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Critical Care Paramedic (Kyle Faudree's Flight Paramedic Certification) Study Guide with Complete Solutions.

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Hyperthyroidism/Grave's Disease/Thyrotoxicosis/"Thyroid Storm" (pg.111) - ANSWER-Patient presents with weight loss, palpitations, nervousness, heat intolerance Exophthalmos (AKA proptosis) 'bulging of the eye' AVOID Aspirin (ASA) - Prevents binding of thyroglobulin, making the situation worse Treatment: IV Fluids 1st, Beta Blockers (Propanolol), Steroids (Dexamethasone), and Tylenol for fever. Septic Shock (pg.113) - ANSWER-Someone who is in shock second degree to sepsis (infection in the bloodstream) Hypotensive with normal HR Hypotensive while being refractory to fluids Patient needs IV fluid therapy and vasopressors Levophed (Norepinephrine) is vasopressor of choice in profound hypotension Do not use Etomidate in RSI (due to its adrenal suppression) *Also do not use Etomidate in Addison's Disease also due to the adrenal suppression Pancreatitis (pg.113) - ANSWER-Pain that is usually centered in the upper middle or upper left abdomen. Often radiates from the front of the abdomen through to the back, begins or worsens after eating, lasts a few days, and may feel worse when a person lies flat on their back.

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Critical Care Paramedic (Kyle Faudree's
Flight Paramedic Certification) Study
Guide with Complete Solutions.

Hyperthyroidism/Grave's Disease/Thyrotoxicosis/"Thyroid Storm" (pg.111) - ANSWER-
Patient presents with weight loss, palpitations, nervousness, heat intolerance

Exophthalmos (AKA proptosis) 'bulging of the eye'

AVOID Aspirin (ASA) - Prevents binding of thyroglobulin, making the situation worse

Treatment: IV Fluids 1st, Beta Blockers (Propanolol), Steroids (Dexamethasone), and
Tylenol for fever.

Septic Shock (pg.113) - ANSWER-Someone who is in shock second degree to sepsis
(infection in the bloodstream)

Hypotensive with normal HR

Hypotensive while being refractory to fluids

Patient needs IV fluid therapy and vasopressors

Levophed (Norepinephrine) is vasopressor of choice in profound hypotension

Do not use Etomidate in RSI (due to its adrenal suppression) *Also do not use
Etomidate in Addison's Disease also due to the adrenal suppression

Pancreatitis (pg.113) - ANSWER-Pain that is usually centered in the upper middle or
upper left abdomen. Often radiates from the front of the abdomen through to the back,
begins or worsens after eating, lasts a few days, and may feel worse when a person lies
flat on their back.

The digestive enzymes in the pancreas are destroying the pancreas.

Increased lipase levels (usually >3x normal)
*Amylase may also be increased but Faudree did not preface this in his study guide
notes.

, Demerol for pain (b/c Morphine has the ability to cause spasms of the Sphincter of
Oddi)

Typically requires surgical intervention.

Grey Turner's Sign (pg.113) - ANSWER-Flank ecchymosis caused by hemorrhagic
pancreatitis.

Cullen's Sign (pg. 113) - ANSWER-Periumbilical ecchymosis caused by hemorrhagic
pancreatitis.

Hypothyroidism/Myxedema Coma (pg. 112) - ANSWER-Patient presents with fatigue,
cold intolerance, weight gain, puffy eyelids, sparse hair, possibly goiter.

Primarily occurs in women.

>90% cases in winter (b/c the patient has cold intolerance and is not suffering from
hypothermia)

Officially Myxedema Coma upon changes in LOC.

Treatment: Levothyroxine (Synthroid) (T4) or Triostat (T3) IV

Cushing's Syndrome (pg.112) - ANSWER-Buffalo hump, moon face, thin arms and legs,
purple striae on abdomen.

Causes: Excessive use of corticosteroids (Iatrogenic, from corticosteroid treatment(s))
or Tumor

Treatment: Usually resolves when corticosteroids are stopped or tumor is removed.

Adrenal Insufficiency/Adrenal Crisis (pg. 112) - ANSWER-Also known as (AKA):
Addison's Disease

Patient presents with depression, malaise, salt craving, and bronze colored skin like
JFK.

Treatment: Oral steroids (Prednisone)

Negative Adrenocorticotropic hormone (ACTH) testing, also known as corticotropin or
cosyntropin test.

No Etomidate in RSI due to adrenal suppression.

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