Medical Emergencies
The blood pressure cuff should be inflated: A) 20-30 mmHg higher than the reading when you no longer feel the radial pulse. B) to 200mmHg C) Until the branchial pulse is no longer heard in the stethoscope D) None of the above
A) 20-30 mmHg higher than the reading when you no longer feel the radial pulse.
Reoccurence of another syncopal event is at higher risk for the first _______ hours: A) 24 B) 36 C) 48 D) 72
A) 24 hours
Individuals with hypertension are at higher risk for: A) CVA B) Diabetes C) Seizures D) Asthma
A) CVA
In children, syncope is often caused by: A) Dehydration B) Lack of sleep C) Coughing D) Medications
A) Dehydration
Symptom's of orthostatic hypotension include: A) Dimming of vision B) Increased blood pressure C) Tachycardia
A) Dimming of vision
The drug of choice for an anaphylactic reaction is: A) Epinephrine .3mg 1:1,000 B) Epinephrine .1mg: 3,000 C) Diphenhydramine 50 mg D) Diphenhydramine 100 mg
A) Epinephrine .3mg 1:1,000
Astha is the result of an abnormal ______ response in the bronchial airways: A) immune B) Biochemical C) Nutritional D) None of the above
A) Immune
The use of oxygen and the production of carbon dioxide and their exchange between the cells and blood is: A) Internal respiration B) External respiration C) Bradypnea D) Orthopnea
A) Internal respiration
Your patient's respiratory rate is 16 per minute. This would be considered: A) Normal B) Bradypnea C) Hypernea D) Orthopnea
A) Normal
All of the following are symptoms of a severe allergic response requiring immediate treatment EXCEPT: A) Pruritus B) Hypotension C) Dyspnea D) Laryngeal edema
A) Pruritus
What is the MOST common artery used to take a patient's pulse rate in the dental office? A) Radial B) Brachial C) Femoral D) Carotid
A) Radial
The next MOST available person to the operator whose patient is experiencing an emergency is reponsible for: A) Recording events of the emergency B) Contacting EMS C) Retrieving the emergency kit D) Preparing drugs from the kit for use
A) Recording events of the emergency
The force of blood against blood vessel walls during ventricular contraction is: A) Systolic blood pressure B) Diastolic blood pressure C) Pulse pressure D) Hypertension
A) Systolic blood pressure
Which of the following would cause an extrinsic attack in the dental office? A) Taking a dental impression B) Self-imposed stress C) Application of cold air to a tooth
A) Taking a dental impression
The type of allergic reaction that is an immediate hypersensitivity caused by immunoglobulin E is: A) Type Me B) Type II C) Type III D) Type IV
A) Type Me
Following the challenge dose, the mast cells and basophils: A) Undergo degranulation and release chemical mediators B) Destroy the allergen C) Block the release of the chemical mediators and histamine D) None of the above
A) Undergo degranulation and release chemical mediators
asthma is characterized by all of the following symptoms except: A) pulmonary edema B) Dyspnea C) Wheezing D) Coughing
A) pulmonary edema
All of the following are signs and symptoms of presyncope EXCEPT: A) pupil constriction B) diaphoresis C) piloerection D) yawning
A) pupil constriction
"A" in REPAIR
Activate CABs of CPR by checking the circulation, airway and breathing
treatment of pulmonary edema
Airway breathing circulation (ABC), call 911, oxygen (high flow), vitals, position of comfort
All of the following are symptoms of a mild allergic reaction EXCEPT one. Which one is the exception? A) Slight pruritus B) Angioedema C) Localized redness D) Mild edema
B) Angioedema
If a patient experiences an allergic reaction and the symptoms are resolved and then reoccur several hours later, this is referred to as a: A) Anaphylactoid reaction B) Biphasic reaction C) Pruritic reaction D) All of the above
B) Biphasic reaction
Activation of the sympathetic nervous system during vasodepressor syncope with lack of physical activity will lead to: A) Tachycardia B) Cerebral ischemia C) Hypertension D) Valsalva maneuever
B) Cerebral ischemia
All of the following would be types of end organ damage signifying hypertensive emergency EXCEPT: A) Cerebral hemorrhage B) Liver failure C) Renal insufficiency D) Aortic dissection
B) Liver failure
A patient with systemic symptoms, but with normal blood pressure, pulse, and respirations, would be considered to be having which type of allergic reaction? A) Mild B) Moderate C) Severe D) None of the above
B) Moderate
The type of asthma attack where the patient has significant dyspnea and can only speak in phrases or partial sentences would be considered: A) Mild B) Moderate C) Severe D) Inconsequential
B) Moderate
The chief physiological concern with asthma patients during an attack is: A) excess sputum production B) narrowing of the airways C) Hypertension D) Myocardial ischemia
B) Narrowing of the airways
If the patient remains in syncope for an extended period of time, it is more likely that he will experience a: A) CVA B) Seizure C) Coma D) Hypertensive emergency
B) Seizure
The patient in syncope should be positioned: A) Supine with head and feed parallel B) Supine with feet above the head C) Semisupine D) Upright
B) Supine with feet above the head
The release of histamine during an allergic reaction causes: A) Reduced vascular permeability. B) Systemic vasodilation C) Reduced cardiovascular function D) Smooth muscle relaxation
B) Systemic Vasodilation
The FIRST sound you hear when deflating the blood pressure cuff is the: A) Diastolic blood pressure B) Systolic blood pressure C) Pulse pressure D) Radial pulse
B) Systolic blood pressure
Forced expiratory effort against a closed airway, suhc as when an individual holds his breath and tightens in the muscles in a concerted, strenuous effort is: A) Micturition B) Valsalva maneuver C) Hyperventilation D) Orthostatic hypotension
B) Valsalva maneuver
Syncope: A) is a primary disease process B) is often associated with a stressful situation C) is caused by increased cerebral oxygentation D) all of the above
B) is often associated with a stressful situation
The type of syncope often observed as a result of hyperventilation or metabolic diseases is: A) cardiac syncope B) noncardiac syncope C) vasovagal syncope D) neurocardiac syncope
B) noncardiac syncope
Normal blood pressure in children is based on their age, sex, and height and is at the _____ percentile or lower: A) 54th B) 76th C) 89th D) 95th
C) 89th
A patient that has stable angina or well-controlled Type I diabetes would be considered: A) ASA I B) ASA II C) ASA III D) ASA IV
C) ASA III
The high prevalence of asthma in urban settings has been linked to: A) Overcrowding B) Increased household insects C) Air pollution D) Increased mole spores
C) Air pollution
The MOST severe form of allergy is referred to as: A) Epistaxis B) Dyspnea C) Anaphylaxis D) Urticaria
C) Anaphylaxis
Painless swelling of the lips, eyes, and hands, during an allergic response is referred to as: A) Bronchospasm B) Pruritus C) Angioedema D) Rhinitis
C) Angioedema
All of the following factors affect blood pressure EXCEPT: A) Blood volume B) Blood viscosity C) Blood stenosis D) Blood vessel resistance
C) Blood stenosis
Cyclic patterns of increased rate and depth of breathing alternating with periods of apnea is referred to as: A) Kussmaul's respirations B) Biot's respirations C) Cheyne-Stokes respirations D) None of the above
C) Cheyne-Stokes respirations
The drug of choice for a mild allergic response as it produces minimal drowsiness is: A) Diphenhydramine 50mg IM B) Epinephrine 1,000 mg IM C) Chlorpheneramine 10 mg orally D) Hydrocortisone 25 mg orally
C) Chlorpheneramine 10 mg orally
In addition to a constriction of the bronchioles the inflammatory response that occurs during an asthmatic attack results in: A) Increased blood pressure B) Decreased arrythmias C) Increased mucus production D) None of the above
C) Increased mucus production
The type of syncope that is often associated with some noxious stimuli is: A) Cardiac B) Noncardiac C) Neurocardiogenic D) All of the above
C) Neurocardiogenic
The MOST reliable test to determine if a patient has a true allergy to a particular substance is the: A) Skin prick test B) Skin Scratch test C) Radioallergosorbent Test D) All of the above are equally reliable
C) Radioallergosorbent Test
If a patient responds positively on his or her medical history to epilepsy, you will need to be on the lookout for: A) Dyspnea B) Hypoglycemia C) Seizures D) None of the above
C) Seizures
The FIRST time a patient is exposed to an allergen is referred to as the: A) Challenge dose B) Half-life dose C) Sensitizing dose D) None of the above
C) Sensitizing dose
Your patient has a blood pressure of 180/110. This would be considered: A) Prehypertension B) Stage I hypertension C) Stage II hypertension D) Normal blood pressure
C) Stage II hypertension
The strength of the pulse against the blood vessel is referred to as the: A) Cardiac output B) Pulse C) Stroke volume D) Pulse pressure
C) Stroke volume
Your patient's pulse rate is 102. This would be considered: A) Normal B) Bradycardia C) Tachycardia D) None of the above
C) Tachycardia
All of the following procedures will help to prevent an emergency in the dental office EXCEPT: A) Accurate medical history taking B) Taking and recording vital signs C) Updating medical emergency kit
C) Updating medical emergency kit
Brain damage or coma can occur if a patient has oxygen deprivation lasting for: A) 1 minute B) 3 minutes C) 5 minutes D) 10 minutes
D) 10 minutes
A patient with an incapacitating systemic disease that is a constant threat to life would be categorized as: A) ASA I B) ASA II C) ASA III D) ASA IV
D) ASA IV
Other than the patient's own medication, the drug of choice for a patient suffering from an asthma attack is: A) epinephrine B) corticosteroids C) glucose D) albuterol
D) Albuterol
All of the following questions should be asked of a patient who provides a positive response on the medical history for asthma EXCEPT: A) Severity of attacks B) Frequency of attacks C) Trigger of attacks D) All of the above
D) All of the above
Bronchospasm occurs during an allergic reaction due to the effect of the histamines on the: A) Chronotropic factors B) Inotropic factors C) Alpha receptors D) Beta receptors
D) Beta receptors
All of the following are types of asthma EXCEPT: A) Intrinsic B) Extrinsic C) Viral D) Latent
D) Latent
Which of the following is a contributing factor in the increase of medical emergencies in the dental setting? A) Decreasing age of the population B) Advances in healthcare C) Advances in dentistry D) None of the above
D) None of the above
A temperature of 99.8 degrees is considered: A) Normal B) Hypothermia C) Low-grade D) Pyrexia
D) Pyrexia
All of the following are common causes of Tachycardia EXCEPT: A) Fever B) Exercise C) Stimulant drugs D) Syncope
D) Syncope
All of the following are factors that affect respiration rate EXCEPT: A) Age B) Body position C) Exercise D) Temperature
D) Temperature
All of the following are factors that affect the severity of an allergic reaction EXCEPT: A) Amount of the allergen B) Rate of exposure C) Route of exposure D) Type of allergen
D) Type of allergen
The appropriate position for a patient suffering from an asthma attack is: A) Upright with the head tilted to the side B) Supine with the head tilted upright C) Semisupine D) Upright with the arms forward
D) Upright with the arms forward
Patient vital signs include all of the following except: A) Pulse B) Respiration C) Blood pressure D) Weight
D) Weight
"E" in REPAIR:
Evaluating the patient's level of consciousness
Bacterial infections are the MOST common cause of infectious asthma: True False
False
Intrinsic asthma is the MOST common type of asthma: True False
False, Extrinsic asthma accounts for 50% of asthmatics.
"I" in REPAIR:
Implement the appropriate emergency protocol for the specific emergency
"P" in REPAIR:
Placing the patient in appropriate position
First "R" in Repair:
Recognizing signs and symptoms
Last "R" in REPAIR:
Refer the patient to the appropriate healthcare professional
What is the most common emergency in the dental office?
Syncope
Local anesthetics containing epinephrine are NOT recommended for asthmatics patients: True False
True
Patients experiencing a severe asthma attack will have a rapid respiration rate and will only be able to speak in single words: True False
True
Stress-induced asthma is the type MOST likely to be seen in the dental setting: True False
True
signs and symptoms of pulmonary edema
abdominal swelling, fatigue/weakness, shortness of breath, cough, diaphoresis, pale, hypertension, tachycardia
anaphylaxis
allergic reaction
signs and symptoms of anaphylaxis
angioedema (swelling, face, airway), urticaria (hives), hypotension, hoarse voice, weakness, altered levels of consciousness
treatment of anaphylaxis
call 911, adult epipen .3-.5 mg 3-5 min, junior epipen .15mg 3-5 min, oxygen, vitals, diphenhydramine hcl (benadryl), vitals, position of comfort
treatment of CVA
call 911, document time, stroke scale, oxygen, vitals, blood glucose levels, position semi upright
treatment of seizures
call 911, oxygen, make sure nothing is obstructing airway, vitals, loosen clothing, post positioning, time (duration)
treatment of hypoglycemia
check vitals (blood glucose level), administer glucose, administer oxygen (4-6L via nasal cannula), cover w/ blanket in supine position (shock)
treatment of hyperglycemia
check vitals, call 911, oxygen, position of comfort
signs and symptoms of hypoglycemia
diaphoresis, pale, weakness, headache, altered level of consciousness, seizure, cold, unresponsive, tremor
signs and symptoms of syncope
dizziness, unresponsive, diaphoresis, pale, hypotension, bradycardia
hyperglycemia
excess of glucose, often associated with diabetes mellitus
pulmonary edema
failure of left side of the heart; excess fluid in lungs causing heart problems, making person unable to breathe
signs and symptoms of CVA
headache, weakness, hypertension, slurred speech, facial droop, arm drift, altered levels of consciousness, unequal pupils, nausea & vomiting
asthma
inflamed, narrowed airways making it difficult to breathe
hypoglycemia
low glucose levels
signs and symptoms of seizures
metallic taste, stare/blinking eyes, smells, altered levels of consciousness, rhythmic jerking, apnea
chest pain
myocardial infarction
treatment of syncope
position supine, oxygen, cover/blanket, loosen tight clothes, call 911
signs and symptoms of asthma
shortness of breath, tightness in chest, pale, wheezing, trouble saying more than 1-2 words at a time, tripod position
cerebrovascular accident (cva)
stroke (damage resulting from interruption of blood supply to brain)
syncope
temporary loss of consciousness
signs and symptoms of chest pain/myocardial
tightness in chest, radiating pain, shortness of breath, pale, diaphoretic, pain in between shoulder blades, nausea and vomiting, cold
treatment of asthma
vitals, ask for inhaler, oxygen (non-rebreather, 12-15 liters per min), albuterol, position of comfort
treatment of chest pain
vitals, call 911, oxygen, nitroglycerin (.4mg-12mg), ASA (aspirin, max 325mg), position of comfort, blood glucose level
signs and symptoms of hyperglycemia
warm dry skin, fruity or acetone smell (diabetic ketoacidosis), hypotension, kussmaul respirations (fast & short), frequent urination, blurred vision