Medical Emergencies

The blood pressure cuff should be inflated: A) 20-30 mmHg higher than the reading when you no longer feel the radial pulse. B) to 200mmHg C) Until the branchial pulse is no longer heard in the stethoscope D) None of the above

A) 20-30 mmHg higher than the reading when you no longer feel the radial pulse.

Reoccurence of another syncopal event is at higher risk for the first _______ hours: A) 24 B) 36 C) 48 D) 72

A) 24 hours

Individuals with hypertension are at higher risk for: A) CVA B) Diabetes C) Seizures D) Asthma

A) CVA

In children, syncope is often caused by: A) Dehydration B) Lack of sleep C) Coughing D) Medications

A) Dehydration

Symptom's of orthostatic hypotension include: A) Dimming of vision B) Increased blood pressure C) Tachycardia

A) Dimming of vision

The drug of choice for an anaphylactic reaction is: A) Epinephrine .3mg 1:1,000 B) Epinephrine .1mg: 3,000 C) Diphenhydramine 50 mg D) Diphenhydramine 100 mg

A) Epinephrine .3mg 1:1,000

Astha is the result of an abnormal ______ response in the bronchial airways: A) immune B) Biochemical C) Nutritional D) None of the above

A) Immune

The use of oxygen and the production of carbon dioxide and their exchange between the cells and blood is: A) Internal respiration B) External respiration C) Bradypnea D) Orthopnea

A) Internal respiration

Your patient's respiratory rate is 16 per minute. This would be considered: A) Normal B) Bradypnea C) Hypernea D) Orthopnea

A) Normal

All of the following are symptoms of a severe allergic response requiring immediate treatment EXCEPT: A) Pruritus B) Hypotension C) Dyspnea D) Laryngeal edema

A) Pruritus

What is the MOST common artery used to take a patient's pulse rate in the dental office? A) Radial B) Brachial C) Femoral D) Carotid

A) Radial

The next MOST available person to the operator whose patient is experiencing an emergency is reponsible for: A) Recording events of the emergency B) Contacting EMS C) Retrieving the emergency kit D) Preparing drugs from the kit for use

A) Recording events of the emergency

The force of blood against blood vessel walls during ventricular contraction is: A) Systolic blood pressure B) Diastolic blood pressure C) Pulse pressure D) Hypertension

A) Systolic blood pressure

Which of the following would cause an extrinsic attack in the dental office? A) Taking a dental impression B) Self-imposed stress C) Application of cold air to a tooth

A) Taking a dental impression

The type of allergic reaction that is an immediate hypersensitivity caused by immunoglobulin E is: A) Type Me B) Type II C) Type III D) Type IV

A) Type Me

Following the challenge dose, the mast cells and basophils: A) Undergo degranulation and release chemical mediators B) Destroy the allergen C) Block the release of the chemical mediators and histamine D) None of the above

A) Undergo degranulation and release chemical mediators

asthma is characterized by all of the following symptoms except: A) pulmonary edema B) Dyspnea C) Wheezing D) Coughing

A) pulmonary edema

All of the following are signs and symptoms of presyncope EXCEPT: A) pupil constriction B) diaphoresis C) piloerection D) yawning

A) pupil constriction

"A" in REPAIR

Activate CABs of CPR by checking the circulation, airway and breathing

treatment of pulmonary edema

Airway breathing circulation (ABC), call 911, oxygen (high flow), vitals, position of comfort

All of the following are symptoms of a mild allergic reaction EXCEPT one. Which one is the exception? A) Slight pruritus B) Angioedema C) Localized redness D) Mild edema

B) Angioedema

If a patient experiences an allergic reaction and the symptoms are resolved and then reoccur several hours later, this is referred to as a: A) Anaphylactoid reaction B) Biphasic reaction C) Pruritic reaction D) All of the above

B) Biphasic reaction

Activation of the sympathetic nervous system during vasodepressor syncope with lack of physical activity will lead to: A) Tachycardia B) Cerebral ischemia C) Hypertension D) Valsalva maneuever

B) Cerebral ischemia

All of the following would be types of end organ damage signifying hypertensive emergency EXCEPT: A) Cerebral hemorrhage B) Liver failure C) Renal insufficiency D) Aortic dissection

B) Liver failure

A patient with systemic symptoms, but with normal blood pressure, pulse, and respirations, would be considered to be having which type of allergic reaction? A) Mild B) Moderate C) Severe D) None of the above

B) Moderate

The type of asthma attack where the patient has significant dyspnea and can only speak in phrases or partial sentences would be considered: A) Mild B) Moderate C) Severe D) Inconsequential

B) Moderate

The chief physiological concern with asthma patients during an attack is: A) excess sputum production B) narrowing of the airways C) Hypertension D) Myocardial ischemia

B) Narrowing of the airways

If the patient remains in syncope for an extended period of time, it is more likely that he will experience a: A) CVA B) Seizure C) Coma D) Hypertensive emergency

B) Seizure

The patient in syncope should be positioned: A) Supine with head and feed parallel B) Supine with feet above the head C) Semisupine D) Upright

B) Supine with feet above the head

The release of histamine during an allergic reaction causes: A) Reduced vascular permeability. B) Systemic vasodilation C) Reduced cardiovascular function D) Smooth muscle relaxation

B) Systemic Vasodilation

The FIRST sound you hear when deflating the blood pressure cuff is the: A) Diastolic blood pressure B) Systolic blood pressure C) Pulse pressure D) Radial pulse

B) Systolic blood pressure

Forced expiratory effort against a closed airway, suhc as when an individual holds his breath and tightens in the muscles in a concerted, strenuous effort is: A) Micturition B) Valsalva maneuver C) Hyperventilation D) Orthostatic hypotension

B) Valsalva maneuver

Syncope: A) is a primary disease process B) is often associated with a stressful situation C) is caused by increased cerebral oxygentation D) all of the above

B) is often associated with a stressful situation

The type of syncope often observed as a result of hyperventilation or metabolic diseases is: A) cardiac syncope B) noncardiac syncope C) vasovagal syncope D) neurocardiac syncope

B) noncardiac syncope

Normal blood pressure in children is based on their age, sex, and height and is at the _____ percentile or lower: A) 54th B) 76th C) 89th D) 95th

C) 89th

A patient that has stable angina or well-controlled Type I diabetes would be considered: A) ASA I B) ASA II C) ASA III D) ASA IV

C) ASA III

The high prevalence of asthma in urban settings has been linked to: A) Overcrowding B) Increased household insects C) Air pollution D) Increased mole spores

C) Air pollution

The MOST severe form of allergy is referred to as: A) Epistaxis B) Dyspnea C) Anaphylaxis D) Urticaria

C) Anaphylaxis

Painless swelling of the lips, eyes, and hands, during an allergic response is referred to as: A) Bronchospasm B) Pruritus C) Angioedema D) Rhinitis

C) Angioedema

All of the following factors affect blood pressure EXCEPT: A) Blood volume B) Blood viscosity C) Blood stenosis D) Blood vessel resistance

C) Blood stenosis

Cyclic patterns of increased rate and depth of breathing alternating with periods of apnea is referred to as: A) Kussmaul's respirations B) Biot's respirations C) Cheyne-Stokes respirations D) None of the above

C) Cheyne-Stokes respirations

The drug of choice for a mild allergic response as it produces minimal drowsiness is: A) Diphenhydramine 50mg IM B) Epinephrine 1,000 mg IM C) Chlorpheneramine 10 mg orally D) Hydrocortisone 25 mg orally

C) Chlorpheneramine 10 mg orally

In addition to a constriction of the bronchioles the inflammatory response that occurs during an asthmatic attack results in: A) Increased blood pressure B) Decreased arrythmias C) Increased mucus production D) None of the above

C) Increased mucus production

The type of syncope that is often associated with some noxious stimuli is: A) Cardiac B) Noncardiac C) Neurocardiogenic D) All of the above

C) Neurocardiogenic

The MOST reliable test to determine if a patient has a true allergy to a particular substance is the: A) Skin prick test B) Skin Scratch test C) Radioallergosorbent Test D) All of the above are equally reliable

C) Radioallergosorbent Test

If a patient responds positively on his or her medical history to epilepsy, you will need to be on the lookout for: A) Dyspnea B) Hypoglycemia C) Seizures D) None of the above

C) Seizures

The FIRST time a patient is exposed to an allergen is referred to as the: A) Challenge dose B) Half-life dose C) Sensitizing dose D) None of the above

C) Sensitizing dose

Your patient has a blood pressure of 180/110. This would be considered: A) Prehypertension B) Stage I hypertension C) Stage II hypertension D) Normal blood pressure

C) Stage II hypertension

The strength of the pulse against the blood vessel is referred to as the: A) Cardiac output B) Pulse C) Stroke volume D) Pulse pressure

C) Stroke volume

Your patient's pulse rate is 102. This would be considered: A) Normal B) Bradycardia C) Tachycardia D) None of the above

C) Tachycardia

All of the following procedures will help to prevent an emergency in the dental office EXCEPT: A) Accurate medical history taking B) Taking and recording vital signs C) Updating medical emergency kit

C) Updating medical emergency kit

Brain damage or coma can occur if a patient has oxygen deprivation lasting for: A) 1 minute B) 3 minutes C) 5 minutes D) 10 minutes

D) 10 minutes

A patient with an incapacitating systemic disease that is a constant threat to life would be categorized as: A) ASA I B) ASA II C) ASA III D) ASA IV

D) ASA IV

Other than the patient's own medication, the drug of choice for a patient suffering from an asthma attack is: A) epinephrine B) corticosteroids C) glucose D) albuterol

D) Albuterol

All of the following questions should be asked of a patient who provides a positive response on the medical history for asthma EXCEPT: A) Severity of attacks B) Frequency of attacks C) Trigger of attacks D) All of the above

D) All of the above

Bronchospasm occurs during an allergic reaction due to the effect of the histamines on the: A) Chronotropic factors B) Inotropic factors C) Alpha receptors D) Beta receptors

D) Beta receptors

All of the following are types of asthma EXCEPT: A) Intrinsic B) Extrinsic C) Viral D) Latent

D) Latent

Which of the following is a contributing factor in the increase of medical emergencies in the dental setting? A) Decreasing age of the population B) Advances in healthcare C) Advances in dentistry D) None of the above

D) None of the above

A temperature of 99.8 degrees is considered: A) Normal B) Hypothermia C) Low-grade D) Pyrexia

D) Pyrexia

All of the following are common causes of Tachycardia EXCEPT: A) Fever B) Exercise C) Stimulant drugs D) Syncope

D) Syncope

All of the following are factors that affect respiration rate EXCEPT: A) Age B) Body position C) Exercise D) Temperature

D) Temperature

All of the following are factors that affect the severity of an allergic reaction EXCEPT: A) Amount of the allergen B) Rate of exposure C) Route of exposure D) Type of allergen

D) Type of allergen

The appropriate position for a patient suffering from an asthma attack is: A) Upright with the head tilted to the side B) Supine with the head tilted upright C) Semisupine D) Upright with the arms forward

D) Upright with the arms forward

Patient vital signs include all of the following except: A) Pulse B) Respiration C) Blood pressure D) Weight

D) Weight

"E" in REPAIR:

Evaluating the patient's level of consciousness

Bacterial infections are the MOST common cause of infectious asthma: True False

False

Intrinsic asthma is the MOST common type of asthma: True False

False, Extrinsic asthma accounts for 50% of asthmatics.

"I" in REPAIR:

Implement the appropriate emergency protocol for the specific emergency

"P" in REPAIR:

Placing the patient in appropriate position

First "R" in Repair:

Recognizing signs and symptoms

Last "R" in REPAIR:

Refer the patient to the appropriate healthcare professional

What is the most common emergency in the dental office?

Syncope

Local anesthetics containing epinephrine are NOT recommended for asthmatics patients: True False

True

Patients experiencing a severe asthma attack will have a rapid respiration rate and will only be able to speak in single words: True False

True

Stress-induced asthma is the type MOST likely to be seen in the dental setting: True False

True

signs and symptoms of pulmonary edema

abdominal swelling, fatigue/weakness, shortness of breath, cough, diaphoresis, pale, hypertension, tachycardia

anaphylaxis

allergic reaction

signs and symptoms of anaphylaxis

angioedema (swelling, face, airway), urticaria (hives), hypotension, hoarse voice, weakness, altered levels of consciousness

treatment of anaphylaxis

call 911, adult epipen .3-.5 mg 3-5 min, junior epipen .15mg 3-5 min, oxygen, vitals, diphenhydramine hcl (benadryl), vitals, position of comfort

treatment of CVA

call 911, document time, stroke scale, oxygen, vitals, blood glucose levels, position semi upright

treatment of seizures

call 911, oxygen, make sure nothing is obstructing airway, vitals, loosen clothing, post positioning, time (duration)

treatment of hypoglycemia

check vitals (blood glucose level), administer glucose, administer oxygen (4-6L via nasal cannula), cover w/ blanket in supine position (shock)

treatment of hyperglycemia

check vitals, call 911, oxygen, position of comfort

signs and symptoms of hypoglycemia

diaphoresis, pale, weakness, headache, altered level of consciousness, seizure, cold, unresponsive, tremor

signs and symptoms of syncope

dizziness, unresponsive, diaphoresis, pale, hypotension, bradycardia

hyperglycemia

excess of glucose, often associated with diabetes mellitus

pulmonary edema

failure of left side of the heart; excess fluid in lungs causing heart problems, making person unable to breathe

signs and symptoms of CVA

headache, weakness, hypertension, slurred speech, facial droop, arm drift, altered levels of consciousness, unequal pupils, nausea & vomiting

asthma

inflamed, narrowed airways making it difficult to breathe

hypoglycemia

low glucose levels

signs and symptoms of seizures

metallic taste, stare/blinking eyes, smells, altered levels of consciousness, rhythmic jerking, apnea

chest pain

myocardial infarction

treatment of syncope

position supine, oxygen, cover/blanket, loosen tight clothes, call 911

signs and symptoms of asthma

shortness of breath, tightness in chest, pale, wheezing, trouble saying more than 1-2 words at a time, tripod position

cerebrovascular accident (cva)

stroke (damage resulting from interruption of blood supply to brain)

syncope

temporary loss of consciousness

signs and symptoms of chest pain/myocardial

tightness in chest, radiating pain, shortness of breath, pale, diaphoretic, pain in between shoulder blades, nausea and vomiting, cold

treatment of asthma

vitals, ask for inhaler, oxygen (non-rebreather, 12-15 liters per min), albuterol, position of comfort

treatment of chest pain

vitals, call 911, oxygen, nitroglycerin (.4mg-12mg), ASA (aspirin, max 325mg), position of comfort, blood glucose level

signs and symptoms of hyperglycemia

warm dry skin, fruity or acetone smell (diabetic ketoacidosis), hypotension, kussmaul respirations (fast & short), frequent urination, blurred vision