Unit 4 EMT - Allied Medical Training

Which type of intracranial hemorrhage often presents with an acute transient loss of consciousness followed by rapid deterioration if untreated?

Epidural hematoma

What is a characteristic symptom of a subarachnoid hemorrhage?

Sudden onset of severe headache described as a "thunderclap"

Where does blood accumulate in a subdural hematoma?

Between dura and arachnoid mater

What motor abnormality is more commonly associated with intracranial hemorrhage?

Abnormal size or response of pupils

Which type of intracranial hemorrhage results from bleeding into the tissue of the brain?

Intracerebral hemorrhage

What is the main cause of altered consciousness due to hypoglycemia?

Reduced blood glucose levels

What is a key feature of an opioid overdose?

Constricted pupils

What distinguishes a hemorrhagic stroke from a non-hemorrhagic stroke?

Hemorrhagic stroke involves rupture of a cerebral artery, while non-hemorrhagic stroke results from an arterial blockage.

Which symptom should raise suspicion of a subarachnoid hemorrhage?

Sudden severe headache

What is the immediate cause of tissue injury and death in a stroke?

Hypoxia due to reduced oxygen supply

What is the recommended action if a patient suspected of having a stroke has pulse oximetry reading below 94%?

Provide supplemental oxygen immediately

How long do symptoms typically last in a Transient Ischemic Attack (TIA)?

24 hours or less

Which type of seizure involves an aura and uncontrollable jerking of one area of the body?

Partial seizure

What is the recommended position for a patient having a seizure?

Recovery position

What is a common characteristic of a Generalized seizure (Grand Mal)?

Patient may have amnesia for the event

What is the primary goal of EMT management in a patient suspected of having a stroke?

Perform rapid transport to the hospital

What is a characteristic feature of absence seizures in children?

Loss of awareness

What are the two main divisions of the neurological system?

Central and peripheral nervous system

Which part of the brain coordinates voluntary movement and ensures balance?

Cerebellum

What is the function of the reticular activating system (RAS)?

Controls consciousness and attention

Which structure is responsible for linking the nervous system to the endocrine system and regulating homeostasis?

Hypothalamus

What is the primary function of the blood-brain barrier?

To protect the brain from certain substances

Which layer of the meninges is tightly adherent to the brain and very vascular?

Pia mater

What is the main function of cerebral spinal fluid (CSF)?

To act as a cushion protecting the brain

Which structure of the eye is responsible for adjusting the pupil size based on light conditions?

Iris

What is the main function of the optic nerve?

To transmit impulses from the retina to the brain

Which cranial nerve is primarily affected in Bell's Palsy?

Cranial nerve VII

What happens to the pupils in response to bright light?

They constrict

What is the function of the conjunctiva?

To protect the anterior sclera and provide lubrication

Which division of the autonomic nervous system is responsible for the fight or flight response?

Sympathetic nervous system

What neurotransmitter is primarily associated with the sympathetic nervous system?

Epinephrine

Which response is mediated by the parasympathetic nervous system?

Rest and relaxation phase

How is the central nervous system evaluated in terms of appearance and behavior?

Assessing the patient's posture and facial expressions

What does the AVPU mnemonic stand for in assessing level of consciousness?

Alert, Verbal, Pain, Unresponsive

How is mood assessed in a patient?

By observing facial expressions, posture, and language content

Which of the following are components of the autonomic nervous system?

The sympathetic and parasympathetic nervous systems

aura

a sensation experienced by a seizure patient right before the seizure that might be a smell, sound, or general feeling.

diabetes mellitus

the condition brought about by decreased insulin production or the inability of the body cells to use insulin properly. The person with this condition is a diabetic.

diabetic ketoacidosis

a condition that occurs as the result of high blood sugar (hyperglycemia), characterized by dehydration, altered mental status, and shock.

epilepsy

a medical condition that causes seizures.

generalized seizure

a seizure that affects both sides of the brain.

glucose

a form of sugar, the body’s basic source of energy.

hyperglycemia

high blood sugar.

hypoglycemia

low blood sugar.

insulin

a hormone produced by the pancreas or taken as a medication by many diabetics.

partial seizure

a seizure that affects only one part or one side of the brain.

postictal phase

the period of time immediately following a tonic–clonic seizure in which the patient goes from full loss of consciousness to full mental status.

reticular activating system (RAS)

series of neurologic circuits in the brain that control the functions of staying awake, paying attention, and sleeping.

seizure

a sudden change in sensation, behavior, or movement. The most severe form of seizure produces violent muscle contractions called convulsions.

sepsis

a life-threatening condition resulting from an abnormal and counterproductive response to infection by the body that causes damage to tissues and organs.

status epilepticus

a prolonged seizure or situation when a person suffers two or more convulsive seizures without regaining full consciousness.

stroke

a condition of altered function caused when an artery in the brain is blocked or ruptured, disrupting the supply of oxygenated blood or causing bleeding into the brain. Formerly called a cerebrovascular accident (CVA).

syncope

fainting

tonic–clonic seizure

a generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups.

The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the following?

Stroke

A hormone called insulin is secreted by the:

islets of Langerhans in the pancreas.

Normal consciousness is regulated by a series of neurologic circuits in the brain that compose the reticular activating system (RAS). The RAS has simple requirements to function properly. Which one of the following items is NOT one of those requirements?

Sodium

Which of the following is characteristic of a patient with hyperglycemia?

A "fruity" odor of the breath

The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which of the factors below is NOT a cause of hypoglycemia?

Reduces sugar intake by eating too much

Which of the following is NOT a sign of a hypoglycemic diabetic emergency?

Slow heart rate

Looking at the following list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and hyperglycemia?

The hypoglycemic patient usually complains of a headache, whereas the hyperglycemic patient does not.

When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or-flight mechanism of the autonomic nervous system. Which of the following is NOT one of the fight-or-flight responses?

The skin is hot and dry.

Which of the following may result in hypoglycemia in the diabetic patient?

Vomiting after eating a meal

Your patient is an unresponsive 30-year-old male wearing a Medic-Alert bracelet indicating that he is a diabetic. The patient's coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do next?

Apply oxygen and begin transport without taking further action.

Which of the following is within the EMT's scope of practice for the treatment of the diabetic patient?

Administration of oral glucose

Which of the following refers to difficulty in using words or understanding speech as a result of a stroke?

Aphasia

Which of the following is the most common cause of seizures in adults?

Failure to take prescribed medication

Your patient is a 19-year-old female who is 7 months pregnant. She just experienced a seizure. Although she has no previous history of seizures or any other medical condition, she was just diagnosed with pregnancy-induced hypertension. Which of the following is the most likely cause of the seizure?

Eclampsia

Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital setting?

Does the patient have a family history of seizures?

You respond to a 32-year-old female who is having a seizure. You arrive on the scene to find the patient drowsy, confused, and complaining of a headache. This patient is demonstrating the:

postictal phase

Which of the following is LEAST important for the patient who has stopped seizing before the EMT's arrival at the scene?

Requesting advanced life support

Which of the following is the MOST critical piece of equipment to have immediately available for the seizure patient who has just stopped convulsing?

Suction

Your patient is a 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival you introduce yourself to the patient, who responds, "Not until nine o'clock." This phenomenon is BEST described as:

receptive aphasia.

Which of the following is a standardized test to evaluate a conscious patient for possible stroke?

Cincinnati Prehospital Stroke Scale

When assessing a conscious patient for a possible stroke using the Cincinnati Prehospital Stroke Scale, which of the following three functions should be tested by the EMT?

Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds

Which of the following is NOT a sign or symptom of stroke?

Chest pain

Your patient is a 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is appropriate?

Immediately transport the patient to a hospital with specialized treatment for stroke patients.

With advances in clot-busting (thrombolytic) drugs, the patient has a window of ________ hours to receive treatment for the best possible outcome.

3

Many factors that cause dizziness and syncope are generally related to the:

brain

allergen

something that causes an allergic reaction.

allergic reaction

an exaggerated immune response.

anaphylaxis

a severe or life-threatening allergic reaction in which the blood vessels dilate, causing a drop in blood pressure, and the tissues lining the respiratory system swell, interfering with the airway. Also called anaphylactic shock.

auto-injector

a syringe preloaded with medication that has a spring-loaded device that pushes the needle through the skin when the tip of the device is pressed firmly against the body.

epinephrine

a hormone produced by the body. As a medication, it constricts blood vessels and dilates respiratory passages, and is used to relieve severe allergic reactions.

hives

red, itchy, possibly raised blotches on the skin that often result from allergic reactions.

What is another name for a severe allergic reaction?

Anaphylaxis

Which of the following statements concerning severe allergic reactions is true?

Severe reactions often occur immediately, but they are occasionally delayed 30 minutes or more.

You are called to a farmhouse on a sunny spring afternoon. Upon arrival, a frantic mother tells you that her 3-year-old daughter was playing in the yard, accidentally stepped on a hornets' nest, and was stung repeatedly. The patient is alert, screaming and crying, and can follow her mother's commands. Her arms and legs are swollen and show the marks of several stings. Her body is covered in hives. Her vital signs are blood pressure 90/40, pulse 110, respiratory rate 24, and oxygen saturation 99 percent. Her lung sounds are clear and equal bilaterally. Her mother states she put "nox-a-sting" on the bites but the bites only seemed to get worse. What condition is the patient suffering from?

Allergic reaction from the hornets' sting

Your patient is a 7-year-old girl who was prescribed an antibiotic for an ear infection. After 4 days on the antibiotic, the patient is experiencing hives and itching on her face, throat, and neck. Which of the following should you do?

Provide supportive care and monitor the patient's condition during transport to the hospital.

Which of the following explains why a patient may experience difficulty breathing during anaphylaxis?

Swelling of the airway tissues causes difficulty breathing.

Which of the following is the reason why infants rarely experience anaphylactic reactions?

Infants have not yet developed antibodies to allergens.

Which of the following is the result of histamine and other chemicals in the body during anaphylaxis?

Capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around the vocal cords.

Upon delivering a patient to the emergency department, you remove your gloves and find that your hands are red and itchy. Which of the following is most likely?

You are having an allergic reaction to the latex in the gloves.

As you prepare to enter a patient's room in a nursing home, you see a sign posted on the door indicating that the patient has a latex allergy. Which of the following is the best way to care for the patient?

Ask the nursing facility staff to find synthetic exam gloves to wear for contact with this patient.

Which of the following is included in the primary assessment of a conscious patient suffering from anaphylactic shock?

Assessing whether the patient is able to speak without difficulty

Your patient has eaten a casserole that may have contained seafood. The patient is worried because he has a seafood allergy. Upon assessment, you find no signs or symptoms of anaphylaxis. The patient's vital signs are stable and he has an epinephrine auto-injector prescribed to him. Which of the following actions is most appropriate?

Try to find out if the casserole contained seafood.

You are on the scene of a motor vehicle collision in which a car has driven off the roadway and is resting at the bottom of an embankment. The driver is in severe respiratory distress and is unable to speak. His skin is flushed and he has hives. A Medic-Alert bracelet indicates an allergy to peanuts. You notice a candy bar wrapper on the floor of the car. Which of the following should you do first?

Administer high-concentration oxygen.

You are called to a residence for a 60-year-old male complaining of chest pain. You find the patient seated in bed. His past medical history includes hypertension and high cholesterol. The patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper fields. He denies any shortness of breath or respiratory distress, but does so in short two- to three-word statements. What condition do you suspect?

Anaphylaxis

You are on the scene of a 22-year-old female patient who is unresponsive. The patient's mother states that she is deathly allergic to peanuts and accidentally ate stir fry cooked in peanut oil. The patient is unresponsive with agonal respirations at 6 per minute. What is your first action?

Insert an oral airway and apply oxygen at 15 liters per minute by bag-valve mask.

You are unsure whether a patient's condition requires the administration of an epinephrine auto-injector. Which of the following actions is most appropriate?

None of the answers are correct.