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Medic 3

Drugs that have alpha or beta sympathetic properties are called

Vagolytics

Sympathominetics

Parasympatholytics

Adrenergic blockers

A patient with orthopnea

Generally has a slow, shallow respiratory pattern

Is awakened from sleep with severe dyspnea

Prefers to lie flat in orer to facilitate breathing

Seeks a sitting position when short of breathe

Aqueous humor

Cannot be replenished by the body if it is lost

Is contained in the anterior chamber of the eye

Is contained in the posterior chamber of the eye

Is found between the iris and the lens of the eye

Signs and symptoms of marijuana use include all of the following EXCEPT

Decreased appetite

Euphoria

Drowsiness

Bloodshot eyes

Myocardial ischemia occurs when the heart muscle ......

Is deprived of oxygen because of a blocked coronary artery

Experiences a decreased oxygen demand and an increased supply

Suffers oxygen deprivation secondary to coronary vasodilation

Undergoes necrosis because of prolonged....

Which of the following is a potentially life-threatening complication of missing one or more dialysis treatments?

Hyperkalemia

Uremic frost

Peripheral edema

Hypocalcemia

Ventricular fibrillation occurs when......

Cardiac cells in the ventricles fall to completely repolarize, resulting in a decrease in ventricular automaticity

The ventricles become the primary pacemaker for the heart, resulting in rapid and irregular ventricular rhythm

The ventricles quiver rather than contract.....

Many different cells in the heart depolarize independently rather than in response to an impulse from the SA node

A decrease in adrenal hormone production will result in all of the following, EXCEPT

Hypertension

Weakness

Inability to respond to stress

Dehydration

A hallmark sign of mania is

Memory distortion

Persistent insomnia

Marked hyperactivity

Speech retardation

Most of the digestive process occurs in the

Small intestine

Jejunum

Pancreas

Liver

Common signs and symptoms of menningitis include

Irritability, back pain, headache and hypertension

Mental status changes, fever, stiff neck and....

Slow-onset fever, tinnitus and an occipital headache

A dark red rash, combativeness and low grade fever

Common clinical findings in patients with obstructive lung disease include all of the following, EXCEPT

Chronic air trapping in the lungs

A decreased expiratory phase

Abdominal muscle use

Pursed-lip breathing

Implantation of a fertilized egg within a fallopian tube

Represents only 3% of all ectopic pregnancies

Produces atypical signs of pregnancy

Can cause severe intra-abdominal hemorrahging

Is usually detected after the 20th week of pregnancy

Organophosphates exert their effect by......

Stimulating the cholinergic nervous system

Agonizing the sympathetic nervous system

Blocking the parasympathetic

Destroying the body's acetylcholine

When managing cardiac arrest, the appropriate dosing regimen for epinephrine is

1 ml of a 1:10,000 solution every 3 to 5 minutes

10 ml of a 1:1,000 solution every 3 to 5 minutes

0.1 mg/kg of a 1:10,000 solution every 3 minutes

1 mg of a 1:10,000 solution every 3 to 5 minutes

Most of the blood's formed elements are.....

Leukocytes

Erythrocytes

Electrolytes

Platelets

A patient with cardiogenic shock and pulmonary edema should be positioned

Supine with the legs elevated

In the Trendelenburg position

In a semi-Fowler's position

In a lateral recumbent position

The toxicity of carbon monoxide arises primarily from

Its destructive properties on ferric ions

Its affinity for hemoglobin in red blood cells

Its ability to markedly decrease the metabolic rate

The fact that carbon monoxide destroys hemoglobin molecules

The odor of bitter almonds on a patients breath should make you suspicious for exposure to

Cyanide

Phosphorus

Arsenic

Turpentine

A morbidly obese man called 911 because of difficulty breathing. When you arrive, you find the 39 year old patient lying supine in his bed. He is in marked respiratory distress and is only able to speak in two word sentences. He has a history of hypertension, but denies any respiratory conditions. What should you do FIRST?

Assess his oxygen saturation level

Sit him up or place him on his side

Begin assisting his ventilations

Administer a beta 2 agonist drug

In contrast to dementia, delirium:

Generally results from conditions such as Alzheimer disease

Is characterized by acute global impairment

Is an irreversible process caused by premature cerebral deterioration

Is a chronic process that causes deficits in memory and abstract thinking

A person who compulsively uses a drug, despite the fact that he or she knows the drug will cause physical or psychological harm is......

Addicted

Tolerant

Dependent

An abuser

The skin of a patient with chronic renal failure is MOST often:

Jaundiced

Cyanotic

Cool and dry

Flushed

Which of the following would have the MOST negative effect on the outcome of a patient with an intracranial hemorrhage?

Slow rise in intracranial pressure

Hypotension

Tachycardia

Hypertension

A pure alpha agent:......

Causes marked vasoconstriction

Has a direct effect on the heart rate

Decreases the blood pressure by dilating the vessels

Causes moderate bronchoconstriction

The by-product of cellular respiration is:

Carbon dioxide

Oxygen

Pyruvic acid

Lactic acid

A physiologic effect of sympathetic nervous stimulation includes:

Dilation of the bronchioles

A negative dromotropic effect

Decreased conduction velocity

Dilation of the blood vessels

Cor pulmonale is defined as

Rupture of the alveoli due to increased surface tension

Left heart failure secondary to mitral valve damage

Right heart failure secondary to chronic lung....

Increased preload caused by sever hypertension

A marked decrease in urine output is called......

Oliguria

Polyuria

Dysuria

Anuria

Prior to administering 50% dextrose (d50) via IV push, it is MOST important to:

Confirm a blood glucose reading of less than 40 mg/dl

Protect the airway with an endotracheal tube

Draw blood for later analysis in the emergency department

Ensure that the IV line is patent and freely.....

Decerebrate posturing

Is an early clinical finding, because it occurs with minimal increases in intracranial pressure

Is a more sever finding than decorticate

Is characterized by abnormal flexion of the arms and extension of the lower extremities

Is considered less severe than decorticate posturing, because it indicates that the brainstem is intact

A 39 year old man in asystole has been unresponsive to high quality CPR and two doses of epinephrine. The patient is intubated and an IO catheter is in place. You should focus on:

Transcutaneous cardiac pacing

Establishing a peripheral IV line

Searching for reversible causes

Providing nild hyperventilation

A patient with status asthmaticus commonly presents with.....

Audible expiratory wheezing and sever cy....

Physical exhaustion and inaudible breath sounds

Compensatory respiratory alkalosis and stridor

Accessory muscle use and inspiratory wheezing

Automaticity is defined as the ability of the hear to:

Increase or decrease its heart rate based on the body's metabolic needs

Generate its own electrical impulses witho......

Spontaneously conduct an electrical impulse between cardiac cells

Generate an electrical impulse from the same site every time

A psychiatric emergency

Is generally the result of a short-term emotional crisis that is treated effectively with behaviour modification

Is caused by a chemical imbalance in the brain but does not interfere with activities of daily living

Generally occurs following the use of illicit drug or excessive consumption of alcohol

Exists when a person's abnormal behavior....

The MOST immediate and significant complication associated with a hemorrhagic stroke is:

Acute hypovolemic shock

Hypertension and bradycardia

Mean arterial pressure increase

Increased intracranial pressure

Diabetes is MOST accurately defined as:

A metabolic disorder in which the body's a.....

An endocrine disorder in which the liver is unable to produce and store adequate amounts of glycogen

Inadaquate insulin secretion, which leads to increased circulating blood glucose levels

A decrease in circulating insulin levels, which results in a drop in serum blood sugar levels

Hepatojugular reflux occurs when:

A patient's jugular veins are markedly engorged when lying in a supine position

Left sided heart failure causes blood to accumulate in the patients liver

The jugular veins collapse in response to palpation of the right upper quadrant

Mild pressure placed on the patients liver......

The primary anatomic link between the endocrine system and the nervous system is/are the

Pancreas

Hypothalamus

Adrenal cortex

Adrenal glands

In contrast to negative-pressure ventilation positive pressure ventilation:

Occurs when the diaphragm descends

Is the forcing of air into the lungs

Can only be provided to intubated patients

Is provided with a nonrebreathing mask

The brief pause between the P wave and QRS complex represents

The period of time when the atria are repolarizing

A momentary conduction delay at the AV.....

Full dispersal of electricity throughout the atria

Depolarization of the inferior part of the atria

A known heroin abuser is found unconscious on a park bench. Your assessment reveals that his respirations are slow and shallow. And his pulse is slow and weak. You should:

Assist ventilations with a bag-mask device....

Apply oxygen via nonrebreating mask, administer naloxone and be prepared to assist ventilations

Suction his oropharynx, perform intubation and then administer naloxone via slow IV push

Preoxygenate him with a bag-mask device for 2 to 3 minutes and then intubate his trachea

A beta adrenergic blocker would counteract all of the following medications, EXCEPT

Epinephrine

Norepinephrine

Atropine

Isoproterenol

In dark skinned patients, cyanosis can be detected in the ......

Iris

Cornea

Conjuntiva

Sclera

Vasoconstriction occurs following stimulation of

Alpha receptors

Beta-2 receptors

Beta-1 receptors

Alpha and beta receptors

Hepatomegaly and jugular venous destention are MOST suggestive of

Right heart failure

Left heart failure

Severe pneumonia

Pulmonary edema

An arteriovenous fistula is usually located in the ......

Forearm or upper arm

Patient's groin area

Distal lower extremety

Peritoneal cavity

You are dispatched to a grocery store for a woman with severe abdominal pain. When you arrive, you find the patient lying on her side in the manager's office. She is confused, is diaphoretic, and appears to be bleeding from her vagina. Her blood pressure is low and her pulse and respiratory rates are elevated. You should:

Administer 100% oxygen, elevate her legs 12 to 18 inches, keep her warm, establish vascular access and give a 500 ml fluid bolus, reassess her blood pressure and transport at once with continuous monitoring en route to the hospital

Assist her ventilations with a bag-mask device, carefully place a trauma dressing inside her vagina to control the bleeding, begin rapid transport, establish two large-bore IV lines en route and administer 20 ml/kg fluid boluses as needed

Apply high-flow oxygen, visually inspect......

Immediately place her in a supine position, firmly massage her uterine fundus to control the bleeding, establish two large-bore IV lines and run them wide open, transport at once and apply high-flow oxygen en route to the hospital

A sudden increase in end-tidal CO2 may be the earliest indicator of

Inadvertent ET tube dislodgment

Return of spontaneous circulation

Ineffective chest compressions

Developing respiratory alkalosis

After delivering a shock to a patient in pulseless ventricular tachycardia you should:

Resume CPR

Deliver two effective ventilations

Reassess the cardiac rhythm

Check for a pulse

An adult who opens her eyes in response to verbal stimuli, is disoriented and pushes your hand away when you palpate a painful area has a Glasgow Coma Scale score of:

Organic brain syndrome is a term used to describe a condition in which a person's abnormal behavior is:.....

Irreversible and cannot be linked to a.....

Caused by premature brain cell deterioration that is progressive and cannot be reversed

Caused by a physical illness or the influence of a substance that interferes with normal cerebral function

Directly related to an endocrine disturbance that results in the underproduction of key hormones

Frothy sputum that has a pink tinge to it is MOST suggestive of:

Turberculosis

Antihistamine use

Chronic bronchitis

Congestive heart failure

In contrast to somatic pain, visceral pain

Is well localized

Indicates peritonitis

Increases with movement

Is difficult to localize

Bedridden patients with excessive pulmonary secretions are MOST prone to developing

A pneumothorax

A pulmonary embolism

Bronchospasm

Pneumonia

In contrast to stable angina, unstable angina.....

Occurs following periods of strenuous exertion

Indicates that myocardial necrosis ......

Is less frequent but is associated with more pain

Often awakens the patient from his or her sleep

Untreated ventricular tachycardia would MOST likely deteriorate to

Pulseless electrical activity

Torsade de pointes

Ventricular fibrillation

Asystole

The presense of a J wave (Osborn wave) on the ECG is an indicator of

A delta wave

Hyponatremia

Hypothermia

Hypercalcemia

Cardiovascular effects of anaphylaxis include

Diaphoresis, bradycardia and edema

Tachycardia, flushed skin and hypoten....

Peripheral vasoconstriction and cool skin

An irregular pulse, pallor and pruritus

Filtering of blood and recycling of dead red blood cells are functions of the......

Spleen

Liver

Pancreas

Kidneys

Virulence is defined as the

Severity of infection once an organism enters the body

Degree of difficulty that is takes to destroy an organsim

Ability of an organism to invade and......

Amount of time that it takes for an organism to infect the host

You are assessing the 12-lead tracing of a 40 year old man with chest pain and note ST-segment elevation in leads II, III and a VF. Lead V4R shows 2mm ST-segment elevation. The patient's blood pressure is 88/58 mm hg and his heart rate is 72 beats/min and regular. He denies any significant past medical history but is allergic to salicylates. After placing the patient on oxygen and starting an IV line of normal saline, you should:

Administer up to 325 mg of baby aspirin

Start a dopamine infusion at 2 mcg/kg/min

Give 2 mg increments of morphine sulfate

Give crystalloid boluses to increase....

Patients with decompensated asthma or COPD who require positive pressure ventilation

May develop a pneumothorax or experience....

Should be intubated promptly and ventilated at a rate of 20 to 24 breaths/min to eliminate excess carbon dioxide

Should be ventilated routinely at a rate that is slightly faster than the rate for a patient without an underlying pulmonary disease

Should be given forceful positive pressure breaths because their primary problem is difficulty with inhalation

__________antibodies respond in allergic reactions and are located ______________

LgG, in the blood, lymph and intestines

LgD, in the lymph and blood

LgA, in tears, saliva, blood and lymph

LgE, on the mast and basophil cells

A synapse is

The point where a nerve cell terminates

A cluster of sensory nerve cells

A slight gap between nerve cells

The body's main neurotransmitter

A regular cardiac rhythm with a rate of 104 beats/min, upright P waves, a PR interval of 0.14 seconds and ORS complexes that measure0.10 seconds should be interpreted as

Sinus tachycardia

Junctional tachycardia

Supraventricular tachycardia

Normal sinus rhythm

The MOST common sign of an infectious disease is the presence of......

Seizures

A fever

A headache

Tachycardia

Abnormal breath sounds associated with pneumonia and congestive heart failure are MOST often heard in the......

Bases of the lungs

Apices of the lungs

Right middle lobe

Midaxillary line

A classic sign of atrial flutter is

The presence of sawtooth F waves

A ventricular rate less than 100 beats/min

A constant 2:1 conduction ratio

An irregular but consistent R-R interval

_________cells are found in the lining of the airways and produce a blanket of mucus that covers the entire lining of the conducting airways

Goblet

Kupfer

Ciliary

Alveolar

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