Paramedic Comprehensive Review

969 terms by Johnaldrocks

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Everything from Basic onward

The chemical symbol for sodium is:

Na+

Bone is an example of which type of tissue?

connective

________ is an anatomical term meaning "toward an attached base."

Proximal

The viscous material that supports all internal cellular structures is called:

protoplasm

You are assigned to a paramedic unit and receive a call to an elderly housing unit for the report of a 76-year-old man who fell. You find the man on the floor of his room, in pain, and you immediately notice that his right foot and knee are pointing outward. You do an assessment and obtain vital signs before calling medical control for an order to give pain medication. Which of the following terms should you use when describing the position of the leg to medical control?

Externally rotated

You arrive at the scene of a bar fight. Your patient has a penetrating stab wound on his left anterior chest about 2 inches above the nipple line. Which of the following conditions is your greatest concern?

developing tension pneumothorax

Maintenance of a relatively stable internal physiologic environment in which the cells live is called:

homeostasis

What is the movement of water out of plasma across the capillary membrane into interstitial space due to hydrostatic pressure called?

Filtration

Small, rod-like organelles that function as the metabolic center of the cell are called

mitochondria

You arrive on the scene of a stabbing. A 23-year-old man has a knife wound approximately 10 cm inferior to armpit. Which of the following anatomical terms best describes the location of the wound?

Midaxillary

Which of the following types of epithelium consists of single layer of cells of varying heights?

Pseudostratified

The function a protein in the human body is fundamentally determined by the protein's:

shape

What is the diffusion of water called

Osmosis

Amino acids are formed by joining an "R" group to a central carbon atom already bonded to a H, an amino group, and a(n):

carboxyllic acid group

Which of the following is NOT a type of tissue?
Nerve, Squamous, Connective, Epithelial.

Squamous

A patient is having trouble breathing and showing signs of a heart attack. The patient is placed on a stretcher, seated, with the back of the stretcher about halfway up. This position is called _______ position.

semi-Fowler's

Your ambulance is dispatched to a 6-month-old patient who is reported to have been sick for two days with diarrhea and vomiting. After performing the assessment you suspect dehydration. One of the signs you should check is the head, where you would expect to find what landmark sunken?

Fontanelle

A fracture to the humerus is best described as having what anatomical location in relationship to the elbow?

Proximal

The motion associated with the return of a body part to the anatomic position is called

extension.

A 55-year-old man has signs and symptoms consistent with an infection after a colonectomy to treat his colon cancer. Which of the following is the most likely?

peritonitus

Your patient was the restrained driver in a high energy MVC where another vehicle struck his vehicle at the driver's door. He is showing signs of hypovolemic shock. However, there is no obvious evidence of trauma other than a faint large bruise over his LUQ. Which of the following internal organs would you suspect to be injured?

spleen, right kidney, liver, esophagus

spleen

You respond to a call for a 3-year-old in the care of a babysitter, who reports that the child fell from the top of a sliding board. Upon arrival you find the child lying on the ground in a supine position and not moving. You immediately start to hold in-line stabilization and check the ABCs. As you position your hands, you notice the child's head is tucked forward with the chin touching the chest. Which term best describes this position?

Hyperflexion

When placing a patient on a long board for spinal immobilization, what body surface of the patient is in contact with the board?

Dorsal

A motor vehicle accident has resulted in a patient with a traumatic closed head injury. Upon arrival at the hospital you are informed that the patient has an internal hemorrhage. The bleeding is most likely in which cavity?

Cranial

Which of the following is NOT one of the stages of mitosis?

Metaphase, Nucleophase, Anaphase, Telophase

Nucleophase

Which of the following patients do you think would be the best candidate for administration of IV sodium bicarbonate?

A. A hyperventillating 17 year old with ETCO2 of 17 torr
B. A full arrest patient with a pH of 7.47
C. A hypoventillating CHF patient with ETCO2 of 49 mmHg
D. A trauma arrest patient with a pH of 7.10

A trauma arrest patient with a pH of 7.10

The movement of a substance accross the cell membrane against a concentration gradient is called:

Active transport

A man is lying on his back with his legs elevated approximately 12 inches and his head down. What is this position called?

Trendelenburg's

Which of the following classes of compounds would you expect to be formed by ionic bonding?

salts

A solution that has equal osmotic pressure to cells and body fluid, such as normal saline, is said to be:

isotonic.

Which projection from the neuron conducts electrical impulses away from the cell body?

Axon

Your patient has a penetrating injury 2" superior and 4" laterally to the left of his umbilicus. The associated exit wound is in the sacral midsagittal region. Which of the following MUST be perforated?

A. pleura
B. left kidney
C. peritoneum
D. descending abdominal aorta

left kidney

What is the uptake of solid particles through the cell membrane called?

Phagocytosis

Which of the following is NOT a type of muscle?

A. Stratified
B. Skeletal
C. Cardiac
D. Smooth

Stratified

The term caudad means:

lower, toward the feet.

When too much water enters a cell and the cell swells and bursts, this process is called:

lysis.

You contact medical control and receive an order for 0.45% sodium chloride in water (1/2 NS). Knowing that 0.9% sodium chloride is isotonic to whole blood, what type of solution is 1/2 NS?

Hypotonic

The division of one cell into two genetically identical and equal daughter cells is called

mitosis.

The layer of the pericardium covering the heart is the ________ pericardium.

parietal

The pleural cavity surrounds what organ?

lung

The major source of energy for all chemical reactions of the body is/are:

adenosine triphosphate (ATP).

While doing a physical assessment you have rebound tenderness in the quadrant where the gall bladder is located. Which of the following best describes that anatomical location of the abdomen?

Right upper quadrant (RUQ)

What is the movement of solutes from an area of higher concentration to one of lower
concentration called?

Diffusion

You have treated a motorcyclist for a right tibia/fibula fracture. The deformity is below the knee. When making the radio report to the hospital, which of the following terms most correctly describes the location of the injury?

A. Proximal to the knee
B. Inferior to the knee
C. Distal to the knee
D. Superior to the knee

Inferior to the knee

Organelles that contain RNA and protein and that interact with RNA from other parts of the cells to join amino acids together to form proteins are called:

ribosomes

Which of the following does not significantly contribute to the mass of an atom?

Electron

The frontal plane divides the body into the ________ and ________ portions.

anterior, posterior

The pericardium lies within the:

mediastinum.

A person lying face down is in the ________ position.

prone

Which term describes the turning of an extremity toward the midline?

Internal rotation

In dealing with an epileptic patient, which emergency procedure should be initiated first?

Protect the patient from injuries

The treatment of the CVA/TIA victim includes airway management, oxygen administration, ventilatory assistance, and -

a bolus of NS if the patient is hypotensive since dehydration can
sometimes mimick the signs and symptoms of CVA

Transient ischemic attacks (TIAs) are defined as episodes of cerebral dysfunction with signs and
symptoms similar to that of CVAs, lasting -

anywhere from 2 to 3 minutes to several hours, but always less than
24 hours

Generalized, full-body tonic-clonic activity, occasionally resulting in tongue biting, is indicative of

grand mal seizures

Status epilepticus is defined as

two or more seizures without an intervening period of consciousness

Decorticate or decerebrate posturing indicates the presence of:

A significant brain injury that is life-threatening

When provided with a pain stimulus, your patient extends and abducts both arms. This response
characterizes:

Decerebrate posturing

When provided with a pain stimulus, your patient flexes and/or retracts the stimulated area to
avoid or escape thestimulus. This response characterizes:

A withdrawal response to pain

The cerebral perfusion pressure is represented by which of the following equations?

CPP = MAP - ICP

Which of the following are the two most important prehospital considerations for reducing
secondary brain injury?

Ventilation and maintaining adequate blood pressure

Which of the following is a disease that affects the dopamine-producing basal ganglia and is
characterized by tremors, muscle rigidity, and bradydinesia?

Parkinson's Disease

Which of the following diseases involves inflammation followed by demyelination of the brain and
spinal cord nerve fibers?

Multiple sclerosis

Your patient is a 48-year-old female who is alert and oriented after a possible seizure. Her friends state they witnessed her slump to the floor and "shake" for about 15 seconds. She awoke in less than 1 minute and was "a bit groggy" for a few minutes. She does not believe she had a seizure, but thinks she may have fainted. Which of the following questions is LEAST important when differentiating seizure and syncope?

A. "Did you injure yourself during the event?"
B. "What happened just before the event?"
C. "What kind of medications do you take?"
D. "Do you have a history of seizures?"

"Did you injure yourself during the event?"

Which of the following is an example of a demyelination disorder?

A. Cerebal palsey
B. Encephalitis
C. Heavy metal poisoning
D. Down Syndrome

Heavy metal poisoning

Abnormal, slow writhing movements are known as:

athetosis

Which of the following is caused by incomplete development of the brain, spinal cord, or meninges Which of the following is caused by incompete development of the brain, spinal cord, or neninges

spina bifida

What sign might be displayed by a syncopal patient, which bystanders can mistake for seizure
activity.

myoclonus

Which of the following is an indication of rising ICP?

A. Cushing's Triad
B. Beck's Triad
C. Saulk's Triad
D. Kussmaul's Triad

Cushing's Triad

In the patient assessment acronym, AEIOU-TIPS, what does the "U" stand for?

uremia

The antagonist for a benzodiazepine medication overdose is called

Flumazenil

The greatest danger in the administration of Narcan to an addict who has overdosed on heroin is

withdrawal.

The antidotes for organophosphate poisoning are

atropine and pralidoxamine.

Your unit is called to assist the police with a 29 year old male patient. The patient is restrained by officers before your arrival. Apparently, the patient was found naked, running down the center of a busy city street shouting that aliens were chasing him. His vital signs are BP 188/72, P 132, R 28 with dilated pupils. Which drug do you think the patient has taken?

PCP

Which of the following is a common sign of organophosphate poisioning?

Bradycardia

Your patient is a 54 year old female that has just been removed from a house fire where she was entrapped for approximately 15 minutes. She has no visible trauma or burns. She is alert, but
not oriented. Her vital signs are BP 132/78, P 128, R 32 with bilateral crackles and an SpO2 of 98% on room air. As you finish your assessment, she becomes unresponsive and begins to
actively seize. You suspect

carbon monoxide poisoning.

Your comatose patient's pupils are 2 mm wide, equal, round, and are reactive to light. This
suggests

opiate overdose

Typical findings within the first 24 hours of acetaminophen overdose include:

No symptoms

Which of the following interventions would be MOST appropriate for a patient that has overdosed on haloperidol and is experiencing dystonic reactions?

A. sodium bicarbonate 1-1.5mEq/kg
B. 5mg diazepam IM
C. Calcium gluconate 2g slow IVP
D. diphenhydramine 50mg IV

sodium bicarbonate 1-1.5mEq/kg

Charcoal is effective in treating specific overdoses because it....

binds with the drug and stops its absorption

Your patient is cyanotic and complaining of shortness of breath. He has just returned from the dentist where he was administered benzocaine. He is also complaining of headache and dizziness. His vital signs are: BP-128/82; P-122; RR-28 with an SpO2 of 91%. His breath sounds are clear bilaterally and he has no significant medical history. Which of the following medications would you expect to help this patient the most?

A. atropine
B. hydroxocaobalamin
C. sodium bicarbonate
D. methylene blue

methylene blue

Your 44 year old patient has intentionally overdosed on labetalol. Which of the following drugs would you expect to give this patient?
A. glucagon
B. calcium gluconate
C. both A and B
D. neither A nor B

both A and B

What is antedotal for acetaminophen toxicity?

acetylcysteine

Your patient has overdosed on diltiazem. You might expect orders to administer:

A. calcium gluconate
B. sodium nitrite
C. atropine
D. Both A and C

Both A and C

Your eleven year old patient has overdosed on his grandfather's Prazosin. Prazosin is a selective Alpha 1 antagonist. Which of the following signs might you expect?

syncope

Your patient has been exposed to capsaicin. Which of the following would you expect?

lacrimation

A regional posion control center can be reached anywhere in the U.S. by dialing:

1-800-222-1222

Polyethylene glycol is an example of a(n):

WBI

Your 3 year old patient has ingested several of his mother's daily vitamins. Which of the following vitamin components is your greatest concern?

A. thiamine
B. iron
C. calcium
D. B12

iron

Your patient has inadvertantly overdosed on his Nortriptyline. You should expect to recieve orders that include:

sodium bicarbonate

Your patient has intentionally overdosed on trazodone. You would expect:

hyperthermia

Your patient is a 28 year old male who is complaining of chest pain and anxiety. He admits to "smoking crack". Which of the following interventions should you anticipate?

administration of diazepam

Your six year old patient has mistaken anti-freeze for Kool Aide. She has ingested over two cups of the toxin. What physiological changes would you expect?

low serum pH levels

Ingestion of methanol can result in _____________.
A. blindness
B. dysphagia
C. low serum pH
D. Both A and C

Both A and C

Tetanus may be a complication of any open soft-tissue injury and is caused by a:

Soil bacterium

A drug used to kill a bacteria's growth or to decrease it is called:

antibiotic

Tuberculosis is an infectious respiratory disease that is causes by

bacteria

Meningitis is an infectious nervous system disease that is caused by

bacteria, fungi or a virus

A bacterial infection of the bloodstream is called

sepsis

Pneumonia is a respiratory disease caused by a -

virus, fungus or a bacterial infection

Organisms that invade and live inside the cells that they effect are:

viruses

Proteins secreted by bacteria during its growth are called:

exotoxins

Acquired Immune Deficiency Syndrome is an immune deficiency disorder precipitated by

HIV

Disease may be caused by which of the following:

bacteria, fungus or viruses

A classic sign of bacterial infection is an increase in the number of:

leukocytes.

Which of the following statements about N. meningitidis is TRUE?

It is the bacteria that most often causes serous cases of meningitis.

Which of the following statements about mumps is TRUE?

A. Mumps are not highly communicable.
B. Mumps are of no concern to the adult patient.
C. There is no vaccine for the mumps virus.
D. Mumps are characterized by enlargement of the salivary glands.

Mumps are characterized by enlargement of the salivary glands.

Which of the following statements about rubella and the rubella virus is FALSE?

A. Mothers infected with rubella during the first trimesters are at risk for
abnormal fetal development.
B. The virus is spread via contact with infected blood and body fluids.
C. Immunization via the MMR vaccination is 98-99 percent effective.
D. EMS providers should receive an MMR vaccination.

The virus is spread via contact with infected blood and body fluids.

Which of the following statements about measles and the measles virus is FALSE?

A. Measles is transmitted by inhalation of infected droplets.
B. Signs of measles infection include high fever and a maculopapular
rash.
C. Measles is highly communicable.
D. Immunization is ineffective until age 15.

Immunization is ineffective until age 15.

Which of the following statements about herpes simplex type 2 (HSV-2) is FALSE?

A. 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.
C. There is a low risk of disease transmission via casual contact.
D. HSV-2 is responsible for 70-90 percent of all genital herpes cases.

Treatment with Acyclovir can eradicate the virus.

Which of the following is NOT a common pediatric viral disease?

A. Mumps
B. Measles
C. RSV
D. Pertussis

Pertussis

Which organism causes mononucleosis?

Epstein-Barr virus

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 no childhood diseases. The patient is most likely suffering from:

varicella.

Which of the following statements about influenza is true?

A. Adults become contagious the day before symptoms occur and
remain contagious for a week
B. Each year the CDC creates a vaccine for one strain of influenza A and
one strain of influenza B
C. Once a person has been infected with influenza, he/she develops life-
long immunity to all strains of influenza
D. Rimantadine shortens the duration of both Influenza A and Influenza B

Adults become contagious the day before symptoms occur and
remain contagious for a week

Which of the following statements is true regarding gonorrhea?

A. Gonorrhea may lead to PID.
B. Gonorrhea can not be treated with antibiotics
C. Women infected with gonorrhea are typically asymptomatic.
D. Both A and C

Both A and C

Your patient has a painful erythema migrans on his leg. He tells you that his symptoms started about three weeks after returning home from a backpacking trip in Montana. He is complaining of joint pain and Bell's palsey. You suspect:

Lyme Disease

What should never be given to infants because of the risk of botulism?

honey

During the examination of an 18-year-old female patient complaining of abdominal pain, the patient denies nausea, vomiting or diarrhea. She also denies the possibility of pregnancy. These denials are known as:

Pertinent negatives

The cause of acute abdominal pain is most accurately assessed in the pre-hospital setting by..

patient history

While examining a patient who is complaining of abdominal pain, the:

Quadrant with pain should be palpated last

The accumulation of serous fluid (edema) in the peritoneal cavity is called -

ascites

Your patient is a 45-year-old type I diabetic complaining of a 5-day history of abdominal pain, nausea/vomiting, and increased urination and thirst. His skin and mucus membranes are warm and dry. HR =112 bpm and regular, BP = 94/60, RR = 12 and regular. Your treatment for this patient would most likely include:

IV of NS 1-2 L.

Your patient is a 22-year-old female in mild distress who is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be LEAST helpful when determining the etiology of her abdominal pain?

A. "Have you ever had a sexually transmitted disease?"
B. "When did your last menstrual period start?"
C. "Are you having any vomiting or diarrhea?"
D. "When did the pain start?"

Have you ever had a sexually transmitted disease?

Your patient is a 12-year-old male who is conscious and alert, complaining of diffuse abdominal pain. He states that the pain began about 3 hours after eating supper. He has had severe diarrhea and some vomiting. You might elect to administer any of the following EXCEPT:

A. diazepam.
B. Compazine.
C. promethazine.
D. IV of NS.

diazepam.

Your patient is a 19-year-old male complaining of a 2-day history of abdominal pain described as
diffuse and colicky, located around his umbilical area. He also states a loss of appetite and a low- grade fever over the same period. Palpation of his abdomen reveals tenderness and guarding to
the periumbilical area. Of the following, which is the most likely cause of his clinical condition?

A. Cholecystitis
B. Bowel obstruction
C. Peptic ulcer disease
D. Appendicitis

Appendicitis

A 52-year-old male is in moderate distress, complaining of nausea and vomiting. He describes a 3-day history of upper left quadrant abdominal pain described as sharp and radiating to his back. You note a slightly distended abdomen. He called EMS today when he developed nausea and vomiting. He denies any change of bowel habits and states he has a history of alcoholism. Of the following, which is the most likely cause of his clinical condition?

Pancreatitis

Which of the following in NOT a life-threatening GI condition associated with hemorrhage?

A. ruptured ectopic pregnancy
B. ruptured spleen
C. GI bleed
D. acute pancreatitis

acute pancreatitis

Your patient is a 67 year old male who complains of upper abdomninal pain, nausea, and weakness. In addition to oxygen and IV access, which of the following is MOST important in the
pre-hospital setting for this patient?

A. ausculation of bowel sounds
B. 12-Lead EKG
C. physical exam of the abdomen
D. administration of nitrous oxide

12-Lead EKG

Mesenteric ischemia refers to a compromise in the vascular supply to which of the following organs?

bowel

Which of the following is an inflammatory bowel disease?

A. ulcerative colitis
B. Addison's disease
C. Crohn's disease
D. Both A and C

Both A and C

Black, tarry stools are referred to as:

melena

Boerhaave's syndrome refers to:

esophageal rupture

Your 22 year old patient is complaining of abdominal cramping, fever, nausea, and
hematochezia. Of the following, you would suspect:

E. coli infection

Acute inflammation of the gallbladder is called:

cholecystitis

When the sacs or pouches protruding out from the bowel become inflamed, the condition is known as:

diverticulitis

Alcohol abuse often causes elevated venous pressure from a back-up of blood from the liver called portal hypertension. What potential cause of upper GI bleeding is caused by portal
hypertension?

esophageal varices

A tear of the esophagus from violent vomiting is known as:

Mallory-Weiss syndrome

The end stage of liver disease marked by the permanent destruction of hepatocytes is called:

cirrhosis

The acronymn, "AAA", in the context of emergency medicine refers to:

Abdominal Aortic Aneurysm

Which of the following is a common acronymn used to assess vomit?

TACO

An effective method of treating most asthma attacks in children is

Albuterol Inhalant

An increased number of mucous-secreting cells in the respiratory epithelium, producing large amounts of sputum, is characteristic of -

chronic bronchitis

Rhonchi may accompany

asthma and chronic bronchitis

Pursed-lip breathing is indicative of __ and serves to assist expiration.

emphysema

You place your CHF patient with severe pulmonary edema on CPAP en route to the hospital. Upon arrival, the hospital staff abruptly removes the CPAP to obtain a "room air" saturation. You would
expect the patient to:

become acutely worse

You are dispatched to a dialysis clinic to treat a patient complaining of difficulty breathing. Upon arrival, you find a 71 year old male with bilateral wheezing. A brief history reveals that the patient has a history of asthma and has just completed 15 minutes of his dialysis treatment. The most appropriate IV therapy for this patient would be:

0.45 percent saline with a micro drip set

The right lung consists of

three lobes of lung tissue: the upper, middle and lower lobes

Bronchial constriction is most associated with:

wheezing on expiration

You have successfully resuscitated your patient from cardiac arrest of cardiac etiology. He is intubated and you are ventillating him with a BVM and supplemental oxygen at a rate of 1 breath
every 6 seconds. You note that his ETCO2 has risen to 47 torr while keeping a normal pattern. Which of the following is the most appropriate action?

A. extubate immediately and resume ventillations with the BVM only
B. hyperventillate at 1 breath per second
C. increase ventillations to 1 every 4-5 seconds
D. decrease ventillations to 1 every 7 seconds

increase ventillations to 1 every 4-5 seconds

The pathophisiology in which the pressure inside of the capillaries at the alveoli-capillary membrane forces fluid into the alveoli causing respiratory distress is known as:

congestive heart failure (CHF)

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