UNIT II - EXAM 2 Flashcards by Lorin Uttinger

Which structure secretes glucagon?

A) alpha cells

B) beta cells

C) islets of langerhans

D) delta cells

alpha cells

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When ___________ minutes have passed without either seeing lightning or hearing thunder, it is safe to resume activities and be outdoors

A) 10

B) 15

C) 20

D) 30

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Type 2 diabetes is a condition whose onset and severity can be greatly decreased with which of the following?

A) surgery

B) medicine

C) exercise

D) genetic therapy

exercise

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A person with low blood sugar will experience which of the following?

A) bradycardia

B) hypoventilation

C) arrhythmia

D) tachycardia

tachycardia

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During the clinical presentation of rhabdomyolysis, the reddish-brown color of urine is caused by

A) urea

B) myoglucose

C) uric acid

D) myoglobinuria

myoglobinuria

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Levels of creatine kinase greater than __________ U/L may indicate ER

A) 250

B) 500

C) 2,000

D) 5,000

5,000

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Which of these therapies should be avoided after insulin use?

A) normtecs

B) hot packs

C) e-stim

D) massage

hot packs

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When normal sodium levels in the blood lower to a level of 125-129 mEqL, the patients decrease in sodium is said to be

A) mild

B) moderate

C) severe

D) acute

moderate

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The gold standard for treating someone with heatstroke is which of the following?

A) cold packs

B) cold towels

C) cold water immersion

D) cold fluids

cold water immersion

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Cold illness mostly affects which of the following organ systems?

A) Respiratory System

B) Nervous System

C) Digestive System

D) Urinary System

Nervous System

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TRUE/FALSE:

McBurney’s point is a palpation location for appendicitis

true

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When a person is a part of the lightning channel as it makes contact with the earth, the strike is said ti be a

A) side flash

B) ground current

C) upward streamer

D) contact injury

upward streamer

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Which of these organs is found in the retroperitoneum?

A) stomach

B) liver

C) spleen

D) small intestine

liver

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A heart murmur will be heard the loudest over which section of the heart?

A) upper right

B) lower right

C) upper left

D) lower left

lower left

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Death from Marfan syndrome can occur from a dissection of which major blood vessel?

A) aorta

B) pulmonary trunk

C) inferior vena cava

D) superior vena cava

aorta

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Typical respiration rate in
Adults:
>65:
<80:

Adults: 12-20bpm
>65: 12-25
<80: 10-30

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External rhabdomyolysis is characterized by the breakdown of which type of tissue?

A) adipose

B) muscular

C) lymphatic

D) neural

muscular

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A blood pressure of 140 to 159/90 to 99 mmHg is considered

A) hypotension

B) prehypertension

C) mild hypertension

D) severe hypertension

mild hypertension

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The respiration rate in a typical adult is ____________ breaths per minute.

A) 5-10

B) 12-20

C) 20-28

D) 30-36

12-20

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Which of these is a cause of rhabdomyolysis?

A) accustomed workouts

B) hypothermia

C) embolism

D) excessive hydration

embolism

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Which heart rate is greater than >100 bpm?

A) normal

B) extreme bradycardia

C) Sinus bradycardia

D) tachycardia

tachycardia

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What type of respiratory sounds occur when air moves freely though the large passageways of the lungs and are heard over the anterior chest in the trachea and bronchi?

A) bronchio vascular sounds

B) bronchial sounds

C) alveolar sounds

D) vesicular sounds

bronchial sounds

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A patient presents to his HCP with pink frothy sputum. This patient most likely has which of the following?

A) hypertrophic cardiomyopathy

B) acute myocardial infarction

C) myocarditis

D) marfan syndrome

acute myocardial infarction

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A patient comes to the clinic complaining of appendix pain. In which quadrant will her pain be located?

A) upper right

B) upper left

C) lower right

D) lower left

lower right

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Signs of heatstroke include A) rectal temperature at 102°F B) clammy skin C) profuse sweating D) headache

clammy skin

If hyponatremia is left untreated, it can lead to A) renal failure B) tachycardia C) elevated blood pressure D) extracellular shrinkage

renal failure

The Valsalva maneuver is used to detect which of the following heart conditions? A) hypertrophic cardiomyopathy B) acute myocardial infarction C) myocarditis D) marfan syndrome

hypertrophic cardiomyopathy

Athletes with hyperglycemia but normal ketonuria are allowed to participate as long as serum glucose is assessed every A) 5 minutes B) 10 minutes C) 15 minutes D) 20 minutes

15 minutes

In patients with rhabdomyolysis, acute renal failure may occur _____________ after initial muscle damage A) 1-2 hours B) 10-12 hours C) 1-2 days D) 10-12 days

1-2 days

Sickle cell trait is most prevalent among persons of African or ____________ descent A) asian B) South American C) mediterranean D) samoan

mediterranean

Hypoglycemia and Hyperglycemia which of these is a symptom of hypoglycemia? A) polyuria B) anxiety C) hypotension D) hypoventilation

anxiety

Which condition is a blockage in a vessel of the lungs commonly caused by a thrombus? A) cardiac embolism B) thoracic thrombosis C) ischemic attack D) pulmonary embolism

pulmonary embolism

A person who has Marfan syndrome will not display A) joint hypermobility B) ocular lens subluxation C) flat feet D) short stature

short stature

According to the AAST grading scale, a liver injury with a sub scapular hematoma of 10% to 50% in surface area is considered to be which grade? A) I B) II C) III D) IV

III

Which of the following is a characteristic of exertional collapse associated with sickle cell? A) often with prodrome of muscle twinges B) slumped to the ground with weak muscles C) physically writing and yelling in pain D) prolonged recovery with rest, rehydration

slumped to the ground with weak muscles

A patient with a suspected kidney injury will suffer from which of these symptoms? A) tachycardia B) nausea C) hypertension D) hematuria

hematuria (blood in urine)

What is the name of the condition that has blood in the pleural cavity? A) pneumothorax B) hemothorax C) hemopneumpthorax D) sanguothorax

hemothorax

What type of IV is needed to treat heat illnesses and hypovolemia? A) dextrose B) Lactated Ringer's (LR) solution C) saline D) amino acid

saline

(Clot) final product of blood coagulation in hemostasis healthy response to injury to prevent bleeding

Thrombus

low level of carbon dioxide in the blood

Hypocardia

<60 bpm

bradycardia

<50 bpm

extreme bradycardia

heard both ant/post toward midline of thorax, medium sized air passages (echo)

bronchiovescular

lower pitched; ant/post away from midline; all other areas of lungs (esp. bronchioles) (deep/full sound)

vesicular

SpO2: 95%-100% Flow Rate: none Oxygen Device: none

Normal

SpO2: 91%-94% Flow Rate: 1-6 L/min Oxygen Device: nasal cannula

Mild Hypoxia

SpO2: 88% - 92% Flow Rate: 6-10 L/min Oxygen Device: simple oxygen mask

Mild-moderate Hypoxia

SpO2: 86%-90% Flow Rate: 10-15 L/min Oxygen Device: non-rebreather mask or bag-valve mask

Moderate Hypoxia

SpO2: <85% Flow Rate: 15 L/min or higher Oxygen Device: non-rebreather mask or bag-valve mask

Severe Hypoxia

Indications: unresponsive altered mental status intact gag reflex oral trauma preventing OPA Contraindications: intolerance facial fx nasal obstruction or epistaxis caution with skull fx

Nasopharyngeal airway

Indications: unresponsive absent gag reflex (if they start to gag can't use) Contraindications: conscious gag reflex trauma to mandible and teeth

Oropharyngeal airway

Nose to throat - Mouth to throat -

Nasopharyngeal airway Oropharyngeal airway

Indications: cardiac arrest not breathing severe anaphylaxis

LMA

MOI: blow to chest S/S: dyspnea, gasping for breath, cyanosis, tracheal deviation, tachypnea, jugular vein distention, decreased breath sounds

Pneumo/Hemothorax

Venous thromboembolisms, blockage (thrombus), DVT, fatal 3rd COD-CV in US S/S: dyspnea & chest pain, anxiety, shock, cyanosis, tachycardia, hemoptysis, hypotension, hypoxia Risk Factors: hereditary blood disorders, birth control, hormone therapy, pregnancy, immobilization, trauma, long-term traveling

Pulmonary Embolism (PE)

60-100 bpm

normal heart rate (sinus rhythm)

rapid heart rhythm; potentially life threatening

ventricular tachycardia (V-tach or VF)

uncoordinated contraction of ventricles and inability to pump blood effectively

Ventricular fibrillation (V-fib or VF)

No cardiac electrical activity, no myocardial contractions, and no cardiac output

Asystole (flatline)

air in plural cavity

pneumothorax

blood & air in pleural cavity

hemopneumothorax

nose bleed

epistaxis

turning blue

cyanosis

coughing up blood

hemoptysis

shortness of breath; difficulty or labored breathing

dyspnea

difficulty swallowing

dysphagia

oxygen-binding protein in muscle tissue that is only found in the blood stream after muscle injury (relevant to myogloburina)

Myoglobin

BP of <90/60 mmHg

hypotensive

BP of 120-139/180 mmHg

prehypertensive

BP of >180/110 mmHg or greater

Severe hypertension

Primary gland secreting the hormone insulin and glucagon

pancreases

- depression of RS - opioid OD - increase inter cranial pressure - diabetic coma - severse airway obstruction - sleep apnea

causes of bradypnoea (slow RR <12 bpm)

- anxiety - emotional distress - p! - fever - asthma/COPD - PE - Pneumonia - acute res distress syndrome - anaphylaxis - heart failure - shock - diabetic ketoacidosis - neuromuscular disorder - increased HR

causes of tachypnoea (fast RR >20 bpm)

life threatening electrolyte imbalance complication of exertional rhabdomyolysis

hyperkalemia

muscle tissue breakdown, leading to muscle cell infiltration into the circulatory system - electrolytes - myoglobin - potassium - creatine kinase (CK) - other muscle enzymes

Exertional Rhabdomyolysis

heart murmurs can be heard/found in the

mitral & tricuspid valve (mid-clavicular line, bw 7th/8th intercostal space)

When can aspirin be used to treat myocardial infarctions

- hemodynamically stable patients with cardiac symptoms or ACS

upper-right quadrant organs

liver gallbladder tail of pancreas small intestine transverse colon ascending colon

upper-left quadrant

spleen stomach small intestine transverse colon descending colon

lower-right quadrant

appendix distal right ureter right ovary right fallopian tube small intestine ascending colon

lower-left quadrant

distal left ureter left ovary left Fallopian tube small intestine descending colon

- characterized by the body inability to produce insulin - not preventable

type 1 diabetes

- inability to use insulin effectively because of a combo of resistance to insulin + overall decreased production of insulin - preventable

type 2 non-insuline-dependent diabetes mellitus

- mm swelling - neuronal ischemia causing paresthesia or paralysis - 30 to 50 mm Hg is an indication for fasciotomy - complication of ER

acute compartment syndrome

often lethal disruption of heart rhythm resulting from a direct blow to the precordial region at a critical time during the cardiac cycle, causing cardiac arrest (dammer Hamlin)

commotio cordis

process of purifying blood by extra corporeal removal of waste products such as creatine and urea and free water from the blood when kidneys are not functioning properly or renal failure (dialysis)

hemodialysis

rupture or lysis of RBCs (erythrocytes) nd the release of their contents (cytoplasm) into surrounding fluid (plasma)

hemolysis

arterial concentration of carbon dioxide more than 50 mmHg typically caused by inadequate respiration

hypercapnia

left ventricle becomes thick resulting in the heart being less able to pump blood effectively. complications include heart failure, irregular heart beat, sudden cardiac death

hypertrophic cardiomyopathy

amount of sodium is diluted in the blood, usually caused by over hydration. can be life-threatening, not caused by heat; self imposed over hydration causes: fluid loss due to vomiting or diarrhea, certains meds or conditions, chronic conditions S/S: headache, malaise to systemic swelling, nausea, lethargy, dyspnea and delirium (reps what system is impacted)

hyponatremia

normal sodium levels mild Na+ levels moderate Na+ levels severe Na+ levels

135-145 mEq/L 130-134 mEq/L 125-129 mEq/L <124 mEq/L

inadequate blood supply to an organ or tissue (esp heart) causing shortage of oxygen and glucose needed for cellular metabolism

ischemia

inflammation developed in myocardium or middle muscular layer of heart wall. weakens heart and its electrical system; ability to pump declines

myocarditis

referred pain at the left shoulder from trauma to the spleen. pain in tip of shoulder due to pressence of blood or other irritants in peritoneal cavity when person is laying down and legs are elevated

kehr's sign

occurs when the microcirculation is obstructed by sickled RBCs, resulting in an infarction, ischemia tissue injury and pain

vaso-occlusion

lodging of an embolus (blood clot or other blockage such as fat or gas in blood vessel) causing occlusion, infarction, and tissue death as a result of blocking the blood supply

embolism

Core temp: 98.6°-95°F (37°-35°C) Derm: pale Motor: impaired fine motor control CNS: typically conscious, amnesia, lethargy Shivering: vigorous BP: normal Respiration: normal Cardio: normal Ocular: Other: polyuria, rhinorrhea

Mild Hypothermia

Core temp: 94°-90°F (37°-35°C) Derm: cyanosis Motor: impaired gross motor control CNS: impaired mental function, loss of consciousness Shivering: absent BP: decreased/difficult to measure Respiration: depressed Cardio: depressed PR; cardiac arrhythmias Ocular: dilated pupils Other: slurred speech, muscle integrity

Moderate Hypothermia

Core temp: below 90°F (below 32°C) Derm: Motor: CNS: usually comatose Shivering: absent BP: hypotension Respiration: severely depressed, pulmonary edema Cardio: bradycardia, spontaneous V-fib, cardiac arrest Ocular: Other: rigidity

Severe Hypothermia

Texture: dry, waxy, edema Color: erythema, white, blue-gray patches Palpation: cold, firm skin Px Complaints: transient burning or tingling

Mild or Superficial Frostbite

Texture: hard, waxy, vesicles present Color: white, black, purple Palpation: immobile to palpation, poor circulation in area Px Complaints: burning, throbbing, shooting pain Other: progressive tissue necrosis, neurapraxia, hemorrhagic blistering (36-72hrs)

Deep Frostbite