UNIT II - EXAM 2 Flashcards
Which structure secretes glucagon?
A) alpha cells
B) beta cells
C) islets of langerhans
D) delta cells
alpha cells
When ___________ minutes have passed without either seeing lightning or hearing thunder, it is safe to resume activities and be outdoors
A) 10
B) 15
C) 20
D) 30
30
Type 2 diabetes is a condition whose onset and severity can be greatly decreased with which of the following?
A) surgery
B) medicine
C) exercise
D) genetic therapy
exercise
A person with low blood sugar will experience which of the following?
A) bradycardia
B) hypoventilation
C) arrhythmia
D) tachycardia
tachycardia
During the clinical presentation of rhabdomyolysis, the reddish-brown color of urine is caused by
A) urea
B) myoglucose
C) uric acid
D) myoglobinuria
myoglobinuria
Levels of creatine kinase greater than __________ U/L may indicate ER
A) 250
B) 500
C) 2,000
D) 5,000
5,000
Which of these therapies should be avoided after insulin use?
A) normtecs
B) hot packs
C) e-stim
D) massage
hot packs
When normal sodium levels in the blood lower to a level of 125-129 mEqL, the patients decrease in sodium is said to be
A) mild
B) moderate
C) severe
D) acute
moderate
The gold standard for treating someone with heatstroke is which of the following?
A) cold packs
B) cold towels
C) cold water immersion
D) cold fluids
cold water immersion
Cold illness mostly affects which of the following organ systems?
A) Respiratory System
B) Nervous System
C) Digestive System
D) Urinary System
Nervous System
TRUE/FALSE:
McBurney’s point is a palpation location for appendicitis
true
When a person is a part of the lightning channel as it makes contact with the earth, the strike is said ti be a
A) side flash
B) ground current
C) upward streamer
D) contact injury
upward streamer
Which of these organs is found in the retroperitoneum?
A) stomach
B) liver
C) spleen
D) small intestine
liver
A heart murmur will be heard the loudest over which section of the heart?
A) upper right
B) lower right
C) upper left
D) lower left
lower left
Death from Marfan syndrome can occur from a dissection of which major blood vessel?
A) aorta
B) pulmonary trunk
C) inferior vena cava
D) superior vena cava
aorta
Typical respiration rate in
Adults:
>65:
<80:
Adults: 12-20bpm
>65: 12-25
<80: 10-30
External rhabdomyolysis is characterized by the breakdown of which type of tissue?
A) adipose
B) muscular
C) lymphatic
D) neural
muscular
A blood pressure of 140 to 159/90 to 99 mmHg is considered
A) hypotension
B) prehypertension
C) mild hypertension
D) severe hypertension
mild hypertension
The respiration rate in a typical adult is ____________ breaths per minute.
A) 5-10
B) 12-20
C) 20-28
D) 30-36
12-20
Which of these is a cause of rhabdomyolysis?
A) accustomed workouts
B) hypothermia
C) embolism
D) excessive hydration
embolism
Which heart rate is greater than >100 bpm?
A) normal
B) extreme bradycardia
C) Sinus bradycardia
D) tachycardia
tachycardia
What type of respiratory sounds occur when air moves freely though the large passageways of the lungs and are heard over the anterior chest in the trachea and bronchi?
A) bronchio vascular sounds
B) bronchial sounds
C) alveolar sounds
D) vesicular sounds
bronchial sounds
A patient presents to his HCP with pink frothy sputum. This patient most likely has which of the following?
A) hypertrophic cardiomyopathy
B) acute myocardial infarction
C) myocarditis
D) marfan syndrome
acute myocardial infarction
A patient comes to the clinic complaining of appendix pain. In which quadrant will her pain be located?
A) upper right
B) upper left
C) lower right
D) lower left
lower right
Signs of heatstroke include
A) rectal temperature at 102°F
B) clammy skin
C) profuse sweating
D) headache
clammy skin
If hyponatremia is left untreated, it can lead to
A) renal failure
B) tachycardia
C) elevated blood pressure
D) extracellular shrinkage
renal failure
The Valsalva maneuver is used to detect which of the following heart conditions?
A) hypertrophic cardiomyopathy
B) acute myocardial infarction
C) myocarditis
D) marfan syndrome
hypertrophic cardiomyopathy
Athletes with hyperglycemia but normal ketonuria are allowed to participate as long as serum glucose is assessed every
A) 5 minutes
B) 10 minutes
C) 15 minutes
D) 20 minutes
15 minutes
In patients with rhabdomyolysis, acute renal failure may occur _____________ after initial muscle damage
A) 1-2 hours
B) 10-12 hours
C) 1-2 days
D) 10-12 days
1-2 days
Sickle cell trait is most prevalent among persons of African or ____________ descent
A) asian
B) South American
C) mediterranean
D) samoan
mediterranean
Hypoglycemia and Hyperglycemia which of these is a symptom of hypoglycemia?
A) polyuria
B) anxiety
C) hypotension
D) hypoventilation
anxiety
Which condition is a blockage in a vessel of the lungs commonly caused by a thrombus?
A) cardiac embolism
B) thoracic thrombosis
C) ischemic attack
D) pulmonary embolism
pulmonary embolism
A person who has Marfan syndrome will not display
A) joint hypermobility
B) ocular lens subluxation
C) flat feet
D) short stature
short stature
According to the AAST grading scale, a liver injury with a sub scapular hematoma of 10% to 50% in surface area is considered to be which grade?
A) I
B) II
C) III
D) IV
III
Which of the following is a characteristic of exertional collapse associated with sickle cell?
A) often with prodrome of muscle twinges
B) slumped to the ground with weak muscles
C) physically writing and yelling in pain
D) prolonged recovery with rest, rehydration
slumped to the ground with weak muscles
A patient with a suspected kidney injury will suffer from which of these symptoms?
A) tachycardia
B) nausea
C) hypertension
D) hematuria
hematuria
(blood in urine)
What is the name of the condition that has blood in the pleural cavity?
A) pneumothorax
B) hemothorax
C) hemopneumpthorax
D) sanguothorax
hemothorax
What type of IV is needed to treat heat illnesses and hypovolemia?
A) dextrose
B) Lactated Ringer’s (LR) solution
C) saline
D) amino acid
saline
(Clot) final product of blood coagulation in hemostasis healthy response to injury to prevent bleeding
Thrombus
low level of carbon dioxide in the blood
Hypocardia
<60 bpm
bradycardia
<50 bpm
extreme bradycardia
heard both ant/post toward midline of thorax, medium sized air passages (echo)
bronchiovescular
lower pitched; ant/post away from midline; all other areas of lungs (esp. bronchioles) (deep/full sound)
vesicular
SpO2: 95%-100%
Flow Rate: none
Oxygen Device: none
Normal
SpO2: 91%-94%
Flow Rate: 1-6 L/min
Oxygen Device: nasal cannula
Mild Hypoxia
SpO2: 88% - 92%
Flow Rate: 6-10 L/min
Oxygen Device: simple oxygen mask
Mild-moderate Hypoxia
SpO2: 86%-90%
Flow Rate: 10-15 L/min
Oxygen Device: non-rebreather mask or bag-valve mask
Moderate Hypoxia
SpO2: <85%
Flow Rate: 15 L/min or higher
Oxygen Device: non-rebreather mask or bag-valve mask
Severe Hypoxia
Indications:
unresponsive
altered mental status
intact gag reflex
oral trauma preventing OPA
Contraindications:
intolerance
facial fx
nasal obstruction or epistaxis
caution with skull fx
Nasopharyngeal airway
Indications:
unresponsive
absent gag reflex (if they start to gag can’t use)
Contraindications:
conscious
gag reflex
trauma to mandible and teeth
Oropharyngeal airway
Nose to throat -
Mouth to throat -
Nasopharyngeal airway
Oropharyngeal airway
Indications:
cardiac arrest
not breathing
severe anaphylaxis
LMA
MOI: blow to chest
S/S: dyspnea, gasping for breath, cyanosis, tracheal deviation, tachypnea, jugular vein distention, decreased breath sounds
Pneumo/Hemothorax
Venous thromboembolisms, blockage (thrombus), DVT, fatal 3rd COD-CV in US
S/S: dyspnea & chest pain, anxiety, shock, cyanosis, tachycardia, hemoptysis, hypotension, hypoxia
Risk Factors: hereditary blood disorders, birth control, hormone therapy, pregnancy, immobilization, trauma, long-term traveling
Pulmonary Embolism (PE)
Venous thromboembolisms, blockage (thrombus), DVT, fatal 3rd COD-CV in US
S/S: dyspnea & chest pain, anxiety, shock, cyanosis, tachycardia, hemoptysis, hypotension, hypoxia
Risk Factors: hereditary blood disorders, birth control, hormone therapy, pregnancy, immobilization, trauma, long-term traveling
Pulmonary Embolism (PE)
60-100 bpm
normal heart rate (sinus rhythm)
rapid heart rhythm; potentially life threatening
ventricular tachycardia (V-tach or VF)
uncoordinated contraction of ventricles and inability to pump blood effectively
Ventricular fibrillation (V-fib or VF)
No cardiac electrical activity, no myocardial contractions, and no cardiac output
Asystole (flatline)
air in plural cavity
pneumothorax
blood & air in pleural cavity
hemopneumothorax
nose bleed
epistaxis
turning blue
cyanosis
coughing up blood
hemoptysis
shortness of breath; difficulty or labored breathing
dyspnea
difficulty swallowing
dysphagia
oxygen-binding protein in muscle tissue that is only found in the blood stream after muscle injury (relevant to myogloburina)
Myoglobin
BP of <90/60 mmHg
hypotensive
BP of 120-139/180 mmHg
prehypertensive
BP of >180/110 mmHg or greater
Severe hypertension
Primary gland secreting the hormone insulin and glucagon
pancreases
- depression of RS
- opioid OD
- increase inter cranial pressure
- diabetic coma
- severse airway obstruction
- sleep apnea
causes of bradypnoea (slow RR <12 bpm)
- anxiety
- emotional distress
- p!
- fever
- asthma/COPD
- PE
- Pneumonia
- acute res distress syndrome
- anaphylaxis
- heart failure
- shock
- diabetic ketoacidosis
- neuromuscular disorder
- increased HR
causes of tachypnoea (fast RR >20 bpm)
life threatening electrolyte imbalance
complication of exertional rhabdomyolysis
hyperkalemia
muscle tissue breakdown, leading to muscle cell infiltration into the circulatory system
- electrolytes
- myoglobin
- potassium
- creatine kinase (CK)
- other muscle enzymes
Exertional Rhabdomyolysis
heart murmurs can be heard/found in the
mitral & tricuspid valve (mid-clavicular line, bw 7th/8th intercostal space)
When can aspirin be used to treat myocardial infarctions
- hemodynamically stable patients with cardiac symptoms or ACS
upper-right quadrant organs
liver
gallbladder
tail of pancreas
small intestine
transverse colon
ascending colon
upper-left quadrant
spleen
stomach
small intestine
transverse colon
descending colon
lower-right quadrant
appendix
distal right ureter
right ovary
right fallopian tube
small intestine
ascending colon
lower-left quadrant
distal left ureter
left ovary
left Fallopian tube
small intestine
descending colon
- characterized by the body inability to produce insulin
- not preventable
type 1 diabetes
- inability to use insulin effectively because of a combo of resistance to insulin + overall decreased production of insulin
- preventable
type 2 non-insuline-dependent diabetes mellitus
- mm swelling
- neuronal ischemia causing paresthesia or paralysis
- 30 to 50 mm Hg is an indication for fasciotomy
- complication of ER
acute compartment syndrome
often lethal disruption of heart rhythm resulting from a direct blow to the precordial region at a critical time during the cardiac cycle, causing cardiac arrest (dammer Hamlin)
commotio cordis
process of purifying blood by extra corporeal removal of waste products such as creatine and urea and free water from the blood when kidneys are not functioning properly or renal failure (dialysis)
hemodialysis
rupture or lysis of RBCs (erythrocytes) nd the release of their contents (cytoplasm) into surrounding fluid (plasma)
hemolysis
arterial concentration of carbon dioxide more than 50 mmHg typically caused by inadequate respiration
hypercapnia
left ventricle becomes thick resulting in the heart being less able to pump blood effectively. complications include heart failure, irregular heart beat, sudden cardiac death
hypertrophic cardiomyopathy
amount of sodium is diluted in the blood, usually caused by over hydration. can be life-threatening, not caused by heat; self imposed over hydration
causes: fluid loss due to vomiting or diarrhea, certains meds or conditions, chronic conditions
S/S: headache, malaise to systemic swelling, nausea, lethargy, dyspnea and delirium (reps what system is impacted)
hyponatremia
normal sodium levels
mild Na+ levels
moderate Na+ levels
severe Na+ levels
135-145 mEq/L
130-134 mEq/L
125-129 mEq/L
<124 mEq/L
inadequate blood supply to an organ or tissue (esp heart) causing shortage of oxygen and glucose needed for cellular metabolism
ischemia
inflammation developed in myocardium or middle muscular layer of heart wall. weakens heart and its electrical system; ability to pump declines
myocarditis
referred pain at the left shoulder from trauma to the spleen. pain in tip of shoulder due to pressence of blood or other irritants in peritoneal cavity when person is laying down and legs are elevated
kehr’s sign
occurs when the microcirculation is obstructed by sickled RBCs, resulting in an infarction, ischemia tissue injury and pain
vaso-occlusion
lodging of an embolus (blood clot or other blockage such as fat or gas in blood vessel) causing occlusion, infarction, and tissue death as a result of blocking the blood supply
embolism
Core temp: 98.6°-95°F (37°-35°C)
Derm: pale
Motor: impaired fine motor control
CNS: typically conscious, amnesia, lethargy
Shivering: vigorous
BP: normal
Respiration: normal
Cardio: normal
Ocular:
Other: polyuria, rhinorrhea
Mild Hypothermia
Core temp: 94°-90°F (37°-35°C)
Derm: cyanosis
Motor: impaired gross motor control
CNS: impaired mental function, loss of consciousness
Shivering: absent
BP: decreased/difficult to measure
Respiration: depressed
Cardio: depressed PR; cardiac arrhythmias
Ocular: dilated pupils
Other: slurred speech, muscle integrity
Moderate Hypothermia
Core temp: below 90°F (below 32°C)
Derm:
Motor:
CNS: usually comatose
Shivering: absent
BP: hypotension
Respiration: severely depressed, pulmonary edema
Cardio: bradycardia, spontaneous V-fib, cardiac arrest
Ocular:
Other: rigidity
Severe Hypothermia
Texture: dry, waxy, edema
Color: erythema, white, blue-gray patches
Palpation: cold, firm skin
Px Complaints: transient burning or tingling
Mild or Superficial Frostbite
Texture: hard, waxy, vesicles present
Color: white, black, purple
Palpation: immobile to palpation, poor circulation in area
Px Complaints: burning, throbbing, shooting pain
Other: progressive tissue necrosis, neurapraxia, hemorrhagic blistering (36-72hrs)
Deep Frostbite
