EMT Chapter 21 Allergy and Anaphylaxis

A 38-year-old woman was bitten by fire ants while at the park. Your primary assessment reveals that she is semiconscious; has labored breathing; and has a rapid, thready pulse. She has a red rash on her entire body, and her face is swollen. You should:

A. perform a rapid secondary assessment.
B. assist her ventilations with 100% oxygen.
C. locate the area where the fire ants bit her.
D. place her supine with her legs elevated.

B. assist her ventilations with 100% oxygen.

Because the stinger of a honeybee remains in the wound following a sting:

A. the toxicity of the venom decreases within 10 minutes.
B. the stinger should quickly be removed with tweezers.
C. it can continue to inject venom for up to 20 minutes.
D. the body's immune system deactivates the bee's venom.

C. it can continue to inject venom for up to 20 minutes.

The adult Epi auto-injector delivers ______ mg of Epinephrine, and the infant-child auto-injector _____ mg.

A. 0.03; 0.3
B. 0.3; 0.15
C. 0.01; 0.1
D. 0.1; 0.01

B. 0.3; 0.15

You have administered one dose of epinephrine to a 40-year-old female to teat an allergic reaction that she developed after being stung by a scorpion. Your assessment reveals that she is still having difficulty breathing , has a decreasing mental status, and has a BP of 80/50 mm Hg. You should:

A. administer a nebulized bronchodilator to improve the status of her breathing.
B. request permission from medical control to give another dose of epinephrine.
C. crush up an antihistamine tablet and place it in between her cheek and gum.
D. monitor her en route to the hospital and call medical control if she worsens.

B. request permission from medical control to give another dose of epinephrine.

A 50-year-old male was stung by honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:

A. reassess his breathing and BP in 15 minutes.
B. record the time and dose of the injection and transport promptly.
C. visualize his airway to assess for oropharyngeal swelling.
D. notify medical control of the PTs response to your treatment.

B. record the time and dose of the injection and transport promptly.

Which of the following medication blocks the release of histamines?

A. Albuterol (Ventolin)
B. Acetaminophen (Tylenol)
C. Epinephrine (Adrenalin)
D. Diphenhydramine (Benadryl)

D. Diphenhydramine (Benadryl)

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

A. purpura.
B. a wheal.
C. a pustule.
D. urticaria.

B. a wheal.

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:

A. histamines and leukotrienes.
B. the bee venom itself.
C. leukocytes and epinephrine.
D. adrenaline and histamines.

A. histamines and leukotrienes.

Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:

A. abdominal cramps.
B. flushing of the skin.
C. drying of the eyes.
D. persistent dry cough.

C. drying of the eyes.

Epinephrine is indicated for patients with an allergic reaction when:

A. a paramedic is present at the scene.
B. the patients is anxious and tachycardic.
C. the reaction produces severe urticaria.
D. wheezing and hypotension are present.

D. wheezing and hypotension are present.

Immediately after giving an epinephrine injection, you should:

A. notify medical control of your action.
B. record the time dose given.
C. reassess the patients vital signs.
D. properly dispose of the syringe.

D. properly dispose of the syringe.

The effects of epinephrine are typically observed within ________ following administration.

A. 1 hour
B. 1 minute
C. 30 seconds
D. 30 minutes

B. 1 minute

The foreign substance responsible for causing an allergic reaction is called an:

A. leukotriene.
B. allergen.
C. histamine.
D. antibody.

B. allergen.

The stinger from a honeybee should be:

A. left in place and covered.
B. scraped away from the skin.
C. squeezed with tweezers and removed.
D. irrigated with copious amounts of water.

B. scraped away from the skin.

The two MOST common signs of anaphylaxis are:

A. hypertension and swollen hands.
B. expiratory stridor and tachycardia.
C. urticaria and angioedema.
D. watery eyes and localized itching.

C. urticaria and angioedema.

Urticaria is the medical term for:

A. hives.
B. burning.
C. swelling.
D. a wheal.

A. hives.

When administering epinephrine via auto-injector, you should:

A. 15 seconds.
B. 8 seconds.
C. 10 seconds.
D. 3 seconds.

D. 3 seconds.

When an auto-injector is used to give epinephrine, the primary injection site is the:

A. medial part of the buttocks.
B. lateral portion of the arm.
C. lateral portion of the thigh.
D. medial portion of the thigh.

C. lateral portion of the thigh.

Which of the following MOST accurately defines an allergic reaction?

A. Destruction of the immune system by an external substance
B. A direct negative effect on the body by an external substance.
C. A release of erythrocytes in response to a foreign substance
D. An exaggerated immune system response to any substance

D. An exaggerated immune system response to any substance

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treat immediately?

A. Systemic vasodilation
B. Upper airway swelling
C. Diffuse urticaria
D. Severe hypotension

B. Upper airway swelling

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

A. 30-year-old male who was stung by a bee
B. 50-year-old male who was exposed to latex
C. 21-year-old female who inhaled pollen
D. 45-year-old male who ingested penicillin

D. 45-year-old male who ingested penicillin

Which of the following sounds indicates swelling of the upper airway?

A. Rhonchi
B. Rales
C. Stridor
D. Wheezing

C. Stridor

Which of the following statements regarding fire ants is correct?

A. Most people are allergic to fire ant toxin
B. Fire ants often bite a person repeatedly
C. Fire ant bites typically occur on the face
D. Fire ant bites rarely cause anaphylaxis

B. Fire ants often bite a person repeatedly

Which of the following would MOST likely provide clues regarding the source of a patients allergic reaction?

A. The patient general physical appearance
B. The patients family history
C. The environment in which the patient is found
D. The time of year in which the exposure occurred

C. The environment in which the patient is found

While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung field. This indicates:

A. narrowing of the bronchioles in the lung.
B. enlargement of the bronchioles in the lungs.
C. a significant amount of fluid in the alveoli.
D. rapid swelling of the upper airway tissue.

A. narrowing of the bronchioles in the lungs.

When an insect bites or stings you, the act of injecting its venom is called:

A. Envenomation
B. Infection
C. Toxicity
D. Contaminating

A. Envenomation

Signs and symptoms of an allergic reaction of the respiratory system includes all of the following EXCEPT:

A. Sneezing or running nose
B. Increased pulse rate
C. tightness in the chest
D. Hoarseness

B. Increased pulse rate

It is critical to remember that with IM epinephrine injection, the concentration must be:

A. 2:2,000
B. 1:1000
C. 4:200
D. 10:10000

C. 1:1000

The most common allergens fall into all of the following categories, EXCEPT:

A. Food
B. Plants
C. Insect bites and stings
D. Chemicals
E. Dust
F. Medications

E. Dust

Typical dose of epinephrine:

A. Adult 0.3; Child 0.15 mg
B. Adult 0.4; Child 0.15 mg
C. Adult 0.15; Child 0.3 mg
D. Adult 0.6; Child 0.12 mg

A. Adult 0.3; Child 0.15 mg

All these symptoms occur during the first exposure to the allergen EXCEPT?
A. Immune system forms antibodies
B. Antibodies identify and attack particular foreign substance
C. Allergens form histamine C in response
D. Antibodies combine only with allergen they were formed in response to

C. Allergens form histamine C in response

Epinephrine is a hormone produced by the body that constricts blood vessels and dilates
bronchioles.
A.True
B. False

A.True

A patient is vomiting. What position do you put them into?
A. On their right side
B. Lateral recumbent
C. Supine
D. A handstand

B. Lateral recumbent

What is dystonia?

A.Involuntary contractions of muscles
B.Involuntary contractions of facial muscles
C.A delusion
D. An imagined futuristic society where there is great suffering & injustice.

A.Involuntary contractions of muscles

The first step an EMT takes in a behavioral emergency is
A.Identity self
B.Primary assessment
C.Patient history
D.Careful scene size up

D.Careful scene size up

A patient who has attempted suicide in the past
A.Less likely to try again
B.Looking for attention
C.More likely to try again
D.Needs forceful restraint

C.More likely to try again

Agitated delirium is associated with all EXCEPT
A.CNS stimulants
B.Strength
C.Agitated
D.CNS depressant

D.CNS depressant

How would you document a patients heart rate of 110 beats per minute with evenly timed
beats
A.Tachycardic and regular
B.Tachycardic and irregular
C.Bradycardia and regular
D.Bradycardic and irregular

A.Tachycardic and regular

A yellowish tint to the skin and conjunctiva is called
A.Flush
B.Pallor
C.Jaundice
D.Cyanotic

C.Jaundice

After receiving a medication order by medical control, you should
A.Reassess vital signs
B.Check the expiration date of the medication.
C.Administer the medication.
D.Verify the proper medication form and dose.

D.Verify the proper medication form and dose.

When a patient is in anaphylaxis, the immune response causes blood vessels to___
the airway passages to __
A.constrict, allate
B.dilate, dilate
C.constrict, constrict
D.dilate, constrict

D.dilate, constrict

You're at the scene of a 9 year old who's been hit by a car. Her parents are unreachable. Why
can you treat the girl?
A.Expressed consent
B.Implied consent
C.Revoked consent
D.Informed consent

B.Implied consent

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose
of:
A.Cocaine
B.Oxycodone (Percocet)
C.Benadryl
D.LSD

B.Oxycodone (Percocet)

The primary function of the endocrine system is to maintain which of the following?
A.Homeostasis
B.Respiration
C.Heartbeat
D.Electrolyte and water balance

A.Homeostasis

A poison that enters the body by ____ is the MOST difficult to treat
A.Injected
B.Inhaled
C.sneezed
D.Topically

A.Injected

Because the stinger of a honeybee remains in the wound following a sting:
A.The stinger should quickly be removed with tweezers
B.The toxicity of the venom decreases within 10 minutes
20 set
C.It can continue to inject venom for up to 20 minutes
D.The body's immune system deactivates the bee's venom.

C.It can continue to inject venom for up to 20 minutes

Which of the following medications blocks the release of histamines?
A.Albuterol (Ventolin)
B.Diphenhydramine (Benadryl)
C.Acetaminophen (Tylenol)
D.Epinephrine (Adrenalin)

B.Diphenhydramine (Benadryl)