - diastolic BP >110 mmHg

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19
Q

Define eclampsia

A

a grave form of pregnancy-induced hypertension, characterized by convulsions, coma, proteinuria and edema.

Most common in patients with severe preeclampsia.

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20
Q

What are the three Blast Injury Phases

A

Primary - caused by heat of explosion and over pressure wave

Secondary - caused by blast projectiles

Tertiary - caused by personnel displacement and structural collapse.

Brady Volume 2 page 37

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21
Q

List the organs in the abdomen.

A 
Stomach
Gallbladder
Pancreas
Liver
Spleen
Large intestine
Small intestine
Colon
Bladder
R and L Kidney
Ovaries - females
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22
Q

Peritoneal Space definition

A

division of the abdomen cavity containing those organs or portions of organs covered by the peritoneum.

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23
Q

Retro-peritoneal Space definition

A

division of the abdomen cavity containing those organs posterior to the peritoneal lining.

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24
Q

Which is in the RUQ?

A 
Gallbladder - always under stomach***
R kidney
most of the liver
some small bowel
small portion of the pancreas
portion of the ascending and transverse colon
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25
Q

What is in the LUQ

A 
Stomach - Mnemonic eating with R hand guarding full stomach with L hand***
Spleen***
L kidney
most of the pancreas
portion of the liver
small bowel
transverse and descending colon
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26
Q

What is in the RLQ?

A 
Appendix***
portions of the urinary bladder
small bowel
ascending colon
rectum
female genitalia
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27
Q

What is in the LLQ?

A 
sigmoid colon
potions of the urinary bladder
small bowel
descending colon
rectum
female genitalia
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28
Q

What are the six rights of drug administration?

A 
Patient
Drug
Route
Time
Dose
Documentation
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29
Q

Signs of Diabetes?

A

polydipsia
polyphagia
polyuria

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30
Q

electric shock can cause?

A

internal damage
v-fib
cardiac irritability
smoldering clothes

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31
Q

What are the four pharmacokinetics are?

A

absorption
biotransformation
distribution
elimination

Mnemonic
A B (no C) D E
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32
Q

define pharmacokinetics

A

how drugs are moved in and out of the body

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33
Q

what is the primary function of nitro when treating angia?

A

reduced preload

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34
Q

what kind of shoulder dislocation presents with a patient in the “squared off” position

A

anterior dislocation

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35
Q

what is the most common age group to experience febrile seizure?

A

6 months - 6 years

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36
Q

what breathing pattern is associated with DKA?

A

kussmaul’s

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37
Q

frothy red blood at a wound site my suggest

A

open pneumothorax

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38
Q

subglottic thermal burns are most likely caused by

A

superheated steam

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39
Q

hyperresonance in the chest can be caused by?

A

pneumothorax or emphysema

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40
Q

anesthetics are which?

A

medications that induce loss of sensation to touch or pain

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41
Q

the buccal route is

A

between the cheek and the gums

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42
Q

patient has palms turned upwards. if the patient rotates palm facing downward this is called?

A

pronation?

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43
Q

unconsciousness followed by a lucid interval with deteriorating LOCK later is caused by?

A

concussion and epidural hematoma.

44
Q

a neck laceration can cause?

A

subcutaneous emphysema
air embolism
external/internal jugular or carotid laceration

45
Q

which vital sign would you expect with Cushing’s reflex?

A

increased blood pressure
decrease heart rate
irregular respirations

Mnemonic S + S opposite of shock
skull and crossbones picture

46
Q

unified command is?

A

a coordinated effort involving several jurisdiction. single command is a single individual responsible in single jurisdiction incident.

47
Q

expect ecg artifact with all except?

A

an enlarged heart

48
Q

which is not a cause of dysthymia?

A

hypertension

49
Q

which is not a common cause of tachycardia?

A

hypothermia

50
Q

what are the two branches of the Left coronary artery?

A

anterior descending and circumflex

51
Q

which of the following causes pulmonary edema?

A

left sided heart failure

52
Q

what are open ended questions?

A

questions that permit unguided spontaneous answers

53
Q

which of the following is subjective

A

patients chief complaint

54
Q

different field diagnosis is?

A

list of possible causes for your patients condition

55
Q

O2 may cause respiratory distress in which patient?

A

COPD

56
Q

car accident patient is experiencing a “tearing sensation” in the chest with pain radiating to the back. what is the most likely cause?

A

aortic aneurysm

57
Q

blunt trauma in a pediatric patient, because of flexibility suspect injury to?

A

spleen

58
Q

what are the lead placements for lead II?

A

+ left leg

- right arm

59
Q

what is considered passive during respiration?

A

expiration

60
Q

is the pressure in the thorax during expiration greater or less then the environment/.

A

greater

61
Q

urticaria is caused by?

A

vasodilation

62
Q

what is bioequivalence?

A

relative therapeutic effectiveness of chemically equivalent drugs.

63
Q

a child asthma attack without wheezing is

A

an ominous sign

64
Q

obese female patient complains of RUQ pain radiating to the shoulder after consuming greasy food. what could be the cause?

A

cholecystitis

65
Q

which occurs during hyperventilation?

A

CO2 levels lower as a result of increased RR

66
Q

what pH is considered alkalosis?

A

greater than 7.45

67
Q

symptoms of meningitis?

A

stiff neck
fever
lethargy
irritability

68
Q

when your partner complains of fever, chills, malaise, aches, and cough. what do you suspect?

A

influenza

69
Q

hypertonic solution moves water?

A

into the vascular space

70
Q

female patient, 36 weeks pregnant, presents with altered LOC and recent seizures. what is most likely?

A

eclampsia

71
Q

supine hypotensive syndrome in a pregnant patient is caused by?

A

gravid uterus compresses the inferior vena cava when the mother is supine

72
Q

hypotension can develop with severe anaphylaxis due to?

A

increased vascular permeability and vasodilation

73
Q

during cardiogenic shock, the body compensates by?

A

increase contractile force, increases preload, lowers vascular resistance

74
Q

alkalosis and hyperventilation may produce?

A

carpal and pedal spams (Cramping)

75
Q

what is tidal volume?

A

the average volume of gas inhaled or exhaled in one respiratory cycle, 500 ml

76
Q

where do internal respiration occur?

A

peripheral capillaries

77
Q

put the upper airway anatomy in order from superior to inferior?

A 
nares
nasopharynx
larynx
laryngopharynx
trachea
78
Q

bronchodilators are which of the following?

A

beta 2 selective

79
Q

what is beneficence?

A

doing good for the patient

80
Q

what is ethics?

A

determines how one should live

81
Q

what is ethical relativism?

A

each person decides how to behave and whatever decision the person makes is acceptable

82
Q

what does NOCP do?

A

serve as a reference point for provincial or territorial bodies seeking to facilitate the mobility of paramedics between provinces and territories. NOCP may become the blueprint for national exam. NOCP is key to defining a national space of practice. All the above

83
Q

what does primum non nocerre mean?

A

first do no harm

84
Q

what is required for a patient refusal?

A

a witness

85
Q

suspect cardiac tamponade when?

A

after a recent CPR

86
Q

which are causes of cardiogenic shock?

A 
tension pneumothorax
cardiac tamponade
pulmonary embolism
prosthetic valve malfunction
trauma
87
Q

PPV is good for an apneic stroke patient because?

A

hyperoxygenation will eliminate excessive CO2 levels

16-20 per min

88
Q

what are the properties of cardiac cells?

A 
excitability
automaticity
conductivity
contractility
elasticity
89
Q

which of the following will cause altered LOC and metabolic acidosis?

A

status epilepticus

90
Q

what is myoclonus?

A

temporary involuntary twitching of muscle

91
Q

what is fremitus?

A

a palpable vibration in the body may be caused by a partial airway obstruction

92
Q

what is pre eclampsia?

A

characterized by an increase in systolic BP by 30 mmHg and diastolic by 15 mmHg above baseline on at least two occasions within 6 hours, most common in the last 10 weeks gestation, during labor, or 48 hours postpartum.

93
Q

what does breathing through pursed lips do?

A

eases SOB by helping to splint the alveoli open during exhalation

94
Q

what are the three mechanisms that remove hydrogen from the blood?

A

bicarbonate buffer system, respiration, kidney fuction

95
Q

where is appendicitis pain initially felt?

A

periumbilical

96
Q

what are biot’s respirations?

A

repeated episodes of gasping followed by periods of apnea caused by increased intracranial pressure,

97
Q

what is skin tugor?

A

a tension in the skin

98
Q

what are the three layers of the heart from inner most to outer most layer?

A

endocardium
myocardium
epicardium

99
Q

which of the following is not an enteral route of med admin?

A

umbilical

100
Q

compartment syndrome is most commonly found where?

A

lower leg

101
Q

what does the P wave represent on an ECG?

A

atrial depolarization

102
Q

what is visceral pain?

A

dull, poorly localized pain that originates in the walls of hallow organs

103
Q

seizure patent represents with muscles tensing and prolonged muscle contractions. this period is known as?

A

tonic phase

104
Q

pediatric patient represents with flushed skin, crying warm to the touch, and barking cough. what is most likely?

A

croup

105
Q

an avulsion occurs when?

A

skin and tissue are pulled back

106
Q

how many vertebrae are in the thoracic section of the spine?

A

12

ACP Entrance Exam (17 decks)

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