Medical 2 Flashcards

A 68-year-old male presents with sudden facial droop, slurred speech, and right arm weakness. His wife states symptoms began about 45 minutes ago. What is your primary field diagnosis?

Answer: Stroke

Sudden onset facial droop, slurred speech, and unilateral arm weakness are the hallmark signs of stroke. Time of onset is critical information for the receiving hospital's stroke team. Rapid transport to a stroke center is your priority.

You respond to a 24-year-old female stung by a bee. She now has hives, severe throat tightness, labored breathing, and her BP is 80/50. What is your immediate treatment priority?

Answer: Administer epinephrine and prepare for rapid transport

This patient is in anaphylactic shock — a life-threatening systemic allergic reaction with hypotension and airway compromise. Epinephrine is the only first-line treatment for anaphylaxis. Antihistamines act too slowly and will not reverse cardiovascular collapse or airway swelling.

A 55-year-old male has crushing chest pain radiating to his left jaw and arm, diaphoresis, and nausea. BP is 140/90, HR 88, RR 16. He has no known drug allergies. What is the most appropriate field treatment?

Answer: High-flow oxygen, aspirin 324 mg, and rapid transport

Classic AMI presentation calls for oxygen to support myocardial demand, aspirin for its antiplatelet effect to limit clot propagation, and rapid transport to a PCI-capable facility. Aspirin should be given as soon as AMI is suspected unless contraindicated.

You find a 32-year-old male unresponsive on the floor. Bystanders say he had a seizure lasting about two minutes. He is now breathing adequately but remains unresponsive. What phase is this patient most likely in?

Answer: Post-ictal phase

The post-ictal phase follows the active seizure and is characterized by decreased responsiveness or unconsciousness as the brain recovers from the abnormal electrical activity. This phase can last from minutes to hours. Airway management and monitoring for additional seizures are the priorities.

A 70-year-old male with a documented history of COPD presents with severe dyspnea, audible wheezing on exhalation, and use of accessory muscles. His SpO2 is 88% on room air. What is the most appropriate oxygen delivery?

Answer: Nasal cannula at 2 L/min

Patients with severe COPD may rely on hypoxic drive to breathe rather than elevated CO2 levels. High-flow oxygen can suppress this drive and cause respiratory depression. Low-flow oxygen via nasal cannula targets an SpO2 of 88–92% in known COPD patients to avoid oxygen-induced hypoventilation.

A 45-year-old female reports a sudden 'thunderclap' headache she describes as the worst of her life. She also has neck stiffness and sensitivity to light. Vital signs are stable. What is your highest priority concern?

Answer: Subarachnoid hemorrhage

A sudden-onset 'worst headache of my life' combined with nuchal rigidity (neck stiffness) and photophobia is the classic presentation of subarachnoid hemorrhage until proven otherwise. This is a true neurological emergency and warrants immediate transport even with stable vitals.