EMT Cardiology Practice Test 1
You are dispatched to a residence of a 46-year-old female patient complaining of nausea, vomiting, diarrhea, and abdominal cramping. She states that the onset occurred shortly after eating some cheesecake. Her only medical history is lactose intolerance. Her blood pressure is 136/88 mm Hg. Her radial pulse is 94 beats per minute and her respiratory rate is 18 breaths per minute. She vomited two times prior to your arrival. From what condition is this patient most likely suffering?
Acute gastroenteritis may be caused by bacterial or viral ingestion, toxic ingestion, or ingestion of lactose in a lactose intolerant patient. Signs and symptoms include nausea, vomiting, diarrhea, and abdominal cramping.
You are treating a 49-year-old patient who complains of an intense pain between his shoulder blades radiating to his lower back. Pain began 10 minutes prior to your arrival while he was eating and has been constant. He rates the pain as a 10 out of 10. Pain is described as a sharp, tearing pain. He has no significant past medical history. Blood pressure is 130/76 mm Hg in the right arm and 78/48 mm Hg in the left arm. Radial pulse in his right arm is 98 beats per minute and regular, and respiratory rate is 20 per minute and non-labored. What condition would you most likely suspect?
Differing blood pressures in each arm, as well as the description of a sharp, tearing pain between the shoulder blades, may indicate an aortic dissection. This is a definite medical emergency that warrants immediate transport to the emergency department.
Cardiac Compromise is:
Cardiac Compromise is a blanket term used to describe any type of heart problem. As an EMT-B, it allows you to identify that the patient has cardiac problems without going above your scope of practice.
What artery carries deoxygenated blood and which vein caries oxygenated blood?
The pulmonary artery is the only artery to carry deoxygenated blood to the lungs for gas exchange. The pulmonary vein is the only vein to carry oxygenated blood back to the heart. Typically, the arteries carry oxygen rich blood away from the heart to the systemic circulation. Veins typically carry deoxygenated blood back to the heart. The aorta is the main artery exiting the left ventricle to the body and the vena cava returns blood back to the right side of the heart.
You are called to a nursing home for a patient with swelling to her legs. Upon arrival, you find a 76-year-old patient sitting in a wheelchair. Assessment confirms pitting edema to both lower legs. You are able to palpate a dorsalis pedal pulse bilaterally. Her skin is warm, pink, and dry. Her lungs are clear bilaterally. Which of the following conditions do you suspect?
Edema to the legs or sacrum is often a result of right-sided congestive heart failure. There may also be jugular vein distention and ascites present as well. The most common cause of right-sided heart failure is left-sided heart failure; therefore, you may also note signs and symptoms of left-sided heart failure such as a dry, hacking cough, or coughing up pink frothy sputum, shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and fatigue.
An AED is used to treat patients in:
An AED is used to treat pulseless, apneic patients in ventricular fibrillation or ventricular tachycardia.
The two-flap valve located on the left side of the heart is the:
The two-flap valve is called the mitral valve, also known as the bicuspid valve. The three-flap valve is the tricuspid valve.
The single largest cause of death for Americans is/are:
Coronary heart disease, also known as coronary artery disease (CAD), is the number one threat to American health, killing an estimated 466,000 persons annually. While some predisposition to coronary heart disease is non-modifiable, many of the risk factors are behaviors that can be changed (e.g., obesity, sedentary lifestyle, and smoking). While chronic obstructive pulmonary disease, cancer, and traumatic injuries represent major health problems, they do not claim lives on the same magnitude of coronary heart disease.
Your patient is a 32-year-old male who was complaining of a severe, crushing feeling in the center of his chest and shortness of breath that began while he was mowing his lawn 45 minutes prior to your arrival. He is now only responding to painful stimuli. Presently, his minute ventilation is still adequate, his pulse oximeter reads 95% on room air, and you find his skin to be pale, cool, and diaphoretic. What would be your initial action?
High flow oxygen would be indicated with extreme shortness of breath during the initial assessment, so long as ventilations are adequate. If the patient is breathing inadequately, then positive pressure ventilation with oxygen should be immediately instituted.
Your patient is a 52-year old male complaining of dull, achy chest pains. He is alert & oriented but upon assessment, you notice his skin is pale, cool and clammy. What is your next step?
Giving Oxygen to a cardiac patient as soon as possible can help reduce damage to the heart muscle.
Which of the following complaints is often used to describe chest pain resulting from a cardiac event?
Typical cardiac related chest pain is often referred to as a pressure, like "a ton of bricks on my chest" or an elephant sitting on their chest. You can rule out a cardiac event on type of chest pain described alone. Some patients will have atypical chest pain which could be described as anything from sharp pain to a pulled muscle to a tooth ache. Sharp stabbing pain, which can be located with one finger, is often a Pulmonary Embolism.
The cardiovascular system or the circulatory system is made up of three major components; which of the following is not a component of the cardiovascular system?
The heart, blood vessels and blood are all major components of the cardiovascular system. Myoglobin is a component of muscle. When large muscle masses are injured they give off myoglobin into the blood stream. Myoglobin molecules are large and cause problems with the renal system during times of trauma, elocution or burns.
Which are not blood components that are responsible for clot formation?
Plaque is actually the buildup of fatty deposits on the artery walls which narrow and harden the arteries. While a clot often forms around plaque, especially around a plaque rupture, it is not a part of the clotting process. Platelets are the flat disks which stick together forming the thrombus. Fibrin are the small strands of fiber which make up the frame work of the clot making it stronger, like reinforcing rods in concrete. Thrombin is the protein chemo activator which signals the formation of a clotting process.
Name the layers of the heart from the outside in.
The layers of the heart from the outer most to the innermost layer are: Epicardium, myocardium, endocardium. The pericardium is actually the protective sac which surrounds the heart. The heart is covered with a thin layer of slippery tissue called the epicardium, it provides a surface which can move inside the pericardium without causing friction. The myocardium is the muscle tissue of the heart which conducts electricity which causes the muscle to squeeze pumping blood. The endocardium is made of the same type of tissue as the epicardium. The endocardium is very smooth to prevent clots from forming and adhering to the valves.
The normal heart rate for a newborn (0-3 months) is:
The normal heart rate for a newborn is 140 – 160 and an infant’s is 120 – 140 beats per minutes. Children between the ages of 1-6 have a heart rate of 100 – 120, while children over the age of 6 have a heart rate of 80 – 100 BPM.
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