EMT Chapter 21 - allergy and anaphylaxis full review

Anaphylaxis is not always life threatening, but it typically involves:

A. multiple organ systems

B. wheezing

C. urticaria

D. wheals

A. multiple organ systems

Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to:

A. raise the pulse rate and blood pressure

B. inhibit an allergic reaction

C. relieve bronchospasm

D. all of the above

D. all of the above

You should not use tweezers or forceps to remove an embedded stinger because:

A. squeezing may cause the stinger to inject more venom into the wound

B. the stinger may break off in the wound

C. the tweezers are not sterile and may cause infection

D. removing the stinger may cause bleeding

A. squeezing may cause the stinger to inject more venom into the wound

You have been called to a park where a local church is holding a potluck dinner. As you exit your ambulance, a woman approaches you holding her 7-year-old son who is wheezing and having difficulty breathing. She informs you that he inadvertently ate a brownie with nuts, and he is allergic to nuts. The child's mother has an EpiPen that contains the appropriate dose of epinephrine for a child. What dose would that be?

A. 0.8 mg

B. 0.5 mg

C. 0.4 mg

D. 0.15 mg

D. 0.15 mg

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________.

A. quickly, within 30 seconds.

B. quickly, within 30 minutes.

C. slowly, over more than 30 minutes.

D. slowly, over several hours.

B. quickly, within 30 minutes.

The goal of invaders such as bacteria and viruses is to __________.

A. cause an immune response

B. spread disease and destruction

C. use a human body as a home

D. kill their human host

C. use a human body as a home

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________.

A. an uncomfortable depression in the skin

B. a series of small, raised pustules

C. a raised, well-defined area of the skin

D. a large area of red, blotchy skin

C. a raised, well-defined area of the skin

Patients may experience allergic reactions to which of the following substances?

A. Insect or animal bites and stings

B. Plant material

C. Food and medications

D. All of these answers are correct

D. All of these answers are correct

During airway and breathing portions of the primary assessment of a victim of an immunologic emergency, the EMT should __________.

Work quickly to assess the adequacy of the patients ability to move air in and out of their lungs

Which of the following medications blocks the release of histamines?

dipenhydramine (Benadryl)

Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following?

A. Routine spinal immobilization due to the potential for traumatic injury

B. Initiate basic life support measures, including the use of an automated external defibrillator, if necessary.

C. Position the patient's airway and initiate positive-pressure ventilations.

D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature.

D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature.

Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction?

A. Flushed, itching, or burning skin

B. A sense of impending doom

C. Tightness in the chest or throat

D. All of these answers are correct.

C. Tightness in the chest or throat

Epinephrine stimulates the ________ response, increasing blood pressure and relieving bronchospasm.

A. respiratory

B. sympathetic

C. parasympathetic

D. cardiac

B. sympathetic

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old woman with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

A. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine.

B. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine.

C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

D. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.

C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Which of the following MOST accurately defines an allergic reaction?

A. a direct negative effect on the body by an external substance

B. a release of erythrocytes in response to a foreign substance

C. destruction of the immune system by an external substance

D. an exaggerated immune system response to any substance

D. an exaggerated immune system response to any substance

Anaphylaxis is MOST accurately defined as a(n):

A. extreme allergic reaction that may affect multiple body systems.

B. severe allergic reaction that typically resolves without treatment.

C. moderate allergic reaction that primarily affects the vasculature.

D. allergic reaction that causes bronchodilation and vasoconstriction.

A. extreme allergic reaction that may affect multiple body systems.

Urticaria is the medical term for:

A. swelling.

B. hives.

C. a wheal.

D. burning.

B. hives.

The stinger from a honeybee should be:

A. left in place and covered

B. scraped away from the skin.

C. irrigated with copious amounts of water.

D. squeezed with tweezers and removed.

B. scraped away from the skin.

Which of the following statements regarding fire ants is correct?

A. most people are allergic to fire ant toxin

B. fire ant bites typically occur on the fae

C. fire ant bites rarely cause anaphylaxis

D. fire ants often bite a person repeatedly

D. fire ants often bite a person repeatedly

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

A. rapid swelling of the upper airway tissues

B. a significant amount of fluid in the alveoli

C. enlargement of the bronchioles in the lungs

D. narrowing of the bronchioles in the lungs

D. narrowing of the bronchioles in the lungs

Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?

A. The time of year in which the exposure occurred

B. The patient's family history

C. The environment in which the patient is found

D. The patient's general physical appearance

C. The environment in which the patient is found

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

A. Quickly determine if there are any bystanders who may carry epinephrine.

B. Remain at the scene with the patient and request a paramedic ambulance.

C. Ask the patient if he has any diphenhydramine tablets that you can administer.

D. Administer oxygen, transport at once, and request a paramedic intercept.

D. Administer oxygen, transport at once, and request a paramedic intercept.

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

A. Rales

B. Rhonchi

C. Stridor

D. Wheezing

C. Stridor

The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg.

A. 0.3; 0.15

B. 0.1; 0.01

C. 0.03; 0.3

D. 0.01; 0.1

A. 0.3; 0.15

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

A. 1 hour

B. 30 seconds

C. 30 minutes

D. 1 minute

D. 1 minute

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

A. administer oxygen and transport her to the hospital.

B. position her legs well above the level of her heart.

C. advise her to see her physician as soon as possible.

D. request a paramedic unit to administer epinephrine.

A. administer oxygen and transport her to the hospital.

The foreign substance responsible for causing an allergic reaction is called a(n):

A. antibody.

B. allergen.

C. leukotriene.

D. histamine.

B. allergen.

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

A. a 21-year-old female who inhaled pollen

B. a 30-year-old male who was stung by a bee

C. a 45-year-old male who ingested penicillin

D. a 50-year-old male who was exposed to latex

C. a 45-year-old male who ingested penicillin

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

A. lateral portion of the arm

B. medial part of the buttocks

C. lateral portion of the thigh

D. medial portion of the thigh

C. lateral portion of the thigh

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

A. a pustule.

B. purpura.

C. urticaria.

D. a wheal.

D. a wheal.

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

A. the stinger can easily be removed with tweezers.

B. the body's immune system deactivates the venom.

C. the toxicity of the venom decreases within 10 minutes.

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

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

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

A. diffuse urticaria

B. severe hypotension

C. upper airway swelling

D. systemic vasodilation

C. upper airway swelling

It is critical to closely monitor and reassess a victim of an immunologic emergency because the patient may __________.

rapidly deteriorate

The assessment of an immunologic emergency is critical because it will help the EMT determine whether the __________.

call is medical or traumatic in nature, or both

You respond to the residence of a 55-year-old woman with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:

Ask her if she has prescribed epinephrine

You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:

apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has labored breathing, and has hives over his entire trunk. You should:

maintain his airway and assist his ventilations.

A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. You should:

administer oxygen if needed, transport the patient, and monitor him for signs of deterioration.

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

A. bronchodilation and vasodilation

B. vasoconstriction and bronchodilation

C. bronchoconstriction and vasoconstriction

D. blocking of further histamine release

B. vasoconstriction and bronchodilation

Epinephrine is indicated for patients with an allergic reaction when:

A. wheezing and hypotension are present.

B. the patient is anxious and tachycardic.

C. a paramedic is present at the scene.

D. the reaction produces severe urticaria.

A. wheezing and hypotension are present.

When administering epinephrine via auto-injector, you should hold the injector in place for:

A. 5 seconds.

B. 3 seconds.

C. 15 seconds.

D. 20 seconds.

B. 3 seconds.

Immediately after giving an epinephrine injection, you should:

A. properly dispose of the syringe.

B. record the time and dose given.

C. reassess the patient's vital signs.

D. notify medical control of your action.

A. properly dispose of the syringe.

A 50-year-old male was stung by a 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:

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

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

A. monitor her en route to the hospital and call medical control if she worsens.

B. crush up an antihistamine tablet and place it in between her cheek and gum.

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

D. administer a nebulized bronchodilator to improve the status of her breathing.

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

Common side effects of epinephrine include all of the following, EXCEPT:

A. drowsiness.

B. tachycardia.

C. headache.

D. dizziness.

A. drowsiness.

Which of the following statements regarding epinephrine administration via the intramuscular (IM) route is correct?

A. The maximum single adult dose is 0.15 mg.

B. The IM route should not be used in children.

C. The 1:1000 concentration should be used.

D. The preferred injection site is the upper arm.

C. The 1:1000 concentration should be used.

Most patients who die of anaphylaxis do so within the first ____ minutes following exposure.

30

Two of the most common signs of anaphylaxis are:

A. urticaria and angioedema

B. watery eyes and localized itching

C. expiratory stridor and tachycardia

D. hypertension and swollen hands

A. urticaria and angioedema

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

A. persistent dry cough

B. flushing of the skin

C. drying of the eyes

D. abdominal cramps

C. drying of the eyes

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

A. leukocytes and epinephrine

B. adrenaline and histamines

C. the bee venom itself

D. histamines and leukotrienes

D. histamines and leukotrienes

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. place her supine with her legs elevated

B. perform a rapid secondary assessment

C. assist her ventilations with 100% oxygen

D. locate the area where the fire ants bit her

C. assist her ventilations with 100% oxygen