Medical Emergencies Test 3 Study Guide

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1. Your patient's girlfriend called 911 when he became unresponsive. They have both
been drinking alcohol. When you arrive, you find that the woman has dragged her
boyfriend into the bathroom, and is attempting to revive him with a "cold shower." The
patient is unresponsive and his skin is pale, cool, and now wet from the shower. In
addition to alcohol poisoning, you should suspect
A. Hyperglycemia
B. Hypothermia
C. Abdominal trauma
D. CNS trauma

B. Hypothermia

2. Your patient is an elderly homeless man who complains of pain in his feet. His shoes
are damp and cold after walking outside in winter weather. Upon inspection, the soles of
his feet appear to be swollen, thickened, and fragmented. You should suspect
A. chilblains.
B. immersion foot.
C. dysbarism.
D. frostnip.

B. immersion foot.

3. Your patient is a child who has been swimming in the ocean. She complains of severe
pain in her lower arm. You suspect a jellyfish sting. You should
A. apply urine to the wound, immerse the arm in cold water, then shave the area.
B. apply luke-warm coffee to the wound, immerse the arm in hot water, then shave the
area.
C. apply vinegar to the wound, immerse the arm in hot water, then shave the area.
D. apply a cola drink to the wound, immerse the arm in cold water, then shave the area.

C. apply vinegar to the wound, immerse the arm in hot water, then shave the area.

4. Your patient has traveled to the Colorado Rockies to ski during his spring break. He
awakens in the middle of the second night with severe dyspnea. His friends tell you that
he was complaining of a cough, fatigue, and a headache before he went to bed. This
patient most likely suffers from
A. high altitude pulmonary edema.
B. chronic hypothermia.
C. high altitude cerebral edema.
D. acute mountain sickness.

A. high altitude pulmonary edema.

5. How do medications such as anticholinergics, antidepressants, antihistamines, MAO
inhibitors, and diuretics contribute to heat illnesses?
A. They inhibit sweating.
B. They mask signs of dehydration.
C. They increase heart rates.
D. They decrease blood pressure.

A. They inhibit sweating.

6. Divers most commonly experience barotrauma
A. after ascent.
B. during descent.
C. after descent.
D. during ascent.

B. during descent.

7. Temperature-sensitive neurons called thermosensors are located in the skin, spinal
cord,
A. heart muscle, and the anterior hypothalamus.
B. heart muscle, and the dorsal medulla oblongata.
C. limb muscles, and the anterior hypothalamus.
D. limb muscles, and the dorsal medulla oblongata.

C. limb muscles, and the anterior hypothalamus.

8. The black widow spider has a
A. dark hour glass shaped spot on its dorsal side.
B. red hour glass shaped spot on its dorsal side.
C. red hour glass shaped spot on its ventral side.
D. dark hour glass shaped spot on its ventral side.

C. red hour glass shaped spot on its ventral side.

9. Your 32 year old patient began experiencing abdominal pain as he ascended from an
underwater dive. He is anxious and describes his pain as severe and not localized. He
tells you that he was diagnosed with a hernia several weeks ago. When you examine his
abdomen, you note that it is distended. How should you treat this patient?
A. Request air transport to the nearest hospital and monitor the patient's ABCs.
B. Administer an anti-flatulent medication such as simethicone.
C. Rapid ground-transport to the nearest facility with a hyperbaric chamber.
D. Administer oxygen and transport to the hospital non-emergently.

D. Administer oxygen and transport to the hospital non-emergently.

10. What law states: "At a constant temperature, the absolute pressure and the volume of
gas are inversely proportional. As pressure increases the gas volume is reduced; as the
pressure is reduced the gas volume increases?"
A. Dalton's law
B. Charles' law
C. Boyle's law
D. Newton's law

C. Boyle's law

11. Your patient has returned from an extended deep dive. She is confused and agitated,
and complains of nausea and blurry vision. As you perform a physical examination, you
note that her eyelid is twitching. What is the likely cause of her symptoms?
A. Nitrogen narcosis
B. Middle ear barotrauma (MEBT)
C. CNS oxygen toxicity
D. Decompression illness

C. CNS oxygen toxicity

12. Why is "reverse triage," in which the first priority is to treat those patients not moving
and not breathing, a principal used in lightning strikes?
A. Studies show that traditional triage methods are discriminatory.
B. Studies show that less traumatized patients shift resources away from those more
traumatized in cases of lightning strikes.
C. Studies show that victims of lightning who are not in cardiac arrest do not improve
with immediate treatment.
D. Studies show that CPR doubles survivability among patients with cardiac arrest due to
lightning strikes.

D. Studies show that CPR doubles survivability among patients with cardiac arrest due to
lightning strikes.

13. In order to prevent "prickly heat," also known as heat rash, you should avoid
A. deodorant.
B. sunscreen.
C. insect repellent.
D. talcum powder.

D. talcum powder.

14. ______________ injuries occur when an object (such as a house or a tree) is stuck by
lightning and the dissipating current jumps to a nearby person.
A. Step voltage
B. Diffusion
C. Splash
D. Flashover

C. Splash

15. A patient is hypothermic when her body temperature drops below ___ degrees.
A. 35 C (95 F)
B. 33 C (91 F)
C. 37 C (98 F)
D. 31 C (89 F)

A. 35 C (95 F)

16. Your 14 year old patient claims that he was bitten by a rattlesnake 30 minutes prior to
your arrival. You notice two, pin-prick bite marks on his hand. The wound is neither
bleeding nor swollen. His heart rate and blood pressure are slightly elevated, but the
patient is otherwise asymptomatic. It is most likely that the patient
A. is suffering from severe envenomation.
B. was bitten by a non-venomous snake.
C. is only suffering from minimal envenomation.
D. was bitten by a rattlesnake with no envenomation.

D. was bitten by a rattlesnake with no envenomation.

17. Which of these sets of symptoms is most likely caused by nitrogen narcosis?
A. Pain near joints, pruritus, and dysrhythmia
B. Hearing loss, vertigo, and tinnitus
C. Euphoria, confusion, and vague numbness
D. Nausea, irritation, and convulsions

C. Euphoria, confusion, and vague numbness

18. Sodium replacement is a standard treatment for what heat-related illness?
A. Heat cramps
B. Heat syncope
C. Heat edema
D. Prickly heat

A. Heat cramps

19. Vigorous shivering is characteristic of which stage of hypothermia?
A. Severe
B. Mild
C. Moderate
D. Irreversible

B. Mild

20. Your patient is a novice SCUBA diver who has returned from his first deep-water
dive. Five minutes after he surfaced, the patient lost consciousness. His diving
companion expresses concern that the patient's ascent was too fast. You should suspect
A. oxygen toxicity.
B. nitrogen narcosis.
C. inner ear barotrauma.
D. arterial gas embolism.

D. arterial gas embolism.

21. Which of the following individuals is statistically at greatest risk to drown?
A. A 45 year old male swimmer who has been drinking
B. A 14 year old male on a boat where alcohol is present
C. A 30 year old female who is surfing while on vacation
D. A 12 year old female who is boating with her friends

A. A 45 year old male swimmer who has been drinking

22. Your elderly patient wandered away from his home and became confused. He is
found lying in a snow covered field a mile away. He responds to voice, and is
bradycardic and hypoxic. His body temperature is 29.6 degrees Celsius. Pre-hospital
treatment should include
A. warm clothing and blankets.
B. warm food and drink.
C. active external rewarming.
D. active internal rewarming.

C. active external rewarming.

23. Your patient has been camping and hiking in the Sonoran Desert. Although she was
careful to drink water continuously, her husband believes that she has become
dehydrated. She is complaining of fatigue, headache, and nausea. She is diaphoretic and
her body temperature is 99.1 degrees F. In addition to moving her to a cool location, how
should you treat this patient?
A. Have her drink distilled water.
B. Start an IV of isotonic saline.
C. Have her drink a sports drink.
D. Start an IV of sodium bicarbonate.

C. Have her drink a sports drink.

24. Which of these patients is at greatest risk for exertional heat stroke?
A. A 82 year old living without air conditioning
B. A 70 year old walking around the lake
C. A 19 year old playing college football
D. A 2 year old left in a car with the windows up

C. A 19 year old playing college football

25. __________ is a superficial injury caused by skin inflammation and tissue hypoxia
when the skin is exposed to above-freezing, often windy, conditions.
A. Hypothermia
B. Chillblains
C. Frostbite
D. Trench foot

B. Chillblains

1. Differentiate between peritoneal dialysis and hemodialysis.
A. In hemodialysis, a filter outside of the body works in place of the kidney.
B. In peritoneal dialysis, the pressure of the dialysis system determines how much fluid is
removed from the body.
C. In hemodialysis, wastes and fluids diffuse across the peritoneum which acts as the
dialysis filter.
D. In peritoneal dialysis, dialysate fluid is circulated through an arteriovenous (AV)
shunt.

A. In hemodialysis, a filter outside of the body works in place of the kidney.

2. Your 27 year old patient is complaining of testicular pain and swelling after lifting a
heavy object. He says the pain becomes "excruciating" upon palpation. He is also
complaining of abdominal pain and nausea. You should most suspect
A. ureterolithiasis.
B. a scrotal mass.
C. an enlarged prostate.
D. testicular torsion.

D. testicular torsion.

3. Your patient complains of severe groin and abdominal pain, and a 'lump' in his lower
abdomen. This patient is most likely suffering from
A. testicular torsion.
B. orchitis.
C. epididymitis.
D. an inguinal hernia.

D. an inguinal hernia.

4. Which of the following includes only those structures associated with the male
genitourinary system?
A. Testicles, urethra, prostate, kidneys
B. Prostate, ureters, urethra, intestines
C. Prostate, kidneys, vagina, urethra
D. Epididymis, ureters, gallbladder, urethra

A. Testicles, urethra, prostate, kidneys

5. The protrusion of an organ through a weak muscle wall is called
A. a hernia.
B. torsion.
C. an evisceration.
D. Fournier's syndrome.

A. a hernia.

6. You are called to the local dialysis center for a patient with seizures. The patient has
just completed his dialysis treatment and has no history of seizure. You should suspect
A. hyponatremia.
B. hypoxia secondary to hypovolemia.
C. hypokalemia.
D. disequilibrium syndrome.

D. disequilibrium syndrome.

7. Differentiate between acute renal failure and chronic renal failure.
A. Chronic renal failure an be classified into prerenal, intrinsic renal and postrenal
causes.
B. Acute renal failure usually results in the irreversible loss of renal function.
C. Chronic renal failure can result in the deterioration of renal function over a period of
several days.
D. Acute renal failure can result in the deterioration of renal function over a period of
hours.

D. Acute renal failure can result in the deterioration of renal function over a period of
hours.

8. You respond to a residence for a 29 year old male complaining of extremely painful
urination with a foul discharge. He tells you that he first noticed the symptoms about 2
days ago and that he had a one-night stand about a week ago. What is the most likely
cause of his symptoms?
A. Neisseria gonorrhea
B. Ureaplastic stenosis
C. Syphilis
D. Herpes simplex virus

A. Neisseria gonorrhea

9. What are the signs and symptoms associated with hyperkalemia?
A. An increase in the PR with a notched QRS visible in V1
B. A flattening of the P-waves with a decrease in the PR interval
C. Peaked T-waves with shortened QT intervals
D. Notched T-waves with ST depression

C. Peaked T-waves with shortened QT intervals

10. How do kidney stones form?
A. A collection of salts forms a mass that obstructs the urethra.
B. The tubules do not adequately filter out solutes, which are then passed on to the
ureters.
C. Crystals precipitate out from urine and build up on the inner surfaces of the kidney.
D. An embolism from the renal artery is released into the renal calculi.

C. Crystals precipitate out from urine and build up on the inner surfaces of the kidney.

1. What generalization could you draw regarding the differences between the
cholinergenic and anti-cholinergenic toxidrome symptoms?
A. Cholinergenic symptoms are "wet," while anti-cholinergenic symptoms are "dry."
B. Cholinergenic symptoms are "sudden-onset" while anti-cholinergenic symptoms are
"gradual-onset."
C. Cholinergenic symptoms are sympathetic, while anti-cholinergenic symptoms are
parasympathetic.
D. Cholinergenic symptoms are "hot" while anti-cholinergenic symptoms are "cold."

A. Cholinergenic symptoms are "wet," while anti-cholinergenic symptoms are "dry."

2. Which of the following pharmacologic agents can cause the anti-cholinergic
toxidrome?
A. Antidysrhythmics
B. Acetaminophen
C. Antihistamines
D. Acetylsalicylic acid

C. Antihistamines

3. A 37 year old male accidentally exposed himself to an organophosphate pesticide. He
is vomiting, wheezing, and sweating profusely. What should you do FIRST?
A. Treat the patient with pralidoxime.
B. Dilute bleach in water and use to decontaminate the patient.
C. Treat the patient with atropine.
D. Decontaminate the patient with clean water.

B. Dilute bleach in water and use to decontaminate the patient.

4. Which of the following substances is more toxic after it has been metabolized?
A. Ethanol
B. Methadone
C. Ethylene glycol
D. Acetaminophen

C. Ethylene glycol

5. You are treating a burn victim who was caught in an industrial plastic plant fire. Which
additional complication should you MOST suspect?
A. Mercury poisoning
B. Hydrogen sulfide poisoning
C. Cholingeric poisons
D. Cyanide poisoning

D. Cyanide poisoning

6. You arrive on the scene of a call to find a patient with respiratory depression and small
pupils. Which of the following substances has the patient likely taken too much of that is
causing the symptoms?
A. Heroin
B. Atropine
C. Amphetamines
D. Cocaine

A. Heroin

7. What are two toxic states that often give misleading pulse oximetry readings?
A. Monoamine oxidase inhibitor poisoning and gamma-hydroxybutrate poisoning
B. Carbon monoxide poisoning and methemoglobinemia
C. Gamma-hydroxybutrate poisoning and carbon monoxide poisoning
D. Methemoglobinemia and monoamine oxidase inhibitor poisoning

B. Carbon monoxide poisoning and methemoglobinemia

8. The most commonly abused drug and leading cause of drug death is
A. cocaine.
B. heroin.
C. nicotine.
D. alcohol.

D. alcohol.

9. A 41 year old female is unconscious and suffers from severe respiratory depression.
Her boyfriend reports that the patient ingested a handful of "some kind of pain killer," but
the bottle cannot be found. Of the following choices, this patient most likely overdosed
on
A. aspirin.
B. ibuprofen.
C. acetaminophen.
D. codeine.

D. codeine.

10. You are treating a patient who is tachycardic, agitated and has dilated pupils. Which
of following toxidromes is the likely cause of these symptoms?
A. Amphetamines
B. Heroin
C. Morphine
D. Nerve Agent Chemical Weapons

A. Amphetamines

11. A 25 year old male regularly takes lithium to treat his bipolar disorder. Today he had
a particularly bad day and decided to take double his prescribed dose. He now is
experiencing abdominal pain, vomiting, confusion, and seizures. What method of
decontamination will this patient receive?
A. Activated charcoal
B. Cathartics
C. Gastric lavage
D. Hemodialysis

B. Cathartics

12. A 42 year old male has overdosed on verapamil (a calcium channel blocker). He
complains of headache and drowsiness. His vital signs are P 47, R 24, BP 80/43. You are
LEAST likely to perform which of the following interventions?
A. Perform endotracheal intubation.
B. Administer high dose insulin with dextrose infusion.
C. Administer vasopressors.
D. Administer activated charcoal.

B. Administer high dose insulin with dextrose infusion.

13. A 27 year old male patient acts confused, trembles, and lacks coordination. He has a
medical ID bracelet that indicates the patient has type 1 diabetes. Co-workers say that
patient began acting strangely during an afternoon meeting. What is the most likely
treatment?
A. Activated charcoal
B. Glucose
C. Naloxone
D. Atropine

B. Glucose

14. Which of these is a major advantage of activated charcoal?
A. It functions as an antidote to certain toxins.
B. It is safe in all circumstances
C. It is easy to administer
D. It can be used for any ingested toxin

C. It is easy to administer

15. Which of these routes of absorbing poison is the least common?
A. Through the skin
B. Through mucus membranes
C. Inhalation
D. Injection

B. Through mucus membranes

16. A(n) __________ is a problematic event that occurs while a patient is using
medication properly.
A. therapeutic error
B. unforeseen interaction
C. adverse drug reaction
D. overdose

C. adverse drug reaction

17. Your patient has overdosed on methamphetamine and is actively seizing. You are
MOST likely to treat the seizures with
A. a sedative.
B. a barbituate.
C. phenobarbital.
D. phenytoin.

A. a sedative.

18. Your 50 year old patient is unconscious. Her skin and eyes are dry, and her pupils are
dilated. Her vitals signs are P 46, R 21, BP 111/76. Her husband tells you, "She was
vomiting, then shook all over and lost consciousness." He also says that she takes digoxin
for congestive heart failure, as well as Benadryl (diphenhydramine) for seasonal allergies.
You are LEAST likely to
A. provide supplemental oxygen.
B. place on a cardiac monitor.
C. administer benzodiazepines.
D. apply synchronized cardioversion.

D. apply synchronized cardioversion.

19. Compared to a patient who is body stuffing, one who is body packing is
A. more likely to absorb drugs, and at a higher dose.
B. less likely to absorb drugs, and at a lower dose.
C. less likely to absorb drugs, but at a higher dose.
D. more likely to absorb drugs, but at a lower dose.

C. less likely to absorb drugs, but at a higher dose.

20. Drugs with what sort of therapeutic window pose the greatest risk of accidental
toxicity?
A. Wide
B. Narrow
C. Closed
D. Open

B. Narrow

21. Which of the following treatments is most commonly used to treat a patient with
toxin induced pulmonary edema?
A. Oxygen and nitrates
B. Oxygen and diuretics
C. Oxygen only
D. Oxygen and morphine

C. Oxygen only

22. If a poisoned patient presents with pulmonary edema, the first course of treatment is
typically
A. positive pressure ventilation.
B. high flow oxygen.
C. nitrates.
D. diuretics.

B. high flow oxygen.

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