FINAL TEST REVIEW

Question 1

What is pulmonary edema and what does it do?

Answer 1

Have an excessive among of fluid in their lungs. This excessive fluid impairs oxygen diffusion into the pulmonary capillaries, leaving the patient hypoxic and severely short of breath.

Question 2

Pre-hospital treatment for pulmonary edema….And what are the contraindications for this treatment?

Answer 2

CPAP

unresponsive patient, unable to speak, unable to protect airway, hypoventilation, hypotension (sbp less than 90), closed head injury, facial trauma, tracheostomy, active bleeding gastro, nausea/vomiting, patient is unable to sit up. Patient does not tolerate mask).

Question 3

the bodies natural ability to clot.

Answer 3

Hemostasis

Question 4

Stablility in the bodies internal environment, process the balances the supply and demand of the bodies needs, works through negative feedback.

Answer 4

Homeostasis

Question 5

positive/ negative effects on hemostasis

Answer 5

Pre-existing conditions(hemophilia, Von Willebrand), liver disease, Aplastic Anemia, alcohol, drugs, diet

Question 6

positive/ negative effects on homeostasis

Answer 6

genetic predispositions, lifestyle choices, environmental conditions, and exposure to toxin

Question 7

Elicited by placing fingers under the right costal arch (below the rib cage, and asking the patient to take a deep breath. As the patient inhales the diaphragm pushes the liver and gallbladder downward. If the gallbladder is inflamed, the patient will experience pain and stop breathing as the inflamed gallbladder comes into contact with the examiner’s fingers. Sign of cholecystitis.

Answer 7

Murphy’s Sign

Question 8

medical finding where pain is referred to the left shoulder when a patient lies down with their legs elevated. Typically associated with a ruptured spleen.

Answer 8

Khers Sign

Question 9

foot reflex that’s normal in infants and children up to two years old. Its also known as the plantar reflex. Test occurs when the sole of the foot is firmly stroked. The big toe moves upward and the other toes fan out. In adults abnormal test findings can indicate a problem with the brain or spinal cord.

Answer 9

Bradinski Sign

Question 10

clinical finding that indicates meningeal irritation which is inflammation of the membranes covering the brain and spinal cord. The examiner passively flexes the patient’s neck while they are lying supine. Positive sign is present when the patient involuntarily flexes their hips and knees in response.

Answer 10

Brudzinski’s sign

Question 11

physical exam finding that indicates meningeal irritation, often caused by meningitis. The patient lies supine with their hips and knees flexed at 90 degrees. A positive sign is present if the patient experiences pain or resistance when the knee is extended beyond 135 degrees.

Answer 11

Kernig’s sign

Question 12

medical test that involves dropping from the toes to the heels to check for appendicitis. Have the patient stand on their toes and straight knees. The clinician stands on their toes for a few seconds. The clinician suddenly drops down onto their heels. If the patient experiences abdominal pain where they land on their heels, the markle sign is positive. Indicates inflammation near the appendix.

Answer 12

Markle Sign

Question 13

bluish-purple discoloration of the skin around the umbilicus (navel) that indicates intraperitoneal hemorrhage (bleeding within the abdominal cavity.). Sign of acute pancreatitis, ruptured ectopic pregnancy.

Answer 13

Cullen sign

Question 14

The presence of bruising on the flanks which is usually a sign of internal bleeding, most commonly associated with severe acute pancreatitis, a ruptured abdominal aortic aneurysm, or other forms of retroperitoneal hemorrhage.

Answer 14

grey turners

Question 15

foot reflex that’s normal in infants and children up to two years old. It’s also known as the plantar reflex. Test occurs when the sole of the foot is firmly stroked. The big toe moves upward and the other toes fan out. In adults abnormal test findings can indicate a problem with the brain or spinal cord.

Answer 15

Babinski reflex

Question 16

controls movement of water across cellular membranes, facilitates muscle contraction, depolarization of

Answer 16

Sodium

Question 17

vital role in repolarization. Potassium is essential for normal cell function, including generating electrical impulses. Potassium helps regulate water balance, blood pressure, and acidity levels. (chronotropic)

Answer 17

Potassium

Question 18

essential for muscle contraction. Calcium levels that are too high or too low can lead to heart rhythm disorders and other cardiovascular diseases (Inotropic)

Answer 18

Calcium

Question 19

the second most abundant intracellular cation, after potassium. Vital role in muscle contraction.

Answer 19

Magnesium

Question 20

energy released due to a chemical reaction. Can be found in explosives or acid, or even from a reaction to an ingested or medically delivered agent or drug.

Answer 20

Chemical

Question 21

energy from a moving vehicle.

Answer 21

Kinetic

Question 22

energy stored in an object, such as a brick sitting on a building ledge.

Answer 22

Potential

Question 23

can result from sudden and radical changes in pressure, as can occur during scuba diving or flying.

Answer 23

Barometric

Question 24

energy transferred from hotter sources than the body, such as a flame, hot water, and steam.

Answer 24

Thermal

Question 25

often takes the form of high voltage electrocution or a lightning strike.

Answer 25

Electrical

Question 26

Question that does not allow for a simple yes or no question. EX: “Can you tell me what happened?”

Answer 26

Brachial Plexus Injury No

Question 27

loss of function of lower arms and hands is most indicative for what

Answer 27

Brachial Plexus Injury

Question 28

These block the action of sympathetic agents by beating them to the receptor sites and preventing these agents from turning on the ignition. The receptors cannot distinguish a blocker from a stimulator until it is too late. With the blocker occupying the receptor site, the stimulating agent cannot access it to turn on the switch.

Answer 28

Sympatholytic

Question 29

imitate the actions of naturally occurring sympathetic chemicals.

Answer 29

Sympathomimetics

Question 30

iv drug abusers are at the highest risk for which strain of hepatitis

Answer 30

Hepatitis B

Question 31

Epicardium protects the heart by reducing friction. This layer is the visceral portion of the pericardium on the surface of the heart, consists of connective tissue and some deep adipose tissue.

Answer 31

visceral pericardial layer

Question 32

Tidal volume formulas

Answer 32

tidal volume= Minute volume/RR minute volume: respiratory rate x tidal volume

Question 33

if you encounter one of these presentations and the newborns head does not externally rotate into position or you are unable to complete the delivery, support the woman and the newborn and provide rapid transport.

Answer 33

cephalic presentation

Question 34

Mcroberts maneuver is one of the safest methods to use in the case of shoulder dystocia. To widen the womans pelvis and flatten the lower back, hyperflex her legs tightly to her abdomen. It may be necessary to apply suprapubic pressure and to GENTLY pull on the fetus’s head.

Answer 34

Shoulder Dystocia

Question 35

if umbilical cord is wrapped around the fetus’s neck, slip your finger under the cord and gently attempt to slip it over the fetus’s shoulder and head. If this attempt is not successful or if the cord is wrapped too tightly, carefully place umbilical clamps 2 in apart and carefully cut the cord between the clamps in a motion going away from the infant.

Answer 35

Nuchal Cord

Question 36

RAAS- Renin, Angiotensin, Aldosterone, System. - Regulates Bp through fluid retention and vasoconstriction.

Answer 36

Renin that is produced in the kidneys, flowing into the bloodstream where it becomes Angiotensin 1, Angiotensin 1 binds with ACE (angiotensin converting enzyme) in the lungs, and becomes Angiotensin 2. Angiotensin 2 stimulates the production of Aldosterone, together Angiotensin 2 and Aldosterone triggers Vasoconstriction, and fluid retention in the kidneys, and tells the brain the body is thirsty.

Question 37

The concurrent failure of 2 or more organs/ organ systems that were initially unharmed by the acute disorder/ injury that caused the Pt’s current illness. Condition is often reversible, especially in previously healthy Pt’s. A major cause of death in sepsis, trauma, and burns. Is an overreaction of of the complement system. Causes vasodilation via “kallikrein-kinin system.”

Answer 37

MODS

Question 38

MODS from direct result from an injury.

Answer 38

Primary MODS

Question 39

MODS from slower more progressive organ dysfunction.

Answer 39

Secondary MODS

Question 40

which anticonvulsant would be most likely administered to a newborn w/ sz

Answer 40

Lorazepam & Diazepam

Question 41

How does the body respond in early stages of hypoperfusion:

Answer 41

The body responds to hypoperfusion by stimulating the sympathetic nervous system, releasing catecholamines, and increasing heart rate and vascular resistance.

Question 42

hardening of the arteries.

Answer 42

Arteriosclerosis

Question 43

develops from plaque buildup, is a common type of arteriosclerosis.

Answer 43

Atherosclerosis

Question 44

positional SOB: usually when laying flat.

Answer 44

Orthopnea

Question 45

any part of the body other than the head leads the way, usually the buttocks. Frank: hips flexed and knees extended, with the buttocks as the presenting part.

Answer 45

Breech Presentation

Question 46

states that a body at rest will remain at rest unless acted on by an outside force. Similarly, a body in motion tends to remain in motion at a constant velocity, traveling in a straight line, unless acted on by an outside force.

Answer 46

Newtons first law of motion

Question 47

States that the force that an object can exert is equal to the product of tis mass (WEIGHT) and acceleration (or DECELERATION):

Answer 47

Newtons Second Law of Motion

Question 48

The greater an object’s _______________and/or ____________, the greater the force that needs to be applied to either change the objects course or stop it

Answer 48

Mass/Acceleration

Question 49

Mass X Acceleration =

Answer 49

FORCE

Question 50

if a teenager w/ gyn issue answers hard NO to pregnant question, what should you do.

Answer 50

Give the pt privacy from parents if applicable, room to answer more honestly, ask questions in a private environment, and if that does not work, continue to consider possible pregnancy, while looking for other possible causes.

Question 51

Conduct that constitutes a willful or reckless disregard for a duty of standard of care. (My own words- A hard left from what’s right)

Answer 51

Gross negligence

Question 52

Confinement of a person w/o legal authority or persons consent.

Answer 52

False imprisonment

Question 53

Failure to act or mistake that caused pt harm

Answer 53

Negligence

Question 54

Organism that can live and reproduce w/o a host/ outside the human body

Answer 54

Bacteria

Question 55

requires a living host to survive and multiply

Answer 55

Virus

Question 56

Movement of particles or molecules from areas of high concentration to low concentration.

Answer 56

Diffusion

Question 57

Diffusion of water across a selectively permeable membrane

Answer 57

Osmosis

Question 58

Movement of molecules or ion into or out of the cell against its concentration (low to high) requires energy

Answer 58

Active transport

Question 59

Form of diffusion is regulated by protein channels in the membrane and requires no energy (sodium potassium pump)

Answer 59

facilitated diffusion

Question 60

acetylcholinesterase inhibitors

Answer 60

Organophosphates

Question 61

These exert toxic effects at junctions (synapse) of the nerve cells of the autonomic nervous system. The conduction of an impulse from one nerve to another occurs through the release of acetylcholine (Ach) at the synapse. Ach works as a chemical messenger, crossing the synapse to depolarize the nerve on the other side of the junction.

Answer 61

Organophosphates

Question 62

These are potent inhibitors of acetylcholinesterase, which terminate synaptic transmissions. This termination creates an abundance of Ach in the CNS and peripheral nervous system. When the muscarinic and nicotinic receptors are overstimulated, a predictable response occurs in the body.

Answer 62

Organophosphates and carbamates

Question 63

the most common form of diabetes a condition in which blood glucose levels are elevated because the body cannot produce enough insulin to compensate for the inability to utilize insulin effectively. The pancreas usually produces enough insulin, however for reasons that aren’t fully understood, the body cannot effectively use it, a condition known as INSULIN RESISTANCE.

Answer 63

Type 2 Diabetes

Question 64

can be related to metabolic syndrome, a cluster of characteristics including excessive fat in the abdominal area, elevated BP, and high blood lipid levels

Answer 64

Type 2 Diabetes

Question 65

insulin dependent, becomes apparent in childhood. Hereditary disposition, disposition, environmental factors can play a factor in it. Body develops autoantibodies that incorrectly identify the body’s own tissue or substances to be destroyed. Pancreas fails to produce insulin as a result. Contributing to pancreatic destruction are autoantibodies to the Insulin-secreting beta cells in the islet of Langerhans, to insulin, and to other pancreatic substances.

Answer 65

Type 1 Diabetes

Question 66

With this type diabetes, beta cells are the body’s only insulin source, this hormone must be administered by injection or with a pump when these cells are destroyed.

Answer 66

Type 1 Diabetes

Question 67

Gradually increasing rate and depth of respirations, followed by a gradual decrease of respirations with intermittent periods of apnea, associated with brainstem insult.

Answer 67

Cheyenne stokes

Question 68

Deep, rapid respirations; seen in patients with DKA.

Answer 68

Kussmaul

Question 69

irregular pattern, rate and depth of breathing with intermittent periods of apnea; results from increased intracranial pressure.

Answer 69

Biot (ataxic):

Question 70

Prolonged, gasping inhalation, followed by extremely short, ineffective exhalation; associated with brainstem insult.

Answer 70

Apneustic

Question 71

slow, shallow, irregular or occasional gasping breaths; results from cerebral anoxia. Agonal gasps may be seen shortly after the heart has stopped but the brain continues to send signals to the muscles of respiration.

Answer 71

Agonal gasps

Question 72

tachypneic hyperpnea; rapid, deep respirations caused by increased ICP or direct brain injury; drives the carbon dioxide level down and the pH up, resulting in respiratory alkalosis.

Answer 72

Central neurogenic hyperventilation

Question 73

refers to pain originating from internal organs, this is vague and often diffuse pain over the abdominal quadrant.

Answer 73

Visceral" pain

Question 74

means swelling and irritation within those organs, produces a sharp localized pain, as in the case of PID or appendicitis.

Answer 74

inflammation" pain

Question 75

describes when that pain is felt in a different area of the body than where the organ is located, due to shared nerve pathways in the spinal cord.

Answer 75

referred" pain

Question 76

pain that originates from the musculoskeletal system or skin. It can feel like a dull ache, throbbing, or sharp pain

Answer 76

somatic” pain

Question 77

if responders at major incident need additional supplies, who would they notify

Answer 77

IC or if there is a logistical chief or supervisor they should be notified.

Question 78

Area where contamination is present

Answer 78

Hot Zone

Question 79

Area outside of the Hot zone, decontamination zone

Answer 79

Warm Area

Question 80

Outside of the warm zone, treatment area.

Answer 80

Cold Zone

Question 81

Fluid that closely matches the bloods composition of sodium. No fluid shifts.

Answer 81

Isotonic

Question 82

3% sodium chloride- More sodium in the solution than the body, fluid shifts out of cells.

Answer 82

Hypertonic

Question 83

Less sodium than in the cells, fluid shifts into cells.

Answer 83

Hypotonic

Question 84

Solutions that contain Proteins that are too large to pass through the cellular membranes.

Answer 84

Colloids

Question 85

dissolved crystals in water. Can pass through cellular membranes.

Answer 85

Crystaloids

Question 86

5 stages of death and dying

Answer 86

Denial Anger Bargaining Depression Acceptance

Question 87

Cations

Answer 87

Potassium, Calcium, Sodium, Magnesium

Question 88

Anions

Answer 88

Bicarbonate, Chloride, Phosphate, Proteins

Question 89

different between antiseptic & disinfectant

Answer 89

Antiseptic- Safe for living tissues Disinfectant- used on non-living surfaces, Toxic to living tissues

Question 90

Primary blast: injury due to blast itself. Give examples of body systems affected.

Answer 90

injury: lungs, eardrums, compressible organs; pressure wave damages air filled cavities

Question 91

Injury d/t due to missles being propelled by blast (shrapnel), can cause blunt and penetrating wounds

Answer 91

Secondary blast injury

Question 92

injuries due to impact w/ another object (thrown against wall)

Answer 92

tertiary blast injury

Question 93

collateral injuries such as burns, crush, and toxic inhalation

Answer 93

quaternary blast injury

Question 94

long term damage from biological, chemical, or radioactive contaminants added to explosive device

Answer 94

quinary blast injury

Question 95

Explain the Electrical System of the heart and the rates.

Answer 95

A.) Electrical system starts in the SA node. Firing rate for the SA is 60-100 B.) If the SA node fails the Impulses then come from the AV node- firing rate of 40-60 C.) If the AV node fails the impulse comes from the Ventricals (bundle branches, bundle of his) Firing rate of 20-40

Question 96

first year of life infant has naturally acquired passive immunity-why?

Answer 96

He or she maintains so of the mother’s immunities.

Question 97

Genetic term for a group of hereditary diseases of the muscular system characterized by the weakness and wasting of groups of skeletal muscles, leading to increasing disability. The various forms differ in age of onset, rate of progression, and mode of genetic transmission. Duchenne muscular dystrophy is included in this group. It is a sex-linked recessive disease (affecting only males).

Answer 97

muscular dystrophy

Question 98

Gap between dendrites and Axons. A gap that allows for a better fine level of control than if the cells were touching each other.

Answer 98

Synapse

Question 99

Physiologic adaptation to the effects of drugs, need increasingly larger doses to achieve the same effect.

Answer 99

Tolerance

Question 100

A physical tolerance to the therapeutic and adverse clinical effects of a medication.

Answer 100

Habituation

Question 101

A physiologic state of adaptation to a drug caused by chronic use, usually characterized by tolerance to the effects of the drug and withdrawal if use of the drug is stopped (especially abruptly).

Answer 101

Physical Dependence

Question 102

Emotional state of craving a drug to maintain a feeling of well being.

Answer 102

psychological dependence

Question 103

L-side- a stroke in the left side of the brain affects the

Answer 103

Right side of the body

Question 104

R-side- stroke in the R side brain affects the

Answer 104

Left side of the body

Question 105

Why should we not hyperventilate an apneic pt?

Answer 105

May decrease venous return to the heart, d/t increasing thoracic pressure

Question 106

difference between nasogastric and orogastric tubes

Answer 106

naso- through the nose, oro- through the mouth. OG tubes do not run the risk for nasal trauma like NG tubes do, and the can be used in severe facial trauma. OG tubes are typically bigger than NG.

Question 107

PASG- anti shock/ who would benefit the most

Answer 107

Hypovolemic Shock- you can use these in pregnancy

Question 108

primary component of immune system

Answer 108

Mast cells and Basophils

Question 109

Pumping sodium out of cel and potassium in has an added benefit

Answer 109

Moving glucose into cell

Question 110

intubation-types/ways- know them.

Answer 110

Cric Oral Nasal

Question 111

formed in the bone, matures in the thymus

Answer 111

T-Cells

Question 112

formed in the bone, matures ing the bone.

Answer 112

B Cells

Question 113

which antibodies respond in allergic reaction and where they are stored

Answer 113

IgE, IgG, B-cells, T-cells IgE & IgG- blood stream

Question 114

How the body responds during times of hypoperfusion

Answer 114

Body releases catacolimines that increase cardiac contraction, ^ HR, vasoconstriction, and ^ vascular resistance. Triggers RAAS. Compensates for BP and HR. If it continues stress on the heart will ^, ends up w/ decreased cardiac output tissue perfusion decreases. Capillary’s start leaking

Question 115

paralytic that triggers muscle contraction, and cause prolonged depolarization. Muscles contract and take a long time to relax.

Answer 115

Depolarizing

Question 116

prevents muscle contraction does not allow for recontraction

Answer 116

non-DEPOLARING

Question 117

New born resuscitation algorithm

Answer 117

Antenatal counseling team debriefing and equipment check. -Birth -Term gestation? Good tone? Breathing or crying? (yes, infant stays with mother for routine care: warm and maintain normal temperature, position airway, clear secretions if needed, dry. Ongoing evaluation.) (No: warm and maintain normal temperature, position airway, clear secretions if needed, dry and stimulate.) -Apnea or gasping? HR below 100/min? (No: labored breathing or persistent cyanosis? Position and clear airway SpO2 monitor supplementary O2 as needed consider CPAP, postresuscitation care team debriefing) (yes: PPV, SpO2 monitor, consider ECG monitor). -HR below 100/min? (no: postresuscitation care team debriefing)(Yes: Intubate if not already down, chest compressions, coordinate with PPV, 100% 02, ECG monitor, consider emergency UVC). -HR Below 60/min? (No: IV epinephrine, IF HR persistent below 60/min, consider hypovolemia, consider pneumothorax) (Yes: back to HR below 100/min).

Question 118

difference between adults and kids in Car vs Person.

Answer 118

Small children are short, so a vehicle’s bumper is more likely to strike them in the pelvis or torso, causing severe injuries from direct impact. Waddell Triad: 1. The bumper hits the pelvis and femurs instead of the knees and tibias. 2. The chest and abdomen hit the grille or low on the hood of the vehicle (sternal and rib fractures as well as abdominal injuries) 3. The head strikes the vehicle and then the ground (leading to skull and facial fractures, facial abrasions, and closed head injury). Although children are less likely than adults to fly over the hood of a vehicle, they are more likely to be run over the vehicle as they are propelled to the ground by the impact. TBI often kills young patients. Adult injuries are generally lateral and posterior because adults tend to turn to the side or away from the impact

Question 119

different blades and tubes, for different intubations

Answer 119

Blade sizes range from 0-4, sizes 0,1,2 are appropriate for infants and children, where as sizes 3 and 4 are considered adult blades. -ET tubes range in size from 2.0 to 10.0 mm in inside diameter. Sizes from 5.0 to 10.0 mm are equipped with distal cuff.

Question 120

correct tube size based off age

Answer 120

age in years/4)+4 uncuffed -(age in years/4)+3.5 cuffed tubes.

Question 121

what % of body weight is water and where is it? What % is where?

Answer 121

60% Intracellular 20% is extracellular, 12% of that is interstitial, 5% is plasma.

Question 122

Chemicals in sympathetic and parasympathetic (pg 344)

Answer 122

how they work: -Sympathetic: also called the adrenergic system/thoracolumbar system, Function: fight or flight, increases body system activities, neurotransmitter: norepinephrine. Deactivating enzymes: monoamine oxidase (MAO), Catechol-0-methytransferase (COMT). -Parasympathetic: cholinergic system, craniosacral system. Action: maintain vegetative state, normal body activity. Neurotransmitter: acetylcholine. Major Nerves: vagus nerves (CN X). Deactivating enzyme: acetylcholinesterase. neurotransmitters for such -Sympathetic: norepinephrine and epinephrine -parasympathetic: ACh.