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Cardiology FISDAP Practice Questions And Answers A Grade
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Paramedic Medical Unit Exam – Study TermsMeningitis
Meningitis is any form of infection that causes the inflammation of the meninges (the outer cover of the
central nervous system brain and spinal cord). Causes includes infectious, chemical, or metabolic causes.
Infectious include bacteria, virus, fungi, or prions gain access to the body and begin to reproduce and
cause damage. S/s include fever, headache, chills, photophobia, and stiff neck. In cases with kids you may
have buldging fontenelles and a high pitched cry due to increased icp. Bacterial meningitis causes icp
while viral does not. Some severe cases involve seizures. Bacterial meningitis should be treated fast at the
hospital. For ems treatment, you need to put a mask on the patient and yourself and be ready for seizures
to occur. You can tell if it is either viral or bacterial with the kernig or brudzinski test. The brudzinski test
causes involentary flexion of the knees when the head is flexed towards the chest. The kernig test you get
pain when you try and straighten the knees when the hips are flexed. If any of those are positive then
bacterial meningitis is suspected.
Hypoglycemia
Hypoglycemia is a low blood sugar level in the body. The blood sugar level should be between 60-120. 45
or below is classifed as hypoglycemia. s/s include altered mental status, tachycardia, fatigue, nausea,
sweating, polydipsia (thirst), polyuria (frequent urination) and polyphagia (hunger). Unexplained weight
loss, blurred vision, frequent infections and confusion. Treatments include glucose and glucagon to raise
blood sugar levels. Type 1 diabetes is insulin dependent while type 2 is not insulin dependant. Causes for
type 1 hypoglycemia may include too much insulin, too little food, or both. Type 2 the pancreas can
generate insulin so these patients can surpress insulin production within their own bodys. Their bodys
might be resistant to the effects of insulin or they may not make enough insulin over time to lower their
blood glucose levels. Meds given to type 2 act by either stimulating the bodys ability to secrete insulin or
by improving the actions of insulin. These meds tend to contribute to hypoglycemia.
Physical abuse 524, 555
Never hesitate to call law enforcement personnel if you have reason to believe abuse has occurred. Fearful
position of women and husband is answering questions for her. Fingerprint bruises (someone being
grabbed, lifted, or dragged), multiple bruising at different stages of healing
Alcohol withdrawal
When a long time drinker stops drinking suddenly, seizures may occur after 6-48 hours. For treatment give
a benzo such as valium 1-3mg for seizure control. For detoxing delirium tremors start within 48-72 hours
after last drink. s/s include fever, tachycardia, hypotension, and may have altered mental status. Treatments
include support of cardiovascular system, seizure control, keep in dark place due to hallucinations, can also
manage body temp and hypotension with infusions of normal saline.
Caustic ingestion
Caustic acids are liquids that are under 2.0 on ph and alkalis solutions are anything above 12.0 on ph.
Caustic solutions are often found in kitchen cleaning solutions and agriculture. s/s include severe pain in
mouth throat or chest, possible respiratory distress due to swelling of larngyx, epiglottis, or vocal cords.
Treatments include management of ABC’s and find substance and contact poison control or online
medical control. Also try to have patient drink milk or water to help dilute solution. For caustic substances
do not put in NG tube because it is contraindicated.
Albuterol
Opens lungs in cases of bronchiospasm. Bronchio dilator. Reacts on beta 2 receptor sites.
Environmental poisoning
Organophosphate is used in agriculture. Suicide is common with this substance. Organophosphates excert
toxic effects on nerve junctions of the nerve cells of the autonomic nervous system. The conduction from a
nerve impulse to another occurs due to the release of acetylcholine at the junction. Ach works as a
chemical messenger crossing the junction to depolarize the nerve on the other side of the junction.
Organophosphates and carbonates are potentate inhibitors of acetylcholineesterase serves to terminate the
synaptic transmissions. s/s include diarrhea, urination, myosis(constriction of puplis)/ muscle weakness,
bradycardia, bronchospasm, bronchorrhea, emisis, lacrimation(tearing of eyes), seizures, salivation,
,sweating. (dumbels). Will get the same s/s if inhaled, ingested, or absorbed. Treatments include decon,
normal abcs, atropine 1mg, 2 pam(pralidoxime) 600 mg in the first hour. treat seizures with benzos.
Carbon monoxide poisoning is colorless odorless and tasteless. It displases oxygen from the hemoglobin
molecule. s/s highly variable and vague often showing early signs of the flu. Cherry red color in skin is a
late sign mostly seen in the great beyond. Management include abcs, monitor, and high flow oxygen.
Cyanide poisioning can happen due to the cobustion of rubber, plastic, and other household substances. In
gas form its colorless but has bitter almond scent. Cyanide causes cellular hypoxia due to damage of
mitochondria.
Sickle cell anemia
Sickle cell anemia is the gene defect in the adult type hemoglobin. The rbc have a oblong shape which
makes it a poor oxygen carrier. It makes the patient more prone to hypoxia which makes the person
anemic. s/s include shortness of breath and signs of puemonia. Typically have joint pain and signs of
jaundice. Dehydration is also common. Treatments include iv therapy for dehydration and to flush out rbc
from system. Also important to maintain body temp because the cold contributes to misshapen rbc.
Oxygen and position of comfort should also be considered.
Acute renal failure
Sudden decrease in the rate of filtration through the glomeruli which causes toxins to accumulate through
the blood. Also known as acute kidney injury. The toxic buildup of nitrogenous waste salts in the blood
assocciated with aki causes impaired mentation, fluid retention, tachycardia, acid-base imbalances, and
increased pr and qt intervals assocciated with hyperkalemia. Treatments include management of abc, iv
bolus for signs of shock (be careful for signs of pulmonary edema). If signs of hyperkalemia are present on
the monitor give sodium bicarb and calcium chloride. Analgesics and antibiotics maybe toxic to the
kidneys.
Kidney infection
Upper utis can lead to pyelonephrits which is the inflammation of the kidney lining. It can lead to
perinephric abscess that is puss that surrounds the kidney that will lead to sepsis. s/s include fever, flank
tenderness, foul smelling urine, dark urine, tachycardia, and hypotension. Treatments include iv fluids,
antibiotics, and pain control.
Kidney stones 1221
Kidney Stones (Renal Calculi) are extremely common and originate in the renal pelvis Formed by excess
of insoluble salts or uric acid crystallizes in the urine. 1-11 people will experience. Men more than women.
Risk Factors diet and hydration, family history of Stones, Hypertension. Most common type Calcium
oxalate/phosphate 80 percent caused by too much calcium in the urine. Increased risk with gout, gastric
bypass surgery, certain metabolic disorders. Strutive stones more common in women associated with
chronic UTI frequent catheterization. Uric acid stones common with gout and dry regions of US. Cystine
stones associated with condition that causes large amounts of amino acids and proteins to be excreted in the
urine.
Almost always has pain. Pain usually starts in the flank, migrates forward to groin until passed.
Worst pain of her life. Patients may be restless, or motionless to guard. V/S the greater the pain
the higher the BP, HR. Hematuria (blood in urine)
Treatment: ABC’s position of comfort. Administer Analgesia if Protocols allow. Establish IV
line administer fluids to hydrate. Alpha Blocker such as tamsulosin (flomax) used to relax
smooth muscle in bladder to increase urine flow. Patients with UTI and stones may become
septic (emergency) Extracorporeal lithotripsy: high energy shock to break stones to make
easier to pass. Cystoscopy with stent placement: Direct visualization with camera in urethra
and ureter place a stent to enlarge diameter to help get stone out. Percutaneous nephrostomy
(PCN) tube placement: small catheter placed on the outside of the body into the kidney to
allow drainage from the obstructed stone.
Blood borne disease
Sickle cell crisis: Most common inherited blood disorder. The defective RBCs have an oblong
shape instead of a smooth round shape. Makes them poor O2 carrier, makes patient highly
susceptible to hypoxia. Sickle cells have a shorter life than normal RBS. PT more prone to
developing anemia.
Assessment: S/s inadequate perfusion, hypotension. Jaundice, yellowing of the eyes (icteric
sclera).
Management: IV fluid for dehydration. O2, PT have high pain tolerance from living with
disease. Position of comfort. Maintain body temp. severe patients will need blood transfusion.
Leukemia: disease that develops in the lymphoid system. Type of cancer blood cells WBCs
develop abnormally and/or excessively. Can cause anemia, thrombocytopenia (decrease in
platelets) leukocytosis (increased WBC) acute leukemia bone marrow replace with abnormal
lymphoblast. Chronic leukemia abnormal mature lymphoid cells accumulate in the bone
, marrow, Lymph nodes, spleen, and peripheral blood.
Assessment: Wear gloves mask. PT have immunocompromised small cold can be fatal. PT
complains of fatigue, headaches, dsypnea. Physical exam fever, bone pain, diaphoresis,
soreness in midpart of chest, unexplained bleeding. Vital signs show hypotension and
tachycardia.
Management: Airway support, IV therapy, position of comfort. Positive support.
Lymphomas: group of malignant diseases that arise within the lymphoid system. Non-
Hodgkin lymphoma: can occur any age, characterized by progression, slow (indolent)
progression, never leaves lymphoid system. Highly aggressive: disease nay affect multiple
organs in a relative short time, usually several months. Hodgkin’s lymphoma: painless
progressive enlargement of the lymphoid glands, affecting spleen/ lymph nodes. 2 peaks, 10-35
YO and late life. Signs. Night sweats, chills, persistent cough, swelling of lymph nodes(
starting in the throat) generalized itching, loss of appetite, fatigue, bone pain.
Assessment: PT may be in chemotherapy. Ask! What type of lymphoma do you have? What
treatment are you doing? May be hot then cold or have different body parts that are hot and
cold.
Management: Pain management may have to be aggressive. High dose analgesic, fluid
therapy, supplemental O2. Be supportive.
Polycythemia: over abundance or overproduction of RBCs. Increased blood viscosity and
velocity.
Disseminated intravascular coagulation: also known as DIC:
May be caused by many things including massive injury,
sepsis, OB complications and traumatic hypotension.
Progresses in two stages: 1=free thrombin and fibrin
deposits in the blood increase, platelets begin to
aggregate, defirination (breakdown of the fibrin clots). 2=
uncontrolled hemorrhage results from reduction in
clotting factors. DIC has up to 65% mortality rate. Signs
and symptoms: uncontrolled bleeding, hypotension,
shock, respiratory difficulty. Treatment: maintain airway,
supplemental oxygen, treat for shock, pain management.
Ensure to be optimistic but honest.
Hemophilia:
A bleeding disorder in which clotting does not occur or is not sufficient. usually associated
with an X-linked recissive inheritance pattern which makes it more common in males.
Classified into 2 primary types. Type A=low levels of factor VIII (antihemophilic globulin and
antihemopholic factor. Type B= deficiency of factor IX (plasma thromboplastin component/the
christmas factor) Signs and Symptoms: acute chronic bleeding, spontaneous intracranial
bleeding, pallor, weak pulse, hypotension, nosebleeds, bloody sputum, melena, hypoxia.
Treatment: ABC, high flow O2, treat symptomatic dysrythmias, IV therapy, analgesics, treat
for shock. Patients may need hospitalization for transfusions of blood or specifically factors
VIII and IX.
Multiple myeloma:
The number of plasma cells in the bone marrow increases abnormally, forming tumors in the
bone, impairs normal bone marrow function causing weakness in the bones, Decreased RBC,
WBC, and platelet formation, results in anemia and susceptibility to infection so PPE is
extremely important for the patients well being. Signs and Symptoms: Early-stage complaints
may be fatigue or mild pain. Later stages= Unexplained hemorrhage, significant weight loss,
frequent bone fractures, pain in various locations. Treatment: IV fluid, pain management,
supportive care. No assumptions that the patient is ready to or is going to die. In advanced
cases, chemotherapy and other anticancer-type treatment may be given.
Complications of blood transfusion:
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