Tonys Review Flashcards
(469 cards)
1
Q
Lidocaine 2gm / 500ml run at 2mg / min =
A
30gtts
2
Q
Lidocaine Drip =
A
4mg / min
3
Q
Lidocaine Drip =
A
2gm in a 500 bag D5W at 30gtts
4
Q
2gm into 500ml with concentration of 4mg/min?
A
60gtts
5
Q
IV set at 20gtts/min using microdrip; how many ml’s?
A
10ml
6
Q
Dr. orders 1000mg of a drug. The Drug comes packaged .5gm/ml. How many ml’s do you give?
A
200ml
7
Q
Dr. orders 200mg of a drug. The Drug comes packaged 25mg/ml. How many ml’s?
A
8ml
8
Q
Epinephrine does what?
A
Vasoconstriction and Bronchodilation
9
Q
Epinephrine stimulates heart in?
A
Asystole
10
Q
Epinephrine causes what?
A
Increased BP, Palpitation, Tachycardia
11
Q
In regards to Epi, what is the correct dose? 1:1000 IV, 1:1000 SQ, IM, 1:10,000 IM, 1:10,000 SQ
A
1:1000 I.V.
12
Q
Burns shift what?
A
Plasma to interstitial space
13
Q
An 80kg . Patient who needs Lidocaine (scenario calls for Lido as TX of choice not Cardioversion due to description they give of the patient)
A
100mg Lido Bolus (best answer)
14
Q
sign of Irreversible Shock?
A
Bradycardia
(Irreversible shock is a condition in which the shock can no longer respond to any treatment as a result of massive cell damage*)
15
Q
Administration of IV Hypertonic solution on a hydrated patient will?
A
Draw water from the cells to the vascular space
16
Q
Anaphylactic & Septic shock, Low BP due to?
A
Vasodilation
17
Q
Beta question =
A
Increased heart rate
did not refer to beta 1or2, just beta
18
Q
When beta-receptors are stimulated, the Heart Rate does what?
A
Increases
19
Q
Cells of the heart that conduct electrical activity causing Depolarization and Contraction? (characteristic)
A
Automaticity
20
Q
Chief Intracellular Cation =
A
Potassium
21
Q
Chief Extracellular Cation =
A
Sodium
Hint: dont get EXTRA = salty) ;
22
Q
Definition of shock?
A
Lack of Tissue Perfusion or Inadequate Tissue Perfusion
23
Q
One of the FIRST Sign’s of Shock?
A
Restlessness, Elevated Heart Rate
24
Q
Irreversible Shock =
A
Low Heart Rate,
slower than normal) (death is inevitable
25
Late Sign of Irreversible Shock?
Bradycardia
26
Which is a sign of UNCOMPENSTAED Shock?
Decrease BP
27
Earliest Detectable Sign of Shock is?
Tachycardia
28
Compensated Shock causes what?
Increased blood & Decreased Peripheral Perfusion
| 1st Tachycardia, Increased Pulse, cool, clammy, anxious
29
Decompensated shock causes what?
Falling BP, Thirst, Decreased LOC
| 1st Hypotension, un-palpable pulse, respirations slows, & Lethargic
30
Pt. with valid DNR order, what treatment can you still offer as a medic?
Pt. Comfort Measures/Supportive Care
(O2, & Pain control)
(*DNR is a form of refusal*)
31
You find clear FLUID coming out of the patient Ears, you should suspect?
Basilar Skull Fracture
32
You see Fluid running out of the patient’s nose and ears, what do you do?
Halo Test
33
Parasympathetic nervous system?
Decreases HR
34
A Chemical Mediator for the Parasympathetic Nervous system is?
Acetylcholine
| SLUDGE
35
What is the neurotransmitter for the Parasympathetic Nervous system =
Acetylcholine
36
Increase PaCO2 Regulates/Controls what?
Respiration
| partial pressure of CO2 in the blood
37
Intent is NOT required to PROVE?
Negligence
38
Malicious Writing in a report?
Libel
| Slander = verbal version of libel
39
Elements of Negligence are? )
Duty to Act, Failure to act, Breach of duty
| Cause harm, damages
40
Adenosine slows conduction where?
The Sinus (SA) & the AV Node
41
Sympathetic stimulation causes what?
Vasoconstriction & Increase HR
42
Emergency Medical Service Act?
Chapter 401
| provides legislation governing all pre hospital EMS
43
In an ambulance crash, the court will try to prove?
Lack of due regard
| for the ambulance driver
44
What’s due regard?
Driving with care for others
45
Put 1gm in 250cc of D5W, how much do you give?
4mg/ml (1gm=1,000mg/250 = 4mg/ml)
46
you have a 15gtts/ml drip set, you must infuse medication for ONE HOUR, & you are running it at 45gtts/min. How many ml/cc?
180cc (45x60=2700/15 = 180)
47
Patient in an MVA has a head injury, Pt. BP 80/60, Pulse 132, you suspect?
Hypovolemia Shock
48
Who were Ethical Standards Developed for =
The Patient
49
The best protection a paramedic has against legal involvement =
Proper Training
50
Info transmitted over the radio, everything EXCEPT?
Name & Insurance
51
The paramedic communicates all of the information to the doctor EXCEPT?
Pt. Name & Insurance Policy
52
Cushing’s Triad?
Widening pulse pressure, hypertension, bradycardia, irregular resp.
53
pH over 7.45?
Alkalosis
| below 7.35 = Acidosis
54
Movement of fluid from LOW to HIGH across plasma membrane?
Osmosis
55
Drug & Dose for Pt. after RSC (rapid sequence circulation)?
Dopamine @ 5mcg/kg/min
56
Child with no parents, what type of consent?
Implied consent
57
You get on scene & the patient rolls up sleeves, what type of consent?
Implied Consent
58
Which is not an indication of an infiltrated IV Site?
Air in tubing
59
The Number 1 buffer system is?
Bicarbonate
60
What electrolyte is the PRIMARY Buffer?
Bicarbonate
61
You don’t have to investigate further?
Pertinent Negative
62
2nd dose of albuterol for adult patient?
2. 5mg
| 2. 5mg/3mls
63
Patient weight is 86lbs, how many Kg?
39kg
64
Patient tells you he doesn’t want to be treated with Glasgow of 15 & you give him a shot, it is?
Battery
65
Battery is?
Unlawfully touching patient (Assault = Threat)
66
Abandonment means?
Not turning over care to an appropriate professional
67
If paramedic charged in lawsuit, he is the?
Defendant
68
3 Stages of Stress?
Alarm, Resistance, Exhaustion (ARE)
69
Which drugs go down the Tube?
Lido, Epi, Atropine, Narcan (remember LEAN)
70
What kind/type of drug is Cocaine?
Schedule II
| schedule I –addictive but NO medical use: heroin, LSD, or crack cocaine
71
What does HR do late in decompensating shock?
Less then normal, There will be a narrowing of the pulse pressures
72
Racemic EPI, Tx to relief?
Croup
| racemic EPI is EPI made for a nebulizer
73
Smooth muscle relaxant used for patient's with bronchial asthma?
Aminophyline 5-6mg/kg
| AKA theophylline, is a bronchodilator
74
3 systems that regulate acid-base balance?
Buffer, respiratory, & renal systems.
(buffer systems functioning in blood plasma include plasma proteins, phosphate, and bicarbonate and carbonic acid buffers)
75
Increase in acid due to metabolism, vomiting, diarrhea, diabetes or meds?
Metabolic Acidosis
76
Parenteral route of med administration?
SQ, IM, IV, IO, ET
| Parenteral: administered or occurring elsewhere in the body than the mouth and alimentary canal
77
ABDUCTION?
Away from the body
78
ADDUCTION?
Towards the body
| remember ADD to me
79
In an ambulance crash the court will try to prove?
Lack of due regard – for the ambulance driver
80
Administration of a Hypertonic solution to a hydrated PT will draw water from?
The PT’s cells into the vascular space.
81
Atropine does what?
Blocks Vagus Nerve (parasympathetic)
82
55 yr old Pt. with P 50, P Wave for every QRS, P – R Interval of 0.16, Cold & Clammy with BP 70/50 with Sinus Bradycardia. The Pt. should be given?
.5mg Atropine
83
What must occur to Maintain Relative Homeostasis?
Input MUST equal Output (equilibrium, balance)
84
Pt. doesn’t speak English?
Try to talk to both pt. & person doing the interpreting
85
Anytime you are dispatched to a call you have a duty to what?
Duty to act
| it’s prescribed by the law as what we must do and how we must do it
86
Name a controlled substance that does not produce constricted pupils?
Valium
| Is a benzodiazepan
87
Blood Components?
1unit = 1pint = 500ml
| 12units in adults or 6 liters
88
Act creating the Food & Drug administration (FDA)?
Controlled Substance Act 1970
89
Pounds to kg? 1kg =
2.2lbs
90
After C-Spine, how do you open the Airway?
Jaw Thrust
91
Hypercarbia =
Increased Co2 in the blood
92
Hypoxemia =
Decreased O2 in the Blood
93
Patient in car accident, not breathing with head injury. What is the risk of intubation?
Increased ICP
94
Pediatric with SPo2 78%, breathing 40bpm, you should do what?
Assist Ventilation
95
When intubating you hear absent lung sounds on the LEFT due to?
Right Mainstem Bronchus insertion
96
What is correct about Nasogastric tube on intubation?
Creates a Bad Face Seal or gets in the way of intubating
97
Complications of nasal gastric tube?
It makes intubations more difficult
98
Suctioning the back of a child’s mouth can cause all of the following EXCEPT?
Dehydration or bradycardia
99
Patient with air in the stomach, what do you do?
NG Tube
100
Attempted to intubate 4 Times without success what do you do?
Try another Advance Airway (use other method)
| I-gel, LMA or Dual lumen etc...
101
Which Blade would you use to intubate an ADULT Pt.?
A curve blade (Macintosh) in the vallecula or a straight blade (miller) lifting the epiglottis
102
A Substance from High to Low concentration?
Diffusion
103
Minute Volume =
Tidal Vol X Resp. Rate
| **amount. of air in or out in one minute**
(tidal volume = amount. of air breathed in or out in one breath)
104
In a normal person, what is the body’s primary respiratory drive?
Increase in Pco2
105
How to Measure Pediatric ET =
Size of Smallest Finger
106
How do you Measure Pediatric ET tube?
Broselow Tape
(Size 6 cuffed, size 6 uncuffed, size of index finger) were the other answers given
107
What separates the upper and lower airway?
Epiglottis (vocal cords)
108
A local alcoholic on a cold night is found to be inarousable, in V-FIB, & is Apneic. TX should include?
Airway, Defibrillate 3 times, CPR, Transport
109
Patient Choking, has PARTIAL Obstruction, you?
Encourage him to keep Coughing
110
What is a good indication for nasal intubation?
Gag Reflex intact
111
What do you check immediately after intubation?
Auscultation of the Epigastric & Breath Sounds
112
When doing a HALO Test, what are you looking for?
CSF (cerebral spinal fluid)
113
You should palpate the Abdomen quadrant?
Area with pain/injury LAST
114
Palpate abdominal quadrants in what order?
UL, UR, LR, LL
115
Kussmaul Respirations?
Rapid Deep Gasping Breathing – Associated with DKA/Hyperglycemia
116
Let CSF (cerebral spinal fluid) leak out, why?
To Relieve Increasing Pressure of the brain (ICP)
117
Mrs. J is in DKA. Her breathing pattern is Bradypena & Tachypnea. What is this respiratory pattern Called?
Kussmaul
118
Increased then Decreased Respiration followed by Apnea (a temporary suspension of breathing)?
Cheyne-Stokes
119
S/S of Hyperglycemia?
Deep, Rapid, Gasping respirations associated with Ketoacidosis
120
Harsh, high pitch sound heard on inspiration that indicate partial airway obstruction?
Stridor
121
You Expect to see Flat Neck Veins in Pt’s with?
Hypovolemia
122
Most important information for ER Doctor?
Chief Complaint (c/c), Patient’s condition, Treatment
123
Medical Pt., the first thing you ask or evaluate?
Chief Complaint
124
Which Vertebrae is responsible for loss of sensation of the Lower & Upper Extremities?
(Look it up) Thoracic? T4 or T6
| *this answer is questionable
125
To make changes in the PCR (patient care report) you would?
Draw a single line & initial, make a notation at the end of the report
126
The Difference between Systolic & Diastolic is?
Pulse Pressure
127
The Systolic Portion of the blood pressure is the?
Pressure of blood against the Atrial Wall
| During the heartbeat (**pressure is arteries during ventricular contraction**)
128
Orthostatic BP =
Supine, Sitting, Standing @ 2min intervals
129
JVD best checked?
Semi-fowlers
130
JVD is best observed at a?
45 degree angle
131
What is a contraindication for an NPO?
Basilar Skull Facture, look for battle signs or raccoon eyes
132
Rales are?
Fluid in alveoli
| small airways or crackels
133
A high-pitched whistling is what type of sound?
Wheezing
134
Decorticate posturing?
Flexion of the arms, extension of legs, & clenched fist
| **head injury**
135
Trauma Pt. with Arms & Legs FULLY extended?
Decerebrate Posturing (**head injury/worse one**)
136
Patient with chest pains, you ask?
O,P,Q,R,S,T
137
Amount of blood pumped by the heart in one (1) min, is called?
Cardiac Output
138
Rales usually heard in? Lower airway –
Fluid in the Aveoli
139
Man was cleaning the bathroom with bleach and fainted, a co-worker pulled him out and upon arrivial you notice the man has RALES. What is his condition?
Pulmonary Edema
140
Cardiac Tamponade causes the following, Except
A. Flat Neck Veins
B. normal pulse pressure C. decrease BP
D. muffle heart sounds
Except = Flat Neck Veins
141
How do you check for stable pelvis?
Downward & Inward pressure on iliac crests
142
What to check for in Extremities?
PMS-D (pulse, motor, sensory, deformities)
143
A repeater does what?
Boosts transmission range
144
Most common frequency in EMS?
VHF & UHF (VeryHF/UltraHF)
145
Types of radio systems?
Simplex (1freq-only talk to listen,
Duplex (2freq-talk & listen),
Mutiplex (2freq-talk, listen, & send ECG)
146
A group of frequencies close together?
Band
147
A Scuba Diver has Tingling in the HAND and FEET with Frothy Red Sputum. The patient should be Transported in?
Trendelenberg on his Left Side
148
All of the following are true regarding electrical burns EXCEPT:
There is more external than internal damage
(There is an entrance & exit wound, it may cause V-FIB, Path of electricity may follow nerve pathways)
[were the other answers given]
149
Air Embolism =
Diver with joint pain, Tingling in the legs, Abdominal Pain
150
Which is part of the 6 P’s?
PULSES
| (pain, pallor, paralysis, paresthesia, pressure) the other five P’s
151
Abdomen Covering or Lining of the stomach?
Peritoneum
152
Lining of the LUNGS?
Visceral Pleura
153
A Pt. with abdomen pain is found in what position?
Fetal
154
Cerebellum controls what?
Motor control, Balance, Coordination
| makes body move smoothly
155
Cerebrum controls what?
Thought, Personality, Analysis, Learning, Memory, & Speech
(T-Palms)
156
Child gets his hand stuck on Dry Ice for more than 5 minutes, what do you do?
Immerse in warm water (105degree’s) sterile dressing - don’t let refreeze
157
Concussion means?
A brief period of Unconsciousness, Followed by a complete return of function
158
Countracoup means?
Injury occurring on the opposite side of impact of the brain
| **Coup – injury to brain on side of impact**
159
Eyes don’t move in Unison (together)?
Dysconjugate Gaze
| **head trauma**
160
Disconjugated Gaze TX?
Cover both eyes loosely
161
Pt. Severed the Spinal Cord at C3–C4 that causes?
Total Paralysis & Pt. can’t Breathe on their own
162
Spleen is Located where?
LUQ left upper quadrant – (Liver = RUQ)
| Appendix RLQ
163
Spontaneous Pneumothorax-Signs/Symptoms =
Short duration of sudden pain, SOB, Knife like pain
164
Tendons connect to what?
Muscles To Bone
| ligaments - bone to bone
165
Difference between Sprain & Strain?
Sprain is injury to Ligaments, Strain is injury to muscles and or tendons
166
A False statement referring to burns is that?
There is insignificant damage to underlying tissue
167
A Pt. in a motorcycle accident has lacerations to his head that is actively bleeding. His Vital Sign’s are BP 80/4 Pulse 110, Treat him by giving what?
Lactated Ringers Wide Open (ringers lactate)
168
Muti trauma Pt., what do you treat first?
Hypoxia
169
To Open the Airway of a Trauma Patient you would use a?
Modified Jaw Thrust
170
Trauma patient fell from the roof with positive JVD, NO Lung Sounds on Right Side, TX would be?
Assist Ventilations, Decompress, Immobilize, Transport, 2 large bore IV’s
171
All are TRUE in Burn Patients, EXCEPT?
Electrical Burns Don’t Effect Soft Tissue
172
Cavitation is?
Object Penetration / Pressure waves from bullet / opening produced by force that pushes body tissues laterally away
173
A Clear Fluid coming from the nose and mouth, you expect?
Basilar Skull Fracture
174
Most Critical concern to a patient with chest trauma?
Hypoxia
175
Poor Bag compliance seen in what Pts.?
Sucking Chest Wounds, Tension pneumo thorax
176
Patient that has Cervical Fracture =
Quadriplegic
177
Placement for Decompression is?
Between 2nd & 3rd Intercostal Space (Midclavicular) or Between 5th & 6th intercostal space – (Mid-Axillary)
Decompress prior to ET, IV, & TRANSPORt)
178
Traumatic Asphyxia occurs from what type of injury?
Crush
| injury to the chest or abdomen
179
Flail Chest is when?
2 or more ribs FX in 2 or more places
180
Complications of fractures & dislocations
Nerve & Vascular damage (vascular is the worst complication)
181
Most commonly fractured bone in the body?
Clavicle
182
Number of LITERS of Blood Loss in Abdominal Distension?
1.5 to 2 Liters
183
Anterior dislocation of a shoulder or fracture clavicle, Pt. presents how?
Leaning Forward with Affected shoulder & arm held close to chest
184
Always splint bones?
Above & Below joint injuries (If it’s a joint? Above/Below fractured bone)
(check PMS Before & After)
185
Treatment of a patient who presents with an OPEN Fracture?
Dress Wound first then Bandage/Splint
186
Patient with 3rd degree burns over 20% BSA, Concern is for?
Hypovolemia
187
You have a patient with head trauma & signs of Shock =
Look elsewhere; Shock is not due to head trauma (rare to see)
188
Your index of suspicious is based on mechanism of injury in regards to what?
Extent of patients injuries
189
Major Complication of thrombolytic therapy is?
BLEEDING OUT
190
Exclusion Criteria from thrombolytic therapy, all EXCEPT?
Hip Surgery 2 Years Ago
191
Blood Loss Replacement?
3 times the volume lost (20ml/kg) (exp. Pt. loss 750ml X 3 = 2,250)
192
Trauma Bolus?
20ml/kg (Adult)
193
Best Fluid for replacement?
BPlasma, packed cells, or wholeblood
194
The Pt. with Increased ICP Varies from the expected in that?
Pulse Decreases & BP increases
195
Signs of Increased ICP?
Hypertension, bradycardia, widening pulse pressures (Pt. with icp should be hyperventilated. lowers ICP by induction of cerebral vasoconstriction with a subsequent decrease in cerebral blood volume. May also lower systemic BP)
(do not hyperventilate or use high flow o2 with stroke PT.)
196
Drug used to decrease ICP
Mannitol
197
In a MVA there is a MULTITRAUMA patient, what is the FIRST thing to Control?
HEMORRHAGE
| Other choices: airway, circulation,
198
Burn patient with Anterior Chest(9), Abdomen(9), & BOTH Arms(18)? 36%. If its says one arm then it’s
27%
199
Adult burn Pt. with burns to anterior chest (9), Abdomen(9), & Anterior upper extremities (4.5each). Using rule of 9’s what is the burn score?
27%
200
What is your primary concern for burn patients?
Hypovolemic Shock
| NOT Septic Shock
201
Occipital part of the brain Controls what?
Vision
202
Flat Neck Veins are common to all of the following EXCEPT?
Cardiac Temponade
| other choices; Dehydration, Hypovolemia, Hemothorax
203
Cardiac Tamponade is?
Narrowing pulse pressures
| pulsus paradoxus, JVD, muffle heart sounds, beck’s triad, Pt. need a pericardial synthesis**
204
Patient has Scalp wound, BP 80/50, Pulse 120, the best IV CHOICE is?
Lactated Ringers
| (Wide Open)
205
Patient in a MVA says he has radiating pain on LEFT Shoulder, you suspect?
Spleen Injury
206
Patient has Stroke like signs & symptoms, but then they RESOLVE & become better. This is what?
TIA
207
Which soft tissue injury causes the most bleeding?
Avulsion
208
An avulsion is a soft tissue injury involving?
The SQ & Facia with lots of blood loss
| rip between subcutaneous & muscle tissue
209
Multiple attempts using ET Tube with ICP, CAUSE’s more?
ICP, Bradycardia, & other Dysrhythmias
210
Patient fell from 3rd floor, Pt. lying down, (R) lung sound absent, & FX leg. After airway TX?
BVM with O2, Decompress (R) Side, PASG, IV in route
211
A Pt. in a trauma accident that gets hit in the abdomen, may mimic peritonitis because?
Stomach acids can spill into abdomen cavity
212
A question about Synch. Cardioversion?
Cardioversion is carried out only for pt.’s whose cardiac
output is severely impaired.
(wrong choice’s: hemodynamically unstable, & V-FIB)
213
Trauma Pt. hit steering wheel, absent lung sounds on the left side, do not?
Decompress on the right side
214
Ascites is?
the build up of fluid in the space between the lining of the abdomen and abdominal organs
(the peritoneal cavity & Bulges in the flanks)
215
Penetrating trauma to abdomen, 40% blood loss from this organ?
Liver
216
Rule of 9’s, what percentage is the child head?
18%
| arms: 9% each, 18% front, 18% back, 1% genitals, 14% each Leg
217
C1 – C4 injury, problems with?
Respiration
| c1=atlas, c2=axis
218
Man Complains of SOB, CHEST PAIN after working out?
Spontaneous Pneumothorax
219
Patient with twisted leg, with low BP, high Pulse, cool & clammy skin?
Hypovolemia
220
Paralyzed from nipple line down?
T-4
221
Umbilicus down?
T-10
222
Tension Pneumothorax is known as what shock?
```
Obstructive Shock
(S/S; JVD, tracheal deviation away from injured side; shock, asymmetrical chest rise)
```
223
Blood in the eye?
Hyphemia
224
Bleed under the dura is described as?
Subdural
225
What part of the brain regulates BP, Resp, and Heart Rate?
Medulla Oblongata
226
Damages to tissues due to high speed bullet is known as what?
Cavitation
227
Babinski Reflex/Sign?
Toes go up / Toe Faced outward
| regarding infants feet when they are stimulated
228
First thing that happens in a blast injury?
Compression of air filled organs
| secondary – struck by flying debris, Tertiary – pts. Propelled through space/impact other objects
229
Fracture on one side of Long-Bone?
Greenstick
230
Most common type of rural MVA?
Frontal
| head on collision) (cause of two lane roads
231
Most common cause of death at a Fire Scene?
Carbon Monoxide (headache,confusion,cherry red lips)
232
Patient in MVA frontal impact suffering down / under injury, you would suspect?
```
Femur Fracture
(down under the dashboard)
```
233
Patient fell through a glass door & has a piece of glass stuck in the neck, what do you do?
C-Spine, Airway, Occlusive dressing, Stabilize the glass, Transport
234
```
Which would you treat Last?
A. Spinal
B. Arterial Hemorrhaging
C. Airway Obstruction
D, Sucking Chest Wound
```
A. Spinal
235
Type of fractures?
```
Transverse (across)
Spiral, Greenstick (kids, incomplete)
Oblique (diagonal with sharp points)
Compound (open)
Comminuted (bone fragments)
```
236
La Forte Fracture:
FX within the face
F1 = Maxilla
F2 = Nose
F3 = Orbits
237
Bradycardia With PVC’s, What MED?
```
Give Atropine
(not lidocaine)
```
238
What is a wide Etopic Beat?
PVC
239
A 22 yr. old woman complains of severe pain in RLQ, She has not eaten in 12 days & is constipated, & No chance of being pregnant. She most likely has?
Appendicitis
240
A 23 yr. old Gym rat has Explosive headache, this indicates?
Subarachnoid Aneurysm
241
When you Approach radiation the 3 Principles of Safety are?
Time, Distance, Shielding
| **alpha – weak 6inches / beta – weak 1-2ft / gamma –Bad**
242
A patient complains of Dyspnea, he is CYANOTIC, has RALES, Reg. Pulse 140, BP 150/120, with Pink
Frothy Sputum. Pt. has?
Pulmonary Edema
243
A patient has a history of SOB, Orthopnea, and Coughing up pink tinged mucus. The patient most likely
has?
Left Sided Heart Failure or Acute Pulmonary Edema (instead of using CHF*)
244
Pulmonary Edema?
Left Heart Failure
245
Lady sitting upright with pink frothy sputum indicative of?
Left Heart Failure
246
Best position for Pt. with Orthopnea?
```
Sitting Position
(orthopnea: SOB laying down)
```
247
A patient is found on the floor in a pool of vomit, shaking, CONFUSED and frightened
of SPIDERS on the wall (there are no spiders!). Patient has stopped drinking for 2 Days and is experiencing what?
Withdraws (DT’s)
248
A patient is Unconscious, Incontinent, and having Generalized Muscle Relaxation and Contraindications, what type of Seizure?
Grand Mal Seizure
249
A prolong P-R Interval is indicative of a?
First Degree Heart Block
250
First Degree block is indicated on ECG tracing when the P-R interval is greater than?
.20 sec
251
P-R Interval begins and ends?
Begins @ the P wave & ends @ the Beginning of the QRS
252
P waves get wider & wider till QRS drops, is set to be?
Mobitz I Wenkebach (going, going – gone*)
253
QRS interval?
0.08 - 0.12
254
A man repeatedly dove today & made a fast ascent from the last dive. He is complaing of Joint pains, Tingling legs, & Adominal pain. The Pt. has?
Decompression Sickness (bends)
255
Septic, anaphylactic, neurogenic shock, the Low BP is due to what?
Vasodilation
256
A Victim is found with Bright Red, frothy blood bubbling from the mouth which each exhalation.
This is an Indication of what?
Lung Damage (hemoptysis)
257
Pt. with Abdomen Pain, position of comfort?
On their sides with knee’s bent (fetal position)
| Or in Lateral Recumbent
258
Acetylcholine / Oxytocin are Secreted by?
The Pituitary Gland
259
Adrenal Glands Secrets / Releases what?
Epinephrine & Norepinephrine
260
Angina caused by physical (exercise) or emotional stress is called?
Stable Angina
| *not unstable angina*
261
During Cardiac Arrest, Build up of Pyruvic & Lactic Acid causes?
Metabolic Acidosis
262
Primary concern with treating a near drowning victim?
Hypoxia / Acidosis
| both metabolic/resp
263
Eclampsia is?
A Seizures
| related to pregnant women
264
What do you do BEFORE Admin. D50?
Check Sugar
| glucose check
265
When a patient is vomiting GREEN like substance, this is a sign of what?
Rupture of the Gallbladder (cholecystitis – RUQ pain, could be yellow or green bile vomit)
266
Antepartum =
Prior to the delivery of the fetus
267
A female Pt. with ABD pain to her LLQ with vaginal bleeding & a missed menstrual cycle
approximately 7-10 days ago, what type of pregnancy?
Ruptured Ectopic Pregnancy
268
A 22yr. old female with LLQ Pain. She is 2 weeks late for her period. Pt. is shocky. She is diagnosed as?
Ectopic Pregnancy
269
A Child that has a headache, STIFF NECK, Vomiting, high fever, lethargic, & pale has?
Meningitis
270
Pt. mother is Pregnant with 2nd child; pt. mother has had 2 Miscarries before, with ONE Live Birth? Gravid 4, Para 1, Abortions 2 (**twins, count as one birth**)
Gravid 4, Para 1, Abortions 2
| twins, count as one birth
271
Transporting a pregnant patient in the 3rd trimester, how do you transport?
Left Lateral Recumbent supine 10 – 15 degree’s
272
Woman in third trimester, minimal bleeding, ridged uterus & pain?
Abruptio Placenta
| pregnancy complication in which the placenta detaches from the uterus
273
Abdominal pain and dark bleeding is characterized by?
Abruptio Placenta
274
S/S of Pregnancy?
lower BP, increase HR, & Plasma increase
275
After you have clamped and cut the cord, blood keeps oozing out, what do you do?
Clamp proximal to the previous clamp (
276
Pregnant female in childbirth with prolapse cord, what to do?
Sterile Gloved hand in canal, Hold baby face away from cord and Transport
(do not push the cord back inside the canal) (transport mother = in knee chest)
277
What do you do if you see a Nuchal Cord?
Insert gloved hand, move baby’s head away From the cord, & transport immediately
278
If baby delivers with amniotic sac not ruptured, what to do?
Poke with glove finger & pull away from baby face
279
Baby delivers in a “bag of water” what do you do?
Puncture the bag with your finger & uncover The baby’s face
280
Patient has been decontaminated from Radiation, come to you, what is he considered?
Low Threat
281
DKA or Diabetic ketoacidosis Pt. present with?
Warm & Dry Skin (*dehydration/fever*)
282
The Upper Area of the Uterus is?
```
The Fundus
(which is a muscular structure located behind the cervix)
```
283
Top Priority of Heat Stroke Pt.?
Rapid Cooling, IV, & Transport (temp is 105-106)
284
Heat Stroke signs/symptoms?
Hot & Dry Skin, Syncope, Weak Pulse, Hypotension
285
Heat Exhaustion is?
Profuse Sweating, weak/pale, Tachy
| sodium and water loss
286
Heat Cramps is?
ABD & Leg cramps
| cool down, give fluids
287
Which one is NOT a SIGN of a Stroke?
Hypotension
| correct choice given; headache, aphasia, facial drooping
288
How long does death generally occur after an MI?
1-3 hours after MI or (1-3hrs Check) OR Most deaths involving MI occur within? 2-3 hours
289
In MI, which part of the heart is affected?
```
Left Atrium
(other choices = Right Atrium, Left Ventricle, Right Ventricle -wrong)
```
290
Blue or Purple Lesions on AIDS Pt. face, neck, mouth is?
Kaposi’s Sarcoma
291
Neurotic VS Psychotic Pts, psychotic pt are not in touch with?
Reality
292
When talking to Psych. Pt.? contact**)
Take away from situation & let them speak
(remove spouse from scene)
(calm approach, good eye contact)
293
PPE is the same as? BSI is used because of assumption that all blood & other body fluids are infection (ppe and bsi are not the same)
PPE is the same as? BSI is used because of assumption that all blood & other body fluids are infection (ppe and bsi are not the same)
294
What happens in the 3rd Trimester?
Decreased BP
295
What trimester does toxemia usually occur in pregnancy?
3rd Trimester
296
Rapid Cooling for Heat Stroke patient is to prevent what?
Irreversible Brain Damage
297
Cardiac Output is the amount of?
Blood pumped by the heart in one min
298
Total amount of blood ejected in each contraction of the ventricle?
AKA stroke vol 80-100mls (Adult male)
299
Patient with chest pain, P-72 and 10MIN later pulse decreases to 38. If stroke volume DOSEN’T CHANGE...?
Cardiac Output DECREASES
300
What is TRUE about HIV patient?
They Appear NORMAL (you couldn’t tell)
301
Fibrinolytic Therapy time frame is?
3 Hours
302
Causes of AMS?
Hypoperfusion, hypoglycemia, hyperglycemia, heat stroke (AEIOU-TIPS)
303
Guy went on Vacation and went diving, how do you transport pt.?
Left Lateral
304
Absent P wave in LEAD II means?
The SA Node is not the Pacemaker
305
Normal Pacemaker of the heart?
SA Node
306
What does the QRS mean on an ECG?
Ventricular Depolarization
307
When dealing with a patient exhibiting a hostile, aggressive behavior, appropriate action would be to?
Contact the police dept. & remove bystanders from the scene
308
Behavior emergency Pt., you should?
Try to orient the Pt.
309
How to restrain a behavioral emergency Pt.?
One arm above his head, One arm by his side,
| Patient lying prone with feet tied at the end of the stretcher
310
Hypogylcemia Pt. resembles what?
Behavioral problems
311
A Pt. complains of SOB. On assessment he has pursed lips & barrel chest, which indicates?
Emphysema
(pink puffers)
(Chronic Bronchitis is called - “blue bloaters”*)
312
Patient with Barrel Chest and is pink has?
Emphysema
313
Female Pt., puffing & with pink skin?
Emphysema
314
A guy in an MVA, Pt. has subcutaneous emphysema on the right neck side, Dyspnea, Absent lung sounds on the right side & diminish lung sounds on the left side?
Tension Pneumothorax
315
Pt. is a Chronic Smoker with Barrel Chest; what condition would you expect him to have?
Emphysema
316
ST Elevation in Leads II, III, AVF?
Inferior Wall MI
317
317. Leads V1-V4?
Anteroseptal MI
318
318. Leads V3-V6?
Anterolateral MI
319
ST elevation on V1-V6, l, AVF?
Anterior Wall MI
320
ST elevation on V2, V3, V4, V5?
Anterior Lateral Wall MI
321
Lead Placement of V4 electrode?
Midclavicular
322
P Wave =
QRS Wave =
T-Wave =
P Wave = Atrial Depolarization
| QRS Wave = Ventricular Depolarization, T-Wave = Repolarization of the Ventricles
323
Enlarged Liver, distended neck veins & edema are Sign’s of?
Heart Failure (RIGHT)
324
Pain in the chest “tearing & shearing” pain towards the neck, with no pedal pulses?
Dissecting Aortic Aneurysm
325
Man complaining of tearing pain in the back & in between SHOULDERS with no pedal pulses?
Aortic Aneurysm
326
Causes of pinpoint pupils?
Narcotics
327
The Drug of choice for Cardiogenic shock is?
Dopamine
| pump problem, MI
328
Pt. presents with whistling sound during exhalation is consider being?
Asthmatic Bronchiolitis
329
When blood leaves the Lungs, where does it go FIRST?
Left Atrium
330
O2 rich blood leaves the pulmonary veins & goes to the?
Left Atrium
331
Where do you put pressure for the Sellick maneuver?
Cricoid Cartilage
332
Sign of a Pt. with a progressive disease that affects the nervous system?
Mental Status
333
```
All are S/S of Kidney Stones EXCEPT?
severe flank pain
pale
Frequent Urination
lower abd pain
```
Frequent Urination
334
Patient with ringing in the EAR & is SICK?
ASA Overdose
335
Patient coping with stress, common reaction?
Stress, Fear, Anxiety Anger
336
2nd Phase of child birth is when?
Full Dilation of cervix until child is delivered
| 3rd phase is when the baby is fully out
337
Blood Clot in the legs will lodge where?
In the Lungs
338
35yr. old female has sudden, sharp, severe headache & becomes unconscious & unresponsive.
She is suspected to have?
Subarachnoid Hemorrhage
339
What is the BEST Method to use on LSD Pt.?
Talk down method
340
Which of the following bites is most neurotoxins?
Coral Snake
| Red to Yellow - kills a fellow / Red to Black - is a friend of jacks
341
Patient with chest pain & back pain, with no pulses in extremities?
Dissecting Aorta
342
What are some of the signs/symptoms expected to be seen in a pt. who has been giving Narcan?
Combative & Aggressive Behavior
343
Definition of Status Epilecticus?
Seizure without gaining consciousness in between 2 or more
Episodes
(prolonged seizure) (remember - no break between Seizures, Don’t Intubate*)
344
Petit mal seizures?
A type of seizure that involves brief, sudden lapses in attention.
Also in children
(many a day / may or may not lose consciousness)
345
Guy playing baseball then DROPS, Swollen tongue & Lips?
Anaphylaxis
346
Guy with Fever, SOB, productive cough, no edema?
Pneumonia
347
Bilateral, Dilated Pupils indicate?
Cerebral Hypoxia
348
What causes unequal pupils?
CNS Injury (neurological crisis)
349
Best way to evaluate a behavioral emergency patient?
Away from crisis & cause
350
Maternal blood volume increases how much?
40%
351
A Pt. has one pupil that is dilated & non-reactive, while the other is slow to respond. This is a form of a?
Neurological Crisis
352
WPW (Wolff-Parkinson-White) Syndrome ( Meds you cant give like Cardizem, why?
Because it will bypass the AV Node & the rapid Firing of the atrium will get to the ventricles & eventually will go into V-Fib
(WPW:extra electrical pathway in the heart causes a rapid heartbeat.
353
Why would you SYNC a Pt. in SVT?
Because he is Hemodynamically Unstable
354
Which is consider a peripheral vein?
The arms, hands, legs and feet
| Not the veins in the chest or abdomen
355
R on T Causes what?
V-FIB
356
What do we NOT want to give a stroke Pt?
```
Fluid Bolus
(*remember by doing so, you will increase BP causing ICP = No Bueno!*)
```
357
What does glucagon do?
Stimulates the liver to change glycogen into sugar and secrete it into the blood stream for energy.
358
```
Which is not a vector of hepatitis ?
blood
Saliva
semen
feces
```
Saliva
| *blood & semen = HEP B*
359
A Fecal or Orally Transmitted Disease is?
Hepatitis A
| (viral) is fecal
360
How does an elderly Pt. mask an MI?
They have a decreased sensation to pain
361
Proper meds for CHF?
02 (CPAP), Morphine sulfate, lasix and Nitro
362
Common finding w/ Cystitis (inflammation of bladder) is?
Urinary tract infection
363
What kind of diabetes do you develop during Pregnancy?
Gestational
| must be on insulin
364
9 month pregnant patient w/ seizures?
Valium 2.5mg - 10mg (Slow IVP) or 5-10mg
365
Valium = Ped:
| Adult:
Ped: 0.2mg/kg
Adult: 5-10mg
366
10 QRS complexes in a 6 sec strip would most likely indicate?
A Ventricular Rate
367
Prolong P-R Interval?
1st Degree Block
368
Normal Rhythm with no Pulses, what med do you give?
Epi
369
Strip shown, the above strip represents? Sinus Bradycardia
| NSR, Junctional Rhythm, 1st Degree heart Block – were the other answers
Strip shown, the above strip represents? Sinus Bradycardia
| NSR, Junctional Rhythm, 1st Degree heart Block – were the other answers
370
V-Tach shown how?
Wide, Bizarre QRS
371
Most common route of poisoning?
Ingestion
372
Tricyclic antidepressants?
Mellaril, Trofranil, Elavil, Amytriptyline
| TX-sodium bicarb
373
Intrinsic Rate of the SA Node?
60-100 BPM
374
Intrinsic Rate of the AV Node?
40 – 60 BPM
375
Intrinsic rate of the Ventricles?
20-40 BPM
| purkinje fibers
376
Tourniquet does what?
Restrict Venous Blood Flow BUT Allows Arterial Blood Flow
377
34 yr. old male appears Jaundiced with Sclera, No appetite, Lost 10 lbs. in 3 weeks, Nauseated, Generally Fatigued, Low fever, & Sudden distaste to cigarettes?
Viral Hepatits
378
51 yr old. Farmer has cramps & diarrhea, this indicates?
Organophosphate Poisoning
379
The Pharmacological TX of Anaphylactic Shock?
Epinephrine & Benadryl
380
Endocrine system acts by?
Releasing hormones into the bloodstream
381
Chicken Pox (Varicella), Measles, & Mumps are spread by?
Airborne Droplets (virus)
382
Delirium Tremors can occur?
48 -72 hours after cessation of alcohol (ETOH)
383
Patient says “I hear bells in my head”?
Aspirin OD
384
22 y/o female, RLQ pain, radiating to right shoulder, no menses with spotting?
Ectopic pregnancy
385
Define Cor Pulmonale?
Right sided heart failure secondary to chronic lung disease
386
Acute Myocardial Infarction, what is the Treatment?
Morphine MONA – (O2,ASA,nitro,Morphine*)
387
What are signs & symptoms of respiratory distress?
Nasal Flaring
388
Most common error with AED use is?
Dead Batteries
389
A situation that is indicated for the use of MAST Suit is a?
Ruptured, Abdominal Aortic Aneurysm, A pelvis fracture
| *inflate – left leg, right leg, ABD*
390
Which of these can lead to permanent Brain Damage if not corrected?
HYPOglycemia
391
constricted pupils are most indicative of?
```
Heroin Overdose
(dilated pupils may indicate amphetamine overdose)
```
392
Addison Disease
Adrenal gland failure
| adrenal glands do not produce enough of the hormone cortisol and in some cases, the hormone aldosterone
393
UPPER GI hemorrhage?
Black tarry stool, vomiting blood or coffee ground
394
Lower GI Bleed?
Bright red or wine color stool
395
Adult GCS scenario = 13 (lowest 3 – highest 15)
Adult GCS scenario = 13 (lowest 3 – highest 15)
396
What is correct about Nasogastric tube on intubation?
Bad Face Seal or gets in the way of intubating
397
Complications of nasal gastric tube?
It makes intubations more difficult
398
Suctioning the back of a child’s mouth can cause all of the following EXCEPT?
Dehydration
| suction can stimulate the vagal nerve causing slower than normal heart rate
399
Inter-facility transport Pt. receiving a blood transfusion & not feeling well?
Stop Transfusion
400
NPA is used when?
Used on pt. with a intact gag reflex
401
When Suctioning the Tracheotomy?
3 – 5 inches
402
During Intubation you could stimulate the Vagus Nerve, what happens?
Bradycardia
403
Aphasia is inability to?
Produce or Understand Speech
404
Catecholamine’s causes?
increase Heart Rate, & Increase vasoconstriction
| Catecholamines are hormones produced by the adrenal glands
405
Increase in acid due to metabolism or vomiting, diarrhea, diabetes or meds?
Metabolic Acidosis
406
External Jugular vein is NOT a?
Central Line
407
Movement of fluid or molecules through a cell membrane against the concentration?
Active Transport
408
Lowest APGAR Score?
0
| highest 10
409
When do you check (APGAR)?
1 & 5min after birth
410
Which is part of APGAR?
Which is part of APGAR? Appearance
| pulse, grimace, activity, respiration
411
A baby is born, delivery finds it's Body is Pink, Extremities are blue, Pulse120, Crying lustily while jerking arms legs. The APGAR score is?
9
412
SIDS?
Below the age of 1 but most occur between 4-6 months, may have vomit or fluids from mouth/nose (unexpected death which is unexplained even after autopsy)
Place infants on back or side to sleep
413
When you get OLD, you get Thirsty because?
Decrease in Bone Mass, skin turgor, & decrease in thermoregulation
414
Which is NOT a characteristic problem in the OLD People?
Increased Thirst
415
Neonate Pt. how much fluid replacement?
10ml/kg
416
Pediatric assessment?
Toe to Head
417
Laryngotracheobronchitis AKA Croup presents with?
Stridor
418
All happens during the AGING Process EXCEPT?
Increase Thirst
419
Rapport with geriatric Pt.?
Be professional, open stance, caring
| be patient
420
How would you approach a geriatric patient differently than a non-geriatric patient?
More formally With an open stance
421
The #1 cause of trauma in elderly injuries?
The #1 cause of trauma in elderly injuries? Falls
| In bathrooms/stairs
422
Elderly Pt. output more than input causing?
Electrolyte Imbalance
423
Child Abuse, what do you do?
Take child to hospital & document, report to authorities
424
Old man urinates MORE than he puts in, due to what?
Dehydration/Electrolyte Imbalance
425
Guy on Vent, how do you treat?
Remove from vent, suction trachea, o2 BVM
426
Child with SOB, mother being hysterical & not letting you treat child, what would you do?
Try & talk to calm her down
427
Most common seizures in children under the age of 6?
Febrile
| rapid increase of temp.
428
Where do you apply pressure when tubing a pediatric?
Larynx
429
Landmark for IO in a 10kg infant?
2-3 inches (fingers) below the Tibial Tuberosity in medial aspect
430
Diabetic Pt. with headache, Most important question to ask?
How long has he had the head ache
431
Newborn treatment?
Dry, Warm, Suction, Stimulate
| *Do What Seems Sensible*
432
Umbilical Cord has?
2 Arteries, 1 Vein, Supplies to the fundus
433
In a Criothyrotomy, the landmark used to determine the proper insertion location is?
The Depression just INFERIOR to the Adam’s Apple
434
Pt. who are decontaminated in the warm zone, have how much threat to paramedics?
Little or no threat to medic
435
Part of the Scene Size Up includes?
Number of Pt. on scene
436
MCI, first crew on scene come upon Pt. in cardiac arrest?
continue triage to triage pt.s
437
What do you check in the triage system?
Breathing, Circulation, & LOC
(32 can do)
(breathing under 30, cap refil less than 2 seconds, follows direction. if pt passes these test triage yellow. if not triage red)
438
When triaging at MCI, the Highest Priority when treating?
Sucking Chest Wound
439
```
When prioritizing patients at an MCI, which one is LEAST important?
AMS
Airway compromise
arm & leg numbness
sucking chest wound
```
arm & leg numbness
440
Last person treated in MCI
Spinal Injury
441
The Incident Commander is in Charge of?
MCI
442
Arrive on scene of an MCI where do you PARK yourself?
Staging area
| wait for assignment
443
Upon Arrival of a disaster scene, the patient who should receive the lowest priority
(of the following) is?
A.Mid sternal chest pain
B.2nd degree burn 20-30%
C.penetrating chest wound
D.3rd degree burns over 80% of the body
D.3rd degree burns over 80% of the body
| pt. will die soon anyway
444
In S.T.A.R.T system a patient breathing at 40bpm is consider a?
Critical Pt.
| red
445
At a crime scene, you have a Pt. that is viable, what do you do?
Treat the Patient, & cooperate with law
enforcement
(“DO NOT DISTURB THE SCENE”)
446
Landing Zone for helicopter is?
100ft x 100ft
447
All are Ignition Sources at a Hydrocarbon Spill, Except
Sealed Flashlight
448
The Front windshield glass is made of
Laminated Safety Glass (use fire ax)
449
In a MVA scene, what should you do first?
Stabilize scene, then car, then patient
| Always put Safety First
450
Assessment begins at?
Dispatch
451
Pt. in MVA, while trying to gain access, what should you try first?
Door, Window, Body
| try before you pry
452
Arrive to an MVA, how should you disable the car battery?
Disconnect the BLACK (negative) First
| don’t cut cables
453
Arrive on scene and see a Burning Vehicle, park where?
100ft away uphill & upwind from hazmat scene
454
At intersections, before proceeding you must?
Look Left first
| obey all traffic laws
455
What lane should you drive on your way to a call, why?
Left lane, so others can pull right
456
An ambulance is called to a house fire. Upon entering the burning house, a paramedic finds an unconscious woman. He decides to mover her from the house using a fireman’s drag. The First step would be to?
Tie the patient’s hands together
457
Definition of Multi System Trauma?
Pt. considered to have more than one injury
458
Highest Level of protection of HAZMAT suits?
Highest Level is A
(then B,C,D)
(hot – scene; warm – decon; cold zones – treatment/transport)
459
Most fatalities among rescuers occur in?
Confined Spaces
460
The most major complication of a joint injury is?
Blood Vessel Damage (not nerve damage)
461
The tool not to use to pull or roll a dashboard is?
A Pry Bar
462
H's
Hypovolemia Hypothermia
Hypoxia
Hydrogen Ion (acidosis) Hyper/Hypo kalemia
463
T's
Thromboemboli (pulmonary & coronary) Trauma
Tension pneumothorax
Tamponade, Cardiac
Toxins (overdose)
464
STAGES OF LABOR
1. Contractions & Dilationofthecervix
2. Baby enters birthcanal until birth
3. Birth to Delivery of the Placenta
465
Transection above T1
Quadriplegia (tetraplegia) no use of upper/lower ext
466
Transection below T1
Paraplegia, use of upper ext, but no use of lower ext
467
Adult respirations and pulse
12-20
| 60-100
468
Child respirations and pulse
18-30
| 65-110
469
Infant/Newborn respirations and pulse
40-60
| 140-160
