Vol 3 Ch 3

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

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

​Bell's palsy

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

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

31

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

A fluid bolus of normal saline

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 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? A. Administer diazepam if seizure activity is present. B. Transport the patient to an emergency department. C. Administer supplemental oxygen to correct hypoxia. D. All of the above.

All of the above

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

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

Cushing's triad

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

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.

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)

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

Portable glucometer

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

Reflex impulses come from the spinal cord.

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

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

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

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.

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

They are often metastasized from elsewhere in the body.

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

They can easily result in elevated intracranial pressures.

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

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 an idiopathic syncopal episode usually caused​ by?

Undetermined cause

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

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.

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

foramen magnum.

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.

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

sympathetic and the parasympathetic.

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

​Huntington's disease

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

​One-third

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

​Parkinson's disease