Block Exam (Ch 18,19,20,21,22,23,24,25)
37- A 59-year old woman presents with acute onset of confusion, left-sided hemiparesis, and a right sided facial droop. Her airway is patent and she is breathing adequately. Her blood pressure is 150/100 mmHg and her pulse is 70 beats/min. The cardiac monitor displays atrial fibrillation with a variable rate of 60 to 90 beats/min. When obtaining the patient's medical history from her husband, the MOST important question to ask him is:
"When did you first notice your wife's symptoms?"
21- Law enforcement requests that you respond to a local apartment complex for a young woman who was sexually assualted. When you arrive at the scene, you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts, near the groin area. What is you intial priority in the care of this patient?
Identifying and treating immediate life threats
22- Anaphylaxis is classified as a response mediated by _____ antibodies
IgE
42- Which of the following conditions, if it remains undetected until puberty, can results in acute pain, severe constipation, and low back pain at the onset of menses?
Imperforate hymen
43- Which of the following assessment findings would indicate dysfunction of the trigeminal nerve?
Inability to feel the part of the face you are touching
39- Which of the following would NOT cause hypoglycemia in the patient with type 1 diabetes?
Insulin underdose
88- Which additional medication should be readily available when administering opioid analgesia to a patient with kidney stones?
Naloxone
35- Which of the following is the MOST immediate complication associated with posterior epistaxis?
Nausea and vomiting
32- You are dispatched to the residence of a 60-year old woman who was found unresponsive by her husband. As you are assessing the patient, her husband tells you that she is a diabetic and has recently experienced several "small strokes". In addition to managing her airway, you should:
Perform a field glucose test to rule out hypoglycemia
34- What type of tremor occurs when a body part is placed in a particular position and required to maintain that position for a long period of time?
Postural
25- Which of the following is NOT a function of the liver?
Storage of bile
97- During your examination of a patient's abdomen, you note the presence of striae. This finding is MOST indicative of:
a change in the size of the abdomen over a short period of time
90- The MOST common sign of an infectious disease of the nervous system is the presence of:
a fever
10- Apneustic breathing is characterized by:
a prolonged inspiratory phase with a shortened expiratory phase and bradypnea
56- You are dispatched to a residence for a 34-year old woman who is "sick". Upon your arrival, the patient greets you at the door. She tells you that she began experiencing a dull aching pain in the left lower quadrant of her abdomen. She further states that she recently had a her menstrual period, which was accompanied by more pain than usual. Her vital signs are stable, she is conscious and alert, and she denies vaginal bleeding or fever. This patient MOST likely has:
a ruptured ovarian cyst
93- Transport of a patient in anaphylactic shock may be delayed for all of the following reasons, EXCEPT:
a secondary assessment
78- In contrast to patients in shock, patients with increased intracranial pressure MOST often experience:
a widened pulse pressure
72- All of the following cranial nerves are responsible for airway control, EXCEPT the:
abducens
11- The MOST common cause of addisonian crisis is:
abrupt termination of corticosteriod use
87- Diabetic patients would MOST likely present with atypical signs and symptoms of:
acute coronary syndrome
18- A high level of oxygen to the brain of a patient with a hemorrhagic stroke and increased intracranial pressure:
causes vasoconstriction and can impair brain perfusion
68- You respond to the residence of a known heroin abuser. The patient, a 30-year old man, is unconscious and unresponsive. He is hypoventilating, bradycardic, and hypotensive. Administration of 2mg of naloxone has had no effect, and your transport time to the hospital is approximately 30 minutes. You should:
check his blood glucose level as your partner prepares give BVM ventilations
58- Blood that has been digested by stomach acids manifests as:
coffee grounds emesis
13-The endocrine component of the pancreas:
comprises the islets of Langerhans
50- A 30 year old woman presents with 3 days of generalized weakness, dizziness, and excessive urination. She is conscious but restless, and she tells you that she is extremely thirsty. Her blood pressure is 96/66 mmHg, her pulse is 110 beats/min and full, and her respiration are rapid and deep. On the basis of this patient's clinical presentation, she will MOST likely require:
crystalloid fluid hydration
26- Anemia resulting from an autoimmune disorder occurs when:
red blood cells are destroyed by the body's own antibodies
53- A person's level of consciousness is regulated by the:
reticular activating system
67- An elderly man presents with slurred speech, confusion, and unilateral facial asymmetry. When asked to squeeze your hands, the strength in his left hand is markedly less than the strength in his right hand. The patient's wife tells you that her husband type 2 diabetes and hypertension. On the basis of your clinical findings, you should:
rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke
27- A sudden onset of emesis with bright red blood in a patient with liver cirrhosis is MOST indicative of:
ruptured esophageal varices
31- The chief clinical manifestation of addisonian crisis is:
shock
65- Early clinical manifestations of an allergic reaction include all of the following, EXCEPT:
stridor
66- An anitgen is MOST accurately defined as a:
substance that causes the immune system to produce anitbodies
48- More than half of all cases of chronic kidney disease are caused by:
systemic diseases such as diabetes
94- Clinical characteristics of syndrome of inappropriate anti-diuretic hormone (SIADH) include:
systemic fluid overload
75- Type 1 diabetes that is secondary to an autoimmune disorder occurs when:
the body builds up antibodies that destroy the islets of Langerhans
91- An idiopathic seizure is one in which:
the cause is not known
98- When administering an EpiPen to a 30-year old man with a severe allergic reaction, you should recall that:
the drug cartridge contains 0.3mg of a 1:1,000 solution
80- A 4-year old child presents with a deep, resonant cough, difficulty breathing, and a high fever. You should suspect:
tracheitis
36- Pelvic inflammatory disease commonly affects all of the following organs, EXCEPT the:
urinary bladder
15- Disequilibrium syndrome is a condition in which:
water initially shifts from the bloodstream into the cerebrospinal fluid, causing an increase in
82- Clinical signs of hypokalemia include:
weakness and flattened T waves.
70- Common symptoms of diabetic retinopathy include all of the following, EXCEPT:
yellow vision
17-An unresponsive patient with signs of anaphylactic shock:
indicates cerebral hypoxia and hypercarbia
46- The middle ear consists of the:
inner portion of the tympanic membrane and the ossicles
89- Which of the following statements regarding conjunctivitis is correct?
Conjunctivitis usually spreads to the opposite eye
44- Which of the following is considered the major contributing factor to fatalities in anaphylactic shock?
Delayed epinephrine administration
19- ______ forms the principal mass of the tooth and is much denser and stronger than bone
Dentin
92- Which of the following would MOST likely cause a sustained increase in intracranial pressure?
intracranial tumor
64- In contrast to cellular immunity, humoral immunity:
involves the use of antibodies dissolved in the blood plasma to fight off invading organisms
45- A 29-year old man, who was recently prescribed an antipsychotic medication, present s with an acute onset of bizarre contortions of the face. Treatment should include:
Diphenhydramine, 50 mg
52- A 55-year old male who is currently receiving radiation therapy for cancer complains of dyspepsia and upper abdominal pain. He tells you that the pain worsens when he lies supine. What should you suspect?
Esophagitis
71- Which of the following statements regarding Grey Turner sign is correct?
Grey Turner sign is characterized by flank bruising and indicates internal bleeding
20- Which of the following clinical signs would specifically indicate ethmoid sinusitis?
Headache
23- Which of the following clinical signs or symptoms can be the earliest indication of upper airway swelling in a patient experiencing a severe allergic reaction?
Hoarseness and stridor
49- A painless, progressive enlargement of the lymphoid glands that most commonly affects the spleen and lymph nodes is called:
Hodgkin lymphoma
62- Any time a patient with end-stage renal diseas is found in cardiac arrestm the paramedic should strongly consider which of the following as the cause?
Hyperkalemia
5- Microvascular complications of diabetes include all of the following EXCEPT:
Hypertension
86- An incarcerated hernia is one that:
cannot be reduced and becomes trapped
74- Bradycardia and hypotension following an overaggressive dialysis treatment are MOST indicative of:
hypokalemia
9- Clinical Manifestations of chronic kidney disease include all of the following, EXCEPT:
hypotension
61- Histamine release causes all of the following effects, EXCEPT:
increased cardiac contractility, which results in hypertensions
6- the MOST immediate and significant complication associated with a hemorrhagic stroke is:
increased intracranial pressure
57- Drinking alchol with a fatty meal:
increases gastric reflux
8- During normal menstruation, approximately _____ to _____ mL of blood is discharged from the vagina
25,65
14- What is the cerebral perfusion pressure of a patient with a mean arterial pressure of 80 mmHg and an intracranial pressure of 5 mmHg
75 mmHg
63- Which of the following is NOT typically associated with leukemia?
Absence of fever
69- Which of the following cranial nerves regulates movement of the head and shoulders?
Accessory
76- Which of the following statements regarding Addison disease is MOST correct?
Addison disease most often occurs when the immune system creates antibodies that attack and destroy the adrenal cortex
60- You receive a call to the county jail for a male inmate who is unresponsive. According to the jailor, the patient was arrested for being "drunk". Your assessment reveals that the patient is profusely diaphorectic, and his respirations are rapid and shallow. His blood glucose levels read 30 mg/dL. As your partner assists the patient's ventilations, you start an IV and administer 50% dextrose. Reassessment reveals that the patient is responsive to pain only and his blood glucose level is 46 mg/dL. You should:
administer a second dose of dextrose and prepare for immediate transport
59- A 55-year old female complains of severe vertigo, tinnitus, nausea, and a sense of fullness in her right ear. You should:
administer an antiemetic and monitor her airway in case she vomits
83- You receive a call to a residence for a patient who is "sick". Upon arriving at the scene, you find the patient, a 39-year old woman lying on the ouch with a wet washcloth on her forehead. She is conscious and alert, and tells you that she has had several episodes of diarrhea and noticed bright red blood in her stool. Her pulse rate is rapid and weak, her skin is cool and clammy, and her blood pressure is 98/58 mmHg. Her medical history is significant for hemophilia, for which she is receiving factor VIII therapy. As you pull out a nonrebreathing mask, she tells you that her husband will be home in a few hours and that he will take her to the hospital. You should:
advise her that her condition dictates immediate transport to the hospital and that delaying transport could result in death.
24- Myelin functions by:
allowing the neuron to send its signal consistently along the axon without losing its electricity
40- Abdominal pain that is associated with polycythemia is usually associated with:
an enlarged spleen
7- Symptoms of temporomandibular joint (TMJ) disorder include:
an uneven bite
30- A 20-year old woman complains of difficulty breathing and the feeling of a lump in her throat approximately 10 minutes after being stung by a wasp. Your assessment reveals that she is anxious, is in obvious respiratory distress and has hives covering her arms and legs. Further assessment reveals diffuse wheezing, a blood pressure of 80/50 mmHg, and a heart rate of 120 beats/min. You should:
apply high-flow oxygen via nonrebreathing mask, administer epinephrine via the IM route, and establish vascular access
29- Patients with chronic kidney disease may present with uremic frost, especially:
around the face
41- The pain associated with a kidney stone MOST often:
begins in the flank region and radiates to the groin
16- Pain over the suprapubic region is MOST suggestive of injury to the:
bladder
The primary site for cell production int he human body is the:
bone marrow
54- You are transferring a 60-year old man with COPD from a community hospital to a metropolitan hospital. The patient is mildly dyspneic, but is otherwise stable. He is receiving oxygen via nasal cannula, has an IV line of normal saline in place, and has an ECG applied. When reading his chart, you note that he has polycythemia, a history of prior stroke, and hypertension. The patient tells you that he feels a fluttering sensation in his chest. you glance at the cardiac monitor and see a narrow complex tachycardia at a regular rate of 190 beats/min, with absent P waves. The patient's blood pressure is 116/70 mmHg and he remains conscious and alert. You should:
ensure adequate oxygenation and ventilation, administer 6 mg of adenosine, and reassess his cardiac rhythm
79- Common signs and symptoms of acute gastroenteritis include all of the following, EXCEPT:
fever
Common signs and symptoms of a lower urinary tract infection include all of the following, EXCEPT:
gross hematuria
4- A patient with thrombocytopenia
has a decreased platelet count
33-Patients with type A hemophilia
have a deficiency of factor VIII
77- If an individual has A-positive blood:
his or her blood contains the Rh antigen
55- Severe dehydration that commonly accompanies diabetic ketoacidosis is caused by:
hyperglycemia-induced osmotic diuresis and vomiting
You would expect a person's hematocrit to be low if he or she:
is hemorrhaging
38-Unlike the patient with hypoglycemia, the patient with severe hyperglycemia:
is tachypneic and hyperpneic
96- Vertigo or loss of balance following an ear infection or upper respiratory infection is most consistent with:
labyrinthitis
12- A stroke to the right cerebral hemisphere would MOST likely cause:
left-sided weakness and a right side visual field loss
51- Emotions such as rage and anger are generated in the:
limbic system
81- The portal vein transports venous blood from the gastrointestinal tract directly to the:
liver
84- The conversion of glycogen to glucose occurs in the
liver
95- Hepatic encephalopathy is a condition in which:
liver disease causes an increase in waste products impairing mental status
28- Pupils that differ in size by less than 1mm:
may be a normal variant in some patients
85- The onset of menses is called:
menarche
99-Risk factors for pelvic inflammatory disease include all of the following, EXCEPT:
monogamy
100- The MOST common acute renal disease is:
nephrolithiasis
73- The majority of the circulating white blood cells are:
neutrophil
47- Common causes of trismus in an unresponsive patient include all of the following, EXCEPT:
opiate toxicity