Tier 2 Test 4

Front 1

Definition of a Poison

Back 1

A substance that is toxic by nature, no matter how it gets into the body or in what quantities it is taken.

Hint 1

33.4

Front 2

Idiosyncrasy

Back 2

A completely unique response to a drug, not usually seen in other pts.

Hint 2

7.22

Front 3

Ingested poison management

Back 3

Management is aimed at removing or neutralizing the poison before it gains access to the intestine.

Hint 3

33.5

Front 4

Opiods vs. Opiates

Back 4

While opiate is used to describe natural drugs derived from opium, the term opioid refers to non-opium-derived synthetics, licit therapeutic agents and illicit substances in this group.

Hint 4

33.19

Front 5

Common presentations of Methamphentamine abuse

Back 5

A low cost, long-acting stimulant. Much the same presentation as cocaine just much longer, including excitment, delirium, tachycardia, hypertension or hypotension with a fast pulse. Toxic levels can lead to psychosis, hyperpyrexia, tremors, seizures, and cardiac arrest.

Hint 5

33.14

Front 6

Side effects of sympathomimetic drugs

Back 6

HTN, tachycardia, dilated pupils (mydriasis), agitation, seizuers, and hyperthermia.

Hint 6

33.8

Front 7

Types of anticholinergic drugs

Back 7

Atropine, scopolamine, antihistamines, and antipsychotics

Hint 7

33.8

Front 8

Drugs that can cause hypertension and tachycardia following exposure

Back 8

Stimulants, and sympathomimetic

Hint 8

33.8

Front 9

S&S of cyanide exposure

Back 9

Alter mental status, if patient is awake enough them may complain of headache, palpitations, or dyspnea. Bitter almonds on the pt's breath, rapid and thready pulse, vomiting, seizures, and coma are common.

Hint 9

33.22

Front 10

Toxins that can cause acetone breath odor side effect

Back 10

Methyl alcohol, isopropyl alcohol, asa, and acetone.

Hint 10

33.8

Front 11

drug abuse

Back 11

Any use of drugs that causes physical, psychological, economic, legal, or social harm to the user or to others affected by the drug user's behavior.

Hint 11

33.9

Front 12

psychological dependence

Back 12

A physiologic state of adaptation to a drug, usually characterized by tolerance to the drug's effects and a withdrawal syndrome if the drug is stopped, especially if it is stopped abruptly.

Hint 12

33.9

Front 13

tolerance

Back 13

Physiologic adaptation to the effects of a drug such that increasingly larger doses of the drug are required to achieve the same effect.

Hint 13

33.9

Front 14

addiction

Back 14

A chronic disorder characterized by the compulsive use of a substance resulting in physical, psychological, or social harm to the user, who continues to use the substance despite the harm.

Hint 14

33.9

Front 15

potentiation

Back 15

Enhancement of the effect of one drug by another drug.

Hint 15

33.9

Front 16

Why alcoholics are more prone to subdural hematomas & gastrointestinal bleeding

Back 16

Alcohol impairs clotting mechanism.

Hint 16

33.10

Front 17

Side effects of delirium tremens

Back 17

A severe withdraw syndrome in alcoholism characterized by restlessness, fever, sweating, disorientation, agitation, and seizure, fatal if untreated.

Hint 17

33.42

Front 18

Priorities in the management of the OD patient

Back 18

Scene safety
ABCs
High flow oxygen
IV access
Manage shock, coma, seizures, and arrhythmias.
Transport ASAP consider left lateral recumbent position.

Hint 18

33.13

Front 19

Stimulant abuser clinical presentation

Back 19

Excitement, delirium, tachycardia, hyper or hypotension with a fast pulse, and dilated pupils.

With a toxic level the pt may develop outright psychosis, hyperprexia, tremors, seizures, and cardiac arrest.

Hint 19

33.13

Front 20

Components of crack

Back 20

Cocaine is a naturally occurring alkaloid that is extracted from the Erythroxylon coca plant leaves found in South America, hydrochloride from 2 to 100%.

Hint 20

33.13

Front 21

ECG abnormalities and cocaine toxicity

Back 21

Widening QRS and prolonged QT, wide-complex arrhythmias, negative inotropic decreasing cardiac output, hypotension, initially tachy followed by bradycardia.

Hint 21

33.14

Front 22

Pre-hospital treatment of the stimulant overdose patient

Back 22

Vitals, Oxygen, Monitor, IV bolus for BP as needed, Transport
Consider Benzo or Halodol as needed.

Contraindicated to give beta-adrenergic antagonist agents as it may cause deadly hyperthermia.

Hint 22

33.15

Front 23

LSD Classification

Back 23

All arounders upper and downer mostly sympathomimetic.
Hallucinogen

Hint 23

33.15

Front 24

Causes of cardiac arrest in the narcotic overdose patient

Back 24

Usually secondary to respiratory arrest.

Hint 24

33.19

Front 25

Narcan recommended dosage and administration

Back 25

0.4 to 2 mg of naxoxone

Front 26

S&S of CO toxicity

Back 26

Early onset resembles the flu-H/A, nausea, and vomiting. Progresses to confusion, pressure or roaring in ears are common.

Physical finding include bounding pulses, dilated pupils, pallor or cyanosis.

Cherry red color is late and usually related to death.

Hint 26

33.21

Front 27

Cyanide poisoning treatment

Back 27

The aim of treatment is to displace the cyanide from the cytochrome oxidase by introducing another chemical that will "attract" the cyanide. In the prehospital setting, that is usually amyl nitrate because of the ease of administration, usually effective if given quickly. Antidote kit include IV 50 mL of sodium thiosulfate solution.

Hint 27

33.22-23

Front 28

Uses for GHB

Back 28

Gamma-Hydroxybutyric Acid is best known of the date-rape drugs.

Only prescribe accepted tx is rare case form of narcolepsy (random falling asleep)

Front 29

Characteristics of Tricyclic Antidepressants

Back 29

Use to be first line tx of depression, now further down the line and also used for pain management. S/S of OD vary but the most common is altered mental status, arrhythmias, dry mouth, blurred vision or dilated pupils, urinary retension, constipation, and pulmonary edema. With a more serious toxic exposure, be alert for v-tach, hypotension, respiratory depression, QT prolongation, and seizures.

Hint 29

33.29

Front 30

Regulatory functions of the blood

Back 30

Respiratory function-Exchange of oxygen and carbon dioxide.

Nutritional function-Carries nutrients (glucose, proteins in fats) from GI tract throughout the body

Excretory function-Ferries wates

Regulatory function-Transport hormones to target organs and heat to the surface to dissipate.

Defensive function-Defensive cells.

Hint 30

34.3

Front 31

Formed elements composition and percentage in the blood

Back 31

Two main components of blood being plasma and formed elements (cells).
Plasma is 92% water and the 6 to 7% are proteins, the rest is a variety of element including electrolytes, clotting factor, and glucose.

Plasma accounts for 55% of total blood. The formed elements account for 45% and include RBC, WBC, and platelets or thrombocytes, most being RBCs (99%).

Hint 31

34.3

Front 32

The definition of hemocrit

Back 32

The percentage of RBCs in total blood volume.

Hint 32

34.15

Front 33

Primary site for cell production in the body

Back 33

The bone marrow is the primary site for cell production in the human body, mainly long bones.

Hint 33

34.5

Front 34

Where clotting factors are made

Back 34

The liver producers the clotting factor found in blood.

Hint 34

34.5

Front 35

Blood types and transfusion reactions

Back 35

In the ABO system, the RBC classification types are "O" "A" "B" and "AB", indicating which antigens are found in the plasma. Transfusion reactions are similar to anaphylactic reactions typically hippen in the first 30 to 60 mins.

Hint 35

34.6

Front 36

Causes of anemia

Back 36

Usually associated with some type of underlying disease process. May result from and acute or chronic blood loss or a decrease in production or increase destruction of erythrocytes. May also be an outcome of a preexisting hemolytic disorder breakdown of RBCs.

Hint 36

34.6

Front 37

Chronic leukemia vs. acute leukemia

Back 37

Chronic tends more frequent in older population, abnormal mature lymphoid cells accumulate in bone marrow, lymph nodes, spleen, and peripheral blood.

Acute leukemia, bone marrow is replaced with abnormal lymphoblasts. Often in children, many of which are cured with chemotherapy and radiotherapy.

Front 38

Definition and presentation of Hodgkin lymphoma

Back 38

Painless progressive enlargement of the lyphoid gland, most commonly affecting the sleen and the lymph nodes.

Hint 38

34.8

Front 39

Causes of abdominal pain with polycythemia

Back 39

Polycythemia is overabundance of RBCs. Abdominal pain is usually associated with a enlarged spleen.

Hint 39

34.8

Front 40

Side effects of stage 2 disseminated intravascular coagulopathy

Back 40

In stage 1 the clotting team boost to handle massive trauma and hypotension, but in the second stage a severe reduction in clotting factor causes uncontrolled hemorrhage. 75% deadly.

Hint 40

34.8

Front 41

Causes of hypoxia in the sickle cell patient

Back 41

The defective RBCs are misshapen; affected cell have an oblong shape instead of a smooth, round shape, making the RBCs a poor oxygen carrier which makes the pt highly susceptible to hypoxia.

Hint 41

34.9

Front 42

Assessment priorities in the hematologic disorder patient

Back 42

The same as other pts other than considering a few extra questions to ask.

Hint 42

34.9

Front 43

Pre-hospital treatment considerations for the altered LOC leukemia patient

Back 43

Know what the family in pt wants especially in arrest situation.

Hint 43

34.11

Front 44

Pain management in the lymphoma patient

Back 44

Since they are in constant pain, you may have to be aggressive, use med con. They should receive fluid, oxygen, and analgesics.

Hint 44

34.12

Front 45

Transport considerations for the hemophiliac patient

Back 45

Treat for shock, hypotension, and loss of blood. Remember BLS including Trendalenburg position.

Front 46

Pain management in the sickle cell patient

Back 46

Use high levels of oxygen to prevent further destruction of RBC's due to hypoxia. Many times dehydrated give fluids. Often require high levels of analgesic due to their high pain threshold.

Hint 46

34.13

Front 47

Examples of indirect microorganism contact

Back 47

Touching a blood stretcher or using the same towel as a pt.

Hint 47

36.6

Front 48

Bacteria vs. Viruses

Back 48

Bacteria invade and multiply in the host.
Viruses are much smaller than bacteria and can multiply only inside a host. Viruses die when exposed to environments for example HIV does not multiply or maintain its infectiousness outside a living host.

Hint 48

36.6

Front 49

Examples of parasites

Back 49

Live in or on another creature, needing that creature to survive. Includes scabies, lice, amoebas, citiates, flagellates, and sporozoans.

Hint 49

36.6

Front 50

The definition of virulence

Back 50

The ability of an organism to invade and create disease in a host. It encompasses the organism's ability to survive outside the living host. Ex HIV does not pose a risk outside the human body b/c it dies upon exposure to air and light.

Hint 50

36.6

Front 51

The definition of host resistance

Back 51

Your ability to fight off infection.

Hint 51

36.6

Front 52

The definition of a reservoir

Back 52

A place where an organism may live and multiply. Humidifier are a common reservoir in ambulances.

Hint 52

36.7

Front 53

Causes of health care workers fears of contracting communicable diseases

Back 53

Fear comes from lack of proper education and training, and there is no reason a paramedic should not be properly educated about disease issues.

Hint 53

36.7

Front 54

BSI vs. Standard precautions

Back 54

BSI assumes that all blood and body fluids are infectious. Standard precautions adds another element, protection from moist body substances that may transmit other bacterial or viral infections.

Hint 54

36.8

Front 55

Vaccinations/immunizations included on the CDC Control & Prevention l list

Back 55

-Hep B vaccine
-Measles, mumps, rubella (MMR)
-Chickenpox vaccine
-TB
-Tetanus (at least every 10 years)
-Flu vaccine (yearly)

Hint 55

36.8

Front 56

Components and definition of PPE

Back 56

Personal protective equipment serves as a secondary protective barrier beyond what your body provides .

Front 57

Components of proper hand washing

Back 57

Use of antimicrobial, alcohol-based foams or gels. Use of antibacterial products is not recommended, due to leaving normal flora intact.

Hint 57

36.9

Front 58

Components of the Ryan White Law

Back 58

Requires that every EMS agent have a designated infection control officer (DICO). Responsible for postexposure process. Rx must be offer in 24 to 48 hours from exposure, actual time frame base on diagnosis. Protects privacy, also requires reporting to a specific reporting system.

Hint 58

36.7

Front 59

S&S of measles

Back 59

Also known as rubeola, a highly communicable viral dz characterized by fever, conjuctivitis, a blotchy red rash, and whitish gray spots on buccal (mouth) mucosa. Spread by droplet transmissions.

Hint 59

36.12

Front 60

CDC childhood immunization recommendations

Back 60

-Measles, mumps, and rebella (MMR)
-Diphtheria, pertussis, tetanus (DPaT)
-Hep A virus (HAV)
-Hep B virus (HBV)
-Inactivated poliovirus (IPV)
-Haemophilus Influenzae type b (Hib)
-Annual flu vaccine

Front 61

S&S of the mumps

Back 61

Viral dz most common in winter in sping. S/s in children include fever plus swelling and tenderness of one of the salivary glands, usually the parotid. Mumps in males past puberty may have very painful complications, inflammation of the testicles occurs in ~25% of cases. Transmitted by droplet, immunization available and common.

Hint 61

36.13

Front 62

Causes of shingles

Back 62

Also known as herpes zoster, arises when the chickenpox virus takes up residence in the ganglion of a nerve. When the pt becomes stressed, lesions may appear along the affected nerve pathway, and can be extremely painful.

Hint 62

36.13

Front 63

Common S&S of meningitis

Back 63

An inflammation of the membranes that cover the brain and spinal cord, the meninges. Transmitted through air droplets. S/s include sudden-onset of fever, severe H/A, stiff neck, photosensitivity, and pink rash that becomes purple in color. May also have changes in alter mental status, ranging from apathy to delirium, projectile vomit is common, dx by Gram's stain.

Hint 63

36.14

Front 64

S&S of TB infection

Back 64

Persistent cough for more than 3 weeks plus one of more following: night sweats, H/A, weight loss, hemoptysis, or chest pain. Not highly communicable dz.

Hint 64

36.14

Front 65

S&S of mononucleosis

Back 65

Caused by a herpes virus.
Transmission through direct contact to infected saliva. S/s sore throat, fever, secretions from pharynx, and swollen lymph glands, with or without malaise, anorexia, H/A, muscle pain, and an enlarged liver and spleen.

Hint 65

36.16

Front 66

Transmission of gonorrhea

Back 66

Transmission occurs by sexually, by contact with the pus-containing fluid from mucous membranes of infected person.

Hint 66

36.16

Front 67

Gonorrhea presentation in females

Back 67

The initial inflammation of the urethra or cervix is so mild that it passes unnoticed, and the illness progress until it presents as pelvic inflammatory dz, with s/s of an acute abdomen.

Hint 67

36.17

Front 68

Causes of prostatitis in males

Back 68

Stains of bacteria.
The bacteria are likely transported in urine that "leaks" from the urethra and into the prostate.

Front 69

S&S of scabies

Back 69

A parasite commonly affecting families, children, sexual partners, chronically ill, and persons in living community. Transmitted skin to skin. S/s include nocturnal itching and presence of rash involving the hands, flexor aspect of the wrist, axillary folds, ankles, toes, genital area, buttocks, and abdomen.

Hint 69

36.18

Front 70

S&S and types of hepatitis

Back 70

Types in book are A, B, C, D, and E
S/s are all the same and include: loss of appetite, nausea, vomiting, general fatigue and malaise, low grade fever, vague abdominal discomfort, and sometimes aching in the joints. Sudden distaste for cigarettes, dark urine, jaundice in skin and eyes.

Hint 70

36.19

Front 71

S&S of HIV infection

Back 71

Acute febrile illness, malaise, swollen lymph glands, H/A, and possibly rash. Following initial infection most individuals present with enlargement of lymph nodes and appear healthy. However the number to T-helper lymphocytes gradually decline causing a suppress immune system.

Hint 71

36.21

Front 72

Causes and definition of the avian flu

Back 72

Fever, sore throat, cough, and muscle aches; some eye infections have been noted. Caused by indirect or direct contact with infected bird secretions.

Hint 72

36.25

Front 73

Ways to protect patients from nosocomial infections

Back 73

Meaning hospital-acquired. Preventions relies on the use of standard precautions, gloves, and good handwashing technique when in contact with wound drainage. Post-transport cleaning limits spread.

Hint 73

36.24

Front 74

Caregiver protections during treatment of the meningitis patient

Back 74

Transmitted through the air through droplets. Place a surgical or NRB mask on pt. Use N95 mask for yourself.

Hint 74

36.14