Volume 3 Chapter 1-13

Damage to organs and systems bodywide is common in patients with sickle cell disease due to which of the​ following?

Repeated vasoocclusive crises

Which of the following factors that contributes to CVD is not the result of lifestyle​ choices?

Family genetics

Which of the following is a nonmodifiable risk factor for developing cardiovascular​ disease?

Family history

A patient you are treating has a PaCO2 of 25 mmHg. If his tidal volume is​ normal, what would you observe about his​ ventilations?

Faster than normal

Which of the following is a complication of fibrinolytic reperfusion​ therapy?

Fatal hemorrhage

Your patient is an elderly female patient that is complaining of bodywide pain. She stated that she was walking at the zoo earlier in the day with her grandson. Her medical history includes lupus and asthma. Vital signs are stable. What treatment may be​ considered?

Fentanyl

Patients with severe abdominal pathology typically present in which of the following​ positions?

Fetal position with little movement

Your​ 92-year-old female patient has been suffering from a urinary tract infection for four days. Assessment reveals she responds to verbal stimuli and has a patent​ airway, with hot and moist skin. Her heart rate is​ 116/min and​ regular, her respiratory rate is 24​ breaths/min, her blood glucose is 80​ mg/dL, and her blood pressure is​ 80/52 mmHg. Management should include which of the​ following?

Fluid administration and consideration for a pressor agent

You analyze a 12 lead and see a negative QRS deflection in lead I and a positive QRS deflection in lead aVf. What is the​ axis?

Right axis deviation

Which of the following nonstroke disorders could result in a​ "probability of ischemic​ stroke" according to the Cincinnati Prehospital Stroke​ Scale?

​Bell's palsy

What is the name of the particular substance released from mast cells and basophils that causes​bronchoconstriction?

​SRS-A

Signs and symptoms of isolated right ventricular failure include which of the​ following?

​Tachycardia, JVD, hepatic congestion

What is the sensation felt by placing a hand on the chest that vibrates during​ speech?

Tactile fremitus

Cardiac arrest beyond what time period exceeds the metabolic phase of​ death?

Ten minutes

What do sickle cell​ anemia, thalassemia, and​ glucose-6-phosphate dehydrogenase deficiency have in​common?

They are hereditary diseases.

Which of the following is true of congenital​ tumors?

They are not neoplasms.

When considering the etiology of most brain​ tumors, which of the following is​ correct?

They are often metastasized from elsewhere in the body.

Removal of the TASER darts by emergency personnel should be​ considered:

after ensuring that the patient is stable and has no other acute medical condition.

The three types of ECG leads are​ bipolar, augmented, and

precordial.

The most common hereditary hematologic disorder among African Americans​ is:

sickle cell anemia.

When educating a patient with a history of renal​ calculi, one of the most important things to impress on him​ is:

the need to drink large quantities of water.

A patient is stimulated by a vigorous sternal rub​ and, in response to such​ stimuli, he flexes his arms and extends his legs. What is this​ called?

Decorticate posturing

Successful defibrillation depends upon which of the​ following?

Decreased chest wall resistance to electricity

During the acquisition and interpretation of a 12 lead ECG on a patient with chest​ pain, you believe the patient may have left ventricular hypertrophy. What finding on the 12 lead may cause you to have that​ suspicion?

Deep S waves in V1 and V2 and tall R waves in V5 and V6

Your patient has ingested a large amount of iron supplement chewable tablets. Which of the following is the chelating agent that could be given in the hospital to bind the iron and not allow it to be​ absorbed?

Deferoxamine

Your cardiac arrest patent has an implanted defibrillator that is not​ functioning, and you see ventricular fibrillation on the ECG. Which of the following is the most appropriate​ treatment?

Defibrillate the patient using your​ pads/paddles but avoid placing them on the implanted defibrillator site

Which of the following does not lead to bleeding that is associated with​ DIC?

Development of neutropenia

What disorder is caused by inadequate ADH secretion relative to blood​ volume?

Diabetes insipidus

What is the blood disorder in which a clotting factor is missing or​ defective?

Hemophilia

Which of the following diseases is an inherited disease that causes abnormally low levels of factor​ VIII?

Hemophilia

A patient in your care is coughing up blood. This is documented as which of the​ following?

Hemoptysis

What are small masses of swollen veins that occur in the anus or​ rectum, usually in patients more than 50 years​ old?

Hemorrhoids

The tenth most common cause of death and most common cause of patients in the intensive care unit​ is:

sepsis.

You are called to a local high school for a​ 64-year-old spectator at a sporting event. The patient complains of shortness of breath. The patient identifies a history of COPD and you note absent breath sounds on the​ patient's left side. Onset of complaint was sudden while the patient was sitting in the stands and no blunt or penetrating trauma occurred. Your immediate concern would​ be:

spontaneous pneumothorax.

Which of the following descriptors of pain is common in a patient suffering from chest pain secondary to a heart​ attack?

​"Heavy"

What percentage of blood loss can a​ young, healthy individual sustain before​ decompensating?

​25-30 percent

When implementing therapeutic hypothermia in an ROSC​ patient, what is the target temperature that is​ desired?

​32-34 degrees Celsius

Which of the following people would be most likely to successfully commit​ suicide?

​60-year-old male

Each​ year, approximately how many Americans die from complications due to heart​ disease?

​610,000

According to current​ estimates, how many Americans have some form of cardiovascular​ disease?

​>60 million

Both glucose and large amounts of water are lost via the kidneys in which of the following​ disorders?

Diabetes mellitus

More than half of all​ end-stage renal failure cases are caused by which of the​ following?

Diabetes mellitus and hypertension

How is the​ children's dosage of epinephrine calculated for anaphylactic​ shock?

0.01​ mg/kg IVP

You are dispatched to the local mall for a​ 25-year-old female who is seizing. When you arrive you note that she is having a​ tonic-clonic seizure. A​ bystander, trained in first​ aid, tells you that this is the third time she has seized and that she​ hasn't regained consciousness between events. After controlling her movements you assist her​ ventilations, administer​ oxygen, check her vital​ signs, which are within normal​ limits, and initiate an IV of D5W TKO. Your patient then starts to seize again. You decide to administer 5 mg​ diazepam; shortly afterward your patient stops active seizing and you take advantage of the break to reassess​ her, only to find her respiratory rate has dropped to 6 breaths per minute and she is now hypotensive. While continuing to assist her​ ventilations, which drug would you consider​ next?

0.2 mg flumazenil

The ECG shows you a regular rhythm at a rate of​ 40, no P waves are​ present, and the QRS complex width is 0.16 seconds. The​patient's blood pressure is​ 82/44. Which of the following would be most​ appropriate?

0.5 mg bolus of atropine sulfate

Epilepsy affects approximately how many Americans per​ year?

1 percent

Over half of all poisonings that occur to children occur in what age​ bracket?

1 year to 5 years

You are managing a patient experiencing exacerbation of emphysema with CPAP. To avoid​ barotrauma, what is the recommended airway​ pressure?

10 ​cm/H2O

Looking at an ECG​ strip, you count 14 QRS complexes in two​ 3-second marks. Your estimate for the heart rate would​ be:

140

Approximately what volume of blood in the GI tract will result in recognizable​ melena?

150 mL

Your patient in cardiac arrest overdosed by ingesting a full bottle of tricyclic antidepressant pills. His rhythm is PEA with a QRS width of 0.18 seconds. Which of the following is a proper​ treatment?

1​ mEq/kg of sodium bicarbonate IV

What time frames do regional poison control centers provide for callers from health care​ providers?

24 hours a​ day, 7 days a week

What is the standard speed for ECG paper to move across the stylus when printing out the​ patient's rhythm?

25​ mm/sec

When obtaining a 15 lead ECG on a​ patient, how many electrodes are placed on the​ patient's right​ thorax?

3

How many poisonings occur annually in the United​ States, according to the American Association of Poison Control​ Centers?

3 million

When examining your​ patient, she tells you that her family physician told her today that she is anemic. If you saw her blood work​ results, which of the following hematocrit values would confirm​ this?

30 percent

How many pairs of spinal nerves exit the spinal​ cord?

31

Adults typically have how many​ teeth?

32

How much oxygen can be transported by a hemoglobin molecule at one​ time?

4 molecules

You are managing a patient who presents with​ unresponsiveness, ongoing​ seizures, heavy secretions in the​ airway, and a blood glucose level of 38​ mg/dL. The patient is a known diabetic who took his insulin but did not​ eat, due to ongoing nausea from a cold. During a moment when he is not​ seizing, you establish an IV and start oxygen therapy. Following​ this, another seizure erupts. What medication should the paramedic​ administer?

50 percent dextrose IV push

Your patient is postictal from a seizure. He opens his eyes to painful​ stimulation, makes incomprehensible​ sounds, and reaches away from the midline when a sternal rub is applied. What is his Glasgow Coma Scale​ value?

8

Which of the following persons would be at the highest risk for developing​ pancreatitis?

A black male

Which of the following is the best definition of a​ hyphema?

A collection of blood in the anterior chamber of the eye due to trauma

Which of the following treatments would most likely benefit a patient complaining of general weakness and​ dizziness?

A fluid bolus of normal saline

How does a simple pneumothorax interfere with the​ body's ability to oxygenate peripheral lung​ tissues?

A loss of negative pleural space pressure inhibits the lung from expanding properly

What is meant by aberrant​ conduction?

A single supraventricular beat conducted through the ventricles in a delayed manner

What disease process can lead to the development of cirrhosis of the​ liver, esophageal​ varices, and​ascites?

Hepatitis

Which of the following blood values may be raised if the patient is suffering from congestive heart​ failure?

ANP

A condition that exists when the pulmonary capillaries have a greater permeability due to a​ non-cardiogenic cause is​ called:

ARDS.

When acquiring a 12 lead ECG on a patient for a suspected ischemic​ episode, what lead tracing on the monitor is not interpreted for waveform​ changes?

AVR

A patient suffering from excited delirium will always present with which sign or​ symptom?

Abnormal pain tolerance

The interval that begins at the QRS complex and ends at the apex of the T wave is which of the​ following?

Absolute refractory period

Individuals engaged in agricultural and food handling industries are most likely to have what type of mechanism behind a toxic​ exposure?

Absorption

Inflammation of the stomach and intestines with a sudden onset of vomiting​ and/or diarrhea, and is a​high-risk complication in individuals that abuse alcohol and​ tobacco, is the definition for which of the​following?

Acute gastroenteritis

What is the general term for a sudden drop in urine output to less than​ 400-500 mL per​ day?

Acute renal failure

You are dispatched to an apartment​ complex, where you find a​ 25-year-old female with altered mental status and shallow breathing. A neighbor tells you that the patient has been in and out of drug rehab and that she overdosed on narcotics. Which of the following is the most appropriate​ intervention?

Administer 1 mg of naxalone.

You are dispatched to a restaurant for a male choking​ victim, in his​ 30s, sitting at the counter. The location is only two minutes​ away, and you arrive promptly. After determining that the scene is​ safe, you proceed inside and up to the​ counter, where your patient is in obvious respiratory distress with some slight perioral​ cyanosis, red splotches on his​ face, and a light rash on both arms. It occurs to you that his face looks​ "puffy." You note as you approach that you hear wheezing and​ stridor, and he has a respiratory rate of 26. When you ask the patient if he can​ speak, he shakes his head​ "no." You ask him if he is​ choking, and you again get a​ "no." While your partner starts the patient on​ high-flow oxygen via a nonrebreather​ mask, you get a radial pulse of 128 and thready and a blood pressure of​ 98/78. The pulse oximeter reads 92 percent on​ oxygen, and the stridor is worsening. You opt to immediately administer epinephrine IM while your partner sets up and establishes an​ IV, followed by a second IV. Your next set of vital signs reveals respirations of 22 with reduced effort and​ stridor, pulse of 132 and​thready, blood pressure​ 92/70 mmHg, and the pulse oximeter indicates 96 on​ high-flow oxygen. What would your next step​ be?

Administer a fluid bolus of normal saline

You are dispatched to a soccer field for a referee complaining of shortness of breath. After determining that the scene is​ safe, you proceed to the sidelines where your patient is in obvious respiratory distress with some significant perioral​ cyanosis, red splotches on his face and​ chest, and swelling in his left leg. You note as you approach that you hear wheezing and​ stridor, and he has a respiratory rate of 34. When you ask the patient if he can​ speak, he slowly responds to shake his head​ "no." You ask him if he is​choking, and you again get a​ "no." While your partner starts the patient on​ high-flow oxygen via a nonrebreather​ mask, you get a​ weak, regular radial pulse of 122 bpm. At that time your patient goes unresponsive. What is your next​ action?

Administer epinephrine

While gathering the medications a patient with respiratory distress is​ prescribed, which of the following indicates that he likely has a​ short-term pulmonary​ problem?

Antibiotics

You are called to the dialysis center for an ill patient. The technician tells you the patient was a​ half-hour into her treatment when she suddenly felt​ light-headed and experienced chest pain. Vital​ signs: blood pressure​ 84/60, pulse​ 114, ventilations 32. What is the best initial management​ strategy?

Administer​ high-flow oxygen and transport her on her right​ side, feet elevated

You are treating a patient with​ substernal, diffuse chest pain that radiates down his left arm. He is​ nauseated, has vomited​ twice, and his skin is​ pale, cool, and diaphoretic. His blood pressure is​ 118/60, pulse is​ 128, showing sinus tachycardia with 3 PVCs per​ minute, SpO2 on room air is 91 percent. Of the following​ choices, which is the best initial​ treatment?

Administer​ oxygen, titrated to attain a pulse oximetry above 94 percent

You are managing a patient who is a known diabetic. You attempt to obtain a blood glucose​ level, but the glucometer is failing to provide a reading after two attempts. From the clinical presentation of the​ patient, you are unsure if the underlying etiology is HHS or DKA. Given​ this, which of the following interventions should be avoided while transporting the patient to the​ hospital?

Administration of 50 percent dextrose

Treatment of disseminated intravascular coagulation during the late stages includes which of the​following?

Administration of fresh frozen platelets

After​ 3-4 minutes of cardiac​ arrest, what physiological process continues in the​ heart?

Aerobic metabolism

What is the psychological term for an observable expression of​ emotion?

Affect

During the assessment of a patient complaining of chest​ pain, when should the paramedic obtain the SAMPLE​ history?

After the primary assessment

Risk factors for pneumonia​ include:

Age and​ immuno-compromising diseases

You are preparing to call the poison control center for a child who has ingested all of his​ parent's Inderal and Procardia. What other information may the PCC want in order to provide you the most relevant​information?

Age of the​ victim, amount of medications and time​ ingested, and current physical condition

A​ 20-year-old male runner comes up to you at the finish line of a cross country meet and says he​ "can't breathe." Physical exam reveals a​ 6'5", very thin male with​ acute, sharp pleuritic chest​ pain, and pale and diminished lung sounds are auscultated in the apex area of the right lung. What has likely happened to​him?

Air has entered in between the visceral and parietal pleura.

You are called to the scene of a​ 68-year-old female patient. The family told your dispatcher that she was​ "breathing but​ wouldn't wake​ up." On your arrival you find the patient lying in bed with sonorous respirations and decorticate posturing. What is your initial​concern?

Airway maintenance

Your patient is presenting with a​ fever, a deep​ cough, dyspnea, and stridor. This has been present for several days and worsened to the point that the family became concerned and called EMS. The patient is now​ disoriented, struggling to​ breathe, and has a low pulse ox reading. What would your treatment consist​ of?

Airway maintenance and ventilation

At the conclusion of your secondary​ assessment, you have determined that the patient is likely suffering from a thyroid storm. As you prepare your management​ plan, which of the following interventions would not be​ appropriate?

Atropine via IVP

Your​ 15-year-old female presents with​ fever, chills, a sore​ throat, and some mild dysphagia that has developed over the past two days. When you examine the oral​ cavity, you observe pockets of pus in the area around her tonsils. Treatment should focus around which of the​ following?

Airway protection and treatment of hypoxia as needed

Why does chronic alcoholism lead to the development of​ pancreatitis?

Alcohol causes platelet plugs in the acinar​ tissue, which disrupts enzyme​ flow; the backup of digestive enzymes causes them to activate and autodigest the pancreatic tissue.

What is the leading cause of esophageal​ varices?

Alcohol consumption

The definitive treatment rationale for the multiple myeloma patient includes which of the​ following?

All of the above

Which of the following is NOT a cause of behavioral​ emergencies?

All of the above

Which of these symptoms indicates that a patient might have a roundworm​ infection?

All of the above

Your patient is a​ 60-year-old male who has a severe​ headache, hypoxia, a new pattern of​ seizures, cognitive​ changes, vomiting, and a change of sensation in his right arm. You diagnose him with a probable spinal or cerebral neoplasm. Which of the following are appropriate​ interventions?

All of the above.

A​ 19-year-old female is complaining of itching on her upper​ extremities, across her​ chest, and on her neck. She states that she started taking a new antibiotic for a urinary tract infection about 30 minutes​ ago, as prescribed. She states she has no allergies but upon physical​ exam, you do see some diffuse urticaria on her right arm and anterior neck. No wheezing or dypnea is noted. Lung sounds are clear. Pulse is 90 and regular and blood pressure is​ 130/80. What would you consider as the field​ diagnosis?

Allergic reaction to the medication

If a suicidal patient begins to tell his story in response to​ open-ended questions, but grows quiet when recounting a difficult​ moment, which of the following is the best communication​ strategy?

Allow the silence to pass and wait until the patient begins speaking.

Which of the following presenting signs may be the only indicator of pneumonia in geriatric​ patients?

Altered mental status

The​ 68-year-old patient you are transporting is presenting with​ hypertension, peripheral​ edema, and tachycardia in the absence of a significant medical history. You suspect that she may be suffering from​AKI; which of the following can provide you with additional pertinent findings that could support your field​diagnosis?

An ECG

What is the collective term for processes in the body that build something big by combining​ individual, smaller​ parts?

Anabolism

You are called to an outpatient health care facility where a patient was scheduled to undergo imaging studies. The patient received the contrast media approximately one hour ago and now complains of an impending sense of​ doom, dizziness, and inability to catch her breath. What is your initial​ concern?

Anaphylactic reaction

Your patient presents to you​ pale, diaphoretic,​ dyspneic, hypotensive, and complains of severe abdominal cramping. Inspiratory and expiratory wheezing is auscultated throughout all lung​ fields, and angioedema is also noted. What do you suspect is this​ patient's ailment?

Anaphylaxis

You are caring for a patient with severe back pain. You find him​ sitting, with his back hunched​ over, and when you try to place him on the cot and lie​ back, the patient is unable​ to, as his back has lost its flexibility. Which of the following would be your first field impression of the​ patient's condition?

Ankylosing spondylitis

Your patient is a known diabetic with a recent history of a laceration to the bottom of his foot. He just noticed it​ today, but never felt the​ injury, so he is unaware when it occurred. Now he is having trouble bearing weight on the​ foot, and there is noticeable swelling and redness over the foot and ankle. Definitive management will involve which of the​ following?

Antibiotics

Which of the following is a substance that enters the human body and induces an immune​ response?

Antigen

Which of the following could cause a prolonged QT​ interval?

Antipsychotic medication administration

What is the abnormal breathing pattern characterized by prolonged inspiration unrelieved by expiration​ attempts?

Apneustic respirations

Which of the following is appropriate management for a patient bitten on a limb by a pit​ viper?

Apply a splint to the limb and immobilize in a neutral position

For infectious disease​ emergencies, which of the following best describes the process of always considering the interaction of the infectious​ agent, the​ host, and environment to allow you to determine your likelihood of​ exposure?

Assessing personal risk

When transporting a​ patient, who you believe to be having a behavioral emergency as the result of a medical​ emergency, what is your first​ concern?

Assessment of the​ airway, breathing, and circulation

You are called to the home of a patient with a neuromuscular disease that has left him dependent on mechanical ventilation through a stoma for survival. The family summoned EMS due to the ventilator alarming​ "low minute​ ventilation." What should the paramedic do regarding management of this​ patient?

Assure the stoma is patent and begin ventilations with a​ bag-valve-mask (BVM)

When looking at an​ ECG, the P wave is representative of​ what?

Atrial depolarization

The hormone that opposes the effects of the antidiuretic hormone​ (ADH) is:

Atrial natriuretic hormone​ (ANH).

When dealing with a child in behavioral​ crisis, it is important to do which of the​ following?

Avoid separating the child from his parent

Which one of the following patients is most susceptible to developing cardiovascular​ disease?

A​ 64-year-old male,​ three-pack-per-day smoker

Why is collection of a thorough history important when building a differential diagnosis on the victim of a severe​ headache?

A​ severe, acute onset headache or a change in headache pattern indicates the need for immediate attention

Your patient is a​ 6-year-old female that has developed a sore​ throat, fever, and drooling over the past three hours. What is most likely the source of her​ infection?

Bacteria

What is the best technique to calm an agitated​ patient?

Be calm and professional

Why should the paramedic transport an ROSC patient receiving induced therapeutic hypothermia protocol in the field to an ED that can maintain this​ therapy?

Because it has been shown that if the patient warms​ up, survival actually is worse than never starting ITH

Why are females generally at higher risk for urinary tract infections than​ males?

Because of the comparatively short length of the female urethra

Why is noting acute kidney injury in the field vital to patient​ care?

Because the condition may be reversible

Why is the use of Lasix or nitroglycerin often of no benefit to the patient suffering from noncardiogenic pulmonary edema​ (ARDS)?

Because the reason for the pulmonary edema is not related to the cardiac pump​ (left ventricle)

When evaluating patients complaining of upper gastrointestinal​ hemorrhage, why is it important to transport expeditiously to an appropriate​ facility?

Because upper GI hemorrhage carries with it a high mortality rate

A patient you are interviewing suddenly loses consciousness and no pulse is presentdash-ECG reveals ventricular fibrillation. What is your initial​ action?

Begin CPR​ immediately, and as soon as the defibrillation pads can be​ applied, charge the machine and defibrillate the patient

How does significant exposure to carbon monoxide affect normal physiology of the​ body?

Binds to the hemoglobin​ sites, preventing the attachment of oxygen and causing cellular anoxia

Your patient has overdosed on his prescribed lithium. What is the medical problem this patient has that would require this​ medication?

Bipolar disorder

Which of the following patient history findings indicates a more serious cause of low back​ pain?

Bladder and bowel incontinence

The most common complications of hemodialysis include which of the​ following?

Bleeding from the needle puncture site and infection

Your patient reports that she has hepatitis C. How might that disease be transmitted to​ you?

Blood

Your patient who complains their vision is​ cloudy, diplopia, and sees halo is likely to have which of the following​ pathologies?

Breakdown of protein within the lens

A patient with a suspected stroke in the brainstem region may display what type of changes to the pulmonary​ system?

Breathing may become deep and rapid.

What is the underlying pathophysiology that creates the clinical findings consistent with toxic exposure to a caustic​ substance?

Burn injuries at site of contact

How can the paramedic differentiate acute kidney injury in the prehospital​ setting?

By clues ascertained by utilizing a focused history

How is a therapeutic level of epinephrine normally maintained in the pediatric​ patient?

By repeating the calculated boluses every​ 3-5 minutes as required

What procedure is utilized on a patient that has extensive myocardial disease​ and/or is not a candidate for percutaneous coronary interventions and has​ thrombocytopenia?

CABG

What is a common etiology underlying abnormal breathing patterns such as​ Cheyne-Stokes or central neurogenic​ hyperventilation?

CNS illness or injury

Your patient was burned by hydrofluoric acid and is complaining of dyspnea and palpitations. Which of the following medications is most appropriate for treating​ him?

Calcium chloride

During your​ assessment, you have determined that the patient is likely suffering from deep venous thrombosis. Which of the following clinical signs is least likely to support this field​ impression?

Calf pain or tenderness

It is the middle of winter and you are called to a scene for a​ "sick family." As you​ arrive, the husband meets you at the road and states he has a headache but also that he returned home this morning and found his wife and two children lying on the couch all complaining of​ nausea/vomiting, headaches, and inability to stand. What would be an appropriate action at this​ time?

Call the fire department and have them retrieve the family with breathing equipment on.

Along with cigarette​ smoking, exposure to​ asbestos, hydrocarbons,​ radiation, and fumes from metal production have been associated risk factors for what lung​ disease?

Cancer

It is the middle of winter and you are called to a scene for a​ "sick family." The husband meets you at the road complaining of a severe headache. He returned home from work this morning and found his wife and two​ children, drowsy and lying on the coach complaining of​ nausea/vomiting and headaches. He developed his headache only after entering the residence. What would you suspect in this​case?

Carbon monoxide poisoning

The ECG monitor shows the​ following: no​ rate, no​ rhythm, P waves that are regular in​ spacing, no QRS complexes. What would you call this​ rhythm?

Cardiac standstill

Which monitoring devices are used by the paramedic for a patient​ anaphylaxis?

Cardiac​ monitoring, pulse​ oximetry, end-tidal carbon dioxide detector

If your patient is suffering poor perfusion to the heart muscle that is drastically reducing the ability of the heart to pump​ blood, this can result in what kind of​ shock?

Cardiogenic

You are managing a patient with systemic​ hypotension, alterations in mental​ status, and poor peripheral perfusion. You have already assessed for and corrected disturbances pertaining to the heart​ rhythm, vascular​ volume, and vascular tone. What is the remaining reason for the​ hypotension?

Cardiogenic shock

You are caring for a patient that upon physical​ exam, you note that she has a​ "moon face"​ appearance, an excessive accumulation of fat on her upper​ back, and an excessive amount of facial hair. Which of the following will she likely have a higher incidence of​ developing?

Cardiovascular disease

Found where the trachea divides into the left and right mainstem​ bronchi, stimulation of the​ _____ can result in violent coughing.

Carina

What is the most common cause of​ TIAs?

Carotid artery disease

Your patient presents with​ tingling, numbness, and weakness in her​ wrists, hands, and all her fingers. She is a secretary in a​ fast-paced law office that requires her to type numerous​ memos, opinions, and other legal paperwork every day during her fifty​ hours-plus workweek. What is the most likely cause of her​ discomfort?

Carpal tunnel syndrome

Which of the following patients display findings of respiratory​ failure?

Central​ cyanosis, 1-2 word​ dyspnea, pulse ox of 84 percent

What is the term for a​ highly-contagious ulcer, more frequently diagnosed in​ men, caused by Haemophilus ducreyi​?

Chancroid

Which of the following is important to consider when assessing and treating infectious diseases in pediatric​ patients?

Children can quickly develop​ life-threatening dehydration.

Your patient is complaining of right upper quadrant abdominal pain. He says he just got back home from the​ all-you-can-eat Friday fish fry and now​ can't get comfortable. A focused physical exam of the abdomen reveals point tenderness under the right costal margin. Most​ likely, he is suffering from which of the​ following?

Cholecystitis

What is the medical term for the formation of​ gallstones?

Cholelithiasis

Atropine works by antagonizing which of the​ following?

Cholinergic response

During what phase of a cardiac arrest event will the heart muscle become distressed due to a lack of oxygen in the myocardial​ cells?

Circulatory phase

You have a patient that was rescued from a​ burning, smoke-filled home and shows a SpCO reading of 28 percent. He is unconscious and you have to make a transport decision. Which of the following facilities is the most​ appropriate?

Closest hospital with a hyperbaric chamber

Which of the following is a​ well-known cause of excited delirium​ syndrome?

Cocaine

You are called for a​ "possible overdose." Examination reveals that the patient has a pulse of 112 per minute. Of the​ following, which is most likely to have caused the​ tachycardia?

Cocaine

The period when the host may exhibit signs of clinical disease and can transmit the infectious agent to another host is which of the​ following?

Communicable period

Which of the following disorders is associated with the development of prerenal acute kidney injury​ (AKI)?

Congestive heart failure

Your patient took a large overdose of citalopram. Which of the following treatment choices is best for​ her?

Consider benzodiazepines for seizures and external cooling for increased body temperature

Which of the following can cause pathogenesis of fungi that are usually a part of the normal​ flora?

Consumption of​ broad-spectrum antibiotics

You are transporting a patient​ who, after a history and primary​ exam, you believe to be suffering from hypochondriasis. What should your next action​ be?

Continue to treat the symptoms until medical conditions have been ruled out

Your patient has a history of mental​ illness, and he calls you because he has not been able to urinate today. When you question​ him, he states that he inserted a pencil into his urethra to help the demons get out. You observe the eraser protruding from his penis and slight bleeding as well. Your best course of treatment is which of the​ following?

Control the external bleeding as best as possible and transport

Which of the following can be caused by pulmonary​ hypertension?

Cor pulmonale

What condition is said to occur when there is an infection of the cornea by an infectious agent that breaks through the epithelial border of the cornea and it presents with a painful red​ eye, tearing, and​photophobia?

Corneal ulcer

What form of cardiovascular disease is the single largest killer of Americans each​ year?

Coronary artery disease

The most important of the glucocorticoids​ is:

Cortisol

Which of the following is not a cardiovascular cause of chest​ pain?

Costochondritis

You are called to care for a pyrotechnician who was too close to a firework that exploded prematurely. Although the patient does not have any​ burns, he is complaining of decreased hearing in one ear with a severe​ earache, a small amount of bloody discharge from the external​ canal, and a​ "buzzing" sound. Given this​ presentation, what should the paramedic​ do?

Cover the ear to prevent infection

When evaluating an​ ECG, you note that in lead III the QRS complex duration is 0.16 seconds. What does this finding​ imply?

Delayed conduction through the ventricular conduction system

What is the most severe form of ethanol withdrawal manifested by altered mental status and sympathetic​overdrive, which can lead to​ mortality?

Delirium tremens

Which of the following disorders can result from​ AIDS, Parkinson's, or drug​ abuse?

Dementia

The feeling of being​ different, that the body has taken a different form or that the patient has become someone​ else, is characteristic of which of the​ following?

Depersonalization

What is the purpose of​ defibrillation?

Depolarize the entire mass of the myocardium and allow it to repolarize uniformly

Suicide is 500 times more common among people also suffering from which of the​ following?

Depression

What mental disorder is normally mistaken for dementia in the elderly​ patient?

Depression

What type of​ exam(s) would best assist you in differentiating potential causes for patients complaining of generalized weakness and​ vertigo?

Detailed history and focused assessment

A dysfunction of the pancreas is most likely to result in which of the following kind of medical​ emergency?

Diabetic ketoacidosis

Which of the following is most indicative of​ schizophrenia?

Disorganized​ speech, distortions of​ reality, and flat affect

Your patient is complaining of chest pain that is sharp and​ "ripping," going straight through to his back. He is​ pale, diaphoretic, and his extremities are mottled. Pulses are weaker on the left arm compared to the right. Blood pressure in the left arm is​ 80/40 and in the right arm is​ 170/90. He tells you he has had heart problems in the​ past, but this​ doesn't feel like any of his previous heart problems. He has taken four of his nitroglycerin tablets within the last fifteen​ minutes, with no relief. Based upon this​ information, what is likely this​ condition?

Dissecting thoracic aneurysm

Colicky pain and tenderness localized to the lower left​ quadrant, low grade​ fever, nausea, and vomiting are the classic presentation for what lower gastrointestinal​ disorder?

Diverticulitis

Your patient is complaining of colicky left lower quadrant abdominal pain and has a temperature of 100.1 F. When assessing a​ history, he says he eats a lot of popcorn​ "for fiber." This all started​ yesterday, but the pain is terrible today and he is quite nauseated. What does he​ have?

Diverticulitis

You observe an irregular rhythm on the ECG with a rate of 66 to​ 80, a normal PR​ interval, and a regular P wave for every QRS complex. The rate seems to vary with the​ patient's ventilations. What is your initial​ action?

Do nothing but observe the patient and transport

Attempted suicides by individuals often involve what type of​ mechanism?

Drug overdose

Which of the following is one of the listed considerations on the Los Angeles Prehospital Stroke​ Screen?

Duration of signs and symptoms less than 24 hours

Symptoms that include protruding​ tongue, twisted​ neck, deviated​ gaze, and abdominal rigidity should suggest which​ diagnosis?

Dystonic reaction

Which of the following statements is most accurate when considering the use of hard​ restraints?

EMS personnel should avoid using hard restraints.

You and your partner possibly have been exposed to tuberculosis. What is the key intervention to prevent an active TB​ infection?

Early drug prophylaxis

Which of the following patients would likely have the highest risk for developing cardiovascular​ disease?

Elderly male who​ smokes, is​ obese, and lives a sedentary lifestyle

In terms of contagious​ diseases, what are the interactions of​ host, infectious​ agent, and environment known​ as?

Elements of disease transmission

Evidence of myocardial injury on a 12 lead ECG will produce an ST segment as which of the​ following?

Elevated above the​ baseline, equal to or greater than 1 mm

You are managing an unresponsive patient with a history of type I diabetes. The patient has a low blood glucose​ level, is​ tachycardic, normotensive, and has a room air pulse ox reading of 94 percent. Following oxygen​ therapy, IV​ initiation, and administration of 50 percent​ dextrose, the patient is still unresponsive. How should this patient be transported to the​ hospital?

Emergency traffic speeds with lights and sirens

Your patient is a thin​ 59-year-old male in respiratory distress. He presents in a tripod position and appears to be working to​ breathe, pursing his lips. He is on home oxygen at 2 Lpm via nasal cannula and takes Atrovent and Proventil as his medications. You immediately notice his​ barrel-chested appearance, increased​ anterior/posterior chest diameter and pink complexion. Most​ likely, this patient suffers from which of the​ following?

Emphysema

In which of the following patients who require positive pressure ventilation to maintain oxygenation status would it be most important to ensure you do not deliver high airway​ pressures?

Emphysema patient

This mechanism is the result behind ectopic foci automatically​ depolarizing, producing ectopic​ (abnormal) beats on the ECG.

Enhanced automaticity

Combined with​ smoking, what complication can develop in a female who is also taking birth control​ pills?

Enhanced clot formation

Upon arrival to the​ scene, you observe that your​ 4-year-old male is having difficulty breathing with audible stridor. He presents in a tripod position sitting on the side of his bed and says his throat hurts. The patient is excessively drooling. Mom states this developed quickly over the past hour and her son​ hasn't been sick lately. What is the most likely​ cause?

Epiglottitis

You are managing a patient found in cardiac arrest. Bystander CPR was initiated and the patient was shocked once with an AED. You have determined that the patient is still pulseless and apneic. While one partner is intubating and another is inserting an IO needle into the proximal​ tibia, what medication should you prepare for administration first via IV​ push?

Epinephrine

A significant finding in the SAMPLE history that will contraindicate the administration of sublingual nitroglycerine to a patient experiencing myocardial chest pain is which of the​ following?

Erectile dysfunction medication use within 24 hours

Your patient has been feeling run down for the last day or so and is very weak and thirsty. He states he takes insulin​ daily, but ran out yesterday morning and​ hasn't been able to get a refill. ECG shows sinus tachycardia. You perform a finger stick and the portable glucometer reads 480​ mg/dL. What would be a beneficial intervention at this​ time?

Establish an IV and administer boluses of normal saline to rehydrate the patient

You are assessing a male who has just finished running a marathon. He presents with pain in his groin area that occurred just as he crossed the finish line and is very nauseated. You examine the area and it is very​ painful, tender, and swollen. What is the most appropriate​ management?

Establish an​ IV, administer​ analgesics, and transport immediately

You are called by police to respond to a downtown street corner for an unresponsive man who is bleeding. You arrive and note that the police are already at the scene. Lying face down on the corner is a​disheveled, unresponsive man who appears to be in his 60s. As you​ approach, the officer tells you that he knows the individual as a homeless man who frequently panhandles in the area. The victim then begins to vomit bright red blood. What is your first treatment​ priority?

Establishing control of the​ patient's c-spine and airway

Which of the following represents the most appropriate field management of a patient with a blood glucose level of 400​ mg/dL, HR of​ 110, and complaints of being hungry all the time and having to urinate​often?

Establishment of an IV and giving boluses of fluid to rehydrate and maintain pressure

You are accidently stuck with the needle from the IV just initiated on a patient confirmed to have HIV. After washing your hand with warm water and​ soap, what should be done​ next?

Evaluation and possible prompt initiation of antiretroviral drugs

During your treatment of a patient with cardiac type chest​ pain, you have provided​ oxygen, IV​ access, nitroglycerin​ x3, and morphine x1. The patient is now pain free and the 12 lead ECG changes have resolved. At a​ minimum, how often should you repeat your reassessment phase during​ transport?

Every 15 minutes

Your patient has been successfully restrained but continues to be​ agitated, noncompliant, and has very hot skin. What​ life-threatening condition is the patient​ developing?

Excited delirium

You arrive at the residence of a​ 15-year-old male complaining of severe abdominal pain. You establish that the patient is alert and well oriented and his vitals are within normal limits. His father tells you that he has been complaining of a stomach ache for several days but it has recently become much worse. The patient adds that it hurts worse than when he broke his wrist playing baseball. As you perform your focused exam on his​ abdomen, you palpate the periumbilical area and note guarding followed by a positive test for rebound tenderness in the lower right quadrant. Shortly after​ palpation, the patient tells you that the pain has subsided to a dull​ ache; he feels much better and​ doesn't wish to be taken to the hospital. What is your next​ action?

Explain to the patient and his father that he could be in grave danger of infection and needs to be transported even though he feels better

What is the risk of infection to health care workers from​ HIV-positive patients when Standard Precautions are adhered​ to?

Extremely rare

How does chronic bronchitis cause the development of pulmonary​ hypertension?

Gas exchange is decreased because of lowered alveolar​ ventilation, resulting in​ hypercarbia, which causes pulmonary vasoconstriction.

Which of the following will likely not produce occult lower gastrointestinal​ bleeding?

Gastroenteritis

The most important intrinsic risk factor leading to respiratory disease development​ is:

Genetic predisposition

A patient with an airway obstruction between which two anatomical points will be unable to ventilate at​all?

Glottis opening and carina

What is the term for the synthesis of glucose molecules from nonsugar​ sources?

Gluconeogenesis

What is the form of inflammatory arthritis that occurs when uric acid accumulates in the​ joints?

Gout

Your elderly patient is complaining of a sudden onset of pain in his left foot. Light touch of his great toe causes excruciating pain. Which of the following joint disorders is the most likely cause of the​ patient's pain?

Gout

Ecchymosis observed along the flank areas of the abdomen and is evidence of abdominal bleeding is described by which of the​ following?

Grey​ Turner's sign

Which one of the following histamine receptor types is located in the central nervous​ system?

H3

Which of the following is a complication of type 2 diabetes due to sustained hyperglycemia and water intake that is inadequate to replace lost​ fluids?

HHS

You are transporting a patient from a nursing home into the emergency room for violent behavior. Along with a urinary tract​ infection, what other set of​ signs/symptoms would lead to a sepsis​ diagnosis?

HR​ >90 bpm and tachypnea

Eighty percent of the persons who successfully commit suicide have done what in the​ past?

Had a previous suicide attempt

Skin exposure to which of the following toxins may be decontaminated by use of water immersion mixed with magnesium​ sulfate, calcium​ salts, or benzethonium​ chloride?

Hydrofluoric acid

What is the proper sequence for removing a TASER​ dart?

Have TASER turned​ off, cut the dart​ wire, pull dart​ out, and cover wound with dressing

What should be the primary action when dealing with a patient sprayed with a pesticide that contains an​organophosphate?

Have the patient remove all​ clothing; then use copious amounts of water to flush the patient clear of any more toxin before attempting to touch the patient

You are dispatched to the home of a male with a history of kidney failure. On​ arrival, the patient informs you that he receives four hours of​ dialysis, three days per week and his shunt is swollen and painful. What could you conclude about this​ patient?

He has chronic kidney disease.

What is the medical term for coughing up or vomiting​ blood?

Hematemesis

What is a blood test that measures the percentage of the volume of whole blood that is made up of red blood​ cells?

Hematocrit

The process of developing the cellular components of blood is which of the​ following?

Hematopoesis

You are called for a​ 59-year-old female with chest pain. Her only medical history she tells you is that she was in the hospital once for an allergic reaction to Novocaine after dental surgery. Pulse is 90 and​ irregular, ventilations​ 20, blood pressure is​ 130/80. She takes no medications and her ECG shows sinus rhythm with​ numerous, multifocal PVCs. What is the most appropriate​ action?

High flow oxygen therapy

In an allergic​ reaction, what substance released by mast cells and basophils causes​ bronchoconstriction, increased intestinal​ motility, vasodilation, and increased vascular​ permeability?

Histamine

Which of the following factors contributes to the high mortality rate of upper gastrointestinal​ bleeds?

Home treatment of symptoms with​ over-the-counter drugs

What is the term for the chemical attack staged by the immune system in response to invading substances by​ immunoglobulins?

Humoral immunity

You are assessing an emphysema patient with respiratory distress and sharp localized chest pain to the left hemithorax. The patient states that he normally has trouble​ breathing, but it suddenly became much worse after a​ "coughing spell." You note absent breath sounds to the left apical and mid lung​ fields, and diminished sounds on the right side. Given these​ findings, what would you anticipate finding when you percuss the​ thorax?

Hyperresonance

What is the term for an unexpected and exaggerated reaction to a particular​ antigen?

Hypersensitivity

Which of the following is a modifiable risk factor for developing cardiovascular​ disease?

Hypertension

Which of the following risk factors has NOT been proven to increase the risk of cardiovascular​ disease?

Hypocholesterolemia

What gland of the body connects the endocrine system with the nervous​ system?

Hypothalamus

Which of the following is most likely caused by permanent loss or atrophy of functional thyroid tissue or insufficient stimulation of a normal thyroid gland as a result of hypothalamic or pituitary​ disease?

Hypothyroidism

Regardless of the type of​ anemia, or the​ cause, significant anemia always results in which of the​following?

Hypoxia

Which of the following acronyms provides a screening mnemonic for major​ depression?

INSADCAGES (The mnemonic represents​ Interest, Sleep,​ Appetite, Depressed​ mood, Concentration,​ Activity, Guilt,​ Energy, and Suicide.)

In which of the following arrest situations should the paramedic withhold​ resuscitation?

If the arrested patient displays dependent lividity

Which of the following is the most abundant class of antibodies found in blood serum and​ lymph?

IgG

A person receiving a blood transfusion experiences a sudden onset of​ fever, headache, and generalized itching. You verify the patient is receiving the correct blood type​ (the label on the bag matches the​patient's chart). What is the appropriate​ action?

Immediately stop the​ transfusion, remove and save the​ tubing, and substitute saline with a 10 drop set at the hub of the intravenous catheter

During your assessment of a patient with​ CHF, what position should he be in prior to the paramedic evaluating for the presence or absence of​ JVD?

In a​ sitting-up position of about 45 degrees

Which of the following findings for a patient complaining of dyspnea is of greatest​ concern?

Inability to speak in full sentences

While transporting a pediatric patient with​ rhinitis, the parents ask if there is anything they can do at home to help alleviate the​ patient's symptoms. What bit of advice could the paramedic offer the​ parents?

Increase the water vapor in the air via a room humidifier

What appears to be the main reason why excited delirium emerges within a​ patient?

Increased brain dopamine levels

What is the underlying pathophysiological change to the lungs that causes the patient to develop adult respiratory distress syndrome​ (ARDS)?

Increased fluid accumulation in the perialveolar interstitial spaces

You have just regained pulses on a cardiac arrest patient. As of right​ now, the heart rate is​ 38/min with sinus bradycardia showing on the monitor with multifocal​ PVCs, the patient is being ventilated at​ 10/min with oxygen via ET​ tube, and the palpable blood pressure is​ 68/palpation. Given these​ findings, what should the paramedic focus the next interventions​ on?

Increasing the heart rate

What is the term for the individual identified as the person who first introduces an infectious agent to a​population?

Index case

Which of the following parameters is not a way that a population is​ identified?

Index case

Which of the following types of immunity provides protection from exposure to an antigen by getting a​vaccination?

Induced active

What postarrest treatment intervention has been shown to be beneficial in improving neurological outcome by slowing metabolism and minimizing oxidative​ stress?

Induced therapeutic hypothermia

A term for describing permanently damaged myocardial tissue that will not heal and may cause the appearance of a pathological Q wave on a 12 lead ECG is which of the​ following?

Infarct

What is the pathophysiological difference between someone experiencing chest pain from an ischemic episode versus an infarction​episode?

Infarction is commonly from a totally occluded coronary blood vessel.

What is the underlying pathology of a patient with an upper respiratory​ infection?

Inflammation of upper airway structures from a virus or bacteria

What is the most common route of toxin exposure in the pediatric​ population?

Ingestion

Which of the following routes of toxic exposure is most​ common?

Ingestion

You are called to a remote campsite for a patient who is unresponsive. According to family​ members, the patient came back to the camp from walking through the woods looking for some wild onions to cook​ with, and was complaining of severe abdominal pain. The patient then​ vomited, and went in his tent to lie down. Later he was found unresponsive. Given the​ presentation, what would be the type of toxic​exposure?

Ingestion of wild mushrooms

Although toxic exposures can have immediate and delayed​ effects, what type of exposure mechanism would likely start out with pulmonary findings such as​ tachypnea, wheezing, or inspiratory​ crackles?

Inhalation

Which of the following is a route of toxic exposure that results in rapid absorption of a toxic agent across the​ alveolar-capillary membrane?

Inhalation

During your management of a spontaneously breathing patient with suspected ARDS who is failing to oxygenate adequately with oxygen via​ NRB, what other intervention can the paramedic attempt to increase the oxygenation status of the​ patient?

Initiate CPAP

Your patient presents with continuous vomiting and diarrhea after eating at the local restaurant two hours earlier. He complains of severe abdominal pain and starting to feel very weak. Which of the following is the best treatment​ option?

Initiate IV​ fluids; replace at a rate sufficient to maintain blood pressure

Anaphylaxis most rapidly develops during what type of antigen​ exposure?

Injection

Your patient is exhibiting signs and symptoms of an allergic reaction with dyspnea and wheezing. The blood pressure is still​ acceptable, but the pulse oximeter is dropping despite​ high-flow oxygen. What should the paramedic consider administering​ next?

Intramuscular epinephrine

During your management of a patient suspected to be suffering from​ Cushing's syndrome, which of the following interventions should be part of the prehospital​ management?

Intravenous therapy

Your elderly female patient is complaining of steadily​ increasing, dull abdominal pain over the past two days. It does not​ radiate, but drawing up her knees helps a little to relieve the pain. She has been vomiting​ greenish-tinged material quite often. Her skin is​ pale, cool, and​ diaphoretic; pulse is 100 and blood pressure is​ 104/70. What is most likely the cause of her​ presentation?

Intussusception

After administering epinephrine and a 1000 ml bolus of 0.9 percent​ saline, you are ordered to administer 300 mg of Tagamet slow IV push to your patient that is experiencing an anaphylactic reaction. What is the benefit of Tagamet in this​ scenario?

In​ theory, it can block the H2 receptors in the peripheral blood vessels and reverse some vasodilation.

The ECG shows a rhythm with​ regularly-irregular groups of QRS complexes. There are more P waves than QRSs and the PR intervals become progressively longer until a P wave is not followed by a QRS complex. Which of the following would you​ suspect?

Ischemia at the AV junction

What is the term for the inability to concentrate or dilute​ urine?

Isosthenuria

Which of the following statements is true regarding hemophilia​ B?

It causes abnormally low levels of factor IX.

How does the brain attempt to compensate for the acidosis associated with​ DKA?

It increases the rate and depth of ventilations.

In terms of public​ health, patients that present with clinical findings pertaining to a particular infectious disease should alert the paramedic to what​ possibility?

It may not be an isolated incident.

How does chronic anemia relate to​ end-stage renal​ failure?

It occurs secondarily to disruption of renal hormone production.

Identify the correct statement regarding a stroke.

It occurs when the normal blood flow to an area of the brain is compromised due to partial or total blockage of a cerebral artery.

What is the benefit to transport a patient experiencing a myocardial infarction to a center with a catheter lab that performs percutaneous coronary​ intervention?

It provides the possibility of rapid reperfusion to distal myocardium by dilating the lumen of a blocked coronary artery with a balloon.

The process in which ketone bodies accumulate to biologically significant levels in the bloodstream is known​ as:

Ketosis

What condition is typically associated or the result of a middle ear infection or upper respiratory​ infection?

Labyrinthitis

You are called to treat a​ patient, post-dialysis, for acute stomach discomfort. Airway is​ clear, breathing is 22 and​ regular, clear lung​ sounds, pulse is 88 and weak-skin is cool and slightly diaphoretic. Blood pressure is​ 106/68 in right arm​ (left has a​ shunt). When​ asked, she tells you she is diabetic​ (glucose is​ 90), has a heart history​ (12 lead shows only an old myocardial​ infarct) and is on dialysis 3 times a week. When you try to stand her​ up, she immediately becomes very​ pale, lightheaded, and dizzy. What should be done​ next?

Lay her supine on your​ cot, establish an​ IV, and prepare to give fluids to maintain peripheral perfusion.

Which of the following lead patterns showing evidence of myocardial ischemia in a patient with chest pain would be indicative of obtaining right precordial​ leads?

Leads​ II, III, and AVF

What​ area(s) of the heart​ is/are directly observed by the precordial leads on a 12 lead​ ECG?

Left ventricle and septum

A patient with a​ long-standing history of systemic hypertension would most likely produce which of the following waveforms on a 12 lead​ ECG?

Left ventricular hypertrophy

Where is lead V5 placed on a​ patient's chest?

Left​ thorax, fifth intercostal​ space, anterior axillary line

The majority of​ out-of-hospital deaths attributed to coronary artery disease are due to what sudden​ event?

Lethal cardiac rhythm disturbance

You are called for a male patient with general illness. The patient complains of fatigue and fever. Physical exam reveals swollen lymph nodes and enlarged​ liver, bilateral weak grip​ strength, and pain within the sternum​ (non-cardiac). Which of the following is most likely the​ patient's condition?

Leukemia

Any patient with a history of diabetic​ ketoacidosis, bacterial​ infection, and/or rheumatoid arthritis can be at risk for which of the​ following?

Leukocytosis

The ECG shows a regular rhythm at a rate of​ 30, QRS is 0.18​ seconds, and no P waves are present. Which of the following treatments is NOT​ appropriate?

Lidocaine

Toxic overdoses of acetaminophen can cause damage and necrosis to what organ of the​ body?

Liver

Which of the following is a cause for artifact appearing on the​ ECG?

Loose​ electrodes/wires

Which of the following is a symptom rather than a musculoskeletal​ disorder?

Myalgia

You are called to a residence to transport a​ 24-year-old female complaining of frequent and painful urination for the past 24 hours. She appears to be restless and continuously moves​ about; her vitals are pulse​ 94, respirations​ 20, blood pressure​ 104/76. Her skin is​ pale, cool, and moist. With this​ information, what would your field diagnosis be and what is your transport​ mode?

Lower urinary tract​ infection, expedite transport to an appropriate facility

When approaching a patient during your scene​ size-up and primary​ assessment, if you determine the potential for​ violence, you should do which of the​ following?

Maintain a safe distance and call police

Prehospital treatment of priapism consists of which of the​ following?

Making the patient comfortable and transporting him immediately

An​ 80-year-old, bed-confined patient has ankylosing spondylitis. She has fallen out of​ bed, is​unconscious,and EMTs have been called. What should EMTs do when they​ arrive?

Manage the airway using devices that do not require​ visualization, adequately pad underneath the​ patient's head, neck and upper back with sheets or​ pillows, and determine how to transport in a​ non-jarring manner

The portion of the brainstem that is located between the diencephalon​ (interbrain) and the pons that is responsible for motor coordination and control of eye movement is which of the​ following?

Mesencephalon​ (midbrain)

You are called to examine a​ middle-aged female patient. She is not responsive to verbal​ commands, but tries to withdraw from and brush away painful stimulus. As you perform a physical​ exam, you find an insulin pump attached to her. Among the following possible​ causes, which one would be least​ likely?

Metabolic alkalosis

Your patient is complaining of difficulty breathing and dizziness. You can hear audible stridor and wheezing. Which of the following will be least​ beneficial?

Methylprednisolone​ (Solu-Medrol)

What is the primary cause of chronic​ gastroenteritis?

Microbial infection

You respond to a patient who experienced sudden vision loss in her left eye. She has a history of diabetes and hypertension. Regarding​ treatment, which of the following is​ correct?

Most patients regain vision without​ treatment, although it rarely returns to normal.

What is the term for cancer in the plasma cells of the immune​ system?

Multiple myeloma

As you approach your​ patient, you can see she has a very flat​ affect, a very puffy​ face, thinned​ hair, and ​doughy-looking, pale skin. From this general​ impression, what might be the underlying pathology with this​patient?

Myxedema

The presentation of which of the following findings in a patient with hypothyroidism would require emergent transport to the closest emergency​ department?

Myxedema coma

You arrive on scene for a patient who has purposely overdosed via ingestion. The empty prescription pill bottle reads​ "ibuprofen, 800​ mg/tab." What drug class would this​ be?

NSAID

You are transporting a patient with severe joint pain secondary to a degenerative mechanism. What can the paramedic consider administering to make the patient feel more comfortable and decrease the pain while en​ route?

Narcotic

You are treating a​ 38-year-old male with a​ painful, closed right tibia fracture. There was no traumatic​mechanism, but the patient says he was recently diagnosed with a chondrosarcoma. Which of the following is the most likely cause of the​ fracture?

Neoplasm

Damage to the kidneys from diabetes​ mellitus, resulting in chronic kidney​ disease, primarily occurs in which renal​ structure?

Nephrons

Which of the following cell types is primarily tasked with fighting​ infection?

Neutrophils

Your patient tells you he was cutting down brush in the woods behind his house today and when he​finished, he noticed a large rash developing on his arms and legs. He is in no outward respiratory or cardiovascular​ distress, but the majority of his anterior arms and legs are covered with urticaria. He lets you assess his vital​ signs, and they are all within normal limits. What is the best treatment option for this​patient?

Observe the patient and consider an IM injection of Benadryl or Tagamet

Synchronized cardioversion delivers energy during which part of the cardiac​ cycle?

On the peak of an R wave

Which of the following patients is at the highest risk of committing​ suicide?

One in possession of a gun

What is an organism that exists harmlessly as part of the normal human body environment and does not become a health threat until the​ body's immune system​ fails?

Opportunistic pathogen

What is the name of the membranous structure that separates the anterior aspect of the eye from the posterior​ aspect?

Orbital septum

What is the term for large amounts of water loss due to the presence of excessively high levels of glucose in the tubules of the​ kidney?

Osmotic diuresis

Which of the following pathologies is not secondary to a repetitive motion​ etiology?

Osteoarthritis

What condition occurs when the bone itself becomes inflamed or​ infected?

Osteomyelitis

What is the medical term for an infection of the​ bone?

Osteomyelitis

Which of the following is most likely to occur in a bedridden​ 65-year-old female alcoholic with a history of rheumatoid arthritis and a vitamin D​ deficiency?

Osteoporosis

The application of physical and chemical restraints to a patient must be performed with what​understanding?

Overstepping the boundaries of proper restraint may be perceived as​ battery, assault, or false imprisonment.

You are called for a​ 24-year-old woman with a rash. You find her sitting in a​ chair, alert and oriented and states she itches all over. She states she has been ill with a cold and saw her physician yesterday. She was given a prescription for an antibiotic and took the first dose last night and a second about​ 1/2 hour ago. Auscultation of the chest reveals clear lung sounds. The​ patient's blood pressure is​ 108/64, pulse​110, ventilations 18. Initial management of this patient should include which of the​ following?

Oxygen by nonrebreather mask and administration of​ 0.3-0.5 mg of​ 1:1,000 epinephrine IM

When examining a patient with abdominal​ pain, which of the following is most likely to produce somatic​ pain?

Pancreas

When a patient tries to commit suicide by ingesting​ something, why could the signs and symptoms be inconsistent with a single​ diagnosis?

Patients will have ingested more than one toxin to try to kill themselves.

What is the most common underlying etiology for upper GI​ hemorrhage?

Peptic ulcer disease

Which of the following is not​ cause/risk for the development of​ cholecystitis?

Peptic ulcer disease

Your patient is a​ 28-year-old male who works in a​ fast-paced, high stress job environment. He is complaining of acute abdominal pain and presents lying supine and very still. He takes no meds and has no medical history. His skin is cool to the​ touch, pulse is​ 108, and blood pressure is​ 96/60. What is he most likely suffering​ from?

Peptic ulcer rupture

The​ 15-month-old you are treating is in respiratory arrest. Pulse still present at​ 108, skin is cyanotic. Mom states the baby was fine a minute ago and when she came​ back, her daughter​ wasn't breathing. You open the airway and make an attempt to ventilate but no air goes in. You reposition the child with padding under her shoulders and reattempt​ ventilations, but still no air entry is achieved. What is your course of action​ now?

Perform a series of 5 back blows and 5 chest thrusts

Which of the following is the principal treatment for​ polycythemia?

Phlebotomy

You are called to a residence for nausea and vomiting. You make your way through the house noting multiple liquor bottles on the floor. This patient is a​ 45-year-old male with shirt and mouth covered in​blood, vomiting large quantities of​ dark, coffee grounds emesis. The​ patient's radial pulse is thready and weak at 114 bpm and he has​ cool, diaphoretic skin. Your initial priorities for this patient include which of the​ following?

Place patient in the left lateral recumbent position on your​ cot, suction as​ needed, and administer oxygen

Which of the following guidelines is recommended for questioning patients who have behavior​ problems?

Place yourself at the​ patient's level and listen to what the patient says.

Maintenance of oncotic​ pressure, clotting of​ blood, and transporting hormones are the responsibility of which of the​ following?

Plasma proteins

What is the type of respiratory problem that occurs when the patient develops an infectious process in one part of a lung that continues to spread throughout adjacent​ alveoli, which ultimately decreases ventilation and​ oxygenation?

Pneumonia

You are caring for an elderly female experiencing respiratory distress. Currently you find her seated upright in bed with accessory muscle use. Audible rales can be​ heard; she is diaphoretic and warm to the​ touch, has a temperature of 102 degrees ​F, and her respiratory rate is 32. The patient tells you that her breathing has been getting worse all night. You auscultate the chest and hear rales and rhonchi in all fields of her left lung and rhonchi in her right​ base, but her right middle and upper lobes sound clear. What do you suspect her problem to​ be?

Pneumonia

Your patient presents with shortness of breath and chest pain. Physical exam reveals some mild intercostal retractions with​ hot, flushed skin. Auscultation of the chest reveals diffuse rhonchi in the apex of the left lung. You also notice several tissues with yellowish sputum streaked with blood. She says​ she's never had this before and has been coughing for a day now. What do you​ suspect?

Pneumonia

Which of the following statements about the epidemiology of toxic exposures is​ true?

Poisonings have been constantly increasing in incidence and severity over the past several years.

Which of the following risk factors are thought to increase the risk of cardiovascular​ disease?

Poor diet

Which of the following assessment tools can provide an accurate differential diagnosis for a patient with altered mental​ status?

Portable glucometer

During your exam of a known CHF​ patient, you auscultate some minor lung​ congestion, observe peripheral edema to her ankles​bilaterally, and a small amount of JVD while sitting upright. The family states these findings are normal for her. The patient complains of a slight headache. What should be your course of​ treatment?

Position of​ comfort, venous​ access, 12 lead​ ECG, oxygen to maintain SpO2 greater than 94 percent

Your patient has overdosed on multiple drugs in an attempted suicide. The patient presents with an open airway with an intact gag​ reflex, clear breath sounds over the​ trachea, but no breath sounds over the lung periphery due to a diminished tidal​ volume, and a pulse ox reading of 84 percent. What intervention should the paramedic provide​ first?

Positive pressure ventilation

Which of the following statements regarding a patient with ROSC is most​ accurate?

Postarrest care is almost as important as prearrest care.

You have a patient who was exposed to cyanide. During your management of this​ patient, which of the following drugs would not be part of the cyanide antidote​ kit?

Pralidoxime

The patient you are treating for palpitations and chest pain has a noticeable goiter and exophthalmos. When you ask her about her medical​ history, she says she has had a​ long-standing thyroid problem but never any​ cardiac, respiratory, or neurological issues. Pulse is 140 and regular​ (sinus tachycardia on the​ECG), ventilations 22 with clear lung​ sounds, and a blood pressure of​ 158/80. Which of the following medications would best treat her current​ condition?

Propranolol

You are dining at a​ restaurant, off-duty, when you notice a slender man at another table who appears to be in severe distress and clutching his throat. He pushes himself away from the​ table; you ask him what is​ wrong, but he cannot speak. What is your first​ action?

Provide abdominal thrusts in a​ rapid, upward fashion

A history of traumatic childhood​ incidents, neglect, dysfunctional​ families, abusive​ parents, and parental alcohol or drug abuse frequently combines with genetic predisposition to produce which of the following kinds of​ disorders?

Psychosocial

You are transporting a behavioral patient with a history of parental neglect. This person is likely suffering from which of the following forms of behavioral​ conditions?

Psychosocial

What is the condition characterized by a​ raised, wedge-shaped growth of the​ conjunctiva?

Pterygium

What is the underlying pathophysiology that is largely responsible for causing pulmonary dysfunction in a patient with any of the four major types of lung​ cancer?

Pulmonary cell growth and reproduction are altered due to the cancer

Your patient has recently come home after a​ bed-ridden 2-week stay in the local hospital. Earlier this​week, he had experienced some bilateral lower leg pains with swelling and redness. Skin is pale with some expiratory wheezing auscultated in the area of his upper right​ thorax, where he complains of chest pain. Most​ likely, what is he​ suffering?

Pulmonary embolism

Which of the following is NOT a good practice for the paramedic to help prevent disease​ prevention?

Put all equipment back in the​ squad, restock, make the​ cot, then wash your hands

What is the term for an infectious inflammation of the​ nephrons, renal interstitial​ tissue, or​ both?

Pyelonephritis

Your patient tells you she is having terrible abdominal pain. She says that she was diagnosed three days ago with a urinary tract​ infection, but is on a fixed income and​ couldn't afford the antibiotics she was prescribed. She is very restless and has noticeable tenderness when you palpate her flank area. What is the likely cause of her​ distress?

Pyelonephritis

Which of the following statements is true regarding​ pyelonephritis?

Pyelonephritis is much more common in pregnant and sexually active females.

The total duration of ventricular depolarization is known as​ the:

QT interval.

A patient with a history of​ Crohn's disease will frequently present with which of the​ following?

Recent weight loss

What is the therapeutic endpoint for reducing the blood pressure in a patient with a hypertensive emergency with a severely elevated blood pressure and evidence of​ end-organ dysfunction?

Reduce MAP by no more than 25 percent initially

How does the respiratory membrane change in patients with​ emphysema?

Reduction of the total surface area available for gas exchange

What mechanism of abnormal impulse formation is responsible for sustaining rapid rhythms such as paroxysmal supraventricular​tachycardia?

Reentry

During the management of a patient in PEA cardiac​ arrest, you have already intubated and ventilated the​ patient, you are performing ongoing​ compressions, and you have administered four doses of epinephrine and a fluid bolus. Prior to termination of the​ arrest, you elect to give 1​ mEq/kg of sodium bicarbonate.​ However, the IV was just pulled out accidentally by your partner prior to the bicarbonate administration. What should you do​ next?

Reestablish the IV or initiate an IO

Why do reflex movements lack the fine motor control of conscious​ movement?

Reflex impulses come from the spinal cord.

What is the term for a chronic pain condition characterized by diffuse​ pain, swelling, and limitation of movement that follows an injury to an arm or a​ leg?

Reflex sympathetic dystrophy

Which of the following can be obtained from a​ single-lead ECG​ tracing?

Regularity of heartbeat

Chief strategies for supportive care in the chronic kidney disease patient include which of the​ following?

Regulation of fluid volume and cardiovascular function

You arrive on scene for an unresponsive male patient with a suspected airway obstruction. Without performing any other assessment on this patient other than knowing he is an adult​ male, what is the most common reason for an upper airway​ obstruction?

Relaxed tongue

You are called to an auto parts store for an​ "agitated person who appears to be​ confused." When you​arrive, the patient is standing in front of the store yelling at two teenagers who appear to be antagonizing him. What should your first goal​ be?

Remove the antagonizers

You are led to a back bedroom where you find the patient lying in bed in a supine position. You immediately notice that she is ashen with​ shallow, unlabored respirations. While your partner begins administration of​ high-flow oxygen via a​ bag-valve unit, you perform a quick check of the radial pulse and find it​ present, with a rate of 130 and thready but regular. Your partner sizes her for and places an oropharyngeal​ airway, but discovers a gag reflex is still present and inserts a nasal airway instead. As you continue your rapid​ assessment, you fold the blankets back and discover that your patient is lying in a large pool of blood with no apparent source. The daughter shrieks and starts sobbing uncontrollably while violently shaking her​ mother's shoulders and screaming for her to wake up. What is your next​ step?

Remove the daughter from the area

What is the first priority when dealing with a patient suffering from a toxic​ inhalation?

Remove the patient from the source as soon as it is safe to do so

Upon arrival to the residence of a​ 32-year-old male, you are told by the patient that he is in extreme pain today. The pain started in his lower back area and now radiates into his lower abdominal area and groin. He is very restless and feels nauseated. He also explains to you that he noticed a​ "little bit of blood in my​pee." What is the most likely​ conclusion?

Renal calculi

Which of the following urinary system disorders tends to occur more often in males than in​ females?

Renal calculi formation

In terms of patient​ privacy, what should paramedics reporting a potential incident of a patient with an infectious disease need to​ understand?

Reporting incidents of infectious disease may be done without fear of violating patient privacy.

During the care of a​ patient, her arterial bleeding results in blood splashing onto your face and eyes. Besides stopping care to immediately flush your​ face, what should you​ do?

Request that you and the patient both be tested for communicable diseases

When the walls of the alveoli and small bronchioles are​ destroyed, as occurs in​ emphysema, vital capacity remains relatively the same while what​ increases?

Residual volume

You are transferring a schizophrenic patient from the local hospital to a specialty hospital for continuing treatment. Despite your​ encouragement, he begins to exhibit aggressive behavior while en route to the specialty hospital. Your next action should be to do which of the​ following?

Restrain the patient

Why should patients not be restrained in the prone​ position?

Restraint in a prone position has been associated with positional asphyxia.

You arrive at the scene of a potential psychiatric emergency at the local​ library; the​ patient, a female in her​ 40s, appears to be​ hallucinating, yelling for​ "them" to leave her​ alone, and throwing books at patrons and bookshelves. The​ police, who were dispatched at the same​ time, have not arrived yet. What should you do​ next?

Retreat to a safe​ location, encouraging bystanders to do so​ also, and await assistance

You have a patient with severe lower right abdominal​ pain, sharp in characteristic. Although the paramedic should assess the​ abdomen, what may result if you repeatedly palpate for rebound tenderness in the area of​ McBurney's point?

Rupture of the vermiform appendix

What federal law provides that neither you nor your employer can force a patient to be tested for a communicable​ disease?

Ryan White Act

What is the disease that develops from a coronavirus and has an incubation period anywhere from​ 2-14 days?

SARS

During the assessment of a 12 lead ECG on a patient with chest​ pain, what type of waveform change is the paramedic assessing for that indicates possible​ damage?

ST segment elevation

What should be included in the care and treatment of most gastrointestinal disorder patients who are acutely​ deteriorating?

Secure​ airway, provide ongoing​ monitoring, initiate a​ large-bore IV, and transport gently in a position of comfort

What is the term for the initial exposure of an individual to an​ antigen?

Sensitization

Your patient experiencing an MI has ST segment elevation in V1 and​ V2, with ST depression and T wave inversion in V5 and V6. Given​ this, what should be your first suspicion as to the ventricular wall​ injured?

Septal wall

How many days are needed following exposure to a new antigen so that the cellular and humoral components of the immune systems will respond to a​ response-inducing antigen?

Several days

You are called to treat a​ 26-year-old African American male with an acute onset of severe joint and abdominal pain. He presents lying on the couch in the fetal position and states the pain is a​ "10." Pulse is ​110, ventilations​ 20, and blood pressure is​ 140/90. Physical exam reveals left upper quadrant abdominal tenderness to palpation. What is the most likely cause for his​ illness?

Sickle cell crisis

Which of the following is most indicative of mood​ disorders?

Significant weight loss and feelings of worthlessness

You are called to a residence for a 7yearold male subject not acting appropriately. On scene the patient appears to be unaware of your arrival and responsive to verbal stimuli from his mother.​ ABC's appear to be intact and no life threats are immediately present. The mother reports that the child was watching television and noticed the​ child's fingers began to twitch. As she continues to describe the course of events leading up to calling for​ EMS, the patient becomes unresponsive and exhibits hyperextension of the back. Which of the following describes the evolution of the​ patient's current​ condition?

Simple partial to​ tonic-clonic

What pacemaker site in the heart serves as the primary​ pacemaker?

Sinoatrial node

A phasic variation of the​ R-R interval that is related to the respiratory cycle and changes in intrathoracic pressure produces which of the following rhythms on the​ ECG?

Sinus arrhythmia

When a patient experiences a sudden increase in cholinergic tone or has intrinsic SA node​ disease, this may lead to the development of which of the following ECG​ rhythms?

Sinus bradycardia

You are looking at an ECG that displays normal P waves at​ 80/min with a​ 1:1 relationship with the​ QRS, a PRI with a 0.24 second​conduction, and the width of the QRS is 0.14 seconds. The T wave is positively deflected. What is the most likely name of this​rhythm?

Sinus rhythm with a​ first-degree AV block and a bundle branch block

Your​ 19-year-old patient admits to drinking a six pack of Red​ Bull, two Monster​ drinks, and six Cokes in order to pull an​ all-nighter. Which of the following rhythms are you most likely to see on an​ ECG?

Sinus tachycardia with multiple PACs

If a patient with an acute coronary syndrome presents to​ EMS, and the ALS providers are able to resolve all pain through the use of nitrates and​ narcotics, why should this patient still be taken to a hospital capable of percutaneous coronary​ interventions?

So that the cause of the MI can be more permanently resolved within a very narrow and​ time-sensitive window of opportunity

What is the disorder that is characterized by physical symptoms that have no apparent physiologic​cause?

Somatoform

You are managing a patient with suspected CO poisoning from using a kerosene heater in his home during a cold winter night. What is the lowest SpCO reading considered to be objective for initiating treatment for the​ exposure?

SpCO​ >10 percent

A​ 62-year-old male with a history of emphysema states an acute onset of pleuritic chest pain after a bout of coughing. He appears mildly dyspneic with ventilations of​ 26/min. When you auscultate the​ lungs, you note that breath sounds are diminished somewhat in the right thorax. You strongly suspect the patient has which of the​ following?

Spontaneous pneumothorax

You are treating a​ 40-year-old male for a sudden onset of chest pain during his daily run. He presents sitting on a park bench in no outward distress. He says the pain started in his chest about 10 minutes​ ago, but when he stopped his run and sat​ down, it went away. What do you suspect the underlying problem to​ be?

Stable angina attack

You receive a phone call at your EMS station from a mother who tells you that her​ 12-year-old son has been sick for several days. She took him to the doctor that morning and was told that the infection was​viral, and antibiotics would not be effective against​ it; she wants to know what you would do. What would you tell​ her?

State you understand how she​ feels, but viral infections are usually​ self-limiting and treated according to their symptoms. Suggest that she contact his doctor.

What is the physiological action of​ dopamine?

Stimulates alpha and beta receptors

What is the mechanism of​ glucagon?

Stimulates breakdown of glycogen

Which of the following findings for a patient complaining of dyspnea is of greatest​ concern?

Stridor on inspiration

Which of the following is the third most common cause of death​ and, in​ middle-aged and older​ patients, is a frequent cause of disability each year in the​ U.S.?

Stroke

Neurologic disorders that display symptoms of unilateral hemispheric involvement are generally the result of which of the following​ mechanisms?

Structural lesions

You are called for a​ 67-year-old male who​ "passed out." You find the patient​ unconscious, lying supine in the bathroom next to a toilet full of bright red blood and vomit. The​ patient's skin is​ cool, pale, and diaphoretic. His blood pressure is​ 60/30, pulse 140 and​ weak, ventilations​ 6/min and shallow. What is your initial management​ action?

Suction the airway and assist his ventilations with 100 percent oxygen and a BVM

Your patient responds only to your voice. He is​ diaphoretic, pale, and​ cool, blood pressure is​ 80/50, ventilations​ 28, and pulse is 34. The ECG monitor shows a rhythm that has​ regular, but independent atrial and ventricular rhythms with no consistent PR interval and a QRS width of 0.14 seconds. Select the most appropriate treatment.

Supine​ position, IV,​ oxygen, externally pace at a rate greater than 60

You are caring for an elderly female experiencing respiratory distress that worsened throughout the night.​ Currently, you find her seated upright in bed with accessory muscle userespiratory rate of 32 and labored. She is​ diaphoretic, very warm to the​ touch, and has a temperature of 102 degrees F. You auscultate her chest and hear rales and rhonchi in most of her upper and middle left lung. What is the most appropriate treatment plan for​ her?

Support adequate ventilation and oxygenation

For the​ paramedic, regardless of the mechanism by which a patient is exposed to a​ toxin, what should be the most important​ focus?

Supporting any lost vital function secondary to the poisoning

You are examining a​ 6-year-old female who is in respiratory distress and has a​ weak, seal-bark-like cough. She complains that her throat is very sore and she has trouble swallowing. Care should include which of the​ following?

Supportive care and humidified​ oxygen, as needed

Your patient presents with purulent drainage and erythema of his left eye. The conjunctiva appears inflamed but the cornea is clear. He also complains of excessive tearing and slight photophobia. What is the best course of action for this​ patient?

Supportive care for the​ patient, crew hand​ washing, and not touching your eyes

You are called to transport an elderly male to the hospital for evaluation of his​ colicky, left-sided parietal pain. The nurse informs you that the patient has had some alternating bouts of constipation and diarrhea over the last few​ days, but​ didn't call you until he noticed​ scant, bright red blood in his stool this morning. When you examine the​ abdomen, no scarring or​ distention, Cullen's, or Grey​ Turner's sign are noted. Tenderness is only noted over the affected area of the left lower abdominal quadrant. What will be your course of​ treatment?

Supportive​ care, establish an​ IV, and monitor SpO2

The patient you are examining complains of an acute onset of severe​ nausea, dizziness,​ vertigo, and tinnitus in his right ear. When​ asked, he states he is a​ one-pack-a-day smoker that just got over a bout of bronchitis and is a diagnosed alcoholic. During your physical​ exam, you detect some nystagmus in the right eye. What is the best course of​ treatment?

Supportive​ measures, establish an​ IV, and give ondansetron for the nausea

Discharge of which branch of the autonomic nervous system causes increased heart rate and blood​ pressure, pupillary​ dilation, a rise in the blood​ sugar, and​ bronchodilation?

Sympathetic nervous system

You respond to a call for a male patient experiencing chest pain. He has an altered level of​ consciousness, blood pressure of​ 80/60, carotid pulse of​ 200, cold, diaphoretic​ skin, and the ECG shows ventricular tachycardia. What is your best treatment option for​ him?

Synchronized cardioversion

What is the neurologic condition characterized by a​ sudden, temporary loss of consciousness that can be caused by​ hypovolemia, hypoglycemia, a heart​ arrhythmia, and/or​ TIA?

Syncope

Your​ 21-year-old female patient calls 911 for general weakness. When you assess​ her, she complains of multiple joint​ aches, fatigue, recent hair​ loss, and sensitivity to light. She noticed just today that when she came​ home, there was a rash that developed over her cheeks and the bridge of her nose. What does she suffer​ from?

Systemic lupus erythematosus

Your patient is presenting with​ earache, dull facial​ pain, and a headache. No trauma is noted and the patient states that she is also having difficulty chewing due to pain. Based on these​ symptoms, you would suspect that the patient is suffering​ from:

TMJ syndrome.

You are transporting a patient with ECG changes and a clinical presentation consistent with an acute coronary event. Assuming that all of the following receiving facilities are roughly the same distance from your​ location, which receiving facility would you transport​ to?

The hospital with PCI capability

During the management of a patient found in cardiac arrest without a known​ downtime, which of the following factors should not be considered as either inclusionary or exclusionary criteria for terminating​ efforts?

The downtime before EMS arrival

Which of the following best describes cellular​ respiration?

The exchange of the respiratory gases between the red blood cells and the various tissues.

Which of the following​ conditions, if present during the management of a patient in cardiac​ arrest, is not sufficient cause to terminate the resuscitative efforts in the field by the​ paramedic?

The patient has a rescue airway in place.

As you question a patient who has recovered from a complex partial​ seizure, which of the following is he likely to​ mention?

The patient has a very bad metallic taste in his mouth.

Why should the use of chemical restraint by paramedics be considered whenever a physically restrained patient struggles​ excessively?

The patient may be suffering from excited delirium syndrome.

You are called to the residence of a​ 16-year-old male complaining of a​ low-grade fever and a​ body-wide rash. After determining the safety of the​ scene, you opt to enter the​ residence, where you find the patient in the living room. You immediately recognize the rash as chickenpox. What are the treatment recommendations for​ chickenpox?

The patient should remain at home until the lesions are crusted and dry

Which of the following is true regarding the vital signs of a patient experiencing the onset severe allergic and anaphylactic​ reactions?

The patient will experience an increase in heart rate.

Which of the following is the definition of​ decontamination?

The process of reducing the amount of toxin absorbed into the body

The infectious disease control officer​ (IDCO) will maintain records of all infectious disease exposures as required by law. Who can these records be released to without the​ employee's written​ permission?

The records cannot be released without the​ employee's written consent.

Which of the following best describes​ afterload?

The resistance against which the ventricle must contract

Severe pain associated with the movement of a kidney stone through the ureter is the result of which of the​ following?

The thin muscle layer surrounding the microscopic ureter and the nerve distribution

Why does a patient with hepatitis present with jaundice and scleral​ icterus?

The virus damages the hepatocytes and tissue that is responsible for processing and removing bilirubin.

You are evaluating a​ 52-year-old male complaining of facial drooping on his left side upon awakening this morning. You have established that he has no prior medical​ history, vital signs were all within normal​ ranges, and his blood glucose level was 98. You have determined that he has​ left-sided facial​ droop, is slurring his words​ slightly, has equal​ grip, and has equal arm drift. What screening result would you determine according to the Cincinnati Prehospital Stroke​ Scale?

There is a 72 percent or higher probability of an ischemic stroke.

If a patient has a PR interval that is 7 mm​ (7 small​ boxes) in​ duration, what can be said about the overall​ ECG?

There is a conduction delay in the AV node.

Why are benign neoplasms of the central nervous system potentially​ harmful?

They can easily result in elevated intracranial pressures.

Which of the following statements is most accurate about poison control centers and the types of health care providers who staff​ them?

They employ​ physicians, nurses,​ paramedics, and toxicologists.

Which of the following statements is true regarding the causes of behavioral​ emergencies?

They most frequently involve biological conditions or substance abuse.

In order for a paramedic to honor an advance directive presented to him at the side of a patient that has just​ arrested, whose signature MUST appear on the written​ document?

The​ patient's physician

You are dispatched to the scene of a​ "belligerent man" who is ranting at passersby. As you​ approach, you note that police have already arrived at the convenience​ store, and your​ victim, who appears to be in his​ 50s, is standing between them talking​ loudly, and appears to be confused. The store owner is telling the officers that your patient frequently panhandles in front of the store and then purchases​ wine, but today he just started​ "carrying on" in a loud voice. The police would like him transported to the​ ED, and one of the officers has volunteered to accompany you. His vital signs are all within normal limits and your exam is unremarkable except for yellowing of the conjunctiva. You initiate an IV and contact the ED while en route. Of the following​ medications, which one might your protocol indicate administering given this specific​ presentation?

Thiamine

What is one of the major causes behind​ Wernicke's syndrome or​ Korsakoff's psychosis?

Thiamine deficiency

Your patient is an​ 85-year-old male who is experiencing a septal wall AMI. Which of the following rhythms would you expect to see on the​ ECG?

Third degree heart block

You are assessing a patient with chronic kidney disease and a recent creation of a fistula in her right arm. As you assess the​ fistula, you palpate a vibration over the area. What do you conclude about this​ finding?

This is normal and should be present.

Which of the following endocrine glands is larger and more active in the child as compared to the​ adult?

Thymus

During your assessment of a patient with a reported​ "psychological problem," you note that he is extremely​ agitated, tachycardic,​ hypotensive, occasionally​ delirious, and has a high fever and normal blood glucose level. Which of the following endocrine problems would be most​ likely?

Thyrotoxic crisis

Which of the following is generally caused by​ Graves' disease?

Thyrotoxicosis

Which of the following is not a typical cause of altered mental​ status?

Tinnitus

When dealing with the victim of a​ stroke, why is it imperative to establish the exact time of onset while rapidly delivering the patient to the​ ED?

To determine the​ patient's fibrinolytic candidacy

What is the basic purpose of poison control centers​ (PCC)?

To provide information about poisonings and treatment recommendations for health care providers

You see ST segment elevation in leads​ II, III, and aVf. Why do you switch the precordial leads to the right side of the chest and take another 12​ lead?

To rule in or rule out a right ventricular AMI

Of the following​ pathologies, which is likely to produce diffuse depression of both​ hemispheres?

Toxic metabolic states

What is a group of signs and symptoms​ and/or characteristic effects associated with exposure to a particular substance or class of substance​ called?

Toxidrome

You are called to a house for a pediatric patient with increased work of breathing. When you walk into the room you see the patient being held by her​ father, nonproductive hoarse​ cough, and flushed. As you get closer you can audibly hear some stridor. What is your immediate​ concern?

Tracheitis

Which of the following would be a reason to continue a cardiac​ resuscitation?

Transient return of a pulse

What is the most common etiology of sudden eye emergencies that EMS is summoned to care​ for?

Trauma

Which troponin isoform value is most specific for cardiac​ injury?

Troponin I

While it can be present in cases of​ hypokalemia, this wave can also be a normal and​ non-pathological ECG​ characteristic:

U wave

What is an idiopathic syncopal episode usually caused​ by?

Undetermined cause

After being bitten by an unknown​ spider, the patient is now in acute pain with severe muscle​ contraction, hypotension, and labored breathing. How should the paramedic categorize the​ patient's stability in order to make a transport priority​ determination?

Unstable

Hematemesis is typically indicative of a hemorrhage to what GI​ location?

Upper gastrointestinal

What is the term for incomplete urination with urine remaining in the​ bladder?

Urinary stasis

You are transporting a child with​ Osgood-Schlatter disease to the hospital for severe pain. During​transport, the parents ask you if you know of anything that could help decrease the pain while at home. What advice could you offer​ them?

Use local measures such as rest and ice application

Which of the following ECG leads would best indicate the presence of a right ventricular myocardial​ infarction?

V4R

Which of the following vascular disorders would probably require the least amount of prehospital intervention by the​ paramedic?

Varicose veins

When looking at an​ ECG, the QRS complex is representative of​ what?

Ventricular depolarization

Which of the following rhythms has an indication for defibrillation as part of its​ treatment?

Ventricular fibrillation

What is the most effective method for preventing disease​ transmission?

Vigorous hand washing with soap and warm water

Which infectious microorganism must rely on a host cell to both grow and​ reproduce?

Virus

If a patient were to suffer a hemorrhagic stroke in the occipital cortex of the​ cerebrum, what would the patient complain about​ most?

Vision disturbances

You are transporting an elderly female patient who displays symptoms of early dementia to the local hospital for routine testing. The patient expresses concern that you are in a rush and she​ can't locate her glasses. How should you​ respond?

We have plenty of​ time, Mrs. Jones.​ I'll help you look for them.

Which of the following best describes the identification of left atrial enlargement on the 12 lead​ ECG?

Widened P wave of 2.5 mm

Your patient states​ "I...can't...breathe...it feels...like...I...am...suffocating!" Physical examination reveals​ cyanosis, diaphoresis, and bilateral rales in the lung bases. Patient has​ 2+ pitting edema bilaterally to the ankles as well as mild ascites. A productive cough is noted with​ pink-tinged sputum and​ pulses/movement are present in all four extremities. Which of the following conditions is most likely for this​ patient?

Worsening left heart failure

Which of the following is true when treating young children and infants for seizures or any other neurologic​ disorder?

You should rely on parents for the patient history and assistance with the primary exam.

A brain abscess can be described​ as:

a localized collection of pus in the brain.

When dealing with either geriatric or pediatric patients in behavioral​ crisis, it is better​ to:

allow a family member to remain with them whenever possible.

You are called for a female patient in respiratory distress. The patient reports an allergy to cats and​ bees; however, she is not aware of recent exposure to either. She states her current complaint is similar to previous episodes but the symptoms are much worse this time and developed much quicker than usual. Your primary concern would​ be:

an anaphylactic reaction despite the inability to identify the antigen.

The principal chemical agents of the humoral immunity attack​ are:

antibodies.

An agent that inhibits growth or multiplication of bacteria is known as​ _______.

bacteriostatic.

A​ person's observable conduct and activity is simply known as​ their:

behavior.

​Non-cancerous enlargement of the prostate is known​ as:

benign prostatic hypertrophy.

It is​ 6:30 a.m. and you are preparing to get off duty when you are dispatched to a residence for a​71-year-old female patient. The daughter stated to your dispatcher that the patient went to bed at about 10 p.m. as​ usual, but​ now, while she is​ breathing, she​ won't wake up. You arrive at the​ home, located in a​middle-class neighborhood, decide that the scene is​ safe, and enter the residence. You are led to a back bedroom where you find the patient lying in bed in a supine position. You immediately notice that she is ashen with​ shallow, unlabored respirations. While your partner begins administration of​ high-flow oxygen, assisting with a​ bag-valve unit, you perform a quick check of the radial pulse and find it​ present, with a rate of 130 and thready but regular. Your partner sizes her for and places an oropharyngeal​ airway, but discovers a gag reflex is still present and inserts a nasal airway instead. As you continue your rapid​assessment, you fold the blankets back and discover that your patient is lying in a large pool of blood with no apparent source. While you begin to collect some history from the​ daughter, you should​ also:

call dispatch to send an additional unit.

You are assessing a small child who was found unresponsive and apneic. The patient is surrounded by Lego® toys. Considering your scene​ size-up, your primary differential diagnosis would​ be:

choking.

When the administration of epinephrine increases the heart​ rate, this is called a positive​ ________ effect.

chronotropic

As anaphylaxis progresses for an unresponsive and intubated​ patient, you would expect end tidal dioxide levels​ may:

climb due to the development of both respiratory and metabolic acidosis.

When responding to a patient with a known a degenerative nervous​ disorder, it is necessary for the paramedic​ to:

conduct a primary assessment and patient history to determine the chief complaint.

You arrive on scene to find a​ middle-aged male pulseless and apenic. Downtime is unknown. Your partner immediately begins CPR and you attach your defibrillator. Your next action should be​ to:

continue and support high quality CPR for at least 90 seconds.

The initial phase of an asthma reaction​ includes:

contraction of the bronchial smooth muscle and leakage of fluid from peribronchial capillaries.

A degenerative disease of connective tissue often associated with hypertension and aging is known​ as:

cystic medial necrosis.

The effect of histamine on the gastrointestinal system includes

diarrhea.

The time period between the onset of signs and symptoms of a disease and the resolution of symptoms or death of the organism is called​ the:

disease period.

You are going in to check on a patient that came into the hospital for general weakness. Her red blood cell count was measured to be 10 ​million/mm3. The patient is at risk​ for:

epistaxis.

The most durable type of cartilage​ is:

fibrinocartilage.

The spinal cord leaves the brain at the medulla and proceeds through an opening called​ the:

foramen magnum.

The majority of adult poisonings and overdoses​ are:

intentional.

The most common method of differentiating bacteria​ is:

gram staining.

The two major components of the cardiovascular system are​ the:

heart and peripheral blood vessels.

The knee is​ a:

hinge joint.

The chemical attack of an invading substance​ is:

humoral immunity.

When differentiating hyperglycemia from​ hypoglycemia, a notable difference when gathering history​ is:

hypoglycemia can develop within minutes to an​ hour, while hyperglycemia may take hours to a day to manifest.

The period of time between the contraction of a disease and the appearance of symptoms is known as​the:

incubation period.

You arrive on scene of a male complaining of​ malaise, headache,​ fever, chills, and sore throat. His wife reports that his symptoms began yesterday but got significantly worse today. The only events leading up to the illness was an incident in which the patient was chasing a raccoon out from under the deck on their house a few days​ ago; though no bite was specifically​ recalled, he was in close contact with the animal. If you did suspect​ rabies, your treatment would​ include:

initiate IV​ fluids; administer antiemetic.

The electric shock delivered to the body by a​ TASER:

is considerably less than needed to affect the heart.

The male urethra is considered a significant entry point for sexually transmitted diseases​ because:

it carries both urine and male reproductive fluid.

If you believe that your unresponsive patient suffered a syncopal​ episode, but he​ didn't regain consciousness within a few​ moments, then:

it is likely something more serious than a syncopal episode.

According to​ Einthoven's triangle, lead I is characterized​ by:

left arm​ positive, right arm negative.

You are treating a​ 22-year-old female complaining of a worsening headache and fever after being diagnosed with​ "strep throat" three days ago. She woke up early in the morning with an increased fever and an extremely stiff neck. She prefers you keep the lights off because they severely hurt her eyes. She may have​ contracted:

meningitis.

Following exposure to an​ antigen, the body will create antibodies specific for that antigen. This process is known​ as:

naturally acquired immunity.

A TASER patient who has normal vital signs and no other injuries can be released to law enforcement after​ being:

observed by the paramedic for 15 minutes.

Characteristics that distinguish whether a patient is suffering from hyperosmolar hyperglycemic state​(HHS) and diabetic ketoacidosis​ (DKA) are:

often difficult to distinguish in the prehospital context and should be treated the same.

The upper portion of the oral cavity is​ the:

palate.

The first and second most common causes of fatal anaphylactic reactions are​ (respectively):

parenteral penicillin injections and insect stings.

Some blood delivered to the lungs via the pulmonary arteries does not participate in gas exchange. Under normal​ conditions, this is referred to​ as:

physiologic shunt.

You are responding to a homeless man that you regularly transport for alcohol abuse. In your assessment his primary complaint is foot pain. He reports a history of​ "sugar in my​ blood," but he denies taking any medications. After taking his shoe​ off, you identify two ulcers with​ redness, swelling, and very warm to the touch. The best treatment for him would​ include:

preventing further​ damage, bracing if necessary during transport.

Which of these​ disease-producing agents are particles of​ protein, folded in such a way that proteases (enzymes that break down​ proteins) cannot act on​ them?

prions.

The right semilunar​ valve, or pulmonic​ valve, connects the right ventricle to​ the:

pulmonary artery.

Animals, humans,​ insects, and the environment are all types​ of:

reservoirs.

Your patient is complaining of flashes of light to her peripheral vision associated with blurred vision secondary to a traumatic eye injury. The likely condition​ is:

retinal detachment.

A woman has brought her daughter to the emergency department. The girl is 4 years old and has had a​ worsening, "hacking" cough for several days. As you evaluate the​ child, her temperature is 104 degrees ​F, her eyelids appear​ swollen, her eyes are red with a crusty​ discharge, and she has reddish spots on her​ forehead, lips, and in her mouth. You quickly identify this patient as​ having:

rubeola.

The oily substance secreted onto the eyelids​ is:

sebum.

When the sinus node fails to discharge for a brief​ period, resulting in short periods of cardiac standstill that persists until pacemaker cells lower in the conduction system​ discharge, this is​ called:

sinus arrest.

The primary​ muscles, along with the abdominal​ muscles, used in periods of heavy respiratory demand are the

sternocleidomastoid and scalene muscles.

An esophageal varix is​ a(n):

swollen vein of the esophagus.

The two functional divisions of the autonomic nervous system are​ the:

sympathetic and the parasympathetic.

The​ whole-body inflammatory state which may result in septicemia is​ called:

systemic inflammatory response syndrome.

Venous access is typically difficult in older patients with sickle cell disease due​ to:

the high number of previous IV starts the patient has had.

Intracardiac pressures are higher on the left than on the right because

the lungs offer less resistance to blood flow than the systemic circulation.

Any condition that results in immobility of the extremities can increase the risk of​ _____.

thromboembolism.

The need for an increased amount of a drug to obtain effects previously attained from a lower dose of the same drug is​ called:

tolerance.

The study of toxins​ (drugs and​ poisons) and antidotes and their effects on living organisms​ is:

toxicology.

When a coronary artery is blocked completely and the result is damage to the full thickness of the​ myocardium, this is known as a​______infarction.

transmural

Bleeding within the gastrointestinal tract proximal to the ligament of Treitz is categorized​ as:

upper gastrointestinal bleeding.

The safest method of patient restraint​ is:

verbal deescalation.

An​ organism's ability to overcome the​ body's defenses is known​ as:

virulence.

You respond to the residence of a​ 64-year-old male who is​ "having a​ stroke," according to his wife. On arrival you ensure the scene is safe and proceed​ inside; your patient is sitting at the kitchen​ table, obviously upset but not in​ distress, and his face displays the traditional​ "sag" on the right side consistent with a stroke. As you begin your primary​ exam, you begin gathering history from your patient. He tells you that the problem began as a headache behind his right ear the previous night and he awoke unable to move the muscles on the right side of his face. Your exam reveals normal​ vitals, feeling and strength of arms and legs are equal on both​ sides, and he has feeling on the right side of his​ face, but little or no muscle​ control; he is also apparently unable to close his right eye. What would be your field​ diagnosis?

​Bell's palsy

What condition is associated with excess levels of​ self-administered glucocorticoids or internal overproduction of cortisol due to a tumor in the pituitary​ gland?

​Cushing's syndrome

An increase in intracranial pressure that results in increased blood​ pressure, decreased​ pulse, and irregular ventilations is known as​what?

​Cushing's triad

Your patient is a​ 63-year-old male complaining of chest​ pain, stating his pain is an​ "8" on the​ 1-10 scale. His skin is cool and​ diaphoretic; he is confused and has a productive cough with​ pink-tinged sputum. ECG shows sinus tachycardia at a rate of 110 and his blood pressure is​ 74/40, ventilations are 24. What is the most appropriate pharmacological​ intervention?

​Dopamine, titrated to maintain blood pressure

You arrive on scene to find a​ 28-year-old male who is very depressed since the loss of his fiancé from a​ single-car motor vehicle crash in which he was driving. You find him sitting in a chair in his​ bedroom, and he informs you he​ hasn't slept well in weeks and has constant nightmares. He expresses extreme remorse and responsibility over the loss. What is the best course of​ treatment?

​Empathy, emotional​ support, and transportation for hospital evaluation

What is the​ "triad of​ signs" which indicates respiratory distress secondary to an infectious process in pediatric​ patients?

​Fever, tachypnea, and retractions

Which of the following is the best definition of necrotizing​ fasciitis?

​Flesh-eating bacterial infection that can rapidly destroy the​ skin, muscles, and surrounding tissues

You are called to the residence of a​ 42-year-old female, known to be HIV​ positive, complaining of​ fever, nausea,​ vomiting, and generalized weakness. On your arrival you determine that the scene is safe and enter the residence. What personal protective equipment have you put on prior to​ entering?

​Gloves, mask, and eye protection

What nervous tissue disease results in a progressive loss of the myelin sheath covering nerve axons and causes a relative loss of nerve impulse​ conduction?

​Guillain-Barre syndrome

Which of the following is a disease process caused by a genetic defect specific to chromosome​ 4?

​Huntington's disease

When you arrive on scene to help an ill​ female, you notice a pole with a clear bag of fluid hanging from it that you can see is dialysate. What can you conclude before meeting her in​ person?

​Hypotension, dyspnea,​ and/or seizure may be possible patient presentations.

What level of disinfection is provided by the use of​ 1:10 to​ 1:100 dilution of water and chlorine bleach or​EPA-registered disinfectants or​ germicides?

​Intermediate-level disinfection

Your patient presents lying in​ bed, unconscious to painful​ stimulation, and very cold to the touch. Pulse is 48​ (low amplitude sinus bradycardia on the​ ECG), ventilations​ 12, and a blood pressure of​ 90/50. Exhaled CO2 is 55​ mmHg, and you notice a vial of Synthroid on her nightstand. What is the most appropriate management for this​ patient?

​Intubate, ventilate to maintain a CO2 between​ 35-45 mmHg

You have a patient lie down and flex her hips. Then you try to straighten the​ knee, but you are unable to fully extend it. What is this test​ called?

​Kernig's sign

What is the order of progression of phases from the initial infection through resolution of the disease​process?

​Latent, communicable, then disease

What is the name given to a severe form of cellulitis of the submaxillary and sublingual​ spaces, usually from a dental abscess or trauma to the floor of the​ mouth?

​Ludwig's angina

The rhythm on your ECG shows a rate of​ 74, PR interval of 0.28​ seconds, QTC interval of 0.35​ seconds, and QRS width of 0.08 seconds. What is your best course of​ action?

​Observe, address, and treat any other chief complaints

What approximate portion of patients who experience a TIA is likely to soon after experience a​ stroke?

​One-third

The general protocol for treatment of patients with a field diagnosis of sepsis would include which of the​ following?

​Oxygenation, ventilation, fluid​ resuscitation, and vasopressor administration

Approximately​ 50,000 people are newly diagnosed in the United States each year with what nervous system​ disorder?

​Parkinson's disease

Which of the following is an indicator of potential danger with a person experiencing a behavioral​emergency?

​Patient's posture and body language

The blood flow through a blood vessel is directly proportional to the fourth power of the​ vessel's radius. This is the definition​ of:

​Poiseuille's law.

While listening to breath sounds on a dyspneic​ patient, you note a crackling sound over the peripheral lung fields. This breath sound is also known as​ __________ and refers to​ ____________.

​Rales; fluid in the smaller airways

A​ fourteen-year-old boy comes to you with​ Osgood-Schlatter disease. What are treatment measures do you​ take?

​Rest, ice, and nonsteroidal​ anti-inflammatory medications

You are dispatched to the home of a​ 54-year-old male with a history of chronic kidney disease. He called 9-1-1 because his shunt is painful and red at the access site. You assess it and believe there is a high possibility that the shunt is occluded. Management of this would include which of the​ following?

​Transport, this requires surgical intervention

When obtaining an 18 lead ECG on a patient with chest​ pain, which lead locations would likely show the ST elevation from a posterior wall​ infarction?

​V7, V8, V9

The​ _____ pleura covers the lungs while the​ _____ pleura lines the thoracic cavity.

​Visceral, parietal

One difference between​ Wernicke's and​ Korsakoff's psychosis​ is:

​Wernicke's is generally​ reversible, while​ Korsakoff's may become irreversible.

The two superior chambers of the heart are the and they .

​atria, pump blood to the ventricles

The order of the gross anatomy in the upper gastrointestinal tract​ is:

​mouth, esophagus,​ stomach, duodenum.

The three layers of the eye include​ the:

​retina, choroid, and sclera.

Examples of flat bones​ include:

​skull, ribs, and sternum.