EMT Written Exam 2

Buildup of too much acid vs too much base

Too much acid is acidosis and too much base is alkalosis

Asystole is

absence of all heart electrical activity --> a straight line

During the postictical state after a seizure, patients most likely experience

fatigue and confusion

What is ventricular tachycardia?

heart beats too fast to pump blood effectively, and as a result the left ventricle does not fill adequately or with enough blood

Cardiogenic shock happens when

heart cannot maintain sufficient output to meet the demands of the body

What is epidural vs subdural bleeding?

Epidural is bleeding outside the dura and under skull, and subdural is bleeding under the dura but outside the brain

If low fluid volume is cause, this can lead to what kind of shock?

Hypovolemic, such as hemorrhagic shock

Uncontrollable AMI risk factors?

Older age, family history, atherosclerotic coronary artery disease, race, ethnicity, and being male

What is used to reverse the effects of an opioid overdose? And how is it administered

Narcan or naloxone, mostly administered through the intranasal route

What is pneumothorax and the difference between tension and spontaneous?

Pneumothorax is the accumulation of air in pleural space and those caused by trauma is tension pneumothorax and those caused by medical conditions is spontaneous

What is pulse pressure and a pulse pressure of what indicates that a patient may be in shock?

Pulse pressure is the difference between the systolic and diastolic pressures and a pulse pressure of less than what may be seen in patients with shock? A pulse pressure of than 25 mmHg

Kinds of distributive shock?

SNAP Septic Neurogenic Anaphylactic and Psychogenic

Types of obstructive shock consist of

Tension pneumothorax, cardiac tamponade, pulmonary embolism

For patient's headache caused by singus congestion, what would cause the pain to worsen?

Their pain would worsen if they begin to bend over

What happens in patients with chronic obstructive pulmonary disease?

They retain carbon dioxide, have low oxygen levels, and therefore they often have to use their hypoxic drive

What is the cincinnati prehospital stroke scale?

This is a part of the secondary assessment when trying to assess for stroke, consisting of facial droop, arm drift, and slurred speech

What is focal onset aware seizure?

This is a seizure that begins in one extremity, these patients have normal levels of consciousness

What is diffusion?

This is going from high to low concentrations for both oxygen and CO2, due to the partial pressures in the air

What is tidal volume, and how do we calculate minute volume?

This is the amount of breath moved into or out of the lungs in one breath Minute volume is then respiratory rate multiplied by tidal volume

What is index of suspicion?

This is your awareness of potentially serious underlying injuries or illness

What is angina pectoris? What are the symptoms?

This occurs when the heart's need for oxygen exceeds supply --> symptoms are usually crushing or squeezing pain

What needs to be present for respiration to occur?

Ventilation and oxygenation both need to be present for respiration to occur

What is the difference between ventilation, oxygenation and respiration?

Ventilation is the physical act of moving air into and out of the lung. Oxygenation is the process of loading oxygen molecules onto hemoglobin molecules in the bloodstream. Respiration is the actual exchange of oxygen and CO2 in the alveoli as well as the tissues of the body.

What is an important cranial nerve to know and what does it control?

We have 12 cranial nerves, an important one to know now is vagus nerve, it controls heart rate and blood pressure

Cardiac output occurs when?

When there is adequeate preload and afterload

Is CPAP a BLS scale?

Yes

Pleural Effusion?

collection of fluid in the pleural cavity, outside the lung

Difference between preload and afterload

preload is the amount of blood heart can physically pump itself and afterload is the resistance to flow in circulation

What are the 3 criteria to put on an AED?

pulseless, apneic, and unresponsive

When caring for a patient with hypoglycemia, you should be most alert for a

seizure

what are the 2 kinds of strokes? and the difference between the two? what is most common?

stroke is also called CVA cerebrovascular accident, the 2 types are ischemic and hemorrhagic, ischemic is blockage of a vessel and hemorrhagic is rupture of a vessel and vleeding inside the brain — ischemic is most common

What are common routes of administration of medication?

Intravneous through the vein Intraosseus in to the bone Subcutaneous beneath the skin and Intramuscular which is into the muscle

Pulmonary embolism

when a blood clot gets stuck in an artery in the lung and blocks the flow of blood

What is difference between aphasia, dysaphasia, dysphagia, and dysarthria

aphasia is the inability to produce or understand speed, dysphasia is difficulty speaking, dysphagia is difficulty swallowing, and dysarthria is slurred, poorly articulated speech common in stroke patients

What are the 6 links of the chain of survival?

1. Recognition or activation of EMS 2. Immediate high quality CPR 3. Rapid defibrillation 4. Basic and advanced EMS 5. ALS and postarrest care 6. Recovery

What are the 3 things that you need if breathing is not adequate?

1. you need ventilation with a BVM 2. you need an oropharyngeal or a nasopharyngeal airway 3. high flow oxygen of 15L

What is the ratio of compressions to ventilations in one rescuer adult CPR?

30:2

How long will it take for the mental status of a patient who has experienced seizure's condition to improve?

5-30 mins

What most likely causes an ischemic stroke?

A blockage to the cerebral artery most likely causes it

What is a tonic clonic seizure?

A generalized seizure with severe twitching in all muscles

When we have a hypertensive emergency, when is the systolic pressure too high?

A systolic pressure is considered too high when its greater than 180 mm Hg

Cardiac tamponade occurs when? And what are the signs and symptoms of such called?

A type of obstructive shock, occurs when there is fluid or blood buildup around the pericardial sac, and the signs an symptoms are referred to as Beck triad --> and jugular vein distension is a sign for Beck triad --> surgery is the only treatment

What is pulmonary embolism?

A. type of obstructive shock, blood clot can occur in the lungs and prevent flow of blood

How is AMI pain different from dissecting aneurysm

AMI pain is more gradual and tightness and pressure whereas dissecting aneurysm is more abrupt and sharp or tearing

For treating anaphylactic shock, what should you administer?

Administer epinephrine

What is dysrhythmia?

An irregular pulse in a patient with a cardiac problem

Angina pectoris and AMI are the 2 types of acute coronary syndrome. how do they differ from each other?

Angina pain typically goes away with rest but AMI does not always go away with rest — it can last 30 mins to several hours

What is aortic aneurysm? And what is the aorta susceptible to?

Aortic aneurysm is weakness in the wall of the aorta, it is susceptible to rupture

What is the most reliable method of assessing a patient's cardiac output?

Assessing the heart rate and strength of the pulse is most accurate

What respiratory disease causes obstruction of the lower airway?

Asthma

Bronchospasm is most often associated with...

Asthma — because asthma is caused by bronchospasm, meaning there is sustained constriction of the bronchioles

For asthma, how should we treat?

Be prepared to suction, assist with an inhaler, and provide aggressive airway management

How does bleeding in the brain affect blood pressure of patients?

Bleeding of the brain increases blood pressure

What are the 3 things needed for respiration?

Blood, pump, and an intact circulatory system

What are the 3 major parts of the brain? What is the biggest part of the brain?

Brainstem, cerebellum, and the cerebrum — The cerebrum is the biggest part.

If the cause is pump failure, what are the types of shock?

Cardiogenic shock and obstructive shock

Before administering nitro, what should you make sure to ask and check?

Check their blood pressure and make sure to ask them if they are on any erectile disfunction medication

What causes dry lung sounds?

Chronic Obstructive Pulmonary Disease

What are controllable AMI risk factors? acute myocardial infarctions?

Cigarette smoking, high blood pressure, high cholestorl, diabetes, lack of exercise, obesity

Compensated and decompensated shocks are the stages in the progression of shock. What is the difference between compensated and decompensated shock?

Compensated is the early stage when the body can still compensate for blood loss while decompensated is late stage when blood pressure is falling

When someone is pulseless, you would do test in the order of

Criculation, Airway, and then Breathing

If cause is poor vessel function, this can lead to what kind of shock?

Distributive shock such as septic, neurogenic, anaphlactic, psychogenic

To whom should you not give aspirin to?

Don't give aspirin to children or anyone under 18

Difference between enteral and parenteral medication

Enteral is entering the body through digestive means whereas parenteral is entering through other means, tends to be much faster and it is injected with a syringe

Difference between epidemic and pandemic

Epidemic is new cases of a disease in a human population which is substantially exceeding what is expected and pandemic is a disease or outbreak that occurs on a global scale

What is the most common medication to deliver intramuscullarly?

Epinephrine is !

What are the different kinds of shock?

Hypovolemic shock, distributive, and cardiogenic, and obstrusive hypovolemic is due to too little blood volume, distributive is blood not being able to be distributed to heart, brain and kidneys, cardiogenic is when heart cant pump enough blood to brain, and obstrusive is when there is something in the blood flow

What happens in pulmonary edema and what kind of sounds are there?

In pulmonary edema, there is fluid build up within the alveoli and lung tissue, and frothy pink sputum comes out of the nose and mouth — there are wet lung sounds

Chest pain usually occurs from what?

Ischemia, which is lack of oxygen in the tissue

What is acute coronary syndrome known as? (ACS)

It can be divided into angina pectoris or AMI — and ACS is mainly known as a group of symptoms that are caused by myocardial ischemia

What consists of the perfusion triangle? And when does shock occur?

It consists of the heart, the blood vessels and the blood and if one or more of these 3 parts don't start working properly, then shock occurs

What is congestive heart failure? What is it often a result of?

It happens when the heart is not being able to pump blood as well as it should — it is often a result of AMI

What is an acute myocardial infarction? And what is the reason as to why most people experiencing it do not seek medical attention?

It is a heart attack; death of heart muscle following obstruction of blood flow to it. Acute in this context means new or happening right now. Most people do not seek it because they are in denial.

What does nitrogylcerin do and how does it help patients?

It is a vasodilator, it relieves angina pain/chest pain, it relaxes veins and increases blood flow

Whooping cause is also known as what? And what is the best way to prevent exposure?

It is also called pertussis, and the best way to prevent exposure is to be vaccinated

What is ischemia?

It is decreased blood flow to one or more parts of the myocardium/the heart — and a result of ischemia is usually severe chest pain

What is thrombolytic therapy used for?

It is often used as medication to destroy blood clots or prevent new ones from forming

What is hyperventilation?

It is overbreathing to point that CO2 levels fall below normal, body may be trying to compensate for acidosis --> and this can result in alkalosis — buildup of excess base in bod. fluids

Distributive shock occurs when

It occurs when there is circulating blood volume that pools in the expanded vascular beds because distributive shock results in widespread dilation of arteroiles, venules ,etc

When should Glasgow Coma Scale scores be calculated?

It should be calculated for patients with an altered mental status

Emphysema is the most common type of COPD, also known as Chronic Obstructive Pulmonary Disease, describe what emphysema is

It's a loss of elastic material in the lungs as a result of stretching the alveoli

What is an aneurysm

It's a result of a hemorrphagic stroke and usually occurs as a result of swelling or enlargement of the wall of an artery resulting from a defect or weakening of the arterial wall

What is a dissecting aortic aneurysm? And when does this occur? What is a key sign in a patient with dissecting aortic aneurysm?

It's a serious condition in which a tear occurs in the inner layer of the body's main artery. This occurs when the inner layers of the aorta become separated. A key sign is when their blood pressures are significantly different on each arm.

What is a petit mal seizure?

It's also known as an absent seizure

What is status epilepticus?

It's when there are seizures lasting longer than 5 minutes

What is tension pneumothorax and how do we relieve of this?

It's when there is air trapped under the pleural space and we relieve of this with decompression of the injured side of the chest

LVAD (left ventricular assist devices) does what? And patients with this will not have...

LVAD is used to enhance the pumping on the left ventricle and patients with this and will not have a palpable pulse

What is the lowest glasgow coma score (i.e. if you are dead) and what is highest? What are the 3 things that glasgow coma score checks?

Lowest is 3, if you are dead, and highest is 15 — the 3 things that glasgow coma score checks is eye opening, sensation, and motor response