Vol 3 Ch 10
Your patient is a 23-year-old male prisoner who is alert and oriented, complaining of general malaise. He describes a month-long history of weakness, joint pain, nausea and occasional vomiting, and anorexia. He has no medical history and takes no medications. Physical examination reveals clear lung sounds bilaterally; warm, dry skin; several prison tattoos; a firm liver; and jaundice to his sclera. Which of the following is most likely? A. Hepatitis B B. HIV C. Cirrhosis of the liver D. Fatty liver
A. Hepatitis B
Mononucleosis presents with all the following signs and symptoms EXCEPT: A. Hepatomegaly B. Sore throat C. Fatigue D. Enlarged and tender lymph nodes
A. Hepatomegaly
A memory or specific response is considered a (an)________ response. A. Humoral B. Cell-mediated C. Immune D. Inflammatory
A. Humoral
Which of the following statements about measles and the measles virus is FALSE? A. Immunization is ineffective until age 15. B. Measles is highly communicable. C. Measles is transmitted by inhalation of infected droplets. D. Signs of measles infection include high fever and a maculopapular rash
A. Immunization is ineffective until age 15.
A paramedic within your service was treating an IV drug addict when the patient spit at her, hitting her in the eye. At the hospital, when asked for blood, the patient refused to consent for testing. In this case, which of the following is TRUE? A. It is within the patient's right to refuse blood testing. B. A judge will issue a court order requiring the patient to allow his blood to be tested. C. By law the patient is required to submit blood for testing. D. The patient can be placed under detention and be required to give a blood sample.
A. It is within the patient's right to refuse blood testing.
Which of the following statements about Haemophilus influenzae type B is TRUE? A. It was once the leading cause of meningitis in children aged six months to three years. B. Vaccines are ineffective against Haemophilus influenzae type B. C. It is the leading cause of conjunctivitis in adults. D. It is a Gram-positive rod.
A. It was once the leading cause of meningitis in children aged six months to three years.
Which of the following statements about hepatitis A is TRUE? A. Many patients are asymptomatic with hepatitis A infection. B. Hepatitis A is transmitted through direct contact with blood and body fluids. C. The incubation period for hepatitis A is three to five days. D. Transmission via needle stick injury is common.
A. Many patients are asymptomatic with hepatitis A infection.
All the following pathogens typically cause meningitis in children EXCEPT: A. Paramyxovirus B. Haemophilus influenza type B C. Streptococcus pneumoniae D. Neisseria meningitidis
A. Paramyxovirus
Your patient is a 40-year-old male. As a child he would have been LEAST likely to have suffered from: A. Pertussis B. RSV C. Measles D. Mumps
A. Pertussis
To test for Brudzinski's sign you would: A. Place the patient in a supine position and flex the neck B. Have the patient take a deep breath while you palpate under the right costal margin C. Check for periumbilical ecchymosis D. Stroke the bottom of the foot from heel to toe with a pen
A. Place the patient in a supine position and flex the neck
Which of the following is a mobile, single-celled, parasitic organism? A. Protozoan B. Bacterium C. Fungus D. Virus
A. Protozoan
From which of the following incidents would infection with Clostridium tetani be most likely? A. Receiving a puncture wound to the foot B. Drinking contaminated well water C. Eating improperly prepared, home-canned food D. Being bitten by an infected animal
A. Receiving a puncture wound to the foot
A life-threatening medical condition that is caused by systemic inflammatory response syndrome (SIRS) is: A. Septicemia B. Hypoglycemia C. Pernicious anemia D. Thrombocytopenia
A. Septicemia
Which of the following findings would be most specific to mumps? A. Swelling and tenderness of the parotid glands B. Redness of the face that gives a "slapped cheeks" appearance C. Fluid-filled vesicles on the trunk D. Temperature of 103°F or higher
A. Swelling and tenderness of the parotid glands
HIV attacks and destroys the: A. T lymphocytes B. Macrophages C. B lymphocytes D. Pluripotent stem cells
A. T lymphocytes
Cell-mediated immunity generates: A. T lymphocytes. B. B lymphocytes. C. inflammation. D. histamine.
A. T lymphocytes.
Which of the following statements about rubella and the rubella virus is FALSE? A. The virus is spread via contact with infected blood and body fluids. B. EMS providers should receive an MMR vaccination. C. Infection in the first trimester of pregnancy increases the risk of birth defects. D. Immunization via the MMR vaccination is 98 to 99 percent effective.
A. The virus is spread via contact with infected blood and body fluids.
Your patient is a 21-year-old male who is alert and oriented, complaining of a rash that started about 36 hours ago, first appearing on his trunk. The rash has now spread to his face and extremities. You notice multiple small, fluid-filled vesicles on the patient's body. The patient is concerned that he will miss work as a second-grade student teacher. He has no medical history, including childhood diseases. The patient is most likely suffering from: A. Varicella B. Herpes simplex C. Epstein-Barr virus D. Rubella
A. Varicella
While working in the emergency department, you accidentally stick yourself with the stylette of an IV needle you just used to start an IV. What should you do immediately? A. Wash the area thoroughly with soap and running water. B. Stop the bleeding with a sterile gauze pad. C. Wipe the area with an alcohol prep. D. Wipe the area with a povidone-iodine swab.
A. Wash the area thoroughly with soap and running water.
Your patient was bitten on the hand by a wild raccoon he tried to capture. Which of the following is the first step in management for this patient? A. Wash the wound with soap and running water. B. Clean the area with an isopropyl alcohol pad. C. Clean the area with a povidone-iodine swab. D. Irrigate the wound with sterile saline, dry the area around the wound, and apply a thin layer of antibiotic ointment.
A. Wash the wound with soap and running water.
You are treating a patient you suspect may be suffering from septic shock. You should consider fluid and pressor therapy to maintain a mean arterial pressure (MAP) of: A. above 60 mmHg. B. below 120 mmHg. C. above 90 mmHg. D. below 60 mmHg.
A. above 60 mmHg.
The body will produce antibodies in response to: A. antigens. B. phagocytes. C. T cells. D. pathogens.
A. antigens.
HIV uses the host cell to copy itself by: A. carrying its genetic material in its RNA. B. replicating its genetic material in its DNA. C. infiltrating the mitochondria. D. glucogenolysis.
A. carrying its genetic material in its RNA.
In response to fever, the patient's metabolic needs will: A. increase. B. become anaerobic. C. decrease. D. remain the same.
A. increase.
In response to fever, the patient's metabolic needs will: A. increase. B. remain the same. C. decrease. D. become anaerobic.
A. increase.
While examining a patient, you note that he exhibits a positive Brudzinski's sign. You suspect: A. meningitis. B. tuberculosis. C. varicella. D. pertussis.
A. meningitis.
Whooping cough is also known as: A. pertussis. B. meningococcus. C. pneumonia. D. varicella.
A. pertussis.
Contaminated sharps need to be placed in: A. properly labeled puncture-resistant containers. B. They can be thrown in the trash if they are "self containing." C. biohazard containers in the dirty-utility room. D. the decontamination room.
A. properly labeled puncture-resistant containers.
One area in which paramedics have a chance to assume leadership is: A. public education and infectious disease prevention. B. FEMA studies. C. CDC studies. D. hospital advisory boards.
A. public education and infectious disease prevention.
You are caring for a patient who is complaining of chills, fever, night sweats, sudden weight loss, and hemoptysis. You suspect: A. tuberculosis. B. Ebola virus disease (EVD). C. AIDS. D. hepatitis B virus.
A. tuberculosis.
Which of the following statements about Streptococcus pneumoniae is TRUE? A. It is an infrequent cause of otitis media in children. B. It is the second most common cause of pneumonia in adults. C. Vaccines are ineffective against Streptococcus pneumoniae. D. It is the leading cause of meningitis in children
B. It is the second most common cause of pneumonia in adults.
Which of the following statements about hepatitis A is TRUE? A. Hepatitis A is transmitted through direct contact with blood and body fluids. B. Many patients are asymptomatic with hepatitis A infection. C. Transmission via needle stick injury is common. D. The incubation period for hepatitis A is three to five days.
B. Many patients are asymptomatic with hepatitis A infection.
Your patient is a 19-year-old female college student complaining of a low-grade fever, extremely sore throat, tenderness of the cervical lymph nodes, and extreme fatigue. Examination reveals warm, moist, flushed skin. Heart rate = 88, respirations = 12, and blood pressure = 118/78. There is tenderness to palpation of the left upper quadrant of the abdomen. Which of the following is most likely? A. Fifth disease B. Mononucleosis C. Hantavirus pulmonary syndrome D. Bacterial meningitis
B. Mononucleosis
Which of the following cells play a functional role in the inflammatory response? A. B lymphocytes B. Neutrophils C. T lymphocytes D. Stem cells
B. Neutrophils
All the following are common signs or symptoms of lice infestation EXCEPT: A. Itching B. Open lesions in the affected areas C. White, oval-shaped nits on the hair shafts D. Red macules or papules on the affected areas
B. Open lesions in the affected areas
Your patient is a 20-year-old female college student who lives in a dormitory. She complains of weakness, fever, chills, nausea, a rash on her chest, and neck pain. Physical examination reveals warm, moist skin; pain with flexion of her neck; and a petechial rash on her chest. HR = 92, BP = 108/68, RR = 14, SaO2 = 99%. Which of the following is most appropriate? A. Administer O2 via nonrebreather mask, cardiac monitor, IV of normal saline, and transport B. Place a face mask on your patient and yourself, transport BLS, notify the hospital before arrival C. Administer oxygen by nonrebreather, BLS, and transport D. Place an N-95 respirator on the patient, transport BLS, notify the hospital before arrival
B. Place a face mask on your patient and yourself, transport BLS, notify the hospital before arrival
From which of the following incidents would infection with Clostridium tetani be most likely? A. Eating improperly prepared, home-canned food B. Receiving a puncture wound to the foot C. Being bitten by an infected animal D. Drinking contaminated well water
B. Receiving a puncture wound to the foot
Cell-mediated immunity generates: A. inflammation. B. T lymphocytes. C. B lymphocytes. D. histamine.
B. T lymphocytes.
Which of the following statements about influenza and the influenza virus is FALSE? A. An influenza vaccine confers immunity against only a few strains of the virus each year. B. The disease is characterized by nausea, vomiting, and diarrhea. C. High-risk individuals include the pediatric population. D. Influenza is the leading cause of respiratory disease worldwide.
B. The disease is characterized by nausea, vomiting, and diarrhea.
Which of the following statements about prions is TRUE? A. Eastern equine encephalitis is the most common prion disease. B. They are neither prokaryotes nor eukaryotes. C. Prions are easily destroyed by heat sterilization. D. Prions are single-celled animals capable of causing disease.
B. They are neither prokaryotes nor eukaryotes.
Which of the following statements about herpes simplex type 2 (HSV-2) is FALSE? A. There is a low risk of disease transmission via casual contact. B. Treatment with acyclovir can eradicate the virus. C. HSV-2 is responsible for 70 to 90 percent of all genital herpes cases. D. In addition to painful lesions to the infected area, fever and enlarged lymph nodes can be present during the initial presentation of the infection.
B. Treatment with acyclovir can eradicate the virus.
After receiving the hepatitis B vaccine, the blood of a paramedic reveals no circulating antibodies for the disease. Which of the following phases would the paramedic most likely be in regarding the immunization? A. Seroconversion B. Window C. Incubation D. Latent
B. Window
You and your partner have just been notified by the infection control officer that you have been exposed to an active meningitis case. You would expect prophylactic: A. penicillin. B. Zithromax. C. Cipro. D. nothing, just self-monitor.
C. Cipro.
You and your partner have just been notified by the infection control officer that you have been exposed to an active meningitis case. You would expect prophylactic: A. nothing, just self-monitor. B. Zithromax. C. Cipro. D. penicillin.
C. Cipro.
Which of the following techniques destroys some, but not all, microorganisms? A. Decontamination B. Sterilization C. Disinfection D. Cleaning
C. Disinfection
Which of the following is NOT a government organization involved with infectious diseases? A. FEMA B. CDC C. EPA D. OSHA
C. EPA
Which of the following measures is most important in protecting EMS providers from infectious disease? A. Glove use for all patient contact B. Thorough disinfection of the ambulance after every call C. Hand washing after all patient contact D. Tuberculosis vaccination
C. Hand washing after all patient contact
Your patient is a 27-year-old male complaining of difficulty breathing. He states that he has just returned from a month-long backpacking trip across Arizona. He describes a two-week history of fatigue, fever, nausea, vomiting, diarrhea, and abdominal pain. He started experiencing difficulty breathing yesterday. He has no significant medical history and takes no medications. Physical examination reveals hot, moist skin; bilateral lower-lobe rales on auscultation of the lungs; and the abdomen is soft and nontender. Which of the following is most likely? A. Scorpion bite B. Legionnaire's disease C. Hantavirus infection D. Anthrax
C. Hantavirus infection
Which of the following statements about Neisseria meningitidis is TRUE? A. It is responsible for 90 percent of patients with a viral meningitis. B. Signs and symptoms of infection can take weeks to develop. C. It is the bacteria that most often causes serious cases of meningitis. D. The vaccine is recommended for health care workers.
C. It is the bacteria that most often causes serious cases of meningitis.
Which of the following statements about Neisseria meningitidis is TRUE? A. Signs and symptoms of infection can take weeks to develop. B. It is responsible for 90 percent of patients with a viral meningitis. C. It is the bacteria that most often causes serious cases of meningitis. D. The vaccine is recommended for health care workers
C. It is the bacteria that most often causes serious cases of meningitis.
Which hepatitis often presents with hepatitis D? A. D B. C C. A D. B
D. B
Which of the following types of agents acts specifically by inhibiting bacterial growth or reproduction? A. Antiseptic B. Pathological C. Aseptic D. Bacteriostatic
D. Bacteriostatic
Which of the following is classified as a helminth? A. Trichomonas B. Treponema C. Spirochete D. Fluke
D. Fluke
Mushrooms and yeasts are examples of: A. Parasites B. Helminthes C. Protozoa D. Fungi
D. Fungi
Mononucleosis presents with all the following signs and symptoms EXCEPT: A. Sore throat B. Enlarged and tender lymph nodes C. Fatigue D. Hepatomegaly
D. Hepatomegaly
Your patient is a 19-year-old female college student complaining of a low-grade fever, extremely sore throat, tenderness of the cervical lymph nodes, and extreme fatigue. Examination reveals warm, moist, flushed skin. Heart rate = 88, respirations = 12, and blood pressure = 118/78. There is tenderness to palpation of the left upper quadrant of the abdomen. Which of the following is most likely? A. Bacterial meningitis B. Hantavirus pulmonary syndrome C. Fifth disease D. Mononucleosis
D. Mononucleosis
Which of the following statements about mumps is TRUE? A. Mumps are of no concern to the adult patient. B. There is no vaccine for the mumps virus. C. Mumps are not highly communicable. D. Mumps are characterized by enlargement of the salivary glands.
D. Mumps are characterized by enlargement of the salivary glands.
You are caring for a patient you suspect of having an active TB infection. Your personal protective equipment (PPE) should include: A. powered air-purifying respirator (PAPR) mask. B. hazmat level B protection. C. Tyvek suit. D. N95 mask
D. N95 mask
Which of the following is NOT a common form of pathogen transmission? A. Sexual contact B. Sneeze C. Cough D. Organisms shed into the environment
D. Organisms shed into the environment
Clostridium botulinum has its effect primarily by: A. Causing septicemia B. Creating gas through the fermentation of carbohydrates in muscle tissue C. Altering cellular structure to create syncytia D. Releasing a toxin that results in muscular paralysis
D. Releasing a toxin that results in muscular paralysis
While on a call you receive a laceration to your thigh from a jagged piece of metal. Which of the following is the correct recommendation for tetanus prophylaxis? A. If you received the entire series of tetanus immunizations as a child, you do not need a tetanus booster. B. If you are over the age of 60, you should receive tetanus immune globulin but not a tetanus booster. C. You must receive a tetanus booster annually to be protected from tetanus. D. You should receive a tetanus booster if you have not had one in the past ten years.
D. You should receive a tetanus booster if you have not had one in the past ten years.
You are suspicious that a patient is suffering from active tuberculosis. Which of the following would be most appropriate? A. Both you and the patient should wear a HEPA respirator. B. Neither you nor the patient should wear a HEPA respirator. C. The patient should wear a HEPA respirator. D. You should wear a HEPA respirator.
D. You should wear a HEPA respirator.
According to the 2009 extension of the Ryan White Care Act, an employee who has been exposed to an infectious disease has the right to: A. nothing; HIPAA is in effect. B. demand that the patient be tested for infectious disease. C. have the receiving ED draw a sample of the patient's blood for testing. D. ask about the source patient's infection status.
D. ask about the source patient's infection status.
When the body produces antibodies against itself, this is known as: A. immunology. B. immunocompromise. C. allergy. D. autoimmunity.
D. autoimmunity.
Poisonous proteins shed by bacteria growth are called: A. spores. B. fungi. C. endotoxins. D. exotoxins.
D. exotoxins.
The lymphatic system is comprised of all of the following EXCEPT: A. lymph nodes. B. thymus. C. spleen. D. liver.
D. liver.
Which of the following organisms causes mononucleosis? A. Pediculus humanus capitus B. Treponema C. Herpes zoster D. Epstein-Barr virus
D. Epstein-Barr virus
You are called to evaluate an ill child. The mother states that the child was fine a few hours ago but now is exhibiting, dysphonia, drooling, dysphagia, and distress. You suspect: A. influenza A. B. croup. C. epiglottitis. D. bronchitis.
C. epiglottitis.
You respond to a 2-year-old child who has a seal-like cough and stridor. You suspect: A. pharyngitis. B. influenza. C. laryngotracheobronchitis. D. influenza.
C. laryngotracheobronchitis.
You respond to an ill patient. Upon your arrival, the patient's caregivers state that the patient has been complaining of lethargy, vomiting, and nuchal rigidity. You suspect: A. pertussis. B. varicella. C. meningitis. D. pneumonia
C. meningitis.
Demographics are: A. Characteristics of human populations B. Statistics related to the incidence of infectious disease C. Statistics related to the morbidity and mortality of all illnesses and injuries D. Geographical distributions of illness and injury
A. Characteristics of human populations
The alternate pathway that reacts quickly to foreign bodies and uses antibodies and inflammation to combat pathogens is the ________ system. A. Complement B. Lymphatic C. Humoral D. Cell-mediated
A. Complement
Hepatitis E is often associated with: A. Contaminated drinking water B. HIV infection C. Tuberculosis infection D. HBV infection
A. Contaminated drinking water
For which of the following diseases is there no vaccine? A. Croup B. Rubella C. Measles D. Mumps
A. Croup
Which of the following is NOT a known transmission route for hepatitis B? A. Blood transfusion B. Insect bites C. Tattooing D. Dialysis
B. Insect bites
Which hepatitis often presents with hepatitis D? A. B B. A C. D D. C
A. B
Hepatitis A is can exist on unwashed hands for: A. 5 days. B. 4 hours. C. 4 days. D. 6 hours.
B. 4 hours.
Which of the following statements about the differences between viruses and bacteria is NOT true? A. Bacteria require a food source to thrive, while viruses do not. B. Bacteria contain only DNA, and viruses contain only RNA. C. Bacteria can reproduce by themselves, while viruses cannot. D. Bacteria are much larger than viruses.
B. Bacteria contain only DNA, and viruses contain only RNA.
Which of the following agencies monitors national disease data and provides disease information to health care providers? A. DHHS B. CDC C. OSHA D. NIOSH
B. CDC
Health care workers can best avoid hepatitis B infection by: A. Receiving gamma globulin in the event of an exposure B. Completing the hepatitis B vaccine series C. Using standard precautions for all patients D. Using an alcohol-based hand sanitizer after each patient contact
B. Completing the hepatitis B vaccine series
The destructive substances released from some bacteria when they die are known as: A. Exotoxins B. Endotoxins C. Prions D. Syncytia
B. Endotoxins
The body will produce antibodies in response to: A. pathogens. B. antigens. C. phagocytes. D. T cells.
B. antigens.
As hepatitis progresses, the patient may become: A. edematous. B. jaundiced. C. less Infectious. D. more infectious.
B. jaundiced.
The lymphatic system is comprised of all of the following EXCEPT: A. spleen. B. liver. C. thymus. D. lymph nodes.
B. liver.
The most common complication in adults contracting the varicella virus is: A. chickenpox. B. pneumonia. C. paranoia. D. respiratory syncytial virus (RSV).
B. pneumonia.
The most common complication in adults contracting the varicella virus is: A. respiratory syncytial virus (RSV). B. pneumonia. C. paranoia. D. chickenpox.
B. pneumonia.
One area in which paramedics have a chance to assume leadership is: A. hospital advisory boards. B. public education and infectious disease prevention. C. FEMA studies. D. CDC studies.
B. public education and infectious disease prevention.
You respond to a patient who has been having trouble with his indwelling urinary catheter. Vital signs are: pulse, 110; respiration rate, 22; ETCO2, 28; temperature, 101.2°F. You suspect: A. renal failure. B. sepsis. C. rhabdomyolysis. D. urinary tract infection (UTI).
B. sepsis.
Hepatitis B is stable on surfaces with dried visible blood for: A. 3 days. B. 3 hours. C. 8 days. D. 8 hours.
C. 8 days.
Which of the following agencies is the primary agency responsible for establishing guidelines and standards to regulate health care worker safety as it relates to communicable disease transmission? A. NFPA B. FEMA C. OSHA D. CDC
C. OSHA
All the following pathogens typically cause meningitis in children EXCEPT: A. Streptococcus pneumoniae B. Neisseria meningitidis C. Paramyxovirus D. Haemophilus influenza type B
C. Paramyxovirus
Which of the following is best described as a change from the absence of antibodies to detectable levels of antibodies in the blood after exposure to an infectious disease? A. Clinical horizon B. Chemotaxis C. Seroconversion D. Virulence
C. Seroconversion
Which of the following findings would be most specific to mumps? A. Fluid-filled vesicles on the trunk B. Redness of the face that gives a "slapped cheeks" appearance C. Swelling and tenderness of the parotid glands D. Temperature of 103°F or higher
C. Swelling and tenderness of the parotid glands
A 44-year-old male staying in a homeless shelter is alert and complaining of shortness of breath. He has a two-week history of cough with hemoptysis, fever, chills, and night sweats. Physical examination reveals skin to be warm and moist and lung sounds decreased in the right upper lobe with rhonchi. HR = 100, BP = 142/100, RR = 20, SaO2=95%. You should assume this patient has a high likelihood of having: A. Hantavirus pulmonary syndrome B. Pneumonia C. Tuberculosis D. RSV
C. Tuberculosis
You respond to an ill patient. Upon arrival, you find out that the patient has just traveled from an area with active Ebola virus disease (EVD). You should initially: A. examine the patient like any other. B. wait for a hazmat tech who is also a paramedic. C. assess the patient from at least 3 feet away. D. examine the patient over the phone.
C. assess the patient from at least 3 feet away.
You are caring for a patient who is complaining of chills, fever, night sweats, sudden weight loss, and hemoptysis. You suspect: A. Ebola virus disease (EVD). B. AIDS. C. tuberculosis. D. hepatitis B virus.
C. tuberculosis.
One of the most effective ways to prevent disease transmission is: A. sterilizing all equipment. B. using an alcohol-based sanitizer. C. washing your hands. D. use of gloves
C. washing your hands.