Medical Emergencies: FISDAP Questions for Third Test, Exams of Medicine

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MEDICAL EMERGENCIES FISDAP QUESTIONS

3rd test LATEST UPDATE VERIFIED BY EXPERT

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1. Which of the following meds helps the body transport sugar into the cells?
   • Insulin/ Orense/ Diabetes/ Oral glucose Reason: Because insulin the key to the cells. 2.A 32 year PT is found unconscious in the snow. You cannot detect a pulse or respiration rate within 10 seconds. What should you do?

• Give a few rescue breaths then check for a response/ Take at least 2 minutes to detect a pulse rate/ Assess her pulse for 30-45 seconds/ Immediately begin cardiopulmonary resuscitation Reason: Hypothermia. Cold conditions make it hard to read vitals.

3. An adult male is sitting alone in a dark room, rocking back and forth. He mutters to his sock puppet, “Are you feeling sad?” What should you do?

• Introduce yourself and start an assessment/ Ask PT if he intends to harm himself or others/ withdraw until ALS arrives/ look for PT’s meds Reason: make the patient aware that you are there.

4. A 42 you man complains of difficulty breathing and pain in his chest and shoulders. He recalls feeling a sharp pin prick on his arm while cleaning out his basement. What type of spider bite is this man most likely suffering from?

• Black Widow/ spitting/ woodlouse/ brown recluse Reason: chest tightness and difficulty breathing usually develop within 24 hours of a black widow bite. These symptoms usually subside within 48 hours and are associated with a black widow bite but not a brown recluse. CLUE: he was in his basement.

5. A car battery exploded in your PT’s face. He denies breathing difficulty. You should?

• Cover eyes with dry/ cover eyes with moist/ begin irrigating eyes with clean water/ irrigate with vinegar and water Reason: This is considered a chemical burn.

6. 19 year old F is unresponsive after taking a whole bottle of her sleeping medicine about 4 hours ago. You should? - Obtain vital signs/ apply high-flow 02/ insert OPA/ admin activated charcoal Reason: If there are vitals in question or info on breathing then consider obtain vital signs. If she is unresponsive, that considers

correcting life threats. (insert OPA)

7. A 32 year old M complains of photophobia and vomiting. The most likely cause is? - Migraine Reason: Photophobia is sensitivity to light.
8. A 68 you PT reports abdominal pain, vomiting and a loss of appetite, as well as black, tarry stools.

• Ulcer disease/fecal impaction/ upper GI / Lower GI[1] Reason: PG. 710 Black, tarry stools are associated with upper GI

9. A 21 you M is unresponsive, has constricted pupils, slow, shallow respirations, you should suspect?

• Alcohol poison/TBI/diabetic reaction/narcotic OD Reason: Constricted pupils are associated to narcotics/opioids. 10.A Pt. tells you he had anemia, you should expect him to present with?
• Hypertension/jaundice/Bradycardia/pallor

Reason: Anemia is associated with jaundice. 11.Your epileptic patient complains of persistent metallic taste in her mouth. You should suspect:

• A seizure may occur/status epileptics/clinic activity/postictal state Reason: The metallic taste is the patient's aura. 12.Pt. is having a tonic-clinic seizure and is not breathing. You should:
• Admin O2 via NRB/check blood glucose level/prevent patient from further injury/insert OPA Reason: Tonic-clinic involves jerking and shaking of the whole body. 13.An 18 you M states “The CIA is after me” you notice he has covered his head and windows with aluminum foil. When you ask why he says “in order to block out the go radio waves” vitals are BP 138/34, P 122, and R24. You should suspect?
• Paranoid bipolar disorder/acute anxiety disorder/paranoid schizophrenia/acute panic attack Reason: patient is anxious could be the reason for the heart rate. 14.A patient is running a high fever, vomiting, and reporting pain that has shifted from around her belly button to the lower right area of her abdomen you should suspect?
• gallbladder disease/pancreatitis/appendicitis/kidney stones Reason: Lower right is where the appendix is. 15.A 20 yr. old male in a college dorm room complains of fever, headache, and a stiff neck. He has an altered mental status, and you notice red blotches on his skin. Which of the following are the most appropriate BSI Precautions
• Gloves and gown/gloves and goggles/gloves and HEPA mask/gloves and surgical mask Reason: (pg. 573) Meningitis causes red blotches and stiff neck and is highly contagious. 16.An unconscious patient has one pupil that is significantly larger than the other and not reactive to light. The most likely cause is
• Drug overdose/ hypoglycemia/ stroke/ glaucoma Reason: Unequal pupils are a sign of stroke. 17.What is hyperglycemia
• High blood glucose Reason: Hyper is key word for high. 18.When assessing a patient for facial droop you should?
• Ask the patient to smile or show his teeth Reason: Cincinnati scale

19.An alert patient has a severe headache/weakness of left arm you should suspect?

• AMI/stroke/migraine/angina pectoris Reason: Key word is weakness in the left arm. 20.A 28 yr. old patient is outside at a concert and appears confused. He is unable to answer your questions. You should
• Admin oral glucose and then reevaluate the patient/ look for medical identification necklace or bracelet / call medical direction for a consultation on treatment / assess his level of intoxication and look for illicit drug use Reason: check for possibility of diabetes or other possible medical conditions 21.Your first priority when dealing with a patient who is exhibiting behavior issues is

• Ensure the safety of yourself and your partner/ call local law enforcement for backup/ determine what mental problem the patient has/ find out what meds the patient is on Reason: Safety first 22.Which of the following most accurately describes insulin?
• It helps the liver store glucose/ it increases sugar in the blood/ it helps glucose move into the cells/ it converts glycogen to Reason: once again, insulin is the key!!!! 23.A patient with a headache. How should you position him on the cot?
• *90 degrees Fowler’s/ supine/ Trendelenburg/ semi Fowler’s Reason: use gravity to reduce blood flow to the brain 24.An unconscious 33 yr. old patient was found lying prone in a local park. He was apneic. You should
• Place the patient in supine position and check airway/ immobilize head, roll patient to supine, and check airway/ assess the scene and surrounding area for safety concerns/ remove the patients clothing and assess for traumatic injuries Reason: PENMAN 25.You have been dispatched to a behavioral emergency. The police are on the scene and have asked you to evaluate the patient. You should - Restrain the patient to your cot and transport him to the nearest hospital/ search patient for weapons and transport to jail/ assess patient and transport to appropriate emergency room Reason: Patient isn't violent NEXT 25 26.An 18 yr. old female has progressively become lethargic at a party. Vital signs are BP 90/60, P 48, R 4 you should suspect
• Alcohol intoxication/ hypoglycemia/ narcotic overdose/ concussion Reason: narcotics depress the CNS

27. 20 you female is resting after running for 30 minutes. She normally runs 5 miles every day but today she “can’t catch her breath”. Flushed skin, fast and weak pulse, fast reparations with wheezing, complains of itching arms and chest.

• Anaphylaxis Reason: her airway is bronchi spamming 28.Unresponsive PT with arms and legs violently jerking. What phase of generalized seizure is this?
• Tonic/Clinic Reason: clinic is jerking motions

29. 78 yr. male Alzheimer’s PT has bruising on back, neck and stomach. Caregiver insists that he fell out of bed.
    • Immediately notify law enforcement to take a report Reason: should only have bruising on one side if he fell once. 30.Elderly PT complains of abdominal pain and back pain. Have tarry stools for three days.

• GI bleeding Reason: Tarry stools are keyword for GI bleeding. 31.PT family reports a glucometer reading of 57 mg/LD.
• Low Reason: normal should be 80 to 120 mg/LD.

32. 82 you female complains of nausea and vomiting for two days. She ran out of her prescription heart medicine last week. BP 158/92, P 92 irregular, R 18
    • Admin 02 and monitor vitals Reason: look for oxygen saturation on test. 33.PT is at an outdoor garden center on a hot and humid day. PT is pale, wheezing, and has hives.

• Bee sting Reason: Hives is keyword.

34. 16 you female with severe abdominal pain. “Haven’t had period in two months and the pain started this morning” BP 90/70, P 130, R 28. Skin is pale and cool

• Hypovolemic Reason: Hypovolemic shock increased bop, increased pulse, and skin sign. 35.A hiker is found in the mountains. PT is flushed and their mucous membrane is slightly blue.
• Low 02 level Reason: pt. is cyanotic.

36. 23 you male with bipolar disorder. Depressed and locked him inside the bathroom.

• *Call law enforcement to secure the scene/Begin assessment outside of the door/ ask family to reason Reason: secure the scene cut he could flip on you. 37.PT has irregular respirations and is agitated. Is pacing back and forth. Skin is cool and clammy.
• Hypoglycemia Reason: Altered mental status (anxious behavior) relates to hypoglycemia 38.Epinephrine effects on cardiovascular system
• Constricts blood vessels Reason: constricts peripheral blood vessels. (It in the book) 39.71 you male is unconscious and cold to the touch at a park. He is a resident of the Alzheimer’s center. Outside temperature is in the low teens. What do you keep in mind when trying to obtain a pulse?
• *Pulse should be palpated in two places Reason: PT is unconscious and cold.

40. 31 you male is vomiting and has diarrhea for 10 hours. Complains of weakness and lightheadedness upon standing. Pale and diaphoretic. Vitals should be:

• BP 90/60, P 124, R 20

Reason: PT is pale and diaphoretic signs of shock.

41. 20 you female is unconscious after being submerged in a lake for three minutes. She has a pulse and atonal breathing.
    • BVM Reason: assist ventilations
42. 72 you female has slurred speech and left arm weakness prior to EMS arriving. What do you think happened

• Transient Ischemic Attack Reason: TIA cannot tell in the field. 43.Middle aged PT outside a homeless shelter. Coughs up pink sputum and passes out.

• N95 respirator prior to continuing assessment Reason: pink sputum is signs of pulmonary edema

44. 42 you female states she is “having the worst headache of my life”. Vomiting. BP 180/90, P 68, R 14

• *Migraine ( May also be Stroke (aneurysm) ) Reason: hemorrhagic bleed is possible

45. 5 employees feel “light-headed”. They have respiratory problems after working in a packing company.

• Toxic substance exposure Reason: could be exposed / multiple patients with same symptoms 46.Characteristics of TIA
• Resolves within 24 hours Reason: Duchy! 47.Strongly indicates syncope
• Blacked out for a few seconds Reason: loss of consciousness for a brief time 48.PT has DKA and is now unconscious and breathing deeply
• Hyperglycemia Reason: Diabetic Ketoacidosis 49.When treating PT with altered behavior:
• Consider any possible medical cause Reason: 50.Elderly PT has been drinking all afternoon. En route to the hospital he has become confused and slow to respond to questions.
• Check blood glucose level/ open airway Reason: indication is an altered mental status. NEXT 25

51. 15 you soccer player is hot, pale, and semiconscious

• Remove PT from hot environment Reason: remove pt. from current environment to cool down 52.A 19 year old male was stung by a bee and the stinger is still embedded in his skin. He is allergic to bees. Vital signs are BP 124/76, P 92, R 16 and SpO 98%. What should you do?
• Remove the stinger by scraping the skin with a card[2] Reason: This is how to properly do so 53.There’s an unresponsive medical PT. What is the primary focus?
• *Chief complaint Reason: primary focus would be the ABC's

54. 23 you female complains of fever, muscle aches, and congestion. Is pale. BP 94/60, P 120, R 24. Roommate feels the same.

• Influenza Reason: congestion= key word. 55.PT is at a fertilizer plant and spilled lye all over their body
• *Brush powder off Reason: Brush powder off then dilute with water. 56.To assess possible stroke PT for abnormal speech
• Ask PT to repeat a common phrase

Reason: Cincinnati scale

57. 40 you unconscious PT was working in 90 degree Fahrenheit for the last 5 hours
    • Move PT to a cool environment, remove clothing, give a cold pack, and give 02 Reason: Heat emergency 58.Elderly Pt. is malnourished and wearing inadequate clothes for the current temperature. They are lying on soiled bedding and have a strong smell of urine all over the house. Caregiver daughter says mother refused to get out of bed most days, won’t do housekeeping, and not taking medication.

• Report suspicion of neglect to medical director and local abuse agency Reason: malnourished, and soiled bedding is a sign of neglect 59.When administering epinephrine auto-injector
• Firmly apply injection to thigh for ten seconds Reason: 60.Virus and bacteria
• Pathogen Reason: pathogen 61.Seeing and hearing things not present. Which type of drug?
• Hallucinogen Reason: 62.Cincinnati Prehospital stroke scales assesses for
• Facial droop Reason: facial droop, arm drift and slurred speech. 63.Employee was cleaning the bathroom and came out gagging and coughing. Eyes are red and watering. Has dyspnea.
• Move PT to well-ventilated area Reason: breathing too much chemical cleaners. 64.Signs of hypoglycemia
• Cold, clammy skin Reason: ìsnap skills concept 5. (Read) 65.When assessing for arm drift you should ask the patient to?
• Hold arms out with palms out and eyes closed Reason: CSS

66. 46 you male has sudden onset of left side weakness and slurred speech. BP 188/92, P 58, R 12.

• Ischemic stroke Reason: Hypertension is related to asthecleorisis. 67.Contraindication of admin oral glucose

• Unconscious Reason: can't protect airway. 68.38 you has a history of hypothyroidism. Is hypertensive, tachycardia, and hyperthermia. There is an empty bottle of Synthroid nearby.
• Contact poison center or medical command Reason: slow metabolism and slow everything

69. 87 you has a productive cough over the past three days and confusion over the past day. There is rhonchi and wheezing in the right lung. BP 116/92, P 92, R 24, and temp are 101 degrees Fahrenheit.
    • Pneumonia Reason: rhonchi is unilaterally
70. 50 you male that went through renal dialysis and is bleeding profusely from the shunt. You should classify the bleeding as?

• Life threatening that requires immediate surgical intervention Reason: shunt is arterial 71.An alert 56 you female has severe headache and weakness in the left arm. BP 188/92, P 106, R 14
• Stroke Reason: 72.72 you male has weak hand grips, blurred vision, and unable to tell what day it is. He has type II diabetes.
• *Evaluate facial droop Reason: CSs 73.PT has been allergy, was stung and says their throat is itchy. Lips are swelling, PT has an Epicene
• Assist with Epicene Reason: 74.Assessment findings that suggest a gastrointestinal GI bleed would be
• *Bright red blood from the rectal area Reason: look at other answers/ possible tarry stools 75.Unconscious PT with medical ID bracelet says she's diabetic. You should:
• contact medical control/obtain BP/ administer oral glucose/ensure airway Reason: ABC’s

76. A patient was stung by a bee you should Flush with copious amounts of water/ soak in sterile saline/ elevate the affected part above the heart/ apply ice cold compress