PARAMEDIC & ADVANCED EMERGENCY CAREEXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
Pulmonary Edema; Symptoms, Treatments? - CORRECT ANSWER -Pulmonary Edema- Plasma
shifts from vasculature to lung parenchyma, Cardiogenic or Non-cardiogenic
Symptoms: dyspnea, anxiety, pink frothy sputem
Treatment: NIV(Noninvasive ventilation),antihypertensives
pleural effusion; Treatments - CORRECT ANSWER -Pleural Effusion- COllection of fluid
between pleural layers
Treatments: Maintain high fowler position, supplemental oxygen, thoracentesis
acute respiratory distress syndrome (ARDS); Assessment Findings - CORRECT ANSWER -
ARDS- Occurs in response to primary injury or illness: sepsis, pancreatitis, Hypovolemic
shock, pulmonary contusion, burns, High risk for ventilator-associated injury
ARDS assessment findings: Precipitating insult, hypoxia, dyspnea if not intubated, high
ventilator pressure if mechanically ventilated, pulmonary edema, ground glass chest
radiography appearance
PaO2 normal range - CORRECT ANSWER -Partial prssure of oxygen in the arterial blood
75 to 100 milimeters of mercury (mm Hg)
FiO2 - CORRECT ANSWER -Fraction of inspired oxygen (FiO2) concentration of the oxygen in
the gas mixture. Room air is 21%
P/F ratio - CORRECT ANSWER -Quick tool to look at severity of ARDS
not accurate in patients with VQ mismatch
Treatment of ARDS - CORRECT ANSWER -Treat underlying cause
optimize oxygenation through safe ventilation
ARDSnet mechanical ventilation protocal
prone position
maintain alveolar recruitment
ECMO
,Pnemonia symptoms - CORRECT ANSWER -Inflammatory processes affecting lower airway
intrapulmonary shunt
Symptoms: Hypoxemia, productive cough, dyspnea, fever, pleuritic chest pain, subjective
abdominal fullness, infiltrates on CXR
Pneumothoarax Symptoms, treatments - CORRECT ANSWER -Accumulation of air in pleural
space, truamatic or spontaneous
Symptoms: Dyspnea, impaending doom, chest pain, if left untreated, tension pneumothorax
and tracheal deviation
Treatments: simple: O2 Severe: decompression, chest tube placement, proect from effects
of altitude
Pulmonary Fibrosis Treatments, causes - CORRECT ANSWER -Pulmonary Fibrosis- progressive
scarring of the lungs
treatment: supplementary oxygen, lung transplant
Causes: medications, occupational exposure, auto-immube disease, radiation
Asthma symptoms treatments - CORRECT ANSWER -Asthma- Imflammation of bronchial
walls, excessive mucus production
Symptoms: wheezing, dyspnea, shortness of air, grunting, orthopnea, fatigue, hypercapia,
Signs of failute in asthma patients: Absent breath sounds, altered mental status, PaO2
<60mmhg
Treatment: remove trigger, beta-2 aginists, bronchodilators, steroids, ventilatory support,
extend expiratory time ,ZEEP
chronic obstructive pulmonary disease (COPD) - CORRECT ANSWER -Emphysema: damage to
ends of bronchioles, alveoli merge into bullae, barrel chest, tachypnea
chronic lung hyperinflation caused by increased airway resistance and decreased elastic
recoil "pink Puffer"
Chronic bronchitis: excessive mucus production in bronchial tree; Productive cough, rhonchi,
hypercapnia, hypoxmeia, cor pulmonale, "blue bloater"
COPD Treatment: Non-invasive ventilation, start at PIP 10 cmH2O and PEEP 5 cmh2O,
bronchodilators, corticosteroids, antibiotics
If intubated: extended expiratory time (1:4+), Low rate (10-12), Set PEEP at 75% less than
the patient's auto-PEEP
V/Q mismatch - CORRECT ANSWER -Ventilation(V)/Perfusion(Q) Ratio
, Inadequate ventilation or perfusion
Ventilation disruption: shunt"
Perfusion Disruption: dead space ventilation
pulmonary embolism - CORRECT ANSWER -Obstruction in pulmonary artery
Acute: symptoms develop immediately
Subacute: symptoms present days/weeks later
Chronic: slow development of pulmonary hypertension over many years
PE Risk factors - CORRECT ANSWER -Pregnancy
malignancy
stroke
Recent surgery
traumatic SCI
Recent orthopedic prodcedures
oral birth control use
inherited thrombotic disorders
nephrotic syndrome: causes coagulation disorders
Massive vs. Sub-massive PE - CORRECT ANSWER -Massive indicates hemodynamically
instability
Sub-massive presents with associated RV strain
Low-risk PE has no evidence of RV strain
PE treatment options - CORRECT ANSWER -May require thrombolysis
HFNC and pulmonary vasodilators
mainstay treatment remains heparin and anticoagulation
may have surgical clot removal in extreme cases
DO NOT over-administer fluids
Acute Respiratory failure - CORRECT ANSWER -PaO2 <60mmhg on room air
SpO2 <90%
PaCO2 >50mmHg
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
Pulmonary Edema; Symptoms, Treatments? - CORRECT ANSWER -Pulmonary Edema- Plasma
shifts from vasculature to lung parenchyma, Cardiogenic or Non-cardiogenic
Symptoms: dyspnea, anxiety, pink frothy sputem
Treatment: NIV(Noninvasive ventilation),antihypertensives
pleural effusion; Treatments - CORRECT ANSWER -Pleural Effusion- COllection of fluid
between pleural layers
Treatments: Maintain high fowler position, supplemental oxygen, thoracentesis
acute respiratory distress syndrome (ARDS); Assessment Findings - CORRECT ANSWER -
ARDS- Occurs in response to primary injury or illness: sepsis, pancreatitis, Hypovolemic
shock, pulmonary contusion, burns, High risk for ventilator-associated injury
ARDS assessment findings: Precipitating insult, hypoxia, dyspnea if not intubated, high
ventilator pressure if mechanically ventilated, pulmonary edema, ground glass chest
radiography appearance
PaO2 normal range - CORRECT ANSWER -Partial prssure of oxygen in the arterial blood
75 to 100 milimeters of mercury (mm Hg)
FiO2 - CORRECT ANSWER -Fraction of inspired oxygen (FiO2) concentration of the oxygen in
the gas mixture. Room air is 21%
P/F ratio - CORRECT ANSWER -Quick tool to look at severity of ARDS
not accurate in patients with VQ mismatch
Treatment of ARDS - CORRECT ANSWER -Treat underlying cause
optimize oxygenation through safe ventilation
ARDSnet mechanical ventilation protocal
prone position
maintain alveolar recruitment
ECMO
,Pnemonia symptoms - CORRECT ANSWER -Inflammatory processes affecting lower airway
intrapulmonary shunt
Symptoms: Hypoxemia, productive cough, dyspnea, fever, pleuritic chest pain, subjective
abdominal fullness, infiltrates on CXR
Pneumothoarax Symptoms, treatments - CORRECT ANSWER -Accumulation of air in pleural
space, truamatic or spontaneous
Symptoms: Dyspnea, impaending doom, chest pain, if left untreated, tension pneumothorax
and tracheal deviation
Treatments: simple: O2 Severe: decompression, chest tube placement, proect from effects
of altitude
Pulmonary Fibrosis Treatments, causes - CORRECT ANSWER -Pulmonary Fibrosis- progressive
scarring of the lungs
treatment: supplementary oxygen, lung transplant
Causes: medications, occupational exposure, auto-immube disease, radiation
Asthma symptoms treatments - CORRECT ANSWER -Asthma- Imflammation of bronchial
walls, excessive mucus production
Symptoms: wheezing, dyspnea, shortness of air, grunting, orthopnea, fatigue, hypercapia,
Signs of failute in asthma patients: Absent breath sounds, altered mental status, PaO2
<60mmhg
Treatment: remove trigger, beta-2 aginists, bronchodilators, steroids, ventilatory support,
extend expiratory time ,ZEEP
chronic obstructive pulmonary disease (COPD) - CORRECT ANSWER -Emphysema: damage to
ends of bronchioles, alveoli merge into bullae, barrel chest, tachypnea
chronic lung hyperinflation caused by increased airway resistance and decreased elastic
recoil "pink Puffer"
Chronic bronchitis: excessive mucus production in bronchial tree; Productive cough, rhonchi,
hypercapnia, hypoxmeia, cor pulmonale, "blue bloater"
COPD Treatment: Non-invasive ventilation, start at PIP 10 cmH2O and PEEP 5 cmh2O,
bronchodilators, corticosteroids, antibiotics
If intubated: extended expiratory time (1:4+), Low rate (10-12), Set PEEP at 75% less than
the patient's auto-PEEP
V/Q mismatch - CORRECT ANSWER -Ventilation(V)/Perfusion(Q) Ratio
, Inadequate ventilation or perfusion
Ventilation disruption: shunt"
Perfusion Disruption: dead space ventilation
pulmonary embolism - CORRECT ANSWER -Obstruction in pulmonary artery
Acute: symptoms develop immediately
Subacute: symptoms present days/weeks later
Chronic: slow development of pulmonary hypertension over many years
PE Risk factors - CORRECT ANSWER -Pregnancy
malignancy
stroke
Recent surgery
traumatic SCI
Recent orthopedic prodcedures
oral birth control use
inherited thrombotic disorders
nephrotic syndrome: causes coagulation disorders
Massive vs. Sub-massive PE - CORRECT ANSWER -Massive indicates hemodynamically
instability
Sub-massive presents with associated RV strain
Low-risk PE has no evidence of RV strain
PE treatment options - CORRECT ANSWER -May require thrombolysis
HFNC and pulmonary vasodilators
mainstay treatment remains heparin and anticoagulation
may have surgical clot removal in extreme cases
DO NOT over-administer fluids
Acute Respiratory failure - CORRECT ANSWER -PaO2 <60mmhg on room air
SpO2 <90%
PaCO2 >50mmHg
