Chapters 14-23: SECTION 6 TUTORING QUESTIONS!

CHAPTER 14

1. Which of the following assessment findings is MOST indicative of a cardiovascular problem

   1. Jugular vein distention

2. Assessment of a patient's blood pressure with an automatic bp cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should:

   1. Obtain a manual blood pressure

3. Reassessment of a patient with a medical complaint should begin by

   1. Repeating the primary assessment

4. The primary prehospital treatment for most medical emergencies

   1. Addresses the patient's symptoms more than the actual disease process

5. Which of the medications is least likely for an EMT to provide

   1. ibuprofen

6. In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?

   1. A 61-year-old man with possible stroke ground transport of 50min

7. Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital

   1. Stroke and heart attack

CHAPTER 15

1. The two processes that occur during respiration are:

   1. Inspiration and expiration

2. In a healthy individual, the brain stem stimulates breathing based on:

   1. Increased carbon dioxide levels

3. When the level of arterial carbon dioxide rises above normal:

   1. Increase rate and depth

4. Which of the following statements regarding the hypoxic drive is correct?

   1. Stimulates people to breathe based on low oxygen levels

5. When administering supplemental oxygen to a hypoxemic patient with chronic lung disease, you should:

   1. Adjust the flow rate accordingly until you see symptom improvement, and be prepared to assist with their ventilation

6. Treatment with continuous positive airway pressure (CPAP) would most likely be contraindicated in which of the following situations?

   1. Shortness of breath with a bp of 76/56 (under 100)

7. Acute pulmonary edema would MOST likely develop as the result of:

   1. Toxic chemical inhalation

8. The respiratory distress that accompanies emphysema is caused by:

   1. Chronic stretching of the alveolar walls

9. Which of the following statements regarding anaphylaxis is correct?

   1. Characterized by airway swelling and hypotension

CHAPTER 16

1. Deoxygenated blood from the body returns to the:

   1. Right atrium

2. Blood that is ejected from the right ventricle

   1. Flows into the pulmonary arteries

3. Which of the following blood vessels transports oxygenated blood?

   1. Pulmonary veins

4. What is the function of the left atrium

   1. It receives oxygenation from the lungs

5. The electrical impulse generated by the heart originates in the:

   1. Sinoatrial node

6. When an electrical impulse reaches the AV node, it is slowed for a brief period so that:

   1. Blood returning from the body can fill the atria

7. The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:

   1. Automaticity

8. The electrical stimulus that originates in the heart’s primary pacemaker is controlled by impulses from the brain that arrive by way of the:

   1. Autonomic nervous system

9. Which of the following is NOT a function of the sympathetic nervous system

   1. Constriction of the blood vessels in the muscles

10. A patient with atherosclerotic heart disease experiences chest pain during exertion because:

    1. The lumen of the coronary arteries is narrowed and cannot accommodate the increased blood flow

CHAPTER 17

• The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

  • Brain stem

• Muscle control and body coordination are controlled by the:

  • cerebellum

• Which of the following MOST accurately describes the cause of an ischemic stroke

  • Blockage of a cerebral artery

• You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 bpm. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced

  • A ruptured cerebral artery

• The MOST significant risk factor for a hemorrhagic stroke is:

  • hypertension

• An area of swelling or enlargement in a weakened arterial wall is called:

  • An aneurysm

• Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

  • Nasal discharge of blood

• A transient ischemic attack occurs when

  • A small clot in a cerebral artery causes temporary symptoms

CHAPTER 18

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

   1. Leakage of the contents into the abdominal cavity

2. 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:

   1. Acute cholecystitis

3. Which of the following statements regarding acute abdomen is correct

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

4. 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

   1. Diabetes

5. Most patients with abdominal pain prefer to:

   1. Lie on their side with knees drawn in

6. 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

   1. Aortic aneurysm

7. When assessing a patient with abdominal pain, you should:

   1. Palpate in a clockwise direction after they indicate which quadrant is the painful one.

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

   1. Age-related deterioration of the sensory systems

9. Which of the following statements regarding dialysis is correct

   1. Patients who miss a treatment often present with weakness

CHAPTER 19

1. A 37-year-old female with a history of diabetes presents with excessive urination and weakness for 2 days duration. Her blood glucose level reads 320 mg/dl. If this patient is not promptly treated she will MOST likely develop

   1. Acidosis and dehydration

2. Kussmaul respirations are an indication that the body is:

   1. attempting to eliminate acids from the blood

3. Diabetic ketoacidosis occurs when:

   1. Insulin is not readily available

4. A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively which has progressively worsened over the last 24 to 36 hours. Based on this patient's clinical presentation, you should suspect that she:

   1. is significantly hyperglycemic.

5. A 50-year-old man with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?

   1. Deep and rapid breathing

6. A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing:

   1. A heart attack

CHAPTER 20

1. Which of the following MOST accurately defines an allergic reaction?

   1. Exaggerated immune system response to any substance

2. A chemical that is responsible for the signs and symptoms of an allergic reaction to a bee sting

   1. Histamines and leukotrienes

3. Anaphylaxis is MOST accurately defined as a(n):

   1. The extreme allergic reaction that may affect multiple body systems

4. Two of the MOST common signs of anaphylaxis are:

   1. Urticaria and angioedema

5. Urticaria is the medical term for

   1. Hives

6. Which of the following patients would most likely have a delayed onset of an allergic reaction

   1. A 45-year-old man who ingested penicillin

7. Which of the following statements regarding fire ants is correct?

   1. Fire ants often times bite someone repeatedly

8. Raised localized bump

   1. A wheal

9. Because the singer of a honeybee remains in the wound following a sting

   1. Can continue to inject for 20 minutes

10. The stinger from a honeybee should be

    1. Scraped away from the skin

11. Most patients who die of anaphylaxis do that within __ minutes of exposure

    1. 30 min

12. 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 epinephrine auto-injector. You should:

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

13. Which of the following physiologic actions does epinephrine prudence when given for an allergic reaction?

    1. Vasoconstriction and bronchodilation

14. Epinephrine is indicated for patients with an allergic reaction when:

    1. Wheezing and hypotension are present

CHAPTER 21

1. Substance abuse is most accurately defined as

   1. Misusing a substance to produce a desired effect

2. An EMT’s primary responsibility to the patient who has been poisoned is to:

   1. Recognize a poisoning occurred

3. Signs and symptoms of a sympathomimetic drug overdose include

   1. tachycardia

4. The poison control center will provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if

   1. They are aware of what substance was involved

5. Following statement about inhaled poisons correct?

   1. Lung damage might progress after the patient is removed from the environment

6. Activated charcoal may be indicated for a patient who ingested

   1. Aspirin

7. Activated charcoal is given to patients who have ingested certain substances because of it:

   1. Binds to the substance and binds to the structure

8. In general, injected poisons are impossible to dilute or remove because they:

   1. Are usually absorbed quickly into the body

9. Airborne substances should be diluted with

   1. oxygen

10. Signs of absorbed poison exposure include all of the following, except

    1. Severe nausea vomiting, and diarrhea

11. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing

    1. Tolerance

CHAPTER 22

1. A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should:

   1. Inquire about a head injury

2. A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene before your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:

   1. Calmly identify yourself to the patient

3. When assessing a patient with a behavioral crisis, you should

   1. Be direct and clearly state your intentions

4. A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he had attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should:

   1. Open the patient's airway and assess his respirations.

5. A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious and has a patent airway and adequate breathing. You should:

   1. Ask the daughter how he normally behaves

CHAPTER 23

1. Each ovary produces an ovum every month and releases it into the:

   1. Fallopian tube

2. In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

   1. Becomes engorged with blood

3. The onset of menstruation usually occurs in females who are

   1. 12-16

4. When a female has reached menarche

• Capable of becoming pregnant

1. It is common for young females who experience their first menstrual period to:

   1. Experience abdominal cramping can be misinterpreted

2. Which of the following statements regarding pelvic inflammatory disease (PID) is correct?

   1. PID can scar the fallopian tube which increases the risk of ectopic pregnancy

3. Pelvic inflammatory disease typically does NOT affect the:

   1. Urinary bladder

4. Potentially life-threatening consequences of pelvic inflammatory disease include

   1. Ovarian abscess and ectopic pregnancy

5. As a woman approaches menopause:

   1. Her menstrual periods become irregular and vary in severity

6. Which of the following conditions would most likely lead to PID if left untreated

   1. Chlamydia

Quarter Two: Test Question Guide

1. What is the online medical direction?

   1. Verbal communication with medical control

2. What is the offline medical direction?

   1. Written protocol

   2. Standing orders

3. What are things to do when decontaminating the ambulance?

   1. Know what cleaning agents do and their requirements

   2. 10% solution of bleach and water (10% bleach), must air dry

   3. A hospital-approved disinfectant that is effective against Mycobacterium tuberculosis can also be used

   4. Any medical waste should be put in a red biohazard bag

   5. Use the cleaning solution in a bucket or a pistol-handled spray container

   6. Do not use alcohol or aerosol products to clean the unit

   7. Any contaminated equipment that is left with the patient at the hospital should be cleaned by hospital staff or put in a red bag for transport and cleaning at the station.

      1. Chapter 2 Page 49

4. What is one life-saving skill that everyone can do?

   1. Use an AED

   2. Perform CPR

5. What is the difference between cover and concealment?

   1. Cover: putting something between yourself from danger

      1. Both can hide you but only cover can protect you

   2. Concealment: hiding yourself from danger

      1. Concealment does not mean that you cannot be seen

   3. According to the textbook:

      1. Cover involves the tactical use of an impenetrable barrier for protection

      2. Concealment involves hiding behind objects to limit a person’s visibility of you

      3. Chapter 2 Page 73

6. When can you legally release confidential information?

   1. When the patient is competent and signs a release form

7. How do we protect the patient’s privacy when speaking on the radio?

   1. Don't use name, address, or any identifying information

8. In the ambulance without your hands free, how do you notify the hospital that you have a patient and are on your way?

   1. Ask the driver to notify the hospital

9. If you are sitting up, what are you?

   1. Fowler’s

10. If you are sitting up and leaning back, what are you?

    1. Semi Fowler’s

11. Supine vs Prone:

    1. Supine: on back

    2. Prone: on face

12. Recumbent:

    1. Lying horizontally (stroke position on your side)

13. What does CVA mean?

    1. Cerebrovascular accident (stroke)

14. What is a TIA?

    1. Transient ischemic attack

15. What is AAA?

    1. Abdominal aortic aneurysm

16. What is an AMI?

    1. Acute myocardial infarction

17. What is an EEG?

    1. Electroencephalogram

18. What is an EKG?

    1. Electrocardiogram

19. What are the different types of shock?

    1. Psychogenic

    2. Cardiogenic

    3. Obstructive

    4. Distributive

    5. Respiratory

    6. Hypovolemic

    7. Chapter 12: Shock: Notes

20. What are the different forms of consent?

    1. Implied

    2. Informed

    3. Expressed

21. What does the skin do?

    1. Provides a protective barrier against mechanical, thermal, and physical injury and hazardous substances.

    2. Prevents loss of moisture.

    3. Reduces harmful effects of UV radiation.

    4. Acts as a sensory organ (touch, detects temperature).

    5. Helps regulate temperature (thermoregulation)

    6. An immune organ to detect infections etc.

22. If you put your finger into the flame of a candle:

    1. Spinal cord reflex arc

    2. Afferent sensory nerve pathway

23. Different stages of lifetime development: KNOW PROGRESSION

    1. Neonate: < 1-month

    2. Infant: < 1 year

    3. Toddler: 1-3 (separation anxiety is common)

    4. Preschool: 3-6

    5. School-Age: 6-12

    6. Adolescent: 12-18

    7. Early Adult: 19-40

    8. Middle Adult: 41-60

    9. Late Adult: 61+

       1. Chapter 7 Pages 241-255

24. What do you do when moving a patient to prevent personal injury?

    1. Power grip

    2. Power stance

    3. Bend at the knees, do not bend back or bend forward

    4. Be as close as possible to the patient

25. Where is the majority of weight when lying down or sitting?

    1. In the torso

26. What creates a pulse?

    1. When the heart pushes blood into the aorta, the blood's impact on the elastic walls creates a pressure wave that continues along the arteries. This impact is the pulse. All arteries have a pulse, but it is most easily felt at points where the vessel approaches the surface of the body.

27. What is the main focus of the secondary assessment?

    1. The main focus of the secondary assessment is to conduct a comprehensive head-to-toe evaluation of the patient's overall condition, gathering additional information about their injuries or illnesses that may not have been immediately apparent during the primary assessment.

    2. During the secondary assessment, the EMT will perform a thorough physical examination, obtain a detailed medical history (if possible), assess vital signs, and conduct specific assessments related to the patient's complaints or injuries. The secondary assessment aims to identify all injuries, illnesses, or other medical conditions that may require treatment or further evaluation. This information is critical in creating an appropriate treatment plan and determining the most suitable transportation destination for the patient.

28. What type of patient needs an NRB?

    1. Respiratory Distress: Individuals who are struggling to breathe, showing signs of severe shortness of breath, rapid breathing, or labored breathing.

    2. Hypoxia: Patients with low oxygen saturation levels (SpO2) usually below 90%, as measured by a pulse oximeter.

    3. Respiratory Failure: Patients who have difficulty maintaining adequate oxygenation or ventilation on their own, which can occur in various medical conditions such as pneumonia, congestive heart failure, chronic obstructive pulmonary disease (COPD), asthma exacerbation, or acute respiratory distress syndrome (ARDS).

29. Know the parts of the upper airway:

    1. Nasal Cavity: The space inside the nose, lined with mucous membranes and hairs that filter and moisten the incoming air.

    2. Mouth: Also known as the oral cavity, air can enter through the mouth as an alternative route to the nasal cavity.

    3. Pharynx: The throat, which serves as a common passage for both air and food. It has three parts: the nasopharynx (above the soft palate), the oropharynx (behind the mouth), and the laryngopharynx (above the larynx).

    4. Epiglottis: A flap-like structure in the pharynx that covers the opening of the larynx during swallowing, preventing food and liquids from entering the airway.

    5. Larynx (Voice Box): The voice box, which houses the vocal cords and is responsible for sound production and protecting the lower airway.

    6. Uvula: A soft, fleshy extension at the back of the soft palate, aiding in speech and swallowing.

30. Know the parts of the lower airway:

    1. Carina: The carina, also known as the tracheal carina, is a critical anatomical structure located within the lower respiratory tract. It is a ridge or cartilaginous ridge found at the point where the trachea, the main airway leading to the lungs, bifurcates into the right and left primary bronchi. In other words, the carina is the point of division where the trachea splits into two main branches, each leading to one of the lungs.

    2. Trachea: Also known as the windpipe, it is a cartilaginous tube that connects the larynx to the bronchi. It is lined with cilia and mucus-producing cells to trap and remove debris from the air.

    3. Bronchi: The trachea branches into two primary bronchi, one for each lung, which further divide into smaller bronchioles.

    4. Bronchioles: Smaller airway branches that lead to the alveoli.

    5. Alveoli: Tiny, thin-walled air sacs in the lungs where gas exchange occurs. Oxygen from the inhaled air diffuses into the bloodstream, and carbon dioxide from the bloodstream is exhaled.

31. Know where the upper/lower airways begin and end:

    1. The larynx, specifically the epiglottis, serves as the anatomical separation between the upper and lower airways. During swallowing, the epiglottis closes over the glottis, which is the opening to the larynx, preventing food and liquid from entering the lower airway. When breathing, the epiglottis is open, allowing air to pass freely into the trachea and lungs.

32. What is a trade name for aspirin?

    1. Aspro Clear®, Disprin®, Bayer

33. What is acetaminophen? Is it the generic or the trade name?

    1. Acetaminophen is a common over-the-counter medication used to relieve pain and reduce fever. It is classified as an analgesic (pain reliever) and antipyretic (fever reducer). Acetaminophen is often used to alleviate headaches, minor aches, and pains, and reduce fevers associated with various conditions such as colds and flu.

    2. Regarding the names, "acetaminophen" is the generic name of the medication. It is the active ingredient found in various brand-name products. Some well-known brand names for acetaminophen include Tylenol, Panadol, and Paracetamol.

34. What is the trade name for Motrin?

    1. The trade name for Motrin is "Motrin" itself. Motrin is a brand name for a medication containing ibuprofen, which is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, reduce inflammation, and lower fever. It is commonly used to treat various conditions such as headaches, muscle aches, menstrual cramps, arthritis, and other minor aches and pains. The active ingredient in Motrin is ibuprofen, and it is available in various forms, including tablets, capsules, and liquid suspensions.

    2. The generic name for Motrin is ibuprofen.

    3. Another trade name for ibuprofen is Advil.

35. What type of sugar is glucose?

    1. Simple

    2. Monosaccharide

36. What happens if you have too many complex carbs?

    1. Consuming too many complex carbohydrates can have both short-term and long-term effects on your body and overall health. Complex carbohydrates are larger molecules that take longer to break down and provide a more sustained release of energy compared to simple carbohydrates. They are typically found in foods like whole grains, legumes, vegetables, and fruits. Here are some potential consequences of excessive complex carbohydrate consumption:

    2. Weight Gain: Consuming an excess of complex carbs can lead to weight gain, especially if your calorie intake exceeds your energy expenditure. When you consume more carbohydrates than your body needs for energy, the excess carbohydrates are converted into fat and stored in the body.

    3. Blood Sugar Imbalance: Although complex carbohydrates are generally considered healthier than simple carbs, they can still raise blood sugar levels, especially if consumed in large quantities. Rapidly increasing blood sugar can lead to energy spikes and crashes, affecting energy levels and mood.

    4. Insulin Resistance: Consistently high carbohydrate intake, particularly refined or processed complex carbs, can lead to insulin resistance. This condition occurs when cells become less responsive to insulin, leading to higher blood sugar levels and an increased risk of type 2 diabetes.

    5. Digestive Issues: Consuming excessive complex carbs, especially those high in fiber, can cause digestive discomfort such as bloating, gas, and diarrhea.

    6. Nutrient Imbalance: If your diet is predominantly based on complex carbs and lacks a variety of other nutrients, you may not be getting essential vitamins, minerals, and proteins necessary for overall health and well-being.

37. What’s the function of the primary assessment?

    1. Identify life threats

38. Why do patients in shock turn pale:

    1. The blood moves to the more important organs

39. How do you clear a mild airway obstruction?

    1. Encourage the patient to cough it out

    2. Head tilt chin lifts if non-trauma

    3. Jaw thrust if trauma

40. What does it mean when we say that a disease is virulent?

    1. When a disease is described as "virulent," it means that the disease-causing agent (e.g., virus, bacteria, or other pathogens) is highly infectious, aggressive, and capable of causing severe or even deadly illness in infected individuals. A virulent disease often spreads rapidly and can overwhelm the immune system, leading to more severe symptoms and potentially higher mortality rates. The term "virulence" is used to describe the degree of pathogenicity or the ability of a microorganism to cause disease in a host. In contrast, less virulent diseases may cause milder symptoms or be less easily transmitted.

41. What do you mean when you say that a lung sound is adventitious?

    1. Adventitious lung sounds are abnormal breath sounds that are not typically heard in healthy lungs. These sounds can indicate underlying respiratory conditions or diseases. They are usually superimposed on normal breath sounds and can be caused by various factors such as airway obstruction, inflammation, fluid accumulation, or lung tissue abnormalities. Examples of adventitious lung sounds include crackles (fine or coarse), wheezes, rhonchi, and pleural friction rubs.

42. What do you mean when you say that a lung sound is vesicular?

    1. Vesicular lung sounds are normal breath sounds that are typically heard during quiet, relaxed breathing. They are soft, low-pitched, and gentle sounds that occur throughout the lung fields. Vesicular sounds are caused by air moving through the smaller airways and alveoli during inhalation and exhalation. The term "vesicular" is derived from the Latin word "vesicula," meaning a small bag or bladder, which refers to the air sacs in the lungs where gas exchange occurs.

43. What do you mean when you say that a lung sound is singular?

    1. Stridor: A harsh, high-pitched sound that comes from the upper airways

    2. Rales: Small clicking, bubbling, or rattling sounds in the lungs that are heard when a person breathes in

    3. Wheezing: High-pitched sounds produced by narrowed airways

    4. Rhonchi: Sounds that resemble snoring and are sometimes called low-pitched wheezes or coarse crackles

    5. Pneumonia: Crackling, bubbling, and rumbling sounds when you inhale

44. What defines normal lung sounds?

    1. Normal lung sounds refer to the typical sounds heard during auscultation (listening with a stethoscope) of healthy lungs. These sounds include vesicular breath sounds, which are soft, low-pitched, and heard throughout the lung fields during normal breathing. During inhalation, the vesicular sounds are slightly louder than during exhalation. The absence of abnormal adventitious sounds, such as crackles, wheezes, or rhonchi, is characteristic of normal lung sounds.

45. What are the steps to giving an MDI:

    1. Look at the practical sheet

46. What causes angina?

    1. Angina is chest pain or discomfort that occurs if an area of your heart muscle does not get enough oxygen-rich blood. It is a common symptom of coronary heart disease, which limits or cuts off blood flow to the heart.

47. What are controllable risk factors?

    1. Exercise

    2. Diet

48. What are uncontrollable risk factors?

    1. Sex

    2. Ethnicity

    3. Genetics

49. How to treat the different types of stroke:

    1. Hemorrhagic: Hemorrhagic stroke occurs when a blood vessel in the brain ruptures, leading to bleeding within or around the brain tissue. Immediate medical attention is vital, and the person will be hospitalized, often in an intensive care unit (ICU) or stroke unit, for close monitoring. The goal of treatment is to stop the bleeding, relieve pressure on the brain, and manage any complications. Surgical interventions may be necessary to repair the ruptured blood vessel, remove blood clots, or alleviate brain pressure. Medications are used to manage symptoms, control blood pressure, and prevent seizures.

    2. Ischemic: Ischemic stroke occurs when a blood clot or plaque buildup blocks a blood vessel, reducing blood flow to a part of the brain. As with hemorrhagic stroke, emergency medical care is crucial. Thrombolytic therapy, involving clot-busting medication like alteplase, may be administered if the person arrives at the hospital within a specific time frame and meets certain criteria. Mechanical thrombectomy, a procedure to directly remove the clot, may also be employed. After the acute phase, anticoagulants and antiplatelet medications may be prescribed to reduce the risk of future clots. Rehabilitation is essential for helping the individual regain lost functions and facilitate recovery.

    3. TIA: A transient ischemic attack (TIA) is a temporary episode that mimics stroke symptoms but does not cause permanent damage. However, it serves as a warning sign of an increased risk of a full-blown stroke in the future. Treatment aims to prevent a future stroke and typically involves lifestyle changes, such as adopting a healthy diet, engaging in regular exercise, and quitting smoking. Medications like aspirin or other antiplatelet drugs may be prescribed to reduce the risk of clot formation.

    4. Chapter 17: Neurologic Emergencies: Notes

50. How to best position a stroke patient:

    1. Recumbent on the side that is paralyzed

51. What is the biggest danger for a patient with nontraumatic/medical sudden onset abdominal pain?

    1. Treatment: rapid transport

    2. Dangers: sepsis, shock, internal bleeding

52. What is sickle cell disease?

    1. With sickle cell disease, an inherited group of disorders, red blood cells contort into a sickle shape. The cells die early, leaving a shortage of healthy red blood cells (sickle cell anemia), and can block blood flow causing pain (sickle cell crisis).

53. What is a wheal?

    1. A wheal is a raised, itchy, and often red or white swelling on the skin. It is a common symptom of an allergic reaction, such as from insect stings or bites, certain medications, or contact with an allergen like pollen or pet dander. Wheals are typically round or oval in shape and may vary in size. They can be quite small or as large as a few inches in diameter. When multiple wheals appear in close clusters, they are often referred to as hives or urticaria. Wheals can be transient and may come and go over a short period. In most cases, they are not harmful and subside on their own. However, severe or persistent cases may require medical attention and treatment with antihistamines or corticosteroids to alleviate symptoms.

54. Signs and symptoms of a heart attack?

    1. Chest Pain or Discomfort: This is the most typical symptom. The pain may feel like crushing pain, pressure, squeezing, fullness, or tightness in the chest. It can last for a few minutes or come and go.

    2. Pain or Discomfort in Other Upper Body Areas: Pain or discomfort may be felt in one or both arms, the back, neck, jaw, or stomach.

    3. Shortness of Breath: Feeling breathless or having difficulty breathing, especially along with chest discomfort.

    4. Cold Sweats: Experiencing cold, clammy skin or sweating without a clear reason.

    5. Nausea and Vomiting: Some people may feel nauseous or vomit during a heart attack.

    6. Lightheadedness or Dizziness: Feeling dizzy or lightheaded, which may be accompanied by weakness.

55. What does salmonella do?

    1. Salmonella, or salmonellosis, is an infection with Salmonella bacteria that causes diarrhea, fever, and stomach pains. Salmonella usually goes away on its own in a few days. You should drink plenty of fluids to prevent dehydration. You can reduce your risk of salmonella with safe food handling habits and by washing your hands after touching animals.

    2. Salmonella infections are diarrheal infections caused by the bacteria salmonella. Symptoms of a salmonella infection may include diarrhea, fever, abdominal cramps 12 to 72 hours after infection chills, headache, nausea, or vomiting.

56. Behavioral crisis vs psychiatric crisis:

    1. A behavioral crisis refers to a situation where an individual's behavior is agitated, aggressive, or potentially dangerous to themselves or others. It can be caused by various factors, such as substance intoxication or withdrawal, acute stress, situational distress, or underlying medical conditions. During a behavioral crisis, the person may display erratic or unpredictable behavior, agitation, or hostility.

    2. A psychiatric crisis involves an individual experiencing severe emotional distress or mental health symptoms that may pose a risk to their safety or well-being. This crisis can arise from a variety of psychiatric conditions, including depression, anxiety disorders, bipolar disorder, schizophrenia, or other severe mental illnesses. A person in a psychiatric crisis may exhibit symptoms such as suicidal thoughts, self-harm behaviors, severe depression, hallucinations, or delusions.

    3. Psychiatric: patient becomes a harm to themselves or others. Suicidal patients can also be homicidal. First priority is scene/personal safety.

57. What should you do before you perform a physical exam on a patient?

    1. Obtain consent

    2. Wear PPE

    3. Make sure that they are not violent

    4. Make sure that there is no C-Spine

58. You have a suicidal patient. What should be a part of your questioning?

    1. If you pose a threat to others as well

    2. Suicidal patients are sometimes homicidal

59. What are the causes of vaginal bleeding?

    1. STDs

    2. Sexual assault

    3. Menstruation

    4. Pelvic inflammatory disease

    5. PCOS

60. How should you do a physical exam on a SA patient?

    1. Preferably a female EMT

    2. Move them to a private location

    3. Any potential bleeding

    4. Treat for shock

    5. Identify life threats

    6. Clothes in a paper bag, not plastic

    7. Advise them not to shower or change if possible

61. What is the proper way to speak on the radio?

    1. Wait 1 second

    2. Hold it a couple of inches away from your mouth

62. What is heroin?

    1. Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance derived from the dried latex of the Papaver somniferum plant and is mainly used as a recreational drug for its euphoric effects. Medical-grade diamorphine is used as a pure hydrochloride salt.

    2. Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder or a black sticky substance known as black tar heroin.

63. Long trip to a hospital with a critical patient. What do you do?

    1. Manage ABCs

    2. Call for ALS

    3. Signal for helicopter

    4. Chapter 23, pg. 835