Paramedics Exam Medical Emergencies 4

Question 1

A 72-year-old female presents with syncope, severe lightheadedness, and bradycardia at 38 bpm. She is pale and diaphoretic with a BP of 80/50. The ECG shows complete heart block. What is the first-line treatment?

Accepted Answer

Transcutaneous pacing

Answer

Transcutaneous pacing is the first-line treatment for symptomatic third-degree (complete) heart block because atropine is often ineffective at this level of block.

Question 2

A patient presents with urticaria, laryngeal edema, bronchospasm, and hypotension after eating shellfish. Which medication is the cornerstone of treatment?

Accepted Answer

Epinephrine 0.3 mg IM (1:1,000)

Answer

Epinephrine 1:1,000 administered IM into the lateral thigh is the first-line and potentially life-saving treatment for anaphylaxis, addressing bronchospasm and hypotension simultaneously.

Question 3

A 45-year-old male presents with profound weakness, hypotension, hyponatremia, hyperkalemia, and hyperpigmentation of the skin. He reports he stopped taking his steroid medication. What is the diagnosis?

Accepted Answer

Addisonian crisis (adrenal crisis)

Answer

Adrenal crisis presents with hypotension, electrolyte disturbances (hyponatremia, hyperkalemia), weakness, and skin hyperpigmentation, often precipitated by abrupt steroid discontinuation.

Question 4

You are treating a patient with narrow-complex tachycardia at 180 bpm who is hemodynamically stable. Vagal maneuvers have failed. What is the next appropriate intervention?

Accepted Answer

Adenosine 6 mg rapid IV push followed by saline flush

Answer

Adenosine is the first-line pharmacologic treatment for stable narrow-complex SVT after failed vagal maneuvers, as it temporarily blocks the AV node to terminate reentrant rhythms.

Question 5

A 60-year-old male with CHF presents with severe dyspnea, pink frothy sputum, SpO2 of 86%, bilateral crackles, and hypertension at 200/110 mmHg. What is the best prehospital treatment?

Accepted Answer

CPAP and nitroglycerin per protocol

Answer

CPAP improves oxygenation and reduces preload, while nitroglycerin reduces afterload and preload; both are evidence-based prehospital treatments for acute pulmonary edema with hypertension.

Paramedics Exam Practice Test

Paramedics Exam Practice Test

Paramedics Exam Medical Emergencies 4