EMS1055 COMPREHENSIVE EXAM STUDY
GUIDE 2026 QUESTIONS AND SOLUTIONS
◍ auscalatory gap Answer:A silent interval that may be present between
the systolic and diastolic blood pressures, i.e. the sound disappears for a
while, then reappears
◍ Know the pulse points and what they mean in regards to SBP
Answer:carotid
femoral
radial
pedal
◍ carotid pulse Answer:the pulse felt along the large carotid artery on
either side of the neck
60 mmHg
◍ femoral pulse Answer:pulse of the femoral artery felt in the groin
70mm Hg
◍ radial pulse Answer:the pulse felt at the wrist
,80 mmHg
◍ pedal pulse Answer:The pulse rate obtained on the top of the foot
90-100 mmHg
◍ Know the types of shock. Answer:Cardiogenic
hypovolemic
distributive (septic,anaphylactic, neurogenic)
obstructive (mechanical)
insulin
◍ cardiogenic shock Answer:A state in which not enough oxygen is
delivered to the tissues of the body, caused by low output of blood from
the heart. It can be a severe complication of a large acute myocardial
infarction, as well as other conditions. Most commonly caused by
AMIOther causes: myocarditis, myocardial contusion"Pump Problem"
Decreased CO leads to hypoperfusionHeart begins to fail standard shock
treatment applies. The patient may not tolerate supine or Trendelenburg
position. Treatment is advanced and complicated. Transport to a cardiac
facility critical. Time is tissue!
◍ hypovolemic shock Answer:Volume issue due to blood loss in
traumaBlood loss covered in previous lecture be due to dehydration in
medical very young and very old more susceptible
,◍ anaphylactic shock Answer:A severe reaction that occurs when an
allergen is introduced to the bloodstream of an allergic individual.
Characterized by bronchoconstriction, labored breathing, widespread
vasodilation, circulatory shock, and sometimes sudden death.
BIG 3 wheezes, urticaria, pruritus
◍ obstructive (mechanical) shock Answer:Tension PneumothoraxAir
trapped in the thoracic cavity with the shifting of mediastinal
structuresLife threateningSigns of shockCan be spontaneous (Male, tall,
thin)Absent lung sounds on affected sidePericardial tamponadeFluid
buildup in the pericardial causes compression of the heartLife
threateningBeck's Triad Narrowing pulse pressure Muffled heart sounds
JVD
clinical signs: Distended neck veins
Cyanosis
Catecholamine effects
Pallor, tachycardia, diaphoresis
◍ insulin shock Answer:Not a true shockAlso called
hypoglycemiaIssue due to low blood glucose levels, not
hypoperfusionCommon cause is when a patient injects insulin, but does
not eat in timeCan affect non-diabeticsPatients have their own
glucometersnormal BGL 70-110 mg/dLBGL below 40 mg/dL will show
LOW on glucometerBGL above 500 mg/dL will show HIGH on
glucometerCan look similar to shockSkin pale, cool, diaphoreticAltered
, mentation (confused, unconscious)Seizures can occurIf the patient is
able to swallow:Oral glucose¡Juice with added sugarPatient MUST eat
afterwardsIf the patient cannot swallow:Immediate transportNeeds IV
glucose
◍ neurogenic shock Answer:Any factor that stimulates parasympathetic
activity or inhibits sympathetic activity of smooth vascular muscles can
cause neurogenic shock, which results in widespread and massive
vasodilation.Spinal cord injury above T6Spinal anesthesia¡Vasomotor
center depressionMay take hours to appearDifferent than typical
shockSkin warm and dryBradycardiaPoikilothermia: unable to control
body temperature
◍ septic shock Answer:Distributive type of shock Due to severe
infection that becomes systemicVery common in the ICU setting Patients
often febrileAntibiotics are needed to treat the infection More gradual
onset, starting with SIRS
◍ Know the parameters of Beck's Triad Answer:Acute cardiac
tamponade: muffled heart sounds, distended neck veins (JVD),
hypotension
◍ Know the signs and symptoms of Basilar Skull Fracture
Answer:Signs: raccoon eyes, battlesignspositive HALO test, injury
(trauma) to the side of the headSymptoms: pain, head injury, headache
GUIDE 2026 QUESTIONS AND SOLUTIONS
◍ auscalatory gap Answer:A silent interval that may be present between
the systolic and diastolic blood pressures, i.e. the sound disappears for a
while, then reappears
◍ Know the pulse points and what they mean in regards to SBP
Answer:carotid
femoral
radial
pedal
◍ carotid pulse Answer:the pulse felt along the large carotid artery on
either side of the neck
60 mmHg
◍ femoral pulse Answer:pulse of the femoral artery felt in the groin
70mm Hg
◍ radial pulse Answer:the pulse felt at the wrist
,80 mmHg
◍ pedal pulse Answer:The pulse rate obtained on the top of the foot
90-100 mmHg
◍ Know the types of shock. Answer:Cardiogenic
hypovolemic
distributive (septic,anaphylactic, neurogenic)
obstructive (mechanical)
insulin
◍ cardiogenic shock Answer:A state in which not enough oxygen is
delivered to the tissues of the body, caused by low output of blood from
the heart. It can be a severe complication of a large acute myocardial
infarction, as well as other conditions. Most commonly caused by
AMIOther causes: myocarditis, myocardial contusion"Pump Problem"
Decreased CO leads to hypoperfusionHeart begins to fail standard shock
treatment applies. The patient may not tolerate supine or Trendelenburg
position. Treatment is advanced and complicated. Transport to a cardiac
facility critical. Time is tissue!
◍ hypovolemic shock Answer:Volume issue due to blood loss in
traumaBlood loss covered in previous lecture be due to dehydration in
medical very young and very old more susceptible
,◍ anaphylactic shock Answer:A severe reaction that occurs when an
allergen is introduced to the bloodstream of an allergic individual.
Characterized by bronchoconstriction, labored breathing, widespread
vasodilation, circulatory shock, and sometimes sudden death.
BIG 3 wheezes, urticaria, pruritus
◍ obstructive (mechanical) shock Answer:Tension PneumothoraxAir
trapped in the thoracic cavity with the shifting of mediastinal
structuresLife threateningSigns of shockCan be spontaneous (Male, tall,
thin)Absent lung sounds on affected sidePericardial tamponadeFluid
buildup in the pericardial causes compression of the heartLife
threateningBeck's Triad Narrowing pulse pressure Muffled heart sounds
JVD
clinical signs: Distended neck veins
Cyanosis
Catecholamine effects
Pallor, tachycardia, diaphoresis
◍ insulin shock Answer:Not a true shockAlso called
hypoglycemiaIssue due to low blood glucose levels, not
hypoperfusionCommon cause is when a patient injects insulin, but does
not eat in timeCan affect non-diabeticsPatients have their own
glucometersnormal BGL 70-110 mg/dLBGL below 40 mg/dL will show
LOW on glucometerBGL above 500 mg/dL will show HIGH on
glucometerCan look similar to shockSkin pale, cool, diaphoreticAltered
, mentation (confused, unconscious)Seizures can occurIf the patient is
able to swallow:Oral glucose¡Juice with added sugarPatient MUST eat
afterwardsIf the patient cannot swallow:Immediate transportNeeds IV
glucose
◍ neurogenic shock Answer:Any factor that stimulates parasympathetic
activity or inhibits sympathetic activity of smooth vascular muscles can
cause neurogenic shock, which results in widespread and massive
vasodilation.Spinal cord injury above T6Spinal anesthesia¡Vasomotor
center depressionMay take hours to appearDifferent than typical
shockSkin warm and dryBradycardiaPoikilothermia: unable to control
body temperature
◍ septic shock Answer:Distributive type of shock Due to severe
infection that becomes systemicVery common in the ICU setting Patients
often febrileAntibiotics are needed to treat the infection More gradual
onset, starting with SIRS
◍ Know the parameters of Beck's Triad Answer:Acute cardiac
tamponade: muffled heart sounds, distended neck veins (JVD),
hypotension
◍ Know the signs and symptoms of Basilar Skull Fracture
Answer:Signs: raccoon eyes, battlesignspositive HALO test, injury
(trauma) to the side of the headSymptoms: pain, head injury, headache
