Chapters 28,29,30

Front 1

The peripheral nervous system is responsible for:

Back 1

Sending messages to and receiving messages from the brain.

Front 2

Components of the diencephalon include the:

Back 2

Thalamus and hypothalamus.

Front 3

A person's level of consciousness is regulated by the:

Back 3

Reticular Activating System (RAS)

Front 4

What portion of the brain stem regulates respiratory rate and depth?

Back 4

Pons

Front 5

Emotions such as rage and anger are generated in the:

Back 5

Limbic system

Front 6

Among other functions, the medulla oblongata:

Back 6

Controls the BP & HR

Front 7

A loss of balance and equilibrium is MOST suggestive of injury to the:

Back 7

Cerebellum

Front 8

A synapse is:

Back 8

gaps between nerve cells across which nervous stimuli are transmitted.

Front 9

Chemicals that relay electrically conducted signals from one neuron to another are called:

Back 9

neurotransmitters

Front 10

A neoplasm is MOST accurately defined as a:

Back 10

A new growth caused by errors that occur during cellular reproduction.

Front 11

In contrast to a benign tumor, a malignant tumor:

Back 11

cancerous - neoplasms forcefully take over the blood supplies, grow and move to other places in the body.. Can be fatal.

Front 12

Degenerative conditions of the nervous system result when:

Back 12

a normal structure is altered over time (wear and tear)

Front 13

A 35-year-old athletic man experiences a stroke that completely incapacitates him, while a 55-year-old man who does not exercise and is sedentary gets a clean bill of health from his physician. The 35-year-old man MOST likely had a/an:

Back 13

has narrow arteries - by genetics

Front 14

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

Back 14

Fever

Front 15

When neurons are deprived of oxygen and glucose:

Back 15

brain cells resort to anaerobic metabolism to stay alive

Front 16

All of the following are examples of acute cerebrovascular emergencies, EXCEPT:

Back 16

Sudden occurrences typically result from emboli or aneurysms. Also, atherosclerosis narrows the walls of the arteries, and can eventually create a complete block.

Front 17

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

Back 17

Increased intracranial pressure

Front 18

As intracranial pressure rises:

Back 18

The amount of blood available to the brain decreases. A Drop in (CPP)

Front 19

What is the cerebral perfusion pressure of a patient with a mean arterial pressure of 80 mm Hg and an intracranial pressure of 5 mm Hg?

Back 19

CPP = MAP – ICP 75

Front 20

Which of the following would MOST likely cause a sustained increase in intracranial pressure?

Back 20

Blood, Swelling , Pus, or a tumor within the cranial vault.

Front 21

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

Back 21

Over oxygenation & Herniation

Front 22

For any patient with an increase in intracranial pressure, the paramedic must:

Back 22

ensure a blood pressure of at least 110 to 120 mmHg

Front 23

Hyperventilating a patient who has increased intracranial pressure (ICP) will:

Back 23

decrease CO2 (thereby decreasing ICP) and increase 02 (thereby decreasing brain perfusion) Pre hospital treatment is simply not very effective at decreasing ICP.

Front 24

Management for a patient with a neurologic emergency begins by:

Back 24

Assessing the neurologic patient as you would any other patient.

Front 25

Decerebrate posturing:

Back 25

The patient points the toes, and extends the arms outward and rotates the lower arms in a palms-down manner (called pronation). The wrists are flexed. This posture is a more sever finding than Decorticate posturing.

Front 26

All of the following cranial nerves are responsible for airway control, EXCEPT the:

Back 26

ARE RESPONSIBLE: trigeminal, glossopharyngeal, vagus, and hypoglossal nerves

Front 27

Patients with trismus often require:

Back 27

sedation or paralyzing to relaxed the clenched teeth

Front 28

In contrast to patients in shock, patients with increased intracranial pressure MOST often experience:

Back 28

the blood pressure rises, the heart/respiratory rates fall and the pulse pressure widens (systolic hypertention), this condition is known as Cushing’s reflex (opposite of shock)

Front 29

When communicating with a geriatric man who has dementia, you should:

Back 29

speak to family, friends, or other caregivers to determine the patient’s baseline LOC. Document that level clearly, using active language

Front 30

score of:

Back 30

12 (3 voice – 4 disoriented – 5 localizes pain

Front 31

An acutely frustrated, angry, or aggressive patient should be assumed to be:

Back 31

low glucose and oxygen levels or taking narcotics.

Front 32

A patient with a Glasgow Coma Scale (GCS) score of 8 or less:

Back 32

is critical (intubation, decrease scene time (less than 8, intubate) (closest appropriate facility)

Front 33

A patient with a unilateral eyelid droop when smiling:

Back 33

Can indicate Bell’s palsy or a stroke.

Front 34

A patient who is experiencing agnosia:

Back 34

PT’s will be unable to name common objects because connections between visual interpretation of objects and the words that name them have become damaged.

Front 35

A patient who is unable to use a common object is said to be:

Back 35

Apraxia.

Front 36

Which of the following is an example of receptive aphasia?

Back 36

The Pt cannot understand (receive) speech, but is able to speak clearly.

Front 37

__________ is a term used to describe changes in a person's ability to perform coordinated motions, such as walking.

Back 37

Ataxia

Front 38

Which of the following disease processes is characterized by an abnormal gait in which the patient places his or her feet very close together and shuffles while walking?

Back 38

Parkinson’s disease

Front 39

When performing the arm drift test on a patient with a suspected stroke, a positive finding is characterized by:

Back 39

Arm falling when eyes closed

Front 40

Which of the following signs is MOST commonly observed in patients with a severe headache or increased intracranial pressure?

Back 40

Nausea and vomiting

Front 41

Which of the following is NOT one of the three major elements that the brain needs to function?

Back 41

All Correct: Oxygen, Glucose, Normal Temperature

Front 42

An adult who opens her eyes in response to verbal stimuli, is disoriented, and localizes pain, has a Glasgow Coma Scale
score of:

Back 42

12 (3 voice – 4 disoriented – 5 localizes pain)

Front 43

Tremors that increase as the patient's hand gets closer to an object that he or she is trying to grab are called _________ tremors and are MOST common in patients with:

Back 43

Intention, Cerebral Palsy

Front 44

____________.

Back 44

Glands, Hormones

Front 45

Which of the following is NOT an exocrine gland?

Back 45

All correct: Liver, sweat glands, salivary glands

Front 46

Unlike exocrine glands, endocrine glands:

Back 46

Release chemicals directly into the bloodstream

Front 47

Molecules that bind to a cell's receptor and trigger a response, resulting in some kind of action or biologic effect, are called:

Back 47

Agonists

Front 48

If there is a physiologic level of antidiuretic hormone (ADH) in the bloodstream:

Back 48

The renal tubules are stimulated to reabsorb sodium and water

Front 49

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

Back 49

Hypothalamus

Front 50

Which of the following is an example of endocrine regulation via a negative feedback mechanism?

Back 50

Stress yields SNS stimulation which stimulates the adrenal medulla to release epi into the blood stream; when the stress stops, SNS stimulation is decreased and therefore epi is decreased in the blood stream

Front 51

If the body experiences a drop in volume or blood pressure:

Back 51

a decrease in sodium or an increase in potassium - the adrenal cortex is stimulated to secrete aldosterone. Which stimulates the kidneys to reabsorb sodium from the urine and excrete potassium by altering the osmotic gradient in the blood

Front 52

The adrenal medulla secretes norepinephrine following stimulation from the:

Back 52

hypothalamus

Front 53

The endocrine component of the pancreas:

Back 53

group of cells composes the islets of langerhans which acts like an organ inside of an organ main hormones that it secrets is glucagon and insulin.

Front 54

The release of glucagon into the bloodstream stimulates:

Back 54

the liver to change glycogen into sugar and secrete it into the blood stream where cells can use it for energy

Front 55

Which of the following statements regarding insulin is MOST correct?

Back 55

Insulin is responsible for the removal of glucose from the blood for storage of glycogen, fats, and protein.

Front 56

What is the function of estrogen?

Back 56

(A) Responsible for secondary sex characteristics: breast growth, fat accumulation at hips and thighs, pubic hair, growth spurts. (B) Involved in pregnancy (C) Regulation of menstrual cycle

Front 57

Diabetes is MOST accurately defined as:

Back 57

a metabolic disorder in which the body’s ability to metabolize simple carbohydrates (glucose) is impaired

Front 58

When the pancreas does not produce enough insulin or the cells do not respond to the effects of the insulin that is produced:

Back 58

Diabetes Mellitus

Front 59

Microvascular complications of diabetes include all of the following, EXCEPT:

Back 59

Retinopathy, Nephropathy, Neuropathy

Front 60

Type 1 diabetes that is secondary to an autoimmune disorder occurs when:

Back 60

(environmental factors may be part of the cause) Antibodies destroy the islets of Langerhans

Front 61

A person with type 1 diabetes:

Back 61

Usually don’t produce insulin at all

Front 62

Excessive alcohol consumption can lead to low blood glucose levels because:

Back 62

alcohol depletes glycogen stores in the liver.

Front 63

Insulin resistance occurs when:

Back 63

the pancreas produces enough insulin; but the body cannot effectively utilize it.

Front 64

Common symptoms of type 2 diabetes include all of the following, EXCEPT:

Back 64

Symptoms are: fatigue; nausea; frequent urination; thirst; unexplained weight loss; blurred vision; frequent infections and slow healing of wounds; being cranky, confused, or shaky; unresponsiveness; and seizure.

Front 65

Which of the following would NOT cause hypoglycemia in the insulin-dependent diabetic?

Back 65

CAUSES INCLUDE: too much insulin, too little food, or both

Front 66

The tissues of the central nervous system:

Back 66

depend entirely on glucose as their source of energy

Front 67

The clinical presentation of a hypoglycemic patient would MOST likely resemble that of a patient with:

Back 67

being intoxicated

Front 68

Thirty minutes of hypoglycemia in a patient:

Back 68

toxic compounds (free radicals) in the brain are produced that can cause permanent neuronal damage

Front 69

Prior to administering 50% dextrose (D50) via IV push, it is MOST important to:

Back 69

inject a test bolus of 10-20mL of NS making sure IV is not prone to infiltration. Recheck by lowering the IV bag and looking for backflow of blood.

Front 70

Hyperglycemia is characterized by:

Back 70

frequent and excessive thirst, accompanied by frequent and excessive urination.

Front 71

An illness or infection would MOST likely cause:

Back 71

hyperglycemia over the course of several days.

Front 72

Diabetic ketoacidosis (DKA) occurs when:

Back 72

Certain acids accumulate in the body because insulin is not available.

Front 73

Severe dehydration that commonly accompanies diabetic ketoacidosis is caused by:

Back 73

As the blood sugar rises, the Pt undergoes massive osmotic diuresis. This together with vomiting.

Front 74

Unlike the patient with hypoglycemia, the patient with severe hyperglycemia:

Back 74

Have high blood sugar that exceed normal range.

Front 75

A patient with diabetic ketoacidosis experiences polydipsia as a direct result of:

Back 75

Dehydration

Front 76

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

Back 76

Weakness, dehydration, loss of control of BP and stress response

Front 77

The primary role of cortisol is to:

Back 77

Assist with the body’s response to stress

Front 78

A patient with Cushing's syndrome would MOST likely present with:

Back 78

Hypoglycemia

Front 79

Signs and symptoms of hypothyroidism include:

Back 79

Bradycardia, sluggish reflexes

Front 80

Unlike hypothyroidism, hyperthyroidism:

Back 80

Causes and increase in oxygen demand

Front 81

An antigen is MOST accurately defined as a:

Back 81

Substance that causes the immune system to produce antibodies

Front 82

An abnormal immune response that the body develops when it is re-exposed to an allergen is called:

Back 82

Allergic reaction

Front 83

IgE antibodies respond in allergic reactions, and are located

Back 83

on mast and basophil cells.

Front 84

Which of the following immunoglobulins is thought to stimulate antibody-producing cells to make antibodies?

Back 84

IgD

Front 85

The term anaphylaxis is MOST accurately defined as:

Back 85

a form of allergy - a very extreme and devastating form - and allergy represents the body’s protective immune system gone overboard. OR it is an extreme systemic form of an allergic reaction involving two or more body systems

Front 86

In contrast to cellular immunity, humeral immunity:

Back 86

the body uses antibodies dissolved in plasma and lymph to wage war on invading organisms.

Front 87

Allergic rhinitis and asthma are MOST often the result of exposure to an allergen via the

Back 87

inhalation route.

Front 88

Following the primary response to a foreign substance, the body:

Back 88

the body develops chemical mediators and they remain inactive unless the body comes in contact with that same antigen again and then the chemical mediators attack it

Front 89

The chemical mediators that initiate and maintain the immune response are:

Back 89

Basophils and Mast Cells

Front 90

Physiological effects of histamine include all of the following, EXCEPT:

Back 90

Systemic vasodilation. Increased permeability of blood vessels. Decreased cardiac contractility and coronary blood flow. Dysrhythmias. Bronchoconstriction. Pulmonary Vasoconstriction.

Front 91

When a person is vaccinated against a disease:

Back 91

The body develops antibodies in response to the vaccine so it can produce an immune response to neutralize the invading disease before it can establish itself and damage the body.

Front 92

In contrast to acquired immunity, natural immunity occurs when:

Back 92

The body encounters the antigen and experiences a full immune response with all the pathology of the disease.

Front 93

Which of the following statements regarding leukotrienes is MOST correct?

Back 93

Leukotriene release causes coronary vasoconstriction, which contributes to a worsening cardiac condition and myocardial irritability.

Front 94

Which of the following clinical signs or symptoms are MOST indicative of upper airway swelling in a patient experiencing a severe allergic reaction?

Back 94

shortness of breath or dyspnea and tightness in the throat and chest. You may also note stridor and/or hoarseness.

Front 95

Cardiovascular effects of anaphylaxis include:

Back 95

Histamine and leukotrienes work directly on the heart to decrease contractility resulting in decrease in CO by vasodilation and increased capillary permeability, which further decreases the amount of fluid returned to the heart. As CO declines perfusion decreases, leading to ischemia and bringing the potential for cardiac dysrthythmias; 50% of vascular volume can be shifted to the extravascular space within 10min of exposure = blood vessels dilate causing hypotension resulting in low blood pressure, increased HR and stress on the compromised heart

Front 96

Common central nervous system manifestations of anaphylactic shock include all of the following, EXCEPT:

Back 96

CNS EFFECTS: headache, dizziness, confusion and anxiety

Front 97

What physiologic effect of anaphylactic shock is seen MOST commonly in patients with neurogenic shock?

Back 97

inability of the blood vessels to constrict

Front 98

The three MOST significant indicators of anaphylactic shock are:

Back 98

cardiogenic, hypovolemic, neurogenic.

Front 99

An unresponsive patient with signs of anaphylactic shock:

Back 99

oxygen level decreases or the carbon dioxide level increases. Should direct you to immediate airway evaluation and management.

Front 100

The MOST ominous respiratory sign in a patient with anaphylactic shock is:

Back 100

Stridor and hoarseness.

Front 101

Which of the following general statements regarding anaphylactic shock is MOST correct?

Back 101

An extreme systemic form of an allergic reaction involving two or more body systems.

Front 102

The primary treatment for hypotension secondary to anaphylaxis is:

Back 102

Epinephrine, if hypotension is unresponsive to epi then fluid admin

Front 103

In the absence of IV or IO access, the ____ route is the MOST appropriate route for the administration of an adrenergic agonist to a patient in anaphylactic shock.

Back 103

IM

Front 104

Diphenhydramine (Benadryl) is used to treat allergic reactions because it:

Back 104

Blocks the histamine effects at the H1 receptor sites

Front 105

Which of the following medications has the SLOWEST onset of action when given to a patient with a severe allergic reaction?

Back 105

Out of all the drugs mentioned on pg. 30.13-- Solu Medrol has the slowest onset of action I think. Double check this.

Front 106

The endocrine system comprises a network of ___________ that produce and secrete chemical messengers called __________.

Back 106

Glands, Hormones