EMT exam 4

function of brainstem

controls ANS, breathing, blood pressure, swallowing, pupil constriction

function of cerebrum and location

cerebrum makes up most of the brain. RH controls left body, LH controls right body. front controls thought, middle controls movement and sensation, and back controls eyesight.

cerebellum function and location

cerebellum is located in the back, lower side of the brain. its function is to coordinate complex motor tasks, such as walking, running, playing piano, etc.

signs of a hemorrhagic stroke

sudden, severe headache with the worst pain they’ve ever felt. the pain istarts localized then spreads as the irritation of the brain tissue spreads with more blood loss. seizures, altered mental status, and recent trauma are common.

what is a TIA (transient ischemic stroke)

a temporary stroke-like event that resolves on its own in less than 24 hours. It does not cause infarction (death of tissue) but may be a warning sign for future strokes.

symptoms of a left-hemisphere stroke

difficulty responding appropriately, right side paralysis

symptoms of right-hemisphere stroke

left side paralysis, trouble producing speech, but understands it well. neglect

conditions that mimic stroke

hypoglycemia: check blood sugar and give glucose if indicated.

postictal state (post-seizure). usually resolves within a few minutes. look for oral trauma, head trauma.
subdural or epidural bleeding. usually as a result of trauma. subdural is bleeding under the dura lining, outside the brain. epidural bleeding is between the dura lining and the skull.

what is focal onset seizure

a type of seizure that begins in one part of the brain. it usually affects only one limb, or only one hemisphere of the brain. it can be differentiated into aware or impaired-awareness seizures; in impaired-awareness, patient has ALOC, and in aware, patient is conscious, and may have changes in senses.

what is generalized seizure

a seizure that is caused by abnormal electrical discharges from large areas of the brain, involving both hemispheres.

what is status epilepticus

seizures that last >30 mins, or every few minutes without person regaining consciousness.

symptoms + definition of cholecystitis

inflammation of gallbladder due to gallstones. Pain often onsets ~30 minutes after fatty meals and often at night.

signs of hyperglycemic emergency

slow onset, with extreme thirst and hunger. If it progresses to DKA, there are Kussmaul respirations, Slurred speech, Treatment response is slow

signs of a hypoglycemic emergency

onset quickly and respond quickly to treatment. There isn’t thirst or hunger. Skin is pale, cool, and moist (almost as if the body is going into shock). pulse is weak and rapid

what is HHNS

hyperosmolar hypoglycemic nonketotic syndrome. a severe fluid imbalnace that is caused by dehydration in type 2 diabetes

what is type 1 diabetes and how does it present, and when does it onset

onsets in childhood. Is an autoimmune disease where the immune system produces antibodies against pancreatic beta cells. Often associated with polyuria, polydipsia, polyphagia, weight loss, fatigue. May have DKA if blood sugar exceeds 400 

what is type 2 diabetes

 resistance to effects of insulin at a cellular level

how does symptomatic hyperglycemia present

polydipsia , polyuria, blurred vision, fatigue. Can cause HHNS

why might symptomatic hypoglycemia occur

if patient takes too much insulin.

what to do if patient is unresponsive and you suspect diabetes

call ALS

poison definition

a substance that harms body structures or impairs body functions

toxin definition

toxins are a type of poison that animals, plants, or bacteria that change cell metabolism or destroy them

SLUDGEM

for cholinergics.

salivation/sweating,

lacrimation,

urination,

defecation/drooling/diarrhea,

gastric upset and cramps,

emesis,

muscle twitching/miosis

how to treat a patient who has had exposure to a toxin

check ABCs and vitals, support airway as needed. if the toxin was inhaled, provide O2 regardless of spO2 reading. call hazmat for help decontaminating the patient.

what are sedative-hypnotics

barbiturates and benzodiazepines. They are CNS depressants. Ketamine and roofies are examples.

what are abused inhalants

cns depressants. displace oxygen in the brain and cause temporary head rush. Over time, these can cause brain damage and seizures. The heart becomes hypersensitive to adrenaline, so do not let patients exert themselves. 

what is hydrogen sulfide and how to treat patients exposed to it

naturally occurring gas in volcanoes, sewers, etc. call hazmat before entering the scene.

how do sympathomimetics work

CNS stimulants that mimic sympathetic nervous system. Like meth, MDMA, cocaine. Acute cocaine overdose is an emergency because of risk for seizures, cardiac dysrhythmias, stroke.

what do synthetic cathinones (bath salts) do

They are similar to MDMA, produce euphoria, increased mental clarity, sexual arousal. Consider calling ALS for chemical restraints because these patients can be a danger to themselves even when restrained

how do hallucinogens work

alter sensory perception

how do anticholinergic agents work and what are the symptoms

Anticholinergic agents: block parasympathetic nerves. Usually have hyperthermia, dilated pupils, dry skin, agitation or delirium.

why is tricyclic antidepressant overdose an emergency

can block the electrical conduction system of the heart.

cholinergic agents MOC and treatment

overstimulate parasympathetic nervous system. Use SLUDGEM mnemonic. Decontaminating the patient takes priority over prompt transport to ED. call hazmat.

how/when to use narcan

only use on patients in respiratory distress from opioid overdose. place an NPA, ventilate with BVM, and then use narcan.

what is a behavioral crisis

when patients exhibit agitated, violent, or uncooperative behavior or who are a danger to themselves or others

categories of behavioral health disorders

organic (physical) and functional (physiological)

what is acute psychosis

a state in which a patient is out of touch with reality

define schizophrenia

a complex disorder that affects how a person thinks, feels, or acts

definition of delirium

an impairment of cognitive function, often with hallucinations, disorientation, or delusions

how to treat patient with excited delirium

call ALS for chemical restraint

what is in each quadrant of the abdomen

RUQ: liver, gallbladder. LUQ: stomach, spleen, pancreas. RLQ: appendix, right ovary. LLQ: descending colon, left ovary

define acute abdomen

Sudden onset of abdominal pain. It is usually correlated with peritonitis 

define peritonitis

irritation of peritoneal wall (which lines the abdominal cavity)

define diverticulitis

irritation of the small pockets in muscle walls of the intestines. causes red blood in stool

define cholecystis and its symptoms, causes

inflammation of gallbladder. pain in RUQ, especially 30 mins after eating a fatty meal and at night, can be caused by gallstones

what is responsible for peptic ulcers

heliobacter pylori bacteria

hematemesis definition

vomiting blood

pancreatitis definition, cause, symptoms

inflammation of pancreas. often caused by chronic alcohol consumption. pain usually after eating, in back left and right quadrants

esophageal varices definition

blood vessels swelling around the esophagus. can empty into liver, leading to liver damage

mallory-weiss tear define

tear between esophagus and stomach. often happens due to frequent vomiting or coughing, and is common in pregnant women

define gastroenteritis

syndrome encompassing infection with diarrhea, vomiting, or nausea

define cystitis

inflammation of bladder, usually due to UTI

define uremia

kidney failure

define CKD

chronic kidney disease: irreversible disease caused by hypertension or diabetes. requires dialysis

how to manage patient with shock associated with abdominal emergencies

if ABCs are compromised or there is internal bleeding, transport immediately and arrange for an ALS intercept

how does PD (peritoneal dialysis) work

uses the peritoneum to filter fluid. cleansing fluid enters the abdominal cavity, sits for a few hours to absorb toxins from peritoneum, then is drained into the machine

how does hemodialysis work

machine acts as an external kidney, taking away blood, cleaning it, and returning it to the body

within what timeframe should you administer activated charcoal

within 1 hour of ingestion

what are the side effects of epi

vasoconstriction, bronchodilation, increased heart rate and blood pressure

what is it called when anaphylaxis rebounds from epi

biphasic reaction

qualifications for cincinnati hospital pre-stroke scale

 facial droop, arm drift, slurred or abnormal speech

Hematochezia definition

bright red blood out of rectum

cushing’s triad

used to identify ICP (intracranial pressure). bradycardia, hypertension, irregular respirations

parietal peritoneum vs visceral peritoneum

parietal: patient can localize the pain. visceral: “deep” pain

define ileus

paralysis of intestinal muscule contractions

how to check for DVT

feel bilateral pulses

define thrombophilia

spontaneous clotting of blood

other word for urticaria

hives

define angioedema

sudden, deep swelling beneath the skin

when to use epi

difficulty breathing, wheezing, widespread hives, dizziness