Fisdap Medical Emergencies Unit Exam S.G Questions With Correct Answers

Pyrogenic Reactions - Answer Two definitions from different sets: - Fever caused by endotoxins and bacteria. The endotoxins may cross over membranes during hemodialysis complications. - "Reaction characterized by an abrupt temperature elevation with severe chills, backache, headache, weakness, nausea, vomiting; a potential complication of IV/IO therapy, complication of hemodialysis." S/G: If the pt is having a blood transfusion and they start to experience the following symptoms: Erythema, urticaria, hypotension (70/40), Tachycardia (P 120), tachypnea (RR 24). The solution is to discontinue the transfusion due to an incompatibility with the donor. Start fluids, benadryl, maybe lasix and possibly epinephrine. Endocrine disease (Such as, but not limited to, thyrotoxicosis) - Answer Thyrotoxicosis aka "thyroid storm" : "Toxic condition caused by excessive levels of circulating thyroid hormone. Generally caused by Grave's disease, severe under-treated hyperthyroidism, or infection. S&S: Flush, red skin, agitated, angioedema" Graves disease: An autoimmune disease that results in elevated thyroid hormone. Graves disease aka Hyperthyroidism is the main cause of "thyroid storm". Grave's can form a goiter on the neck. S/S: Fever, irritability, delerium, coma, tachycardia, hypotension. Care is mainly supportive. Hashimoto disease: More mild form of hyperthyroidism Addison's disease : Not enough cortisol is produced (hypoadrenalism) Cushing's disease: Too much cortisol (Hyperadrenalism) Moon face Thyrotoxicosis aka "Thyroid storm" - Answer Visual Aide Pancreatitis - Answer Inflammation of the pancreas typically seen by EMS due to alcoholic pts. Caused by bile duct obstruction from gall stones S/S: "Pain that radiates to the back x 5 days" - NVD - RUQ pain - Mid-abdominal tenderness - CULLENS SIGN due to intrabdominal bleeding Airway infections: laryngotracheobronchitis aka "Croup" - Answer laryngotracheobronchitis aka "Croup" Viral Infection of Upper Airway Inflammation of the larynx, trachea, bronchi strongest S&S at night--> severe respiratory distress Stridor, Hoarseness, Barking Cough, dyspnea/respiratory distress, low grade fever, hypoxia, nose inhalations Airway Mangement BVM, High Flow o2 Tube size might be 2 times smaller than normal size Racemic Epinephrine 0.5 mL mixed with 3ms of normal saline Airway infections (Others) - Answer - Epiglottitis: Fever, Drooling - Respiratory syncytial virus - Bronchiolitis - Pneumonia (Single sided fluid in the lungs) - Pertussis (Whooping cough) - Influenza type A Tuberculosis - Answer An infectious disease that may affect almost all tissues of the body, especially the lungs "26 yom c/o chest pain and hemoptysis. Pt has a productive cough with purulent, bloody discharge and a low grade fever. What is it?" TB can manifest in many ways. S/S include; Night sweats, hemoptysis, chills, fever, fatigue, and weight loss. Don a N95 mask and mask up the pt. Bleeding Disorders - Answer - Sickle Cell disease: RBC's are "sickle shaped" and interfere with oxygenation. This causes hypoxia throughout the body and causes excessive pain. Provide supportive measures and GIVE PAIN MEDS (Morphine Sulfate IV). "24 yom w/ hx of sickle cell Lying in the fetal position" - Disseminated Intravascular Coagulation: Found in severe trauma and septic patients. Causes weird clotting AND bleeding throughout the body. Common sign is purpura on the chest and abdomen -Hemophilia: Hereditary disorder with very poor clotting - Thrombocytopenia: Poor clotting due to a low level of platelets - Thrombocytosis: Too many platelets (Asymptomatic) Coagulation Processes - Answer Steps: 1. Vasoconstriction 2. Platelet Plugging 3. Coagulation Clotting cascade: Refers to the process by which clotting factors work together to ultimately form fibrin Coagulopathy: A condition in which the blood's ability to coagulate (form clots) is impaired Physiology Electrical Injuries - Answer Produce devastating internal injuries with little external evidence may have two injuries sites 1. one at the point where electricity entered the body (entry wound) where it exited the body (exit wound) as electrical current travels from the contact site into the body, it is converted to heat, which follows the current flow--usually along side blood vessels and nerves--causing extensive damage to the tissue in its path. respiratory muscle paralysis ventricular fibrillation serious injury because the electricity may have flowed across the chest, potentially injuring the cardiac conduction system "11,000 volts usually fatal, 40,000 volts almost always fatal." Pathophysiology of Angioedema - Answer "A vascular reaction, that may have am allergic cause and may result in profound swelling of tongue and lips" "Marked edema of the skin and usually involves the head, neck, face, and upper airway. Caused from allergic reactions and anaphylaxis." - Sudden onset of dyspnea & swollen tongue = Immediate Epinephrine, benadryl, breathing treatment. The vasoconstriction relieves the angioedema - Watery eyes and "eyelid edema" with a food allergy and semi normal VS = Diphenhydramine. S/S are local NOT systemic