Paramedics Medical Emergencies Questions and Answers

Question 1

A 72-year-old male complains of the sudden onset of a 'tearing' abdominal pain that radiates to his back.
He is pale, diaphoretic, and has a blood pressure of 82/54 mmHg with a heart rate of 124 bpm.
A pulsatile mass is palpable just superior to the umbilicus.
Which of the following is the most appropriate prehospital fluid management strategy for this patient?

Accepted Answer

Establish large-bore IV access and administer fluid boluses judiciously to maintain a systolic BP of 70-80 mmHg or presence of a radial pulse.

Answer

Administer 2-3 liters of normal saline as rapidly as possible to raise systolic BP above 120 mmHg.

Answer

Withhold all IV fluids to avoid hemodilution and worsening coagulopathy.

Answer

Administer a 500 mL bolus of 5% Dextrose in water to provide free water and support cellular function.

Question 2

You are dispatched to a farm where a 45-year-old male is found confused and vomiting. His coworkers state he was spraying pesticides without protective gear. The patient has pinpoint pupils, is profusely sweating and salivating, and is incontinent of urine. These findings are most characteristic of which toxidrome?

Accepted Answer

Cholinergic

Answer

Anticholinergic

Answer

Sympathomimetic

Answer

Sedative-Hypnotic

Question 3

A 19-year-old female with a history of Type 1 Diabetes is found lethargic by her roommate. She has deep, rapid respirations (Kussmaul breathing) and her breath has a distinct fruity odor. Her blood glucose level is 580 mg/dL. This presentation is most consistent with which diabetic emergency?

Accepted Answer

Diabetic Ketoacidosis (DKA)

Answer

Hypoglycemic Crisis

Answer

Myxedema Coma

Answer

Hyperosmolar Hyperglycemic State (HHS)

Question 4

You are assessing a patient with a suspected infection who was transferred from a skilled nursing facility. Using the quick Sequential Organ Failure Assessment (qSOFA) score, which combination of findings indicates a high risk for poor outcomes from sepsis?

Accepted Answer

Respiratory rate 24/min, Altered mental status, Systolic BP 98 mmHg

Answer

Heart rate 110 bpm, Temperature 38.5°C, New onset cough

Answer

Systolic BP 105 mmHg, Respiratory rate 18/min, GCS 15

Answer

Altered mental status, SpO2 92% on room air, Capillary refill > 3 seconds

Question 5

A 66-year-old female presents with a sudden onset of severe vertigo, ataxia (inability to walk straight), and diplopia (double vision). A FAST exam reveals no facial droop, arm drift, or speech slurring. These findings are most suggestive of a stroke occurring in which part of the brain?

Accepted Answer

Posterior circulation (vertebrobasilar system)

Answer

Right cerebral hemisphere

Answer

Frontal lobe

Answer

Left internal capsule

Question 6

An elderly man is found unresponsive in a non-air-conditioned home during a heatwave. His skin is flushed, hot, and notably dry. He has a rectal temperature of 41.1°C (106°F). Which of the following interventions is the most critical and immediate priority?

Accepted Answer

Initiating immediate and aggressive active cooling measures, such as applying cold packs to the groin and axillae and misting with water.

Answer

Administering IV acetaminophen to lower his core temperature.

Answer

Starting an IV of 0.9% Normal Saline and infusing it as rapidly as possible.

Answer

Covering the patient with a dry sheet to prevent heat loss and shivering.