969 terms

Paramedic Comprehensive Review

Everything from Basic onward
The chemical symbol for sodium is:
Bone is an example of which type of tissue?
________ is an anatomical term meaning "toward an attached base."
The viscous material that supports all internal cellular structures is called:
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:
What is the movement of water out of plasma across the capillary membrane into interstitial space due to hydrostatic pressure called?
Small, rod-like organelles that function as the metabolic center of the cell are called
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?
Which of the following types of epithelium consists of single layer of cells of varying heights?
The function a protein in the human body is fundamentally determined by the protein's:
What is the diffusion of water called
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.
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.
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?
A fracture to the humerus is best described as having what anatomical location in relationship to the elbow?
The motion associated with the return of a body part to the anatomic position is called
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?
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
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?
When placing a patient on a long board for spinal immobilization, what body surface of the patient is in contact with the board?
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?
Which of the following is NOT one of the stages of mitosis?

Metaphase, Nucleophase, Anaphase, Telophase
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?
Which of the following classes of compounds would you expect to be formed by ionic bonding?
A solution that has equal osmotic pressure to cells and body fluid, such as normal saline, is said to be:
Which projection from the neuron conducts electrical impulses away from the cell body?
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?
Which of the following is NOT a type of muscle?

A. Stratified
B. Skeletal
C. Cardiac
D. Smooth
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:
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?
The division of one cell into two genetically identical and equal daughter cells is called
The layer of the pericardium covering the heart is the ________ pericardium.
The pleural cavity surrounds what organ?
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?
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:
Which of the following does not significantly contribute to the mass of an atom?
The frontal plane divides the body into the ________ and ________ portions.
anterior, posterior
The pericardium lies within the:
A person lying face down is in the ________ position.
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
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?
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:
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
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?
The antagonist for a benzodiazepine medication overdose is called
The greatest danger in the administration of Narcan to an addict who has overdosed on heroin is
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?
Which of the following is a common sign of organophosphate poisioning?
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
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?
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?
Your patient has been exposed to capsaicin. Which of the following would you expect?
A regional posion control center can be reached anywhere in the U.S. by dialing:
Polyethylene glycol is an example of a(n):
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
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:
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:
Tuberculosis is an infectious respiratory disease that is causes by
Meningitis is an infectious nervous system disease that is caused by
bacteria, fungi or a virus
A bacterial infection of the bloodstream is called
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:
Proteins secreted by bacteria during its growth are called:
Acquired Immune Deficiency Syndrome is an immune deficiency disorder precipitated by
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:
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
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
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
D. 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:
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?
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 -
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.
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
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?
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?
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:
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:
When the sacs or pouches protruding out from the bowel become inflamed, the condition is known as:
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
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:
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?
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.
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)
During transport of your intubated patient, you note a sudden decrease in the patient's capnography reading from 38 to 16 mmHg. You should:
reassess the ABC's
Adenosine is also called
This drug slows conduction time through the AV node, can intereupt the reentry pathways through the AV and SA nodes, and can restore NSR in patients with PSVT, including PSVT from WPW
Adenosine mechanism of action
This drug is indicated for PSVT refractory to vagal manuevers
Adenosine indications
Do not use this drug for any hr <100, any 2nd or 3rd degree AV block.
Adenosine contraindications
1st Adult dose for Adenosine
6mg rapid IVP
2nd adult dose of Adenosine
12mg rapid IVP, may repeat x 1
If the patient is hemodynamically unstable, administration of this drug should not delay appropriate cardioversion
Amiodarone is also called...
Aratac, Cordarone, Cordarone X, Pacerone.
Class 3 antiarrythmic agent which inhibits adrenergic stimulation (alpha- and beta- blocking), affects Na+, K+, and Ca+ channels, prolongs the action potential and vascular smooth muscle, decreases peripheral vascular resistance, increases coronary blood flow, and blocks effects of sympathetic stimulation.
This drug is indicated for V-fib, and V-tach
Adult first dose of Amiodarone
300mg slow IV/IO push
Adult second dose of Amiodarone
150mg slow IV/IO push
Parasympatholytic. That blocks cholinergic /muscarinic receptor sites causing: increased heart rate, increased conduction through the AV node, reduced motility and GI tone, reduced action and tone of urinary bladder, dilates pupils, suppresses sweating, suppresses lacrimation, suppresses
salivation, suppresses secretions in the upper airways, and can result in bronchodilation.
This drug is indicated for symptomatic bradycardia, and as an antidote for organophosphate poisoning.
Atropine indications
Adult Dose of atropine for bradycardia
0.5mg IV/IO/IM, may repeat in 5 minutes to MAX of 3mg / 1.0mg ET.
Adult dose of atropine for organophosphate poisoning
2mg IV/IM/IO every 5 min, titrate to effect
Another name(s) for Diltiazem
Apo-Diltiaz, Cardizem, Dilacor, Tiazac
Nondihydropyridine calcium channel blocker which inhibits calcium ion from entering the "slow channels" or select voltage-sensitive areas of vascular smooth muscle and myocardium during
depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation; increases myocardial oxygen delivery in patients with vasospastic angina.
To control atrial fibrillation, atrial flutter, and PSVT refractory to adenosine
Indications for Diltiazem
Contraindications of this drug include Sick sinus syndrome, 2nd or 3rd degree heart block, hypotension, wide-complex tachycardia, Wolfe-Parkinson-White syndrome. Use caution in pregnant patients (Cat C), nursing mothers, children, CHF, conduction abnormalities, renal or hepatic impairment, and the elderly.
Contraindications of Diltiazem
Do not use this drug because of increased risk of CHF, bradycardia, and asystole.
Interactions of Diltiazem
Adult first dose of Diltiazem
0.25 mg/kg IV bolus over 2 minutes
Adult second dose of Dilitiazem
0.35 mg/kg; 15 min after first dose followed by infusion
Adult infusion dose of Diltiazem
5-10mg/hr. MAX dose 15mg/hr for 24 hours
Catecholamine/Sympathomimetic. This drug is a naturally occurring neurotransmitter and immediate precursor of norepinephrine. It has effect on alpha, beta, and dopaminergic receptors of the sympathetic ANS. It's actions differ depending on dosage given
A Dopamine dose of 1-5 mcg/kg/min has what effects
dilates renal and mesenteric blood vessels
A Dopamine dose of 2-10 mcg/kg/min has what effects
beta effects on heart
A Dopamine dose of 10-20 mcg/kg/min has what effects
alpha peripheral effects
A Dopamine dose of 20-40 mcg/kg/min has what effects
alpha effects reverse dilation of renal and mesenteric vessels
This drug is indicated for: Refractory shock, particularly cardiogenic, distributive, or obstructive
Dopamine indications
Contraindications of this drug include Hypovolemic shock. Adrenal gland tumor. Tachydysrhythmias. Caution should be used in pregnancy (Cat C), in nursing women, and in children.
Dopamine contraindications
Adult dose of dopamine.
5-20 mcg/kg/min IV/IO infusion with a 1600 mcg/mL solution. Start infusion at 2-5 mcg/kg/min and increase gradually by 5 mcg/kg/min until desired effect is achieved. Do not exceed 20 mcg/kg/min
This drug is a catecholamine/ sympathomimetic, and is an agonist to alpha and beta adrenergic receptors causing increased chronotrophy, ionotrophy, dromotrophy, bronchodilation, and peripheral vasoconstriction.
Indications for this drug include cardiac arrest. Moderate and severe allergic reactions. Severe refractory wheezing. Pediatric bradycardia with cardiopulmonary compromise.
Epinephrine indications
Adult dose of Epinephrine in cardiac arrest
1 mg IV/IO of 1:10,000 every 3-5 minutes or 2-2.5 mg 1:10,000 ET every 3-5 minutes
Adult dose of Epinephrine in moderate allergic reaction/ refractory wheezing
0.3 mg IM/SC of 1:1000
Adult dose of Epinephrine in major allergic reactions
0.3 mg 1:10,000 IV/IO push repeat every 5 minutes as needed
This drug is and antidysrhythmic/ anesthetic that suppresses automaticity in the His-Purkinje system and elevates electrical stimulation threshold of the ventricles during diastole. In increased serum concentrations, this drug also has anticonvulsant, sedative, and analgesic effects.
This drug's use is indicated to convert ventricular fibrillation and ventricular tachycardia. To control malignant PVC's.
Lidocaine indications
This drug is contraindicated in patients with bradycardia
Lidoaine contraindications
Adult initial dose of Lidocaine
Initial dose of 1.5 mg/kg IV/IO
Adult second dose of Lidocaine
0.75 mg/kg IV/IO every 3-5 min as needed to a maximum dose 3 mg/kg
Maintenance infusion dose of lidocaine
2-4 mg/min
Decrease maintenance dose of this drug by 50% if patient is in CHF, is > 70 years old, is in shock, or has liver disease
Lidocaine Special Considerations
This electrolyte acts a physiologic calcium channel blocker and blocks neuromuscular transmission by reducing Ach release at the neuromuscular junction.
Magnesium Sulfate
Adulst dose of magnesium in cardiac arrest with Torsades de Pointes:
2 grams in 250 mL IV/IO
Calcium chloride or calcium gluconate should be available as an antidote to this drug due to toxicity
Magnesium special considerations
Narcotic analgesic and opiate agonist that causes analgesia and sedation. This drug increases venous capacitance, decreases venous blood return (reduces preload), and reduces systemic vascular resistance at the arteriolar level (reduces afterload) which may lead to decreases in myocardial oxygen demand.
Peak effect of action in this drug, when given IV, is 10 minutes with a duration of 3-5 hours.
Adult dose of NTG
0.4 mg SL, may repeat twice every 5 minutes until relief of chest pain
This drug is essential for the functional integrity of nervous, muscular, and skeletal systems and cell membrane and capillary permeability. It is also an important activator in many enzymatic reactions and is essential to a number of physiological processes including transmission of nerve impulses, contraction of cardiac, smooth, and skeletal muscles
Calcium Chloride
Adult dose of Calcium Chloride
1 gram (10 cc of 10% solution) slow IV push
Dialysis patients in cardiac arrest should be considered to be hyperkalemic and receive
Calcium chloride.
This drug is a polypeptide hormone extracted from animal posterior pituitaries. It possesses pressor and antidiuretic properties. In high doses acts as a non-adrenergic vasoconstrictor that acts by direct stimulation of smooth muscle receptors.
Adult dose of vasopressin
40 Units IV/IO one dose only
To treat metabolic acidosis in aspirin overdose, tricyclic antidepressant overdose, cocaine overdose and prolonged cardiac arrest resuscitation.
Sodium Bicarbonate
Adult dose of Sodium Bicarbonate
1 mEq/kg IV/IO
Rapid acting potent sulfonamide loop diuretic that inhibits the reabsorption of sodium and chloride in the Loop of Henle. This drug also causes rapid venous dilation.
The Brain Trauma Foundation has established three criteria for traumatic brain injury patients before:
hyperventilation is appropriate
Which drug would NOT terminate status epilepticus in any setting?
Abnormal, slow writhing movements are known as
sustained muscle contractions cause twisting and repetitive movements or abnormal postures
A blockage of which cerebral arteries would be the most catastrophic?
A disease of which nerve causes severe recurrent pain in the face and forehead?
CVA's that occur as a result of long-term arteriosclerosis and progressive narrowing of the cerebral arteries where a blood clot develops within a cerebral artery or one of the smaller branches are classified as:
thrombotic strokes
Which of the following is a demyelination disorder of CN VII?
Bell's palsey
Which of the following is the middle layer of the meninges?
arachnoid mater
"Sleep starts" is called:
The midbrain is also known as the:
A patient exhibiting involuntary flexion is positive for:
decorticate posturing
An abnormal movement characterized by irregular, unpredictable, involuntary muscle jerks that impair voluntary activity is called:
Which of the following expressions regarding cerebral perfusion pressure is most accurate?
Involuntary muscle twitching is called:
Which letter in the memory aid "AEIOUTIPS" is associated with a patient unconscious from kidney failure?
Which types of neuroglia forms myelin?
Which of the following types of seizures is characterized by a loss of interaction, staring off into space, and returning to normal with no memory of the event?
absence seizures
What is CN-VIII called
Your 67 year old patient is experiencing slurred speech and notable left side weakness. Her vital signs are: BP-226/112; P-64; RR-16 with a room air SpO2 of 95%. Of the following, which is NOT a goal of the management of this patient?

A. maintain oxygenation
B. early notification and transport to a facility capable of managing stroke patients
C. correct any hypoglycemia
D. reduction of blood pressure
reduction of blood pressure
The hypothalamus regulates
body temperature, water and electrolyte balance, hunger and body weight
Which of the following occurs MOST commonly in diabetics?

A. muscular dystrophy
B. spina bifida
C. periperal neuropathy
D. poliomyelitis
periperal neuropathy
Which of the following is a demyelinating disease?

A. spina bifida
B. Parkinson's Disease
C. Bell's palsy
D. multiple sclerosis
multiple sclerosis
A patient who opens his eyes to pain, has no verbal response, and withdraws from pain would have a GCS of:
If a patient has a CT scan that shows a dense, white area, then you would suspect that the patient has suffered:
an intraparenchymal hemorrhage
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
A 52-year-old female is in moderate distress, complaining of nausea and vomiting. She describes a 3-day history of upper right quadrant abdominal pain. You note that the patient's skin feels warm. She is also positive for Murphy's sign. She called EMS today when she developed nausea and vomiting. She denies any change of bowel habits and states she has a history of alcoholism. Of the following, which is the most likely cause of her clinical condition?
During the examination of an 18-year-old female patient complaining of abdominal pain, the patient denies
nausea, vomiting or diarrhea. She reports a constant, intense pain in her lower abdomen which started two hours ago. Which of the following is the MOST helpful to ask this patient?
When was your last menstral cycle?
Your 67 year old male patient is complaining of abdominal pain and weakness. His vital signs are: BP-72/P; HR-134; RR-28 with a SpO2 of 93% on room air. His 12 lead EKG reveals sinus tachycardia with no indication of acute MI. His skin is pale and diaphoretic. He has a history of hypertension, COPD, and lung cancer. Which of the following should an early consideration for this patient?
abdominal aortic aneurysm
The three types of abdominal pain are:
visceral, somatic, and referred
Your 23 year old female patient is complaining of intense abdominal pain. Her vital signs are: BP-72/P; HR-122; RR-28 with a room air SpO2 of 95%. There is no recent history of trauma. She has a medical history of tubal ligation surgery and asthma. Of the following, which do you suspect?
ectopic pregnancy
Your patient is a 67 year old male who complains of upper abdomninal pain, nausea, and weakness. In addition to oxygen and IV access, what is MOST important in the pre-hospital setting for this patient?
12-Lead EKG
Your 22 year old patient is complaining of left lower quadrant pain, fever, nausea, and hematochezia. Of the following, you would suspect:
In an elderly, bed-ridden patient with a broken hip, sudden chest pain and dyspnea should suggest:
Pulmonary emboli
________ is a severe, prolonged asthma attack that cannot be broken by repeated doses of bronchodilators.
Status asthmaticus
A barrel chest, pink skin coloring, and recent weight loss is characteristic of a patient suffering from -
Your patient is a 9-month-old infant in respiratory distress with grunting respirations of 50 per minute, nasal flaring, and intercostal retractions. He is pale, and you note scattered bilateral wheezing on auscultation of the lungs. The mother states that the child is healthy and up to date on all his immunizations. Which of the following conditions is most likely, based on this information?
Bacterial tracheitis
Rales, or crackles, may be auscultated in patients with which of the following conditions?
Congestive heart failure
Your patient has profound pulmonary edema, but has a normal blood pressure. No periphereal edema is noted. The patient is afebrile. Which of the following is the most likely cause?
Bronchial constriction is most associated with:
wheezing on expiration
________ is a drop in systolic blood pressure of more than 10 mmHg with inspiration.
Pulsus paradoxus
Which of the following is LEAST likely to be associated with an acute myocardial infarction?
Chest pain with inspiration
The thick middle tissue layer of the heart is the:
A patient's ECG shows a rhythm at a rate of 64, regular RR intervals, a PR interval of 0.24 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:
first-degree AV block.
Complications of myocardial infarction include all of the following EXCEPT:

A. pulmonary embolus.
B. heart failure.
C. hypotension.
D. dysrhythmia.
pulmonary embolus.
Release of acetylcholine at the neuroeffector junction of the autonomic nervous system results in a(n):
negative chronotropic effect.
What is LEAST likely to be associated with the pain of acute myocardial infarction?
Pain reproducible with palpation
What is the most common cause of sudden cardiac death?
Ventricular fibrillation
Which of the following is NOT a likely immediate cause of acute myocardial infarction?
The pressure in the left ventricle at the end of diastole is called:
Paroxysmal nocturnal dyspnea may indicate which disease process:
Heart failure, Respiratory infection, COPD
Which cause of chest pain is most likely to present with a severe ripping pain?
Aortic dissection
The most common cause of death resulting from myocardial infarction is:
A decrease in preload results in a(n):
decrease in cardiac output
The heart sound produced by closure of the AV valve is:
The mitral valve is also known as the ________ valve.
left atrioventricular
Which of the following occurs during depolarization of a cardiac cell?

A. Potassium moves into the cell.
B. The cell becomes negatively charged.
C. Sodium moves out of the cell.
D. The cell becomes relatively more positively charged.
The cell becomes relatively more positively charged.
Which of the following ECG findings may occur with unstable angina?

A. ST segment depression
B. Q wave formation
C. T wave elevation
D. U wave
ST segment depression
The amount of resistance that must be overcome by the left ventricle during systole is called:
Which of the following is not one of the three pillars of cardiac function as described in our text?
Stroke volume
The appearance of a pathological Q wave on an ECG indicates the presence of ________ tissu
Which of the following drugs is indicated for tachycardia that is narrow complexed and regular?
Cardiac ventricular distention just prior to contraction is directly correlated to stroke volume. This principle is called the:
Frank-Starling principle
Beck's triad is the three classic, clinical manifestations of :
cardiac tamponade
The blockage of a pulmonary artery that stops blood flow to a group of alveoli is called what?
Pulmonary embolism
Angina is due to the imbalance in:
Supply and demand for oxygenated blood
After defibrillating your patient in VF, you should:
immediately resume CPR
Dopamine is administered:
In an IV drip titrated to patient's BP
Atropine should not be given to treat:
second degree Type II block
A patient's ECG shows a a rate of 42, regular RR intervals, a PR interval of 0.16 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:
sinus bradycardia.
In the treatment of acute pulmonary edema or acute MI the best dosage and frequency of Morphine Sulfate is:
2 to 4mg every 5 minutes PRN
An elevation of the ST segment is associated with:
myocardial injury
A deficiency of blood supply to the heart to meet myocardial oxygen needs results in a condition called:
Myocardial ischemia
Which of the following drugs is used in treating Asystole?

A. Atropine
B. Epinephrine
C. Calcium Chloride
D. Lidocaine
Where do the left and right coronary arteries originate?
Aortic sinuses
A patient's ECG shows a rate of 64, regular RR intervals, a PR interval of 0.24 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:
first-degree AV block
While treating a patient for a suspected MI, You have already put the patient on O2, started an IV, Given Nitro, and morphine. You look at the cardiac monitor and notice Ventricular tachycardia. What should your next action be?
Check a pulse
Chest compressions on your pulseless patient should not be interrupted for a few seconds and only during:
Death secondary to myocardial infarction is MOST COMMONLY due to:
Which part of the pericardium covers the heart and is also known as the epicardium?
Visceral pericardium
The mitral valve is also known as:
left atrioventricular valve
Acute pulmonary edema can be caused by
acute CHF, MI, cardiogenic shock
Which of the following drugs is indicated for tachycardia that is narrow complexed and irregular?

A. Amiodorone
B. Atropine
C. Adenosine
D. Diltiazem
The atrium opens into the ventricle through the:
atrioventricular valve.
Which of the following can be determined by lead II cardiac monitoring?
Impulse conduction time
Which of the following is NOT a typical complication of thoracic aortic aneurysm?
C. Hypovolemic shock
Which of the following beta-blockers acts very rapidly and is, therefore, MOST appropriate in the treatment of hypertensive emergencies?
Your 74 year old patient has called you for back pain. He states that he has a tearing sensation in his back which started several hours ago. He has a history of hypertension, previous CVA, bundle branch block, hyperlipidemia, and CHF. His vital signs are: BP- 178/92; P- 68; RR-28 with an SpO2 of 96% on room air. He has not sustained any traumatic injuries. You note a pulse deficit on his left side and he displays no new neurological deficits. His 12-lead EKG shows a right BBB with no ectopi. What is MOST likely for this patient's present condition?
aortic dissection
A patient with an acutely red, swollen, and painful lower limb that is not associated with any trauma is indicative of:
While working on a critcal care transport unit, you recieve a medical order to administer nitroprusside to your 220 lbs patient at 5 mcg/kg/min over a ten minute period to your patient in hypertensive crisis. Your partner has mixed 50mg of nitroprusside in 250 mL of D5W. Using a microdrip set, what is the appropriate drip rate?
150 gtt/min
Which of the following in NOT indicated for a patient that is suspected of having an acute arterial occlusion of the left leg?

A. administration of morphine
B. elevate the left leg above the level of the heart
C. rapid transport
D. removal of compression hose on the left leg
elevate the left leg above the level of the heart
Which of the following medications is MOST effective in treating hypertensive emergencies by dilating both arterioles and veins?

A. nifedipine
B. propanolol
C. nitroprusside
D. nitroglycerine
One of the defining signs of malignant hypertension is papilledema. What does papilledema mean?
swelling of the optic disk
Your 59 year old male patient is complaining of right leg pain and weakness. He tells you that his right thigh aches often while he is resting and always when he tries to walk. His sympotms started about 12 hours prior to your arrival. You note pallor of his right leg compared to his left. He has a history of smoking, hypertension, diabetes, and hyperlipidemia. You suspect:
Chronic venous insufficiency often causes tissue inflammation which is called:
What effect does chronic hypertension have on the lumen of the vasculature?
causes chronic hypertrophy of vascular endothelium narrowing the lumen
Which of the following is NOT a major risk factor for DVT's?
atrial fibrillation
Intermittent claudication in the quadriceps from PAD is MOST similar in pathophisiology to:
angina from exertion
The main concern for a patient with a DVT is the likely development of which life-threatening complication?
Which of the following is NOT an identified risk factor for AAA?

A. hypertension
B. tobacco use
C. caffiene intake
D. family history
caffiene intake
Which of the following medications used to treat hypertension can cause cyanide toxicity?
An acute marked elevation in blood pressure WITHOUT end-organ damage is best described as
hypertensive urgency
The smooth muscle layer of the aorta is known as the:
tunica media
The localized reaction to the thrombosis of a superficial vein characterized by warmth, tenderness and occasionally induration is called:
The sound made by blood turblance in a partially occluded artery is called a(n):
Which of the following conditions creates a "false lumen" within the walls of the aorta?
aortic dissection
Arterial segments that are permantly dilated 1.5 times the diameter of the adjacent artery are called:
Which of the following is generally NOT associated with hypertensive emergencies?

A. damage to occular function
B. malignant nephrosclerosis
C. reduced proteninuria
D. damage to kidney function
reduced proteninuria
________ bind(s) and transport(s) carbon dioxide and oxygen.
Which propert of cardiac cells is best described as the ability to respond to an electrical stimulus?
Which valve separates the right atrium from the right ventricle?
The semilunar valves separate the heart from the:
aorta and pulmonary artery.
Freshly oxygenated blood is returned to the heart through the:
pulmonary veins.
The sinoatrial (SA) node is located where in the heart?
High in the right atrium
The ability of cardiac cells to transmit electrical impulses from cell to cell is referred to as the property of:
The regulation of the heart's rate of contraction is called:
chronotropic state.
Special receptors that sense changes of pressure within the vasculature are called:
Which receptors of the sympathetic nervous cause vasoconstriction when stimulated?
What are the three positively charged ions responsible for initiating and conducting electrical signals in the heart.
Sodium (Na+), Calcium (Ca2+), Potassium (K+)
The resting cell normally has a net negative charge with respect to the outside of the cell. What is this state called?
Polarized state
The circumflex coronary artery is a branch of which coronary artery?
Left coronary artery
How is cardiac output of the heart expressed?
Liters per minute
The inherent rate of the SA node is ________ beats per minute.
The inherent rate of the ventricle is ________ beats per minute.
What term is used to refer to the process of electrical discharge and the flow of electrical activity
In a cardiac cell the electrical charges are provided primarily by which two electrolytes
sodium and potassium
When stimulated, this branch of the nervous system will increase heart rate, AV conduction, and irritability.
These structures form branching networks and are barely the diameter of a single red blood cell.
When pressure increases, flow:
When resistance increases, flow:
The high resistance of the arterial system is called what?
Peripheral resistance
which movements of skeletal muscles near a vein compress it, helping push blood toward the heart.
_____ is the accumulation of fluid in the interstitial spaces.
Which nervous system adjusts cardiac output and peripheral resistance?
Which portion of the brain has the cardiac and vasomotor centers?
Medulla oblongata
Which reflex responds to changes in blood pressure
This is the network of blood vessels that carries blood to and from the rest of the body.
systemic circuit
Which chambers of the heart supply with the pulmonary circuit?
Right atrium, right ventricle
In what order do the heart chambers contract when the heart beats?
Atria then ventricles
Which connective tissue divides the thoracic cavity into two pleural cavities and encloses the heart?
Which part of the pericardium covers the heart and is also known as the epicardium?
Visceral pericardium
The muscular wall of the heart is called the what?
These are specialized sites that allow cardiac muscle cells to rapidly transmit electrical impulses
Intercalated discs
The atrium opens into the ventricle through the:
atrioventricular valve.
The right atrium receives blood from the head and neck via which vessel?
Superior vena cava
The flaps of the right atrioventricular, or tricuspid, valve are called what?
These are the connective tissue fibers that brace the flaps of the tricuspid valve
Chordae tendineae
The valve between the left atrium and left ventricle is the:
bicuspid or mitral valve
Where do the left and right coronary arteries originate?
Aortic sinuses
Where is blood pressure highest in the systemic circuit?
The right coronary artery supplies the:
right atrium and both ventricles.
The left coronary artery supplies the:
left ventricle, left atrium, and septum
What is another name for the conductive pathway between the AV node and the bundle branches?
Bundle of His
What is the contraction phase of the cardiac cycle called?
This is the amount of blood ejected by a ventricle during a single beat.
Stroke volume
The general rule of "more in equals more out," or the greater the amount of blood entering the ventricle, the greater the contraction, is referred to as the:
Frank-Starling principle.
In which leads will the QRS complex have a higher amplitude?
the precordial leads
Low voltage or abnormally small complexes are seen in
Obese patients
Characteristics of normal P waves include
Upright round and one P wave preceding each QRS complex.
Tall and symmetrically peaked P waves may be seen with
impulses that originate outside the SA node.
The PR intervals are not measurable in
atrial flutter.
The point at which the QRS complex meets the ST segment is called the
J point.
A double negative impulse immediately following the S wave is called
double S prime.
With atrial fibrillation the PR intervals are
The PR intervals get progressively longer in
2nd-degree AV heart block, Type I.
Normal P waves are those that
are rounded and upright
In leads I, II, aVF, and V2 through V6, the deflection of the P wave is characteristically
With 3rd-degree AV heart block the PR intervals are
If the ectopic impulse arises from the middle of the right atrium the P' wave is
less positive than one that originates from the upper-right atrium.
Shorter than normal PR intervals may be seen in
junctional escape rhythm.
P' waves that continuously change in appearance indicate that the
impulses are arising from different locations in the atria.
Premature beats that arise from the atria or internodal pathways produce P' waves that
may be obscured or buried in the T wave of the preceding beat.
The normal QRS complex has a duration of.
0.06 to 0.12 seconds.
When there are more P waves than QRS complexes it indicates that
the atria are firing so fast that not all the impulses can pass through the AV node and some are blocked.
An ECG tracing that is regular with an R to R interval of 15mm would have what rate?
Inverted P' waves occur when the
electrical impulse originates in or near the AV junction and travels upward into the atria causing retrograde depolarization.
A PR interval of less than 0.12 seconds indicates
a pacemaker site which is either in or close to the AV junction.
Which of the dysrhythmias arise from the ventricles?
Idioventricular, V-fib, V-tach,
With 2nd-degree AV heart block, Type II, the PR intervals associated with the P waves which are followed by a QRS complex will be
A positive impulse immediately following the R wave is called
R prime.
The first step of analyzing an ECG rhythm is to
determine the heart rate.
Impulses that arise from the ventricles produce QRS complexes that
appear wide and bizarre-looking.
The PR interval is normally ____ to ____ seconds in duration.
0.12, 0.20
The R wave
is the first positive deflection in the QRS complex.
The S wave in the QRS complex is
the negative deflection that follows the R wave and extends below the baseline.
A PR interval of greater than 0.20 seconds indicates
a delay in conduction of the impulse between the SA node and the ventricles.
Normal QRS complexes are those that
are upright and narrow.
When the P waves seem to "march through" the QRS complexes it indicates
a complete blockage of the AV node
The PR interval is the distance from the beginning of the __ to the beginning of the__.
P wave, Q wave
A complex that comes early in the rhythm that appears to be initiated from outside of the SA node:
Must be caused by ectopy
The most common cause of longer than normal PR intervals i
1st-degree AV heart block
When a P' wave follows the QRS complex the PR interval is referred to as the
RP' interval
This man, Napoleons chief surgeon, wrote the earliest recorded specifications for ambulances
Dr. Dominique-Jean Larrey
In the United States, the development of the ambulance and the first ambulance system occurred during which war
The Civil War
As a response to the disaster at Bull Run, this type of ambulance was designed.
The Rucker ambulance
The year that the white paper was published, and the Highway safety act was put in place.
The year 911 was designated as the national emergency telephone number
The year that the NREMT was founded
in 1865 this became the first ambulance service in america
Cincinnati General Hospital
This year marked the birth of the 'breath of life'
The father of resuscitation
Dr. Peter Safar
This is the first time trauma was officially recognized and classified as a disease process.
White Paper - 1966
Any substance (protein, bacteria, virus, etc.) that is capable of causing a disease
Primum non nocere
First do no harm
Defined legally as the behaviors expected of similarly trained, competent individuals within a profession
Standard of Care
For consent to be valid it must be
in what type of situation is it important to determine if the patient is both legally, and mentally competent.
Any refusal situation
The failure to act as a reasonably prudent and careful person would under similar circumstances
Placing a patient in a position where he fears for his safety or perceives you mean to cause him harm
The touching of or contact with another person without that persons consent
The confinement of a person against his or her will or without the persons consent
False Imprisonment
saying or publicizing something untrue about a person that tends to injure that persons character.
Verbal defamation
written defamation
What layer of the of the gastrointestinal (GI) system is made up of smooth muscle that contracts
progressively from the esophagus to the colon?
The spleen is located in the _______ quadrant.
left upper
The liver is located in the _______ quadrant.
right upper
The gallbladder is located in the _______ quadrant.
right upper
During the digestion process, where in the digestive tract is water absorbed?
The innermost portion of the gastrointestinal (GI) system is the:
The pyloric sphincter is located between the:
stomach and the duodenum.
The salivary glands include all EXCEPT the _______ gland.

A. parotid
B. dorsal
C. sublingual
D. submandibular
The esophagus is ______ to the trachea.
The stomach is located in the:
left upper quadrant.
What is the thick ring of smooth muscle between the stomach and the small intestine called?
Pyloric sphincter
Pepsin, which is an enzyme found in the stomach, is important in the initial breakdown of:
Hormones produced by the endocrine cells of the stomach and intestine have significant effects on
the motility of substances. Gastrin has what effect on stomach secretions and emptying?
The second portion of the small intestine after it leaves the stomach is the:
Peptidases break down:
The common bile duct and the hepatic duct drain into the opening of the duodenum at the:
ampulla of Vater.
The colon consists of how many portions?
What part of the large intestine extends upward from the cecum?
Ascending colon
The two circular sphincters of the anal canal are the:
internal and external.
The reservoir for bile, a digestive enzyme, is the:
Which of the following is NOT one of the functions of the liver?

A. Removal of red blood cells
B. Storage of glucose
C. Protein synthesis
D. Filtering body wastes from blood
Removal of red blood cells
What is made by the pancreas?
Insulin, Glucagon, Digestive enzymes
_______ is a pancreatic enzyme that digest proteins.
Which organ occupies the retroperitoneal space?
The parts of the peritoneum that hold the abdominal organs in place are called the:
The thoracic duct empties into the:
superior vena cava.
Lymphatic capillaries are present in which of the tissues?
Lymph is a thin plasma-like fluid formed, in part, from which of the following fluids?
Interstitial fluid
The lymphatic system is what type of circulatory system?
Lymphatic vessels carry fluid in what direction in relation to tissue?
Lymph vessels pass through at least how many lymph nodes before entering the bloodstream?
The spleen consists of two types of lymph tissue. The venous drainage of the spleen is what type
of pulp?
The thymus is a triangular gland located where?
A response to a given substance that is faster and stronger after subsequent exposures is called a
_______ response.
Of the five classes of antibodies, which makes up 80% to 85% of the total serum antibody?
Which type of specific immunity is achieved by actions of T lymphocytes (T cells)?
Cell-mediated immunity
The lay term for a lymph node is:
What term that is used to describe the spread of cancer to lymph nodes?
Which of the following is NOT a type of leukocyte that may play a role following infection of
various areas in the body?
The human immunodeficiency virus (HIV) adversely affects a protein on T helper cells called the:
CD4 antigen.
Tuberculosis (TB) is an infectious disease that is spread through what kind of transmission?
These are possible infectious agents?
Viruses, Bacteria, Fungi
T/F: A patient with a depressed immune system can be severely affected by exposure to a minimal infectious disease
Eventually, the lymphatic vessels empty into the:
left and right subclavian veins.
Lymphatic capillaries are present in all tissues EXCEPT which system?
Central nervous system
What kind of boundary does diffuse lymphatic tissue share with surrounding tissues?
No clear boundary
Lymph nodules are NOT found in the loose connective tissues of which system?
What is the inflammation of lymph nodes that is caused by infection called?
A nonspecific response is an immune response that is _______ each time the body is exposed to
a particular challenge.
Which of the following does NOT help continuously wash away foreign matter?

Synovial fluid
Synovial fluid
Which lobe plays an important role in hearing and memory and is separated from the rest of the
cerebrum by a lateral fissure?
The V cranial nerve supplies sensation to the scalp, forehead, face, and lower jaw via three
branches and provides motor innervation to the muscles of the throat and inner ear; this nerve
ear is also called the _______ nerve.
The nervous system is divided into a number of systems. Name them.
Central (Autonomic (sympathetic, parasympathetic) and peripheral
You respond to a patient in a nursing home, and while getting a SAMPLE history you are told
about a subarachnoid hemorrhage that occurred a few years before. Where did that hemorrhage
Between the arachnoid and pia mater
The dispatcher informs you that you have call for respiratory distress. While responding, you
receive a radio report from a first responder on the scene giving you patient information. The
report includes that the patient is a smoker with a history of COPD. Based on the pathophysiology
of this disease, which other piece of information is MOST likely to be included in the first
responder's radio report?
Symptoms increased gradually over days
You respond to a report of a 14-year-old female patient who is reported having difficulty
breathing. Upon arrival you find that she is having difficulty breathing, and her mother tells you
that the girl has asthma. You consider which events occur with an asthma attack in order to
develop a plan of treatment. Which would you NOT expect with an asthma attack?
Decreased secretion of mucous
Each respiratory bronchiole divides to form:
alveolar ducts.
The inferior portion of the midbrain coordinates heart rate, blood vessel diameter, swallowing,
vomiting, and coughing and is called the:
You are treating a 24 year old male who has fallen from a height of 20 feet onto concrete. The
patient is unresponsive with an intact gag reflex. The only sign of trauma is a depression in the
occipital region. His vital signs are: BP 190/92, P 62, R 12 with an SpO2 of 97% on room air. You
note that his pupils are 5mm and sluggish. You should
maintain the patient's blood pressure.
Which adrenergic receptor effects occur in the peripheral blood vessels, causing vasoconstrictions?
A patient with black lung disease and asbestosis may demonstrate a significant decrease in vital
capacity, indicating:
restrictive lung disease.
The process of moving air in and out of lungs is called:
Electrical impulses travel down the nerve and trigger the release of chemicals known as:
The vocal cords are formed by two pairs of:
Numerous folds greatly increase the surface area of the cortex. These folds are called:
The trachea is approximately how many inches long in most adults?
Cerebral spinal fluid is manufactured in what part of the brain?
Bundles of myelinated nerves are referred to as:
white matter.
Neuroglia cells have a number of basic functions, except...
Facilitate electrical impulses through neurons
Vestibular folds are also called:
false vocal cords.
This type of cell protects cell membranes of neurons, regulate composition of interstitial fluid, and defend neural tissue from pathogens.
Neuroglia cells
How a drug is transported into, inside, and out of the body absorbed, distributed metabolized (biotransformed and excreted
How drug interacts with body to cause its effects
rules & standards of members of a particular group or profession
What are the 4 elements of Negligence
Duty to act
Breach of Duty
Actual Damage
Proximate cause
Ankle bone means
the bone that forms the outer ankle
Lateral malleolus
The term for normal unequal pupils in a small % of people
Name for the discoloration around the umbilical area That indicates an intra abdominal bleed
Cullens Sign
The name for the discoloration around flank indicationg abdominal hemorrhage
Grey turners sign
The body's response due to cerebral ischemia increase in systemic BP, which maintains cerebral perfusion during IICP
Cushings reflex
Increased BP, erratic respiration, bradycardia
Cushings Triad
JVD, distant heart tones, Hypotesion
Becks Triad
Blood vessel that connects the pulmonary trunk to the aorta in the fetus.
Ductus Arteriosus
Fetal blood vessel that connects the umbilical vein and the inferior vena cava.
Ductus Venosus
The opening in the interatrial septum in a fetal heart.
Foramen Ovale
Excessive urination
Age-related hearing loss.
Causes infant to turn the head toward anything that brushes the face.
Rooting reflex
Occurs when a newborn is startled by a noise or sudden movement, the infant reacts by flinging the arms and legs outward and extending the head.
Moro reflex
When the infants palm is touched and whe an object is placed across the palm. the infants hands grip tightly.
Palmar Reflex
When the sole of the infant's foot is stroked on the outside from the heel to the toe, the infant's toes fan out an curl and the foot twists inward.
Babinski reflex
When the infant is held so that the feet are flat on a surface, the infant will lift one foot after another in a stepping motion.
Stepping reflex
A range of radio frequencies.
A radio system that allows transmitting and receiving at the same time through two different frequencies.
Describes a radio system that can use the components of several different systems; it can use specialized equipment to connect several different radio systems and components together and have them communicate with each other.
A system that allows the crew to transmit voice and data at the same time, enabling the crew to call in a patient report while transmitting an ECG strip to the hospital.
A system that receives transmissions from a low-wattage radio and rebroadcasts the signal at a higher wattage to the dispatch center.
A system that allows only one at a time communication. The transmission cannot be interrupted; both operators use the same frequency.
A system that uses multiple repeaters (five or more) so that the computer can search for an open channel to transmit by.
Trunking system
Paramedics are at an elementary school where a child has sustained minor injuries, and the school nurse insists on sending the child to the emergency department. What type of consent is this?
Parens Patriae
This organelle within the cell transports material through the cytoplasm
Endoplasmic Reticulum
This organelle within the cell converts energy and nutrients to ATP
infant RR
Toddler RR
24 - 60
preschooler RR
22 - 34
School age RR
18 - 30
Adolescent RR
12 - 16
Adult RR
12 - 20
sa node stimulates
atrium and av node
av node leads to the?
bundle of His
ECG tells you nothing about...
whether the heart is pumping properly.
sa node rate =
60 - 100
av node rate =
40 - 60
r on t phenomenon
ventricular depolarization falling somewhere within a T wave. Can result in v-tach or v-fib.
This is where the renal artery enters, and the renal vein and ureter emerge
The Hilus of the kidney
The renal vein returns blood to where?
Inferior vena cava
The nephrons are located where in the tissue of the kidneys?
The outer tissue (renal cortex)
What is the name for the inner tissue layer of the kidneys?
Renal Medulla
The functional unit of the kidney is_______?
Nephron, each kidney has about 1 million of these
The expanded end of a renal tubule is called?
Bowman's capsule
At what systolic BP do the kidneys start to fail?
Around <60 or lower
What does Angiotensin do?
It "squeezes" the tank to increase pressure, keeps the fluids in the body
What does Renin do in the renal system?
It initiates the renin-angiotensin to raise the blood pressure, the end product being angotensin II
Purpose of ADH?
It allows the distal convoluted tubules and collecting tubules to reabsorb more water from the filtrate. Helps maintain body volume and BP
Dose for Activated Charcoal
1 gram/kg PO
What is a highly specific protein produced by the body in response to foreign substances?
A symptomatic infection caused by the Epstein-Barr Virus.
Infectious Mononucleosis
What does the upper respiratory tract consist of?
Nose, nasal cavity, pharynx, larynx, and upper trachea
What does the lower respiratory tract consist of?
Lower trachea and the lungs, which include the bronchial tubes and alveoli
How many lobes of lungs are there?
3 right, 2 left
The base of each lung rests on what?
The diaphragm
where the primary bronchus, pulmonary artery and veins enter the lung
The Hilus
This lines the chest wall
Parietal pleura
This covers the lungs
Visceral pleura
What does serous fluid do?
Prevents friction and keeps the two membranes together during breathing
The respiratory centers are located in?
Medulla and pons
During inhalation, the diaphragm does what?
Contract, which takes energy
Amount of air involved in one normal inhalation and exhalation
Tidal Volume
Amount of air inhaled and exhaled in 1 minute. (TV)(RR)
Minute respiratory volume
Amount of air, beyond tidal volume, that can be taken in with the deepest possible inhalation
Inspiratory reserve
Amount of air that can be expelled with the most forceful exhalation
Expiratory reserve
Sum of tidal volume, inspiratory reserve, and expiratory reserve
Vital capacity
Amount of air that remains in the lungs after the most forceful exhalation; exchange of gases is a continuous process
Residual air
Most carbon dioxide is carried in the form of what?
Bicarbonate ions
Carbon dioxide and water mix to form what?
Carbonic acid (CO2 + H2O = H2CO3)
Excess CO2, results in formation of more H+ ions, which decreases pH
Respiratory acidosis
Decrease CO2, results in less H+ ions, which increases pH
Respiratory alkalosis
Increased H+ ions, need to exhale more CO2 to decrease and raise pH to normal
Metabolic acidosis
H+ decreased, decrease in respiration to retain CO2
Metabolic alkalosis
scraping or abrading away of the superficial layers of the skin; an open soft-tissue injury
condition in which the placenta separates from the uterine wall
abruptio placentae
type of generalized seizure with sudden onset, characterized by a brief loss of awareness and rapid recovery
absence seizure
period of the cardiac cycle when stimulation will not produce any depolarization whatsoever
absolute refractory period
enzyme that stops the action of acetylcholine
a substance that liberates hydrogen ions (H+) when in solution
high concentration of hydrogen ions; a pH below 7.35
cyanosis of the extremities
acquired immunity that occurs following exposure to an antigen and results in the production of antibodies specific to the antigen
active immunity
movement of a body part toward the midline
force of attraction between a drug and a receptor
the resistance against which the the heart must pump
drug that binds to a receptor and causes it to initiate the expected response
a substance that liberates hydroxyl ions (OH-) when in solution; a strong base
low concentration of hydrogen ions; a pH above 7.45
an exaggerated response by the immune system of a foreign substance
allergic reaction
absence of the sensation of pain
communication between two or more vessels
absence of all sensations
medication that induced a loss of sensation to touch or pain
ion with a negative charge
drug that binds to a receptor but does not cause it to initiate the expected response
a marker on the surface of a cell that identifies it as "self" or "non-self" and that is capable, under appropriate conditions, of inducing a specific immune response
breathing characterized by a prolonged inspiration unrelieved by expiration attempts, seen in patients with damage to the upper part of the pons
apneustic respiration
response in which an injured cell releases enzymes that engulf and destroy itself; one way the body rids itself of damaged and dead cells
clear fluid filling the anterior chamber of the eye
aqueous humor
alveolar (lung) collapse
forceful tearing away or separation of body tissue; an avulsion may be partial or complete
application of the forces of trauma along the axis of the spine; this often results in compression fractures of the spine
axial loading
amount of a drug that is still active after it reaches its target tissue
relative therapeutic effectiveness of chemically equivalent drugs
What is another name for sensory neurons? And what is their purpose?
Afferent neurons. Carry impulses from receptors to the CNS
What is another name for motor neurons? And what is their purpose?
Efferent neurons. Carry impulses from CNS to effectors
Where are somatic sensory neurons found?
Skin, skeletal muscles, and joints
Visceral sensory neurons are found?
internal organs
Somatic motor is linked to...
Skeletal muscle
Visceral motor is linked to.
smooth muscle, cardiac muscles, and glands
'C3-C5 keeps the ______ alive?"
"Horses tail", group of nerves that hang below the cord
cauda equina
Located between the spinal cord and the pons. Control of vital signs and reflex center is located here as well. Coughing, sneezing, vomit, swallowing
This part of the brain is responsible for respiratory control of rhythms and patterns, it tries to compensate for medulla
This part of the brain is responsible for visual/auditory reflexes (hearing a bee) and equilibrium/balance (keeping upright)
responsible for muscle tone, voluntary movement, stopping movements, and equilibrium
Related to loss of circulating blood volume; the most common type of shock
hypovolemic shock
Related to abnormality in vascular tone arising from several different scenarios
distributive shock (vasogenic)
Interference with the pump action of the heart
cardiogenic shock
What other types of shock are included into Distributive?
Neurogenic, psychogenic, septic, and anaphylactic
What does the heart do during hypovolemic shock?
It increases cardiac output by increasing strength and rate of contractions caused by the release of epi
What are the skin signs in association to neurogenic shock?
warm, dry, and pink
In Septic shock, what is released in response to the infection?
Cytokines, which cause damage to the walls of the blood vessels, vasodilation, and leakage of fluid from capillaries
Vomiting blood
Blood in Urine
What are neurons that carry impulses from the CNS to the body?
motor / efferent
What are neurons that carry impulses from the PNS to the CNS?
sensory / afferent
S.V. x H.R. x P.V.R = ?
Blood Pressure
H.R x S.V. = ?
Cardiac Output
Bones are connected to the muscles by?
ligaments connect what?
bone to bone
the strength of contraction in the heart
The "Lub-dub" sound we hear from the heart is caused by what?
the closing of the heart valves
What hormone is indirectly responsible for increasing Blood Pressure due to the absorbing of sodium?
What hormone is directly responsible for increasing Blood Pressure due to the increase absorption of water in the kidneys?
alpha cells produce
beta cells produce
around the bone
What is age limit for a cuffed ET-Tube?
8 years old
What is the normal percentage of expired oxygen?
What is the percentage of inspired oxygen?
The ______________ branch of the autonomic nervous system innervates all three pacemaker sites and the working cells of the heart.
The right atrium receives blood from these two vessels
The superior and the inferior venae cavae
The name of the valve between the right atrium and the right ventricle.
tricuspid valve
The blood from the right ventricle travels through what valve before going into the pulmonary artery?
pulmonary valve
The name of the only artery in the body that carries deoxygenated blood.
Pulmonary artery
After the blood is oxygenated in the alveoli of the lungs, it returns to the left atrium via the...
pulmonary vein
The blood in the left atrium is ejected through this valve into the left ventricle.
mitral valve
Another name for the mitral valve
The blood is ejected from the left ventricle into the aorta through what valve?
aortic valve
The ability of the cells within the cardiac conduction system to generate a cardiac impulse on their own
A fibrinous clot formed in a blood vessel or in a chamber of the heart.
Disc-shaped elements that are fragments of cells from the bone marrow.
A protein responsible for activating the formation of a clot.
Strands that are responsible for making the clot stronger.
The period during the normal beating of the heart in which the chambers of the heart, especially the ventricles, contract to force blood into the aorta and pulmonary artery.
The space between the P wave and the QRS is referred to as what?
the PR interval
What does the PRI represent?
the time it takes the heart's electrical impulse to travel from the atria to the ventricles
Term used to refer to death of tissue
Front side of body
back of the body
Imaginary line drawn vertically from middle of the forehead through the umbilicus floor
Referring to the middle of the clavicle parallel to the midline
Referring to middle of armpit parallel to the midline
Towards the head of the body
Towards the feet
Structures closer to the trunk
Structures further from the trunk
Towards middle
Towards the outside
Belly side of the body
Spinal side of the body
The palms
The soles of the feet
Tip of a structure
Both sides
One side
Refers to the same side of the body
bending of a joint
Straightning of a joint
Moving towards midline
moving away from midline
the bones that lead to the toes. Also called phalanges
Bones in the wrist
Bones in the hand leading to the phalanges
The RUQ contains:
Liver, gallbladder, bile duct, colon, pancreas
LUQ contains
Stomach, spleen, pancreas, colon
RLQ contains:
Cecum, small intestines, appendix
LLQ contains:
a rigid stretcher commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom. Also called a stokes litter
basket stretcher
A carrying technique in which one emt is located at the head end, one at the foot end, and one at each side of the patient; all face forward as they walk
Diamond Carry
a lifting technique used for the patients who are found lying supine on the ground with no suspected spinal injury
Direct ground lift
a move in which the patient is dragged or pulled from a dangerous scene before initial assesment and care are provided.
Emergency move
a lifting technique for patients who are supine or in a sitting position with no suspected extremity or spinal injuries
Extremity lift
A stretcher that is a rigid carrying device when secured around a patient but can be folded or rolled when not in use.
Flexible stretcher
a stretcher with a strong rectangular tubular metal frame and rigid fabric stretched across it
Portable stretcher
The back board is gripped by inserting each hand inder the handle with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and thumb
Power Grip
A lifting technique in which the EMT's back is held upright, with legs bent, and the patient is lifted whtn the EMT straightens the legs to raise the upper body and arms
Power lift
A technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than one minute whrn conditions do not allow for standard immobilization
Rapid Extracation technique
a stretcher that is designed to be split into two or four sections that can be fitted around a patient who is lying on the ground; also called a split stretcher
Scoop Stretcher
a lightweight folding device that is used to safely move patients up or down stairs.
Stair chair
a specially designed stretcher that can be rolled along the ground. A collapsible under carriage allows it to be loaded into the ambulance. also called and ambulance cot.
Wheeled Ambulance stretcher
Fixed-wing aircraft and helicopters that have been modified for medical care; used to evacuate and transport patients with life threatening injuries to treatment facilities
Air ambulance
A specialized vehicle for treating and transporting sick and injured patients
The designated area in a hazardous materials incident where all patients and rescuers must be decontaminated before going to another area
Decontamination area
Medical evacuation of a patient by helicopter
Complicated entry that requires special tools and training and includes breaking windows or using other force.
Complex access
An area where individuals can be exposed to electrical hazards such as sharp metal edges, broken glass, toxic substances, lethal rays, or ignition or explosion of hazardous materials. OR The area immediately surrounding a HazMat site that is directly dangerous to life and health
Danger (hot) Zone
Removal of a patient from entrapment or a dangerous situation or position, such as removal wrecked vehicle, industrial accident, or building collapse.
Any substances that re toxic, poisonous, radioactive, flammable, or explosive and cause injury or death with exposure
Hazardous materials
Incident Commander (IC)
The individual who has overall command of the incident in the field
Incident Commander (IC)
An area of protection providing safety from the danger (hot) zone
Safe zone
A hostage, robbery or other situation in which armed conflict is threatened or shots have been fired and the threat of violence remains
Tactical Situation
A team of individuals from one or more departments in a region who are trained and on call for certain types of technical rescue
Technical rescue group
A rescue that requires special technical skills and equipment in one of many specialized rescue areas, such as technical rope rescue, cave rescue and dive rescue.
Technical rescue situation
An area set up by physicians, nurses, and other hospital staff near a major disaster scene where patients can receive further triage and medical care.
Casualty collection area
a safe area at a hazardous materials incident for the agencies involved in the operations. The incident commander, command post, EMS providers, and other support functions necessary to control the incident should be located in the cold zone, also referred to as the clean zone or the support zone.
Cold Zone
In incident command, the position that oversees the incident, establishes the objectives and priorities, and from there develops a response plan.
The designated field command center where the incident commander and support personnel are located
Command Post
the process of direction responders to return to their facilities when work at a disaster or Mass-casulity incident has finished, at least for those particular responders
rA widespread event that disrupts community resources and functions, in turn threatening public safety, citizens' lives and property
barrel-like containers used to store a wide variety of substances, including food-grade materials, corrosives, flammable liquids, and grease
A preliminary action guide for first responders operating at a hazardous materials incident in coordination with the US Dept. of Transportation's labels and placards marking system
Emergency Response Guidebook
In incident command, the person appointed to determine the type of equipment and resources needed for a situation involving extrication or special rescue; also called rescue officer
Extrication supervisor
In incident command, the position in an incident responsible for accounting all expenditures
When individual units or different organizations make independent and often inefficient decisions about the next appropriate action
An incident in which a hazardous material is no longer properly contained and isolated
Hazardous materials (HazMat) Incident
An oral or written plan stating general objectives reflectin the overall strategy for managing an incident
Incident Action Plan
A system implemented to manage disasters and Mass casualty incidents in which section chiefs, including finance, logistics, operations, and planning, report to the incident commander
Incident command system (ICS)
Shipping and storage vessels that can be either pressurized or not pressurized
Intermodal tanks
An area designated by the IC, or a designee, in which public information officers from multiple agencies disseminate information about the incident
Joint information center
A sorting system for pediatric patients younger than 8 years or weighing less than 100 lb. There is a minor adaptation for infants since then cannot walk on their own.
JumpSTART triage
In Incident command, the person who relays information, concerns, and requests among the responding agencies
Liaison officer
In incident command, The position that helps procure and stockpile equipment and supplies during an incident
An emergency situation involving three or more patients or that can place great demand on the equipment or personnel of the EMS system or has the potential to produce multiple casualties.
Mass-casualty Incident (MCI)
A form, provided by manufacturers and compounders of chemicals containing information about chemical composition, physical and chemical properties, health and safety hazards, emergency response, and waste disposal of a specific material
Material safety data sheet (MSDS)
A branch of operations in a unified command system, whose three designated sector positions are triage, treatment, and transport
Medical incident command
In IC, the person who works with area medical examiners, coroners, and law enforcement agencies to coordinate the disposition of dead victims
Morgue supervisor
An agreement between neighboring EMS systems to respond to MCIs or disasters in each other's region when local resources are insufficient to handle the response
Mutual aid response
A department of Homeland Security system designed to enable federal, state, and local governments and private sector and nongovernmental organizations to effectively and efficiently prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size or complexity, including acts of catastrophic terrorism
National Incident Management System (NIMS)
In IC, the position that carries out the orders of the commander to help resolve the incident
Measures of the amount and type of protective equipment than an individual needs to avoid injury during contact with a hazardous material
Personal Protective Equipment (PPE) levels
Signage required to be placed on all four sides of highway transport vehicles. The sign identifies the hazardous contents of the vehicle
In IC, the position that ultimately produces a plan to resolve any incident
A type of patient sorting used to rapidly categoryize patients; the focus is on speed in locating all patients and dertermining an initial priority as their conditions warrant.
Primary triage
In IC, ther person who keeps the public informed and relates any information to the press.
Public information officer (PIO)
the area that provides protection and treatment to fire fighters and other personnnel working an emergency. Here, workers are medically monitored and receive any needed care as they enter and leave the scene.
rehabilitation area
in IC, the person who establishes an area that provides protection for responders from the elements and the situation.
rehabilitation supervisor
In IC, the person who gives the "go ahead" to a plan or who may stop an operation when rescuer safety is an issie.
Safety officer
An engineered method to control spilled or released product if the main containment vessel fails.
Secondary containment
A type of patient sorting used in the treatment sector that involves retriage of patients.
Secondary triage
single command system A command system in which one person is in charge, generally used with small incidents that involve only one responding agency or one jurisdiction.
single command system
In IC, the subordinate positions under the commander's direction to which the workload is distributed; supervisor/worker ratio
Span of control
In IC, the person who locates an area to stage equpiment and personnel and tracks unit arrivial and deployment from the staging area
Staging supervisor
patient sorting process limited to assessing the patients ability to walk, respitory status, hemodynamic status, and neurologic status --Simple Triage And Rapid Treatment
START triage
The end of the incident command structure when an incident draws to a close
termination of command
Measures the risk that a hazardous material poses to the health of an individual who comes into contact with it
Toxicity levels
The area in an MCI where ambulances and crew are organized to transport patients from the treatment area to receiving hospitals
transportation area
The individual in charge of the transportation sector in a MCI who assigns patients from the treatment area to awaiting ambulances in the trasnport area.
Transportation supervisor
The individual usually a physician, who is in charge of and directs EMS personnel at the treatment area in a MCI
Treatment supervisor
The process of sorting patients based on the severity of injury and medical need to establish treatment and transportation priorities
The individual in charge of the incident commandtriage sector who directs the sorting of patients into triage categories in a MCI
Triage supervisor
A command system used in larger incidents in which there is a multiagency responce or multiple juridictions are involved
Unified command system
the area locates betwwn the hot zone and the cold zone at a HazMat incident. The decontamination corridor is located in the warm zone.
warm zone
A type of energy that is emitted from a strong radiologic source; is slightly more penetrating that alpha and requires a layer of clothing to stop it.
Severe(RED)- Severe Risk, High(ORANGE)- High Risk, Elevated(Yellow)- Significant Risk, Guarded(BLUE)-General Risk, Low(GREEN)- Low Risk
Terrorist threat levels
A type of energy that is emitted from a strong radiologic source; it is the least harmful penetration type of radiation cannot travel fast or through most objects.
A disease caused by deadly bacteria that lay dormant in a spore. The germ is released from the spore when explodes to the optimal temperature and moisture.
The process by which the temporary bond between the organophosphate and acetylcholinestrarase undergoes hydrolysis, resulting in a permanent covalent bond.
What term is used to describe the condition in which blood accumulates in the pleural space
A hemothorax occurs when blood accumulates in the pleural space
3 effects of intracranial pressure on vital signs
bradycardia, irregular breathing, hypertension
___ ___ is part of a syndrome called chronic obstructive pulmonary disease (COPD)
chronic bronchitis
___ ___ is usually caused by viruses or bacteria and may last several days or weeks.
Acute bronchitis
a group of diseases characterized by the pathological limitation of airflow in the airway that is not fully reversible.
A late sign of shock is:
decreased blood pressure
A PASG is contraindicated if the patient presents with cardiogenic shock or _______.
abnormal lung sounds
a policy or protocol issued by a medical director that authorizes EMTs to perform particular skills in certain situations
standing orders
A sign of breathing difficulty in children is a decrease in ___ ___.
pulse rate
A sudden loss of _______ of blood is considered serious in an average adult.
A thrombus which has broken loose, moving with blood flow, is called
an embolism
A weakened section of an arterial wall that begins to dilate is known as a(n)
Activated Charcoal: Contraindications
Poor LOC, vomiting
Activated Charcoal: Dosage
1 g/kg of body weight, adults usually 25-50g, children 12.5-25g
Activated Charcoal: Side Effects
Constipation, nausea, vomiting, bowel obstruction
After delivering your first shock with an AED, the patient is still pulseless, you should next
perform two minutes or 5 cycles of CPR
Albuterol: Action
Albuterol: Contraindications
Albuterol: Dose
2.5 mg nebulized with 2.5 mL saline (for a total of 3mL)
Albuterol: Indications
Acute bronchospasm due to asthma or COPD
Albuterol: Side effects
Headache, tachycardia, hypertension
An infant or child patient who exhibits wheezing, increased breathing effort on exhalation, or rapid breathing without stridor probably has:
A lower-airway disease
an inflammation of the bronchi (medium-size airways) in the lungs
ASA: Action
Impedes blood clotting
ASA: Contraindications
allergy, bleeding disorder, already taken 324mg
ASA: Dosage
324mg (81mg x 4)
Atrovent: Action
Atrovent: Contraindications
Allergy to drug, soybeans, peanuts, glaucoma
Atrovent: Dose
0.5 mg nebulized w/ 2.5 mL saline (3mL total)
Atrovent: Side Effects
Dry mouth, headache, gastrointestinal distress
caused by loss of elasticity of the lung tissue, from destruction of structures supporting the alveoli, and destruction of capillaries feeding the alveoli.
Chaotic electrical activity originating from many sites in the heart is called:
Ventricular fibrillation
Emphysema, chronic bronchitis, and many undetermined respiratory illnesses are classified as
Epinephrine: Action
vasoconstriction, bronchodilation
Epinephrine: Contraindications
Glaucoma, shock other than anaphylactic, diabetes, cardiac problems, hypertension, pregnancy, meds include a beta blocker or MAOI
Epinephrine: Dosage for allergic reactions.
Epi-Pen = 0.3mg, Epi-Pen Jr = 0.15mg (for <60 lbs)
Epinephrine: Side Effects
Headache, palpitations, hypertension, tachycardia
Flow rates for nasal cannula
1-6 L/min
Flow rates for NRB
12-15 L/min
Full dilation of the cervix occurs in the _______ stage of labor.
Glucagon: Action
increases blood glucose by stimulating liver to release stored glycogen
Glucagon: Contraindications
allergy, hx of pheochromocytoma (tumor which secretes epinephrine)
Glucagon: Dosage
1.0 mg for >44lbs, 0.5 mg for <44lbs, repeat in 20 min if no response
Glucagon: Side Effects
hypotension, nausea, vomiting, respiratory distress
Blood sugar less than 60
If a patient is eight months pregnant, how much blood can she potentially lose before exhibiting signs of shock?
If the patient is not defibrillated within _______ minutes of a cardiac arrest, there is almost no chance for survival.
In an adult, a systolic BP of __ or less is hypotensive
In patients > 1 y/o, the 1st pulse you check
In the condition called ____, there is not electrical stimulus to cause the heart muscle to contract.
Lung sounds that resemble low-pitched snoring or rattling are called
Normal breathing rate for adults
Normal breathing rate for children
Normal breathing rate for infants
Normal diastolic BP in adults
60 to 90
Normal pulse rate for an adult
60-100 bpm
Normal systolic BP in adults
90 to 150
NTG: Action
vasodilator, decreases blood return to heart
NTG: Contraindications
systolic pressure <100mm/Hg, use of ED med within last 24 hrs, head injury
NTG: Dosage
0.4mg SL, repeat every 3-5 min for 15 min
NTG: Indications
chest pain of cardiac origin, angina, acute CHF
NTG: Side Effects
headache, hypotension, tachycardia
occurs when an object migrates from one part of the body and causes a blockage of a blood vessel in another part of the body
Pertinant characteristics of breathing
rate, rhythm, quality, depth
Prior to delivery, if the mother is in the supine position, she may develop dizziness and a drop in blood pressure. This is called:
supine hypotensive syndrome
Signs of internal bleeding include:
Bruising, swelling, and pain over vital organs; painful, swollen, or deformed extremities
Small round purplish spots, called petechiae, are caused by:
capillary bleeding
Splinting a closed, angulated fracture in the position in which it was found may cause a(n) _______ during transport.
open fracture
This increases in adults with breathing difficulty.
Pulse rate
the amount of air breathed in during each respiration multiplied by breaths/minute
minute volume
The butt or feet of a baby presents first
Breech presentation
The condition of excessive fluid buildup in the lungs because of the inadequate pumping of the heart is called
the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system
The normal headfirst delivery of a baby is called a:
Cephalic presentation
The primary electrical disturbance that results in cardiac arrest is...
Ventricular fibrillation
The required amount of suctioning that a suction unit must provide.
30 L/min, 300 mmHg
The spinal column is made up of _______ separate irregularly shaped bones called vertebrae
Type _ diabetes usually develops in adults and often is controlled by diet and oral medication.
Type _ diabetes usually develops in childhood, and requires at least daily doses of supplemental insulin.
Usually only _______ patients can develop hemorrhagic shock due to a closed head injury.
Ventilation rate for adults
Ventilation rate for children
Ventilation rate for infants
What is a very late sign of an ectopic pregnancy?
Low BP
When gases enter the bloodstream as the result of a damaged lung, it is called a(n)
arterial gas embolism
When pressure increases inside the skull because of swelling of brain tissue, blood flow is decreased. This results in...
the brain being starved for oxygen and carbon dioxide increasing, causing more swelling.
APGAR stands for?
Appearance, pulse, grimace, activity, respiratory effort
layers of skin, outside to inside
epidermis, dermis, subcutaneous
Which body parts are considered to be 9% of total body surface area
head, chest, abdomen, both arms, each leg
What part of the body can be used to estimate 1% surface area
Common diseases from wheezing
Chronic bronchitis
Common diseases from rhonchi
Chronic bronchitis
Common diseases from crackles
Pulmonary edema
difficult or labored respiration
Acute infectious disease characterized by a cough that has a "whoop" sound.
Occurs when the body's cooling mechanism have been expended
Skin is normal to cool in temp
Pale or Grey in color
And sweaty
Heat exhaustion
muscle pain or spasm due largely to the loss of salt from the body from sweating, or inadequate intake of salt
Heat cramp
A knife or other impailed object in the body exerts damage to the immediate area of impact and it's underlying structures. The length of the object used is important
Low velocity injuries
Med/High velocity projectiles are from pellets or bullets. The damage caused, depends on the Trajectory and the dissipation of energy. Dissipation of energy is affected by Drag,Profile,Cavitation, & Fragmentation.
Medium and high velocity injuries
Injuries due to the pressure wave of the blast. Injuries primarly effect the gas-containing organs, such as the lungs, stomach, intestines, inner ears and sinuses. Death may occur from this stage w/o any sign of external injury
Primary phase injuries
Injuries due to flying debris propelled by the blast
They are usually lacerations fracture burns
Secondary phase injuires
Injuries due to being throw and then landing on the ground similar to being ejected out of a car
Tertiary phase injuries
a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling
Superficial burn - 1st degree
a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence.
Partial thickness burn - 2nd degree
a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white
Full thickness burn - 3rd degree
first stage of labor; the uterine muscle contracts strongly to expel the fetus; the fetus presses on the cervix and causes it to dilate or expand
Dilation stage
When the baby is expelled from its mother's body
Expulsion stage
placenta is expelled-afterbirth
Placenta stage
Umbilical cord around the neck; assess by as soon s the head is out of the vagina, run index finger around the neck; if unable to stretch over the babies head, clamp cord 2" apart and cut, then deliver as normal.
Nuchal cord
You should use D50 with caution in patients who have
increased intracranial pressure.
The process of movement of a drug from the site of application into the body and into the extracellular fluid compartment is known as:
Drug absorption
Medical control orders an IV lidocaine bolus to control the PVC's. What is the dose?
1.0-1.5 mg/kg first dose, and 0.5-0.75 mg/kg second dose
As a paramedic, if you are given a verbal medical order for drug administration by a medical
control physician which you believe will harm your patient, you should:
Withhold the drug, inform the medical control physician the
reason for withholding the drug, and document the
Small amounts of opiates, such as opium, dihydrocodeine, and diphenoxyate, when used as
antitussives or antidiarrheals in combination products are usually classified as:
Schedule V
What classification would a drug be that has a high potential for abuse, and has no currently accepted medical use in treatment in the United States.
Schedule I
What classification would a drug be that have a currently accepted medical use in treatment in the United States, or currently accepted medical use with severe restrictions, and abuse of the drug or other substances may lead to severe psychological or physical dependence.
Schedule II
This classification of substances are those that have a currently accepted medical use in treatment in the United States, and abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence. ie. anabolic steroids, vicodin, or tylenol 3
Schedule III
Benzodiazepines fall into what classification (schedule)
Schedule IV
Which of the following is an example of a cholinergic receptor site?
What is the adult dose for D50?
25 g
What is a contraindication of Adenocard?
third degree AV heart block
The medical order generally does not contain:
drug manufacturer
A drug for which animal studies have not demonstrated a risk to the fetus, but there are no
adequate studies in pregnant women would be which pegnancy category?
A drug for which adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Category A
A drug for which animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Category C
A drug for which there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Category D
A drug for which studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
Category X
FDA has not classified drugs in this category for use in pregnant patients
Category N
The medical abbreviation "hs" stands for:
hora somni (at bedtime)
Your patient shows you an unfilled prescription which states, "ASA 81mg po qd a.c.". This
take 81 milligrams of aspirin by mouth every day before
The opposition between Romazicon and Valium is an example of:
Medical control orders dopamine at 5mcg/kg/min for your 176lbs patient. You add 400mg of
dopamine to 250mL of NS. If you use a microdrip set, what is the drip rate?
15 gtt/min
Electrolytes are most commonly measured in:
Your patient is in cardiac arrest and you are unable to establish IV access. However, an ET has
successfully been placed. So, you could give your patient:
2.5 mg epinephrine ET diluted in 8-10 mL NS
A hypertensive patient is given two different drugs to control his blood pressure at different
times to determine which drug is best suited for the patient. If drug A consistently lowers the
patient's blood pressure more effectively than drug B, then:
Drug A has higher efficacy than drug B
The first adult dose of adenosine is:
6 mg
Dextran is an example of a(n):
colloid IV fluid
Epinephrine and Norepinephrine exist in the human body as:
neurotransmitters and hormones
Medical control orders an infusion of amiodarone at 1mg/ min. If you mix 150mg in a 500cc bag
of NS and use a 15gtt/mL set, what is the appropriate drip rate for your 220lbs patient?
50 gtt/min
What is the dose for magnesium sulfate to treat Torsades de Pointes in an adult?
2g in 250mL IV/IO infusion
You are ordered to administer 50mcg/kg/hr of glucagon to your beta-blocker overdose patient
that weighs 88 lbs. If you mix 4mg of glucagon in 100mL and use a microdrip set, what is the
proper drip rate?
50 gtts/min
Digoxin is an example of a drug that is derived from:
An example of an IV fluid which is hypotonic would be:
Plasma accounts for approximately what percentage of total blood volume?
The body's tendency to maintain all of its physiological activities in proper balance is called:
What is the name of the process in which "helper proteins" on the surface of the cell are required
to move substances across the cell membrane?
facilitated diffusion
In 1983, Congress passed a law which offers substantial tax credits to companies that develop:
orphan drugs
You are dispatched to a local home improvement wharehouse on "general illness". You arrive on
the scene to find a 22 year old male responsive to voice, who has been vomiting. You note
evidence of incontinance and diaphoresis. He was unloading a cargo truck of garden supplies at
symptom onset. His initial vital signs are: BP-88/P; P-62; RR-28. You suspect:
parasympathetic stimulation
Acetylcholine is normally rapidly destroyed by an enzyme called:
Which classifications of drugs would result in increased chronotrophy?
What is the pediatric dose for nebulized albuterol?
0.15 mcg/kg
These drugs are preparations that contain the drug in an alcohol solvent.
What is the correct adult dose for atropine to treat organophosphate poisoning?
2 mg IV/IO/IM q 5 min prn
The legislation in the United States that classifies drugs into five different schedules is known as:
The Controlled Substance Act of 1970
The first federal law regulating labeling foods and drugs containing certain drugs including cocaine and heroin and also recognized the U.S. Pharmacopeia and the National Formulary as standards authorities for drugs
1906 Pure Food and Drug Act
a set of laws passed by Congress giving authority to the U.S. Food and Drug Administration (FDA) to oversee the safety of food, drugs, and cosmetics.
Federal Food, Drug, and Cosmetic Act 1938
A 74 year old female is complaining of shortness of breath. Her skin is normal temperature and
moisture, and she denies any pain or nausea. Her lung sounds are clear bilaterally. Should you give this patient Albuterol?
Medical control orders an infusion of D5W at 90mL/hr for your 110lbs patient. If you use a
10gtt/mL set, what is the appropriate drip rate?
15 gtt/min
A drug which never reaches market because it's not profitable to the manufacturer, is sometimes
called a(an):
orphan drug
"ASA" is the accepted abbreviation for:
What type of drugs would result in increased ionotrophy?
sympathomimetics, and MAOI's
While gathering a SAMPLE history on your chest pain patient, you note that he is taking beta blockers
Suddenly, your patient collapses in cardiac arrest. How would you expect this patient to respond
to epinephrine as compared to other patients?
epinephrine will not be as effective
These are factors which affect drug absorption
Bioavailability, Drug pH, and Concentration of the drug
For a severe allergic reaction, you should give your adult patient
0.3 mg epinephrine 1:10,000 IV/IO
For a moderate allergic reaction, you should give your adult patient
0.3 mg epinephrine 1:1000 IM/SC
What is the principle neurotransmitter of the sympathetic nervous system at the post-ganglionic
The adult dose for diazepam to stop seizures is:
5-10mg slow IV/IO
The enhancement of the effect of barbiturates by alcohol is an example of:
What is the correct dose for amyl nitrite?
0.3 mL ampule inhaled every minute
The placental barrier is an example of:
Physiological barrier
One advantage of giving a drug through a parenteral route is:
Absorbed dosage and action are more predictable than
enteral routes
Ipratropium is best classified as a(n):
describes the introduction of nutrition, a medication, or other substance into the body via a route other than the mouth, especially via infusion, injection or implantation
You would expect a patient taking an ACI to exhibit decreased effects of
Which drug should be given very slowly when giving an IV bolus to a patient NOT in cardiac arrest?
Albuterol is a:
Beta 2 selective agonist
Medical control orders an Isuprel drip at 0.1mcg/kg/min for 75lbs patient. You mix 1mg Isuprel in 250mL of D5W. If you use a microdrip set, what is the appropriate drip rate?
51 gtt/min
A popular device for determining pediatric drug dosages is:
the Broselow tape
Atropine is best classified as a(n):
Vagal manuevers can be useful in treating patients experiencing
tachycardias originating in the atrias
An individual who carries the A and B antigen on the red blood cells is which blood type?
After giving your anaphylactic patient a subcutaneous injection of 1:1000 epinephrine, you
notice a small bubble of fluid under the skin at the injection site. You should:
realize that this is normal for a SC injection, document the
time and dose, and observe your patient for effects
The official drug standard for the United States is:
The United States Pharmacopeia
After the FDA approves a drug for one indication, a physician legally may prescribe it, a
pharmacist may dispense it, and a nurse or paramedic may administer it for:
for any labeled or unlabeled indications
Which drug should be used to convert PSVT associated with Wolfe-Parkinson-
White Syndrome that is refractory to vagal manuevers?
The law that originally required a label on drugs that accurately described the package's contents
is called:
Federal Food, Drug, and Cosmetic Act of 1938
Which adrenergic receptor effects occur in the peripheral blood vessels, causing
The plasma level of a drug at which severe adverse reactions are expected or likely is called:
toxic level
What is the adult nebulizied dose of Ventolin?
2.5 mg
If you were to instruct your patient to bear down as if having a bowel movement, you would
expect for them to respond by stimulation of:
the parasympathetic system
lidocaine would be classified as
If the surrounding fluid is hypotonic to the cell, then fluid shifts:
into the cell
An example of a drug that acts by chemically combining with other substances would be:
Activated charcoal
Which adrenergic receptor is responsible primarily affects the lungs, causing bronchodilation?
A test that determines the amount and purity of a given chemical in a preparation in the
laboratory is called a(n):
The enhancement of one drug's effects by another is called:
which best describes dopamine?
The action of atropine can best be described as:
cholinergic antagonist
Normally, hepatic failure will increase a drug's _________________because the drug's
____________ rate is diminished.
accumulation, metabolism
The doctor orders a starting dose of 2mcg/min of epinephrine. Your assistant has mixed 1 mg of
epinephrine into a 250mL bag of NS. What is the drip rate with a microdrip set?
30 gtt/min