AMLS Final Flashcards by Joseph Rivera

A 27-year-old male is agitated and talks continuously. His pupils are dilated. He admits to being awake for 36 hours straight. Vital signs are BP 188/98, P 140, R 30. What type of overdose should you suspect?

• Anticholinergic
• Bath salts
• Pesticide
• Heroin

Bath salts.

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An alert 49-year-old male complains of a headache. He has tremors in his hands and has been in the detoxification unit for 38 hours. He has a history of alcoholism. Vital signs are BP 168/96, P 104, R 22. What is he most at risk for?

• Seizure
• Hypoglycemia
• Myocardial infarction
• Stroke

Seizure.

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A patient complains of nausea and is passing black, tarry stools. What should you suspect?

• Lower Gl bleeding
• Upper GI bleeding
• Bowel obstruction
• Cholecystitis

Upper GI bleeding

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A 49-year-oid male presents in a tripod position with audible stridor and marked respiratory distress. His skin is flushed, and he complains of dysphagia. What should you suspect?

• Bronchitis
• Acute asthma
• Pneumonia
• Epiglottitis

Epiglottitis

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60-year-old female complains of indigestion and mild upper abdominal discomfort. What
should you do?

• Listen for heart sounds and determine whether pericardial fluid is present
• Don a mask, gown, and observe standard precautions in case of influenza
• Place a gastric tube and assess for Gl bleeding
• Acquire a 12-lead ECG and transport to a cardiac center

Acquire a 12 lead ECG and transport to a cardiac center

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A 45-year-old female reports a headache, vertigo, and leg cramps after exercising. Vital signs are BP 108/62, P 124, R 18, Temp 100.6°F (38.1°C), and SpO2 98%. What should you do?

• Place ice packs in the axilla
• Administer 25 g of D50
• Remove the patient’s clothes
• Provide oral fluid replacement

Provide oral fluid replacement

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An alert 22-year-old male complains of a “lump in his throat” and a hoarse voice after a failed
suicide attempt. He unsuccessfully attempted to hang himself with a bed sheet. Vital signs are BP 150/80, P 120, R 16, SpO2 88%, ETCO2 40 mmHg. What should you do?

• Assist his ventilations with a bag-mask device and immobilize him to a long backboard
• Administer midazolam and transport him to a psychiatric facility
• Administer oxygen and transport to a trauma center
• Administer a sedative and intubate, apply a cervical collar, and transport

Administer oxygen and transport to a trauma center

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Which of the following is a hallmark sign of tricyclic antidepressant toxicity?

• Dysrhythmias
• Rash
• Drooling
• Hyperventilation

Dysrhythmias.

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A 68-year-old femaie who has a history of COPD may rely on which of the following breathing mechanics?

• A decrease in lactic acid produced from aerobic metabolism
• A decrease in the oxygen level in the blood as the stimulus to breathe
• An increase in the carbon dioxide level in the blood as the stimulus to breathe
• An increase in the oxygen level in the blood as the stimulus to breathe

A decrease in oxygen level in blood as the stimulus to breathe

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A 45-year-old female is supine on the floor. Her pupils are pinpoint, and she has vomitus in and around her mouth. Vital signs are P 48, R 8 with gurgling. What should you do?

• Administer naloxone
• Assist ventilations with a bag-mask device
• Suction the airway
• Obtain a blood glucose level

Suction the airway.

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What is an age-reiated change that increases the risk of respiratory compromise?

• Increase of mucus production
• Decrease in lung compliance
• Increase in intrathoracic volume
• Decrease in dead space ventilation

Decrease in lung compliance.

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A 71-year-old female complains of shortness of breath. She has a productive cough that has
increased in severity over the last week. She speaks in 1- to 2-word broken sentences with
pursed lips. What should you suspect?

• Costochondritis
• COPD
• Pulmonary embolism
• Pleurisy

COPD.

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A 33-year-old female is threatening suicide because her partner left her. Which of the following would be an appropriate response?

• “Talking with me will be helpful. How long have you been having problems?“
• “What was your plan to kill yourself ?”
• “I understand your feelings. | would be suicidal too.“
• “I’m sure that there are many people in your life who want you to live.“

What was your plan to kill yourself?

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A 62-year-old female presents with severe nausea and blurred vision that began while watching TV. She describes the headache as the worst headache she has ever had in her life. Vital signs are BP 194/110, P 98, R 20. What should you suspect?

• Brain abscess
• Subarachnoid hemorrhage
• ischemic stroke
• Cluster headache

Subarachnoid hemorrhage.

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An 82-year-old female complains of foul-smelling diarrhea, abdominal cramping, and loss of appetite. She developed an infection following knee surgery 2 weeks ago. She is prescribed antibiotics. What should you suspect?

• Escherichia coli
• Clostridium difficile
• Methicillin-resistant Staphylococcus aureus
• Streptococcus pyogenes

Clostridium difficile.

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A 13-year-old male has been skateboarding in temperatures of 100 °F (37.7°C) and has been
drinking caffeinated soft drinks. He complains of palpitations. The cardiac monitor displays a
narrow-QRS tachycardia at a rate of 150 beats/minute. Vital signs are BP 108/62, R 24. What
should you do?

•Suggest that the father drive his son to the clinic because vital signs are within normal limits.
• Obtain a 12-lead ECG and, if rhythm unchanged, perform vagal maneuvers.
• Transport the patient by ambulance, monitor closely, and administer fluids en route.
• Perform vagal maneuvers and, if unsuccessful, administer adenosine.

Transport the patient by ambulance, monitor closely, and administer fluids enroute

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A 44-year-old female complains of a sudden onset of sharp pain in her right flank that radiates to her groin area. Intermittently the pain becomes very severe. She also reports nausea. Vital signs are BP 152/94, P 104, R 16, SpO2 98%. What is the most likely cause?

• Acute Hepatitis
• Kidney stones
• Diverticulitis
• Crohn’s disease

Kidney stones.

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A 30-year-old female complains of acute chest tightness, shortness of breath, and a
nonproductive cough. She states that this happens frequently and usually resolves after using her “inhaler.” What should you suspect?

• Pulmonary embolism
• Pneumonia
• Simple pneumothorax
• Asthma

Asthma

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What respiratory changes are common in obese patients?

• Increased minute ventilation
• Chronic tachypnea
• Increased tidal volume
• Decreased tidal volume

Decreased tidal volume

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A 41-year-old female has returned from missionary work in South Africa. She reports night sweats, chest discomfort, and a persistent cough for the past several weeks. What should you suspect?

• Respiratory Syncytial Virus
• Tuberculosis
• Cytomegalovirus
• Mononucleosis

Tuberculosis.

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What type of shock is caused by a cardiac tamponade?

• Hypovolemic
• Obstructive
• Cardiogenic
• Neurogenic

Obstructive

Metabolic acidosis is best described by which arterial blood gas results?

• pH elevated, Pco2 elevated, H2CO3 normal range
• pH decreased, Pco2 decreased, H2CO3 low
• pH decreased, Pco2 elevated, H2CO3 normal range
• pH elevated, Pco2 elevated, H2CO3 low

PH decreased, Pco2 decrease, H2CO3 low

An elderly patient has COPD. What clinical finding should concern you the most?

• Respiratory rate of 36/min
• ETCO2 of 50 mm Hg
• Coarse, scattered rhonchi
• SpO2 of 92%

Respiratory rate of 36/min.

A 52-year-old male is suffering from acute chest pain after physical exercises. He is pale, cool, and clammy. Vital signs are BP 88/40, P 110, R 22, SpO2 96%. What should you do?

Administer nitroglycerin
Apply high-flow oxygen
Acquire a 12-lead ECG
Request a cardiac stress test

Acquire a 12-lead ECG

A 26-year-old male has abdominal pain. He is able to pinpoint exactly where it hurts, experiences rebound tenderness on physical exam, and guards the affected area. Which type of pain should you suspect? * Visceral * Somatic * Radiating * Referred

Somatic.

A 15-year-old male complains of lower abdominal pain with nausea. He is in the fetal position and states, “It hurts to walk.” What should you suspect? • Acute pancreatitis • Appendicitis • Pleural effusion • Gi Bieed

Appendicitis

A 27-year-old male is breathing fast and deep. He works at a preschool and believes that the children plan to harm him. Which of the following statements is most helpful when treating this patient? • “Please calm yourself. Have you talked to your supervisor?” • “Concentrate on staying calm. This is all in your imagination. Children can’t hurt adults.” • “Your difficulty breathing is most important. What medications do you take?” • “I understand that you are concerned. Please tell me more about why you feel this way.”

“I understand that you are concerned. Please tell me more about why you feel this way.”

Continuous positive airway pressure would be most beneficial in treating which of the following patients? • A 22-year-old with severe asthma that is unresponsive to albuterol treatments • A 43-year-old with a decreased level of consciousness with respiratory difficulty • 38-year-old with carpopedal spasms with a respiratory rate of 40 • A 55-year-old with jugular vein distention and BP 90/60

A 22-year-old with severe asthma that is unresponsive to albuterol treatments.

It is 0600 hours and you are treating a 63-year-old female with slurred speech, facial droop, and altered mental status. At 0400 hours, her husband heard her go to the bathroom. At 2300 hours they went to bed and everything was “fine.” How should you report the last time she was known normal? • Unknown • 2300 hrs • 0600 hrs • 0400 hrs

2300 hrs.

A 22-year-old male has recently undergone a surgical procedure to repair an injury to thoracic vertebrae T1-T2. Assessment indicates the patient is alert and oriented, bradycardic, hypotensive, and has warm, dry skin. Which type of shock is most likely occurring? • Cardiogenic • Obstructive • Neurogenic • Hypovolemic

Neurogenic.

A 45-year-oid male complains of shortness of breath. He has a history of alcohol abuse and presents with severe ascites. Vital signs are BP 142/78, P 104, R 24 with crackles. What should you suspect? • Congestive heart failure • Liver failure • Gastroenteritis • Cholecystitis

Liver failure.

An 18-year-old male nearly drowned at a local lake after treading water for 25 minutes. He is shivering uncontrollably and complains of nausea and weakness. Vital signs are BP 122/62, R 28, P 136, and his temperature is 93.2°F (34°C). What should you suspect? * Acute pulmonary edema * Severe hypothermia * Water intoxication * Mild hypothermia

Mild hypothermia

What is the initial treatment for a patient experiencing hyperosmolar hyperglycemic state (HHS)? • Dextrose • Normal saline • Insulin • Thiamine

Normal saline.

What condition causes paroxysmal nocturnal dyspnea? • Left-sided heart failure • Pneumonia • Asthma • Multiple sclerosis

Left-sided heart failure.

A confused 67-year-old male has vomited multiple times prior to EMS arrival. He was involved in a car crash 48 hour prior. Bystanders state he became increasingly confused and lost coordination since the crash. Vitals signs are BP 150/88, P 72, R 18, BGL 92 mg/dL. What should you suspect? • Absence seizure • Epidural hematoma • Carotid dissection • Subdural hematoma

Subdural hematoma.

Anaphylaxis is most commonly associated with which physioiogical event? • vasodilation • Hemorrhage • Hypertension • Bradycardia

Vasodilation.

An anxious 61-year-old male complains of severe shortness of breath and localized chest pain with blood-tinged sputum. His dyspnea started when he stood up from watching television all day and increased in severity as he moved around. Vital signs are BP 104/60, P 98 and irregular, R 26 and labored. What should you suspect? * Pulmonary embolism * Congestive heart failure * Angina pectoris * Angioedema

Pulmonary embolism

A 72-year-oid femaie compiains of a sudden onset of a burning sensation to the left side of her forehead and blurred vision. She wants to follow up with her primary care physician tomorrow. Vital signs are BP 150/70, P 80, R 16. What should you do? • Explain that she should follow up with her physician later today. • Perform a complete neurological exam and contact her physician. • Obtain a refusal and allow her to follow up with her physician tomorrow. • Encourage her to be transported by ambulance to the hospital.

Encourage her to be transported by ambulance to the hospital.

A 21-year-old male complains of sharp chest pain and shortness of breath. The symptoms started when he lifted a heavy object. Vital signs are BP 152/96, P 108, R 24 and diminished on the left. What should you suspect? • Aortic dissection • Spontaneous pneumothorax • Pectoralis muscle tear • Pulmonary embolism

Spontaneous pneumothorax.

What finding is unique to pericarditis? * S3 gallop is auscultated * Diffuse ST segment elevation * Pulsus alternans is present * Pain is relieved when supine

Diffuse ST segment elevation

Which of the following statements is correct regarding radioactive material? • Neutrons are low energy particles and do not cause bodily harm • Simple clothing can stop beta particles from entering the body • Gamma rays are unable to penetrate bone and connective tissue • Alpha particles are harmless when ingested or inhaled

Simple clothing can stop beta particles from entering the body.

What reference is the MOST beneficial to obtain for a suspected stroke? • Last known well • Daily aspirin dose • Past medical history • Last oral intake

Last known well.

What statement is correct regarding responding to a suspected nerve agent exposure? • Nerve agents degrade immediately when exposed to sunlight • Parking downwind will ensure first responder safety • Patients should be treated in well-ventilated areas • Secondary contamination rarely occurs in nerve agent exposure

Patients should be treated in well-ventilated areas.

An anxious 32-year-old female compiains of chest pain with palpitations. She has a history of Graves’ disease. She reports she was seen in the ED earlier that day and had a CT scan of her abdomen with IV contrast. She is diaphoretic and has a temperature of 101.5°F (38.6°C). Vital signs are BP 100/62, P 156, R 30, BLG 133 mg/dL. What should you administer? • Calcium chloride • Normal saline • Amiodarone • Aspirin (ASA)

Normal saline.

An elderly COPD patient complains of difficulty in breathing upon exertion. She has a 1-week history of productive cough. She has pursed lip breathing. She is prescribed a bronchodilator as needed. Vital signs are BP 132/70, P 88, R 20 with rhonchi. What should you suspect? • Chronic bronchitis • Pulmonary embolism • Epigiottitis • Congestive heart failure

Chronic bronchitis.

The renin-angiotensin-aidosterone system is activated during shock in order to cause which of the following? • Decrease in preload, afterload, and reabsorption of sodium • Increase in preload, afterload, and reabsorption of sodium • Vasodilation and sodium retention • Hypotension and bradycardia

Increase in preload, afterload, and reabsorption of sodium.

20-year-old male compiains of severe pain after a jellyfish sting. He has a red, swollen ankle and foot. What should you do? * Splint the limb and administer an antipyretic * Apply an ice pack and administer an opioid * Apply a hot pack to the area and mark the affected area * Wash the area and administer an analgesic

Wash the area and administer an analgesic

20-year-old male college student complains of acute onset of fever, headache, vomiting, and malaise. He appears ill and has a petechial rash on his extremities. What should you suspect? • Meningitis • Encephalitis • Acute gastroenteritis • Influenza

Meningitis.

A quadriplegic male is experiencing difficulty breathing and restlessness. His skin is warm and his urine is dark yellow and cloudy. Vital signs are BP 86/68, P 128, R 24, temperature 101.2 °F (38°C). Which type of shock should you suspect? • Cardiogenic • Septic • Obstructive • Hypovolemic

Septic.

Which of the following may cause primary respiratory alkalosis? • Vomiting • Fever • Renal failure • Chest wall pain

Fever