Emc103 (Chapter 19: Gastrointestinal and Urologic Emergencies (pre q))

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Solid abdominal organs include the:

 

urinary bladder, colon, and ureters.

 

stomach and small intestine.

 

spleen, kidneys, and pancreas.

 

gallbladder and large intestine.

spleen, kidneys, and pancreas

Which of the following organs would MOST likely bleed profusely if injured?

 

Stomach

 

Appendix

 

Liver

 

Gallbladder

Liver

Which of the following organs lies in the retroperitoneal space?

 

Pancreas

 

Spleen

 

Liver

 

Gallbladder

Pancreas

Injury to a hollow abdominal organ would MOST likely result in:

 

profound shock due to severe internal bleeding.

 

impairment in the blood's clotting abilities.

 

leakage of contents into the abdominal cavity.

 

pain secondary to blood in the peritoneum.

leakage of contents into the abdominal cavity

Functions of the liver include:

 

secretion of bile and filtration of toxic substances.

 

release of amylase, which breaks down starches into sugar.

 

production of hormones that regulate blood sugar levels.

 

absorption of nutrients and toxins.

secretion of bile and filtration of toxic substances

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?

 

Pancreas

 

Kidneys

 

Spleen

 

Liver

Spleen

The kidneys help to regulate blood pressure by:

 

eliminating toxic waste products from the body.

 

removing sodium and water from the body.

 

accommodating a large amount of blood volume.

 

retaining key electrolytes, such as potassium.

removing sodium and water from the body.

The parietal peritoneum lines the:

 

surface of the abdominal organs.

 

retroperitoneal space.

 

walls of the abdominal cavity.

 

lungs and chest cavity.

walls of the abdominal cavity.

The MOST common and significant complication associated with an acute abdomen is:

 

high fever.

 

internal bleeding.

 

peritonitis.

 

severe pain.

peritonitis

In the presence of ileus, the only way the stomach can empty itself is by:

 

diarrhea.

 

muscular contraction.

 

spontaneous rupture.

 

vomiting.

vomiting

Peritonitis may result in shock because:

 

intra-abdominal hemorrhage is typically present.

 

severe pain causes systemic dilation of the vasculature.

 

abdominal distention impairs cardiac contractions.

 

fluid shifts from the bloodstream into body tissues.

fluid shifts from the bloodstream into body tissues.

In contrast to the parietal peritoneum, the visceral peritoneum:

 

lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract.

 

is less likely to become inflamed or infected because it lines the abdominal organs themselves.

 

is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

 

is supplied by the same nerves from the spinal cord that supply the skin of the abdomen.

is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

 

radiating pain.

 

remote pain.

 

visceral pain.

 

referred pain.

referred pain

A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:

 

appendicitis.

 

pancreatitis.

 

acute cholecystitis.

 

acute cystitis.

acute cholecystitis

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?

 

Liver

 

Kidney

 

Pancreas

 

Gallbladder

Kidney

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:

 

acute pancreatitis.

 

acute appendicitis.

 

a kidney infection.

 

an aortic aneurysm.

an aortic aneurysm

Which of the following statements regarding the acute abdomen is correct?

 

The most common cause of an acute abdomen is inflammation of the gallbladder and liver.

 

An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.

 

The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated.

 

The initial pain associated with an acute abdomen tends to be vague and poorly localized.

The initial pain associated with an acute abdomen tends to be vague and poorly localized

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in:

 

cholecystitis.

 

appendicitis.

 

ileus.

 

an ulcer.

an ulcer

Which of the following is characteristic of peptic ulcer disease (PUD)?

 

Sharp pain that is typically located in both lower abdominal quadrants

 

The passage of bright red blood in the stool or coughing up blood

 

Symptom relief after taking nonsteroidal anti-inflammatory drugs

 

Burning or gnawing stomach pain that subsides immediately after eating

Burning or gnawing stomach pain that subsides immediately after eating

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:

 

cholecystitis.

 

gastroenteritis.

 

appendicitis.

 

pancreatitis.

appendicitis

Which of the following statements regarding gastrointestinal bleeding is correct?

 

Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

 

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

 

Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome.

 

In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe.

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself

Esophageal varices MOST commonly occur in patients who:

 

have weak immune systems.

 

consume a lot of alcohol.

 

have uncontrolled diabetes.

 

have a history of esophagitis.

consume a lot of alcohol

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:

 

esophagitis.

 

esophageal varices.

 

Mallory-Weiss tear.

 

acute pancreatitis.

Mallory-Weiss tear

The principal symptom in both infectious and noninfectious gastroenteritis is:

 

diarrhea.

 

dysuria.

 

vomiting.

 

high fever.

diarrhea

Which of the following conditions is more common in women than in men?

 

Cystitis

 

Pancreatitis

 

Cholecystitis

 

Hepatitis

Cystitis

Chronic renal failure is a condition that:

 

is often caused by hypertension or diabetes.

 

can be reversed with prompt treatment.

 

occurs from conditions such as dehydration.

 

causes dehydration from excessive urination.

is often caused by hypertension or diabetes

Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems MOST likely caused this?

 

Hypertension

 

Seizures

 

Diabetes

 

Heart failure

Heart failure

A strangulated hernia is one that:

 

can be pushed back into the body cavity to which it belongs.

 

spontaneously reduces without any surgical intervention.

 

loses its blood supply due to compression by local tissues.

 

is reducible if surgical intervention occurs within 2 hours.

loses its blood supply due to compression by local tissues

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to:

 

notify the dispatcher of your arrival.

 

assess the scene for potential hazards.

 

quickly gain access to the patient.

 

place a paramedic ambulance on standby.

assess the scene for potential hazards

Most patients with abdominal pain prefer to:

 

lie in a supine position with their knees in a flexed position.

 

sit in a semi-Fowler position with their knees slightly bent.

 

lie on their side with their knees drawn into the abdomen.

 

sit fully upright because it helps relax the abdominal muscles.

lie on their side with their knees drawn into the abdomen

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:

 

kidney stones.

 

acute pancreatitis.

 

aortic aneurysm.

 

strangulated hernia.

aortic aneurysm

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:

 

rapidly transport her to the hospital.

 

keep her supine and keep her warm.

 

give her high-flow supplemental oxygen.

 

protect her airway from aspiration.

protect her airway from aspiration

Patients with acute abdominal pain should not be given anything to eat or drink because:

 

digestion prevents accurate auscultation of bowel sounds.

 

it will create referred pain and obscure the diagnosis.

 

substances in the stomach increase the risk of aspiration.

 

food will rapidly travel through the digestive system.

substances in the stomach increase the risk of aspiration

When assessing a patient with abdominal pain, you should:

 

ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area.

 

visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition.

 

observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.

 

palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful

Older patients with abdominal problems may not exhibit the same pain response as younger patients because of:

 

interactions of the numerous medications they take.

 

age-related deterioration of their sensory systems.

 

progressive deterioration of abdominal organ function.

 

chronic dementia, which inhibits communication.

age-related deterioration of their sensory systems

An important aspect in the treatment of a patient with severe abdominal pain is to:

 

administer analgesic medications to alleviate pain.

 

give 100% oxygen only if signs of shock are present.

 

provide emotional support en route to the hospital.

 

encourage the patient to remain in a supine position

provide emotional support en route to the hospital

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:

 

assess his blood pressure to determine perfusion adequacy.

 

be alert for signs and symptoms of shock.

 

determine the exact location and cause of his pain.

 

transport him in a supine position.

be alert for signs and symptoms of shock

The MOST important treatment for a patient with severe abdominal pain and signs of shock is:

 

transporting the patient without delay.

 

administering high-flow oxygen.

 

positioning the patient on his or her side.

 

giving oral fluids to maintain perfusion.

transporting the patient without delay

A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

 

vigorously palpate the abdomen to establish pain severity.

 

place the patient in a sitting position and transport at once.

 

administer oxygen and prepare for immediate transport.

 

request a paramedic unit to give the patient pain medication.

administer oxygen and prepare for immediate transport.

You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:

 

continue transporting and alert the receiving hospital.

 

immediately perform a rapid physical examination.

 

assist his ventilations with a bag-valve mask.

 

consider requesting a rendezvous with an ALS unit.

consider requesting a rendezvous with an ALS unit

Which of the following statements regarding dialysis is correct?

 

The purpose of dialysis is to help the kidneys retain salt and water.

 

Acute hypertension is a common adverse effect of dialysis.

 

Patients who miss a dialysis treatment often present with weakness.

 

Hemodialysis is effective but carries a high risk of peritonitis.

Patients who miss a dialysis treatment often present with weakness

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:

 

perform a detailed secondary assessment and then transport him to a dialysis center.

 

place him in a supine position, elevate his lower extremities, and transport at once.

 

leave him in a sitting position, keep him warm, and prepare for immediate transport.

 

treat for shock and request a paramedic unit to respond to the scene and assist you.

leave him in a sitting position, keep him warm, and prepare for immediate transport