EMT Medical Practice Test 3
Patients who inhale poisons to get high are often referred to as _____________?
Huffing usually occurs by placing a small amount of chemical, glue, paint or cleaner in a paper bag and then the huffer places the bag over their mouths and/or noses and inhales deeply. This causes an anoxic response in the brain which causes all of the blood vessels to dilate. This gives the huffer a period of euphoria and then a pounding head ache.
There are many causes of syncope. When does a syncopal episode usually happen?
Most syncopal episodes occur when the patient stands - postural hypotension. Blood has been pooling in the dependant appendages, when the patient stands cardiac output drops and the patient passes out.
This type of seizure activity is absent of large muscle contractions. The patient often just stares off in space.
Petit mal seizures are generally thought of as an absence of seizure activity. They usually present with the young patient staring off in space with little to no muscle contractions. Petit mal seizures are generally short in nature and there is usually no postictal period, the patient just wakes up and realizes that something happened.
There are few antidotes for the number of poisons available, so what is the treatment goal for a poisoning if there is no antidote?
If a particular poison does not have an antidote the next best treatment is to limit the amount of the poison to be absorbed. Activated charcoal is often used to absorb ingested poisons. Brushing off powdered poisons or flushing with high volumes of water will block, slow or prevent absorption. Once the absorption has been controlled or contraindicated then you are left to treating symptoms.
Which of the following does not lead to seizure activity?
There are many complications secondary to diabetes and there certainly can be co-morbid chronic medical conditions. Diabetes, however, does not lead to seizure activity. A seizure can occur at the time of a head injury but usually develop during the recovery phase. Seizures from opioid withdrawal can occur as a result of the patient quitting the drug, running out, or the use of an antagonist (Narcan).
Anaphylactic shock is a form of distributive shock where the blood vessels _______________?
Due to the chemical release from the immune system, bronchioles constrict causing blood vessels to dilate and dropping the blood pressure. Capillaries become permeable and leak a little causing hives to form on the skin. Distributive shock is difficult to recognize in the field, heart rate remains relatively low, skin is flushed due to the dilatation of the blood vessels.
After aggressive airway control, the next treatment choice would be epinephrine. Why would epinephrine be such a good choice?
Epinephrine has Alpha 1 & 2 beta 1 & 2 effects. Alpha 1 stimulation causes vaso constriction which works to counter the distributive shock. Alpha 2 stimulation regulates the amount of vaso constriction required to achieve desired results. Beta 1 stimulation increases the heart rate to increase cardiac output. Beta 2 stimulation dilates the bronchioles to counter act the reactive airway syndrome.
Your patient has a history of epYour patient has a history of epilepsy. He has had a seizure and has not recovered the way he normally does, according to his family. While assessing this unresponsive patient, he suffers a second seizure. What is this con
When a patient has a second or subsequent seizures without waking up, this is classified as status epilepticus. This condition is a serious problem. Secondary hypoxia causes more cerebral irritation and propagation of ectopic foci which causes more seizures.
Food poisoning may be difficult in the field to diagnose due to its broad range of symptoms and the time it takes to make the patient ill. All of the following are types of food borne illness except?
Encephalitis is an infection of the brain usually viral in nature. All of the others are indeed food borne illnesses.
Arriving on scene of any allergic reaction, what is the clinician's first concern regarding the patient?
Airway edema and bronchial constriction/ edema (reactive airway) should be the first concern for the EMT to attend to. Without an airway the patient will die, without the ability to ventilate the patient then the patient will become hypoxic which may cause brain damage and death.
Routes of entry for accidental poisoning are the same as for allergic reactions. What route is the most common route of entry for a poisoning?
Ingestion is the number one cause of accidental poisoning mostly secondary to children eating or drinking stuff they shouldn't. Smaller children explore with their mouths, they don’t have enough dexterity or experience with much other than eating or placing things in their mouths, hence drinking or eating things which could be hazardous to them.
You arrive to find the patient actively seizing. What is your primary concern with this patient?
When a patient is actively seizing, all muscles are contracting erratically without coordination so there are ineffective respirations. Plus with every muscle contracting there is an increase in oxygen demand so the patient will be in oxygen debt. Also there may be a partial or complete airway obstruction.
Poisonous ingestions by children usually occur ____________?
Most child poisonous ingestions occur accidentally. Children explore with their mouths and once they find something new they usually place it in their mouths to taste.
While interviewing a patient with a complaint of an allergic reaction, your partner asks, "What is new and different?" Most patients with an allergy must be exposed to the allergen at some point. What is the process called?
Sensitization is the process where an antigen enters the body and there is an immune response where antibodies are produced to protect the organism from an invader. The antibodies help protect the patient from developing an overreaction towards the antigen which will then become an anaphylactic reaction. Anaphylactic reaction is such a massive response against a first time exposure to an antigen this reaction looks like a full on anaphylaxis, the differential is no prior sensitization.
Which of the following routes of entry is the most common cause of anaphylactic reaction?
Injection is the most common way an allergen will be exposed to a patient: medicine being injected by a syringe, insects stinging and animal bites
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