NREMT Quizes III Flashcards
(165 cards)
1
Q
Pt was rear ended and got whip lash. Now complaining of weak/numb upper extremities. What’s wrong?
A
Central cord syndrome DT hyper flexion of the neck
2
Q
Pt has weak/numbness in lower extremities DT a tumor on the spinal cord. What’s wrong?
A
Anterior cord syndrome
3
Q
Regarding the heart, what is backwards failure vs forwards failure?
A
Backwards = L ventricle cant pump blood out fast enough = BACK flow into lungs
Forwards failure = L vent can’t pump enough pump out to rest of body
4
Q
If afterload increases, what will happen to stroke volume?
A
It decreases
5
Q
CO = ___ x ____
A
CO = SV x HR
6
Q
What are normal bicarbonate (HCO3) levels?
A
22-26
7
Q
Differentiate between the following antibodies:
IgM
IgD
IgA
IgG
A
IgM = produced first (*M= Me first)
IgD = lowest quantity
IgA = saliva/tears
IgG = Greatest memory
8
Q
Explain the “Atrial kick”
A
Atria pumps blood into ventricles after ventricles are already full = greater ventricular contraction
9
Q
In what arryhthmia would you see PR depression?
A
Pericarditis
10
Q
R wave progression is a sign of what? When would you see the transition?
A
good R wave progression = healthy septum
Transition @ V3
11
Q
What is “Mittlesmirtz”
A
Mittleshmirtz = middle pain (pn during ovulation in the middle of a period)
12
Q
The egg that popped out of the ovary first is called the…
A
Graffian follicle
13
Q
What is the ductus arteriosus?
A
Fetal artery that connects the pulmonary artery & aorta (bypassess the lungs)
14
Q
Pt w/ bowel obstruction typically has hypotension & bradycardia. Why?
A
Pressure pushes on vagus nerve = bradycardia
Fluid swelling & inflammation = hypotension DT 3rd spacing
15
Q
2 major classic signs of an addisonian crisis?
A
Hypotension & hypoglycemia DT no adrenal hormones (epi/norepi)
16
Q
Would a person w/ Cushing’s disease be hyper or hypotensive? Why?
A
Hypertensive. Cushing = excess corticosteroid/cortisol hormones which are OPPOSITE of epi/norepi. They will instead have fluid retention issues
17
Q
What is TORCH? What does it mean?
A
Mnemonic shows all diseases that cross placenta barrier & can infect fetus in utero
Toxoplasmosis Other (syphilis, chicken pox) Rubella Cytomegalovirus Herpes infections
18
Q
What’s Hanson’s disease?
A
AKA Leprosy = slow growing bacterial infections on skin hands, nerves, eyes, nose
19
Q
What’s cytomegalovirus?
A
Herpes virus spread via body secretions. Similar SS like mono
20
Q
What’s tularemia?
A
Infects animals & people, attacks skin, eyes, lymph nodes, lungs
21
Q
What is wellen’s syndrome
A
ECG w/ deep inverted or biphasic T waves in V2-3 = critical LAD narrowing. High risk impending widow maker
22
Q
What is the circle of Willis? What arteries feed it?
A
Circle of Willis = blood supply in brain, supplied by…
- Internal carotids
- Basilar arteries
- Vertebral arteries
23
Q
Define status Epilepticus
A
2+ consecutive seizures OR seizure >5min
24
Q
Obese pt SOB when supine DT heavy stomach pressing on diaphragm. What is this called?
A
Pickwickian syndrome
25
Elderly pt w/ dysphagia after eat. Pt complains tasting the same food she ate yesterday still. What’s the issue?
Zankers diverticulum (pouch forms in esophagus & traps old food)
26
On a 12-lead ECG, which lead is the only lead w/ a normally inverted P wave
AvR
27
What’s a fancy medical name for “headache”?
Cephalalgia
28
Pt w/ migraine Hx w/ aura has increased risk of what…
Hemorrhagic stroke DT defect in vascular walls.
29
Pt (usually a kid) stops everything they’re doing and freezes/stares for a couple seconds into space. What’s wrong?
Absence (petite mal seizures)
30
Pt suddenly becomes rigid, and starts spasming before becoming postictal. What kind of seizure is this?
Tonic-clonic (grand mal seizure)
31
How are pseudoseizures different from normal seizures?
Cause is psychiatric not physiological. (Ex. Traumatic emotional stress or pain)
32
Pt has tremors initially in their L hand. Tremors then move to L arm… then L shoulder… then R shoulder… what’s wrong?
AKA “Jacksonian March”. A partial seizure that moves from one body part to another
33
What nerve controls the intercostal muscles?
The intercostal
34
What nerve controls the scapula & helps lifts the ribs?
The thoracic nerve
35
What nerve controls the diaphragm
The phrenic nerve
36
What’s the graffian follicle and what hormone does it secrete?
Graffian follicle = first egg pop out of ovarian follicle. Secretes estrogen
37
What is inderal? What’s it used for?
Inderal = brand name for propranolol (beta blocker).
38
What’s amitriptyline?
Amitriptyline - tricyclic antidepressant
39
What happens when pt overdoses on a tricyclic antidepressant? What Rx?
Anticholinergic SS (mad hatter, red beat, dry bone, hot hare)
Cardiac: stretches out all QRS, QT, PRI until torsades.
Rx = sodium bicarb
40
A deficiency in Magnesium can result in what arrhythmia?
Torsades
41
What structure suspends the duodenum & separates upper from lower GI?
Ligament of trietz
42
Pt has bilateral calf pain w/ bilateral purple discoloration mid calf downwards. What’s wrong?
Venous stasis
43
Following an animal bite, pt has itching, fever, headache, confusion, hallucinations and insomnia. What’s wrong?
Rabies
44
What is rabies
neuro virus that spreads via saliva of animals
45
What respiratory disease has excessive mucus plugs in bronchioles?
#1 = chronic bronchitis
#2 = asthma
46
What is the smallest functional unit of the liver?
Hepatocytes
47
What is the smallest functional unit of the lungs
Alveoli
48
What is the smallest functional unit of the kidneys?
Nephrons
49
What is the smallest functional unit of the brain
Neurons
50
What is the smallest functional unit of the heart?
Cardio yet
51
Explain, physiologically, why pt’s have chest pain from angina?
The cardiocytes are in anaerobic metabolism
52
How does Afib affect a persons cardiac output?
Knocks it by 20-25% DT loss of atrial kick
53
Pt has JVD when they breathe in. What’s this called and what does it mean?
AKA Kussmauls sign = obstruction to R ventricle outflow = backwards pumping of blood
Ex. Pericarditis, Pericardial tamponade, R ventricular failure, COPD
54
What is Prinzmetals angina? What causes it?
CP DT coronary artery spasms DT defect in Calcium channels
55
R side failure = peripheral edema. What is a “national registry” way of calling “peripheral edema”
Venous congestion
56
The lymphatic system empties into the…
Subclavian vein
57
West Nile virus causes ____ and is spread by ____
Encephalitis, mosquitos
58
When benzodiazepines are metabolized.. they become…
Active metabolites
59
Besides a blood clot. What are 3 other things that can cause Claudication?
Spinal problem, atherosclerosis, Diabetes mellitus
60
Of the following, which doesn’t have JVD?
Cardiac tamponade, hemothorax, tension pneumo, L side failure?
Hemothorax
61
Coumadin is a blood thinner that disables the action of which?
Vitamin K
Vitamin D
Vitamin E
Vitamin B1
Vitamin K
62
Pt has circumferential burn to leg from mid femur down. They’re at risk for what emergency?
Hyperkalemia & kidney damage, compartment syndrome
63
What’s a hypochondriac?
Someone way too stressed about their health
64
What ligament attaches your femur to your pelvis
Ligamentum teres
65
In which of the following is the O2 Torr pressure the highest?
- Atmosphere
- venules
- alveoli
- arteries
Alveoli
66
When RBCs can’t fold and get clumped together DT acidosis, this is called…
Rouleaux
67
What does terbutaline do?
B2 agonist = bronchodilation for asthma, bronchitis & emphysema
Slows uterine contractions
68
How fast can an epidural bleed become fatal
Usually < 1hr
69
Pt has SOB & hemoptysis during a rapid ascent from a dive. What’s wrong?
POPs = pulmonary overpressurization syndrome.
The alveoli rupture = pneumo, embolism, arterial gas embolism
70
People w/ kidney disease tend to have which condition:
- hypokalemia
- cephalic neuralgia
- hypotension
- HTN
HTN
71
Pt has chronic, intermittent condition of intense burning/stabbing pain at upper neck, back of head, face or behind ears. What’s wrong?
Neuralgia. Can be occipital, trigeminal hypoglossal depending on what cranial nerve is affected.
72
What’s neuro glycogen is
Shortage of glucose in the brain usually DT hypoglycemia
73
Which nerve plexus is next to the aorta?
The brachial plexus
74
Which of the following metabolic disorders has abdominal pain:
- DKA
- Acromegaly
- Dwarfism
- hypoglycemia
DKA
75
What is the parkland burn formula?
(BSA x 4ml x pt weight in kg) = X amount of fluids
50% of x in first 8 hours
50% of x in remaining 16 hours
76
Pt is exposed to an allergen and develops sensitization only in the bronchioles (IgE attaches to mast cells). Pt has another exposure to antigen w/ adverse respiratory reaction. What is this condition called?
Asthma. Same mechanism as anaphylaxis except only in the lungs
77
What happens in the blood when you hyperventilate?
Ph rises >7.45 = Calcium falls off receptor sites and attaches to albumins = temporary hypocalcemia
78
What are the contraindications to epi?
Closed or open angle glaucoma; they can go blind
79
Which of the following drugs can cause an intracerebral bleed?
- Heroin
- Fentanyl
- cocaine
- tricyclic antidepressant
Cocaine
80
What’s your main concern in a pt w/ HONK?
Osmotic diuresis. Give them fluids
81
Where is cortisol made and what does it do?
Cortisol = anti stress hormone made in the adrenal cortex.
* think: cortex/cortisol
82
Pt has numbness/less sensation in saddle area (groin butt inner thigh) following a traumatic accident. What is this called, what does it mean?
Positive saddle anaesthesia sign = Cauda equina syndrome (injury to lumbar/sacral nerve roots)
83
What toxic substance do ppl usually “huff”? What medical concerns & SS would you have for them?
Hydrocarbons = cleaning supplies, chemicals, paint thinners, oils…
Neuro & cardiopulmonary injuries (ex. Seizure, hallucinate, pulm edema, dysrhythmias)
84
26 YOM complains low back pain w/ low fever, dysuria & feeling need to pee. What’s wrong?
Prostitis (inflamed prostate).
85
Which of the following causes ring worm?
- fungi
- bacteria
- virus
- parasite
Fungi
86
Which infectious disease = night sweats, productive cough x many weeks, emaciation
Tuberculosis
87
What is hyperpyrexia?
Extreme fever. Temp > 106.7 F
88
Thermolysis vs thermogenesis
Thermolysis = heat removal (ex sweating)
Thermogenesis = heat production (ex. Shivering)
89
Cyanide vs CO effect on oxygen
CO binds to hemoglobin prevents O2 binding
Cyanide enters all CELLS and prevents utilization of O2
90
Best Rx for a jelly fish sting?
Hot water
91
Which of the following requires no intervention except airway?
Sucking chest, flail chest, hemothorax, tension pneumo
Hemothorax. You can’t do anything for it specifically except support ABCs
92
What is “first pass metabolism” and where does it occur?
Percentage of a drug doesn’t reach systemic circulation DT absorption/breakdown in LIVER (mostly)
93
Of the main spider bites, which requires surgical debridement? Which requires calcium gluconate?
Brown recluse = surgical debridement
Black widow = calcium gluconate
94
Pharmacokinetics vs pharmacodynamics
Pharmacokinetics = what BODY does to drug
Pharmacodynamics = what DRUG does to body
95
Pt has SOB what should you check first?
Lung sounds
96
When assessing pt ventilatory status, what is the most important thing to look for?
Respiratory rate high or low?
97
Trauma pt has snoring respirations. What do you do?
Jaw thrust
98
Pt has increasing Respiratory rate despite O2 administration. What do you do?
Bag them
99
Your asthma pt is in respiratory distress. What O2 Rx would you do?
NRB 12-15lpm
100
What is the earliest key signs of hypoxia in a pt?
Anxiety
101
How can you tell if a pt has improvement in ventilatory status following your Rx?
Decreased respiratory rate
102
You place a SOB pt on a NRB and he keeps pulling it off. Complains that its smothering him. What do you do?
If he wont tolerate it, use NC 1-6lpm
103
Following an OD, pt resp rate is 8 & shallow. What do you do?
Intubate
104
Best way to verify correct ETT placement?
ETCO2
105
Pt w/ SOB and possible allergic reaction. You elect to use Epi. What are some considerations against using it?
If pt has cardiac Hx, be extra careful. Call MCP
106
Which intercostals to use needle decompression?
2,3 mid clavicular
4,5 axillary
107
Pt has a heat inhalation injury. What do you do?
Intubation w/ one size smaller ET tube
108
Respiratory therapists often use what type of device on COPD pts?
Venturi mask = 24-50/60% FIO2
109
Pt has abnormal lung sounds localized to one lobe. What do you think?
Pneumonia
110
Your pneumonia pt has high fever with SOB despite O2 Rx. What do you do?
Albuterol & fluids
111
Your OD pt is breathing 4x/min. What’s your biggest concern? What Rx?
Respiratory acidosis = intubate and assist ventilation
112
Alcoholic OD w/ vomiting but no gag reflex. What airway would you use?
A supraglottic (combi-tube)
113
You have successfully resuscitated a near drowning pt. What lung sounds would you expect to hear?
Crackles and then diminished lung sounds the next day
114
17 YOF w/ fluttering feeling in chest. You note delta waves on her ECG. What Rx?
Probable WPW. Cardiovert
115
When is it particularly important to ask for family medical hx?
When there is cardiac involvement
116
Why would you avoid ASA in pts w/ hx ulcers
ASA = NSAIDS = more acid production
117
Mainstay Rx of R side heart failure
Fluids
118
Which is more important in SAMPLE: medical Hx or events leading up to emergency?
Medical Hx
119
Aside from maintaining ABCs, what’s the only other intervention (not assessment) you could do for thoracic aneurysm?
Pn mgmt
120
What is the field vs definitive Rx for pericardial tamponade?
Field = Fluids
Definitive = pericardial centesis
121
When is the only time you can remove an impaled object?
Obstructs airway, CPR, or is through the cheeks
122
Pt has injury to vertebral prominence (C7) what type of breathing would they have?
Belly/diaphragmatic breathing
123
When would you give pn meds during a fracture trauma?
Prior to manipulation in order to relieve pain
124
Pt CC: hot grease burn. What Rx?
Dry sterile dressing + pain mgmt
125
Pt has CHF w/ cervical spine fracture. What Rx during extrication/transport?
KED (idk why)
126
Pt has closed head injury with cushings reflex. What pharmacological Rx?
Mannitol (has hypertonic properties)
127
Rule of nines in a kid vs infant
Head: I = 18, C = 12
Legs: I = 13.5, C = 16.5
* everything else is the same as adults
128
If a pt sustains a spinal cord injury, what temp would you expect to find below the injury site?
Warm and dry
129
Pt in neurogenic shock should get what vasopressor at what dose?
Dopamine 2-20mcg/kg/min
130
Multiple pts in nursing home w. Sudden onset of ab pn and nausea. What do you think?
Food poisoning
131
Terminal cancer pt unresponsive, HR 44, BP 60, pinpoint pupils. What’s wrong?
OD on pn meds
132
In a grand mal seizure pt, what should you always check first?
Airway for vomit
133
Main SS of pheochromocytoma
Tachycardia and HTN
134
Rx of cocaine OD
Benzos and O2
135
Unresponsive hypoglycemic diabetic, what meds to give?
100mg thiamine & 25g d50
136
What does it mean “extra pyramidal”
Think dystonic
137
What’s the dose of diazepam
0.1-0.2mg/kg
138
Pts with kidney stones usually have what SS
Hematuria
139
Anyone in cardiogenic shock gets what med?
Dopamine
140
What minimum MAP for perfusion?
70
141
If breathing Rx ineffective in asthma pt, what next?
Epi
142
Best airway for seizure pt?
NPA
143
What defining assessment helps decide whether to intubate or not?
SPO2
144
Max dose of lidocaine?
3mg/kg
145
Kid has projective vomiting and diarrhea w/ a palpable mass on abdomen. What’s wrong?
Bowel obstruction
146
How to secure airway in LEfort Fx?
Surgical cric
147
Neonate CPR ratio
3:1
148
Besides electrolytes, what medication helps with hyperkalemia? How?
Albuterol. Drives K back into cells
149
Earliest signs of shock in infant?
Tachypnea, tachycardia
150
Pt w/ recent Hx traveling can get what type hepatitis?
Hep A = oral/fecal route from contaminated shit
151
On the O2 dissociation curve, a shift to the R or L means what?
Acidotic = shift to R = O2 falls off hemoglobin more easily
L = opposite
152
What’s central cord syndrome
Whiplash or degenerative disease = weakness in upper extremities
153
What’s anterior cord syndrome?
DT tumor or mass = upper and lower extremity weakness
154
How does anaphylaxis affect the CNS
Depression
155
What is the purpose of lactated ringers?
Good for slowing down acidosis (i.e. traumas)
156
Mydriasis vs miosis
Mydriasis = dilated (has the D)
Miosis = pinpoint
157
At what age do VS become adult like?
12
158
How many drops in a ML?
10!
159
Ectopic beats vs escape beats
Ectopic - early
Escape = late (next pacemaker sets in)
160
How to guess pediatric weights (in Kg)
(Age + 4) x2 = wt (in kg)
161
What is the Krebs cycle
How we make energy in a cell
162
All stages of grieving process
Deny, anger, depression, bargain, accept
163
What’s wellen’s syndrome
V2 &V3 (LAD) = biphasic T wave or deeply inverted T wave = imminent MI
164
Name all stages of a blast injury
Primary = pressure
Secondary = shrapnel
Tertiary = body thrown
Quarternary = burns & all other
165
What is dale’s method to give dopamine
W/ 1600mcg/ml concentration..
If you want to give 5mcgs/min, drop last number in pts weight (lbs) & minus 2
