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Questions for Advanced Medical Studies(Paramedics) - Book Report/Review Example

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  When local hypoxia develops in the lungs, vasoconstriction occurs.  Blood is shunted away from the hypoxic area and this may cause right sided heart failure (cor pulmonale – characterised by enlargement of right ventricle).





  In terms of V/Q match and…
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Questions for Advanced Medical Studies Questions structure: 42 true/false = 42 marks. 32 multiple choice = 32 marks. Total Questions 73 Question   Labetalol is a peripheral alpha blocking and nonselective beta blocking drug that has demonstrated efficacy in the treatment of hypertensive emergencies.




Answer
True or False
Question 2

  Airway obstruction in the condition chronic bronchitis is usually the result of lung tissue changes rather than mucous production and the inflammatory process


Answer: 
True or False
Question 3

  Disseminated intravascular coagulation is a specific diagnosis, and its presence does not always indicates another underlying disease.


Answer:True or False
Question 4

  Respiratory drive impulses originate in the brainstem and its respiratory centre.




Answer
True or False
1 points  
Question 5

  When local hypoxia develops in the lungs, vasoconstriction occurs.  Blood is shunted away from the hypoxic area and this may cause right sided heart failure (cor pulmonale – characterised by enlargement of right ventricle).




Answer
True or False
1 points  
Question 6

  Lung compliance decreases in conditions that scar lung tissue, causing it to become filled with fluid, or produce a deficiency in surfactant.




Answer
True or False
1 points  
Question 7

  The primary effect of V/Q mismatch is to increase alveolar dead space




Answer
True or False
1 points  
Question 8

  Cyanosis is an early and reliable sign of Hypoxia




Answer
True or False
1 points  
Question 9

  The mediator release which causes the acute phase of an asthma attack, peaks within 15 to 30 minutes and is primarily bronchospastic in nature




Answer
True or False
1 points  
Question 10

  In acute severe asthma, steroids remain the mainstay of immediate treatment.




Answer
True or False
1 points  
Question 11

  In terms of V/Q match and mismatch due to gravity, the lung can be divided into three zones:

•  Upper zone: V & Q are matched

•    Middle zone: higher V, lower Q

•   Lower zone: lower V, higher Q




Answer
True or False
1 points  
Question 12

  Pulmonary oedema may occur in severe asthma, likely due to the high negative intra-thoracic pressures generated to overcome the airway obstruction.


Answer
True or False
1 points  
Question 13

  In the condition ARDS the pulmonary oedema that may potentially occur is the result of changes in pressure gradients. 




Answer
True or False
1 points  
Question 14

  Once started, PEEP should not be abruptly discontinued, as a severe fall in PaO2 may occur



Answer
True or False
1 points  
Question 15

  Non-cardiogenic pulmonary oedema occasionally occurs as a single clinical feature of anaphylaxis and is a common post mortem finding in patients who die of anaphylactic shock, but rarely is it described in multi-system anaphylaxis.




Answer
True or False
1 points  
Question 16

  Continuous Positive Airway Pressure (CPAP) is a form of respiratory support that is useful in the treatment of patients with respiratory failure, who are spontaneously breathing.




Answer
True False
1 points  
Question 17

  Depolarising agents are long acting and are used most often for procedures such as intubation. Non-depolarising agents are short acting and are used when it is essential to maintain paralysis for an extended period of time




Answer
True or False
1 points  
Question 18

  Suxamethonium is a non-depolarising agent


Answer
True or False
1 points  
Question 19

  SIRS is a complex systemic response that is always initiated when a micro-organism enters the body and stimulates an antigen/antibody immune response.




Answer
True or False
1 points  
Question 20

  Enalapril is an angiotensin-converting enzyme (ACE) inhibitor having both arterial and venodilating properties and causes little change in heart rate, cardiac output or pulmonary artery pressure.




Answer
True or False
1 points  
Question 21

  Nitroprusside is considered the agent of choice for minute-to-minute control in most cases of severe hypertension both in and out of the critical care environment.

Answer
True or False
1 points  
Question 22

  Nitroprusside serves as a source of nitric oxide


Answer
True or False
1 points  
Question 23

  When ventilating an intubated patient with acute asthma, you should increase the ventilation rate to reduce CO2 levels


Answer
True or False
1 points  
Question 24

  Lennox-Gastaut syndrome is a severe form of epilepsy 



Answer
True or False
1 points  
Question 25

  Overall, intracranial aneurysms occur more frequently in males


Answer
True False
1 points  
Question 26

  There are two specific types of nerve fibres important in nocioception; 
 A-delta fibres and   C fibres. 




Answer
True or False
1 points  
Question 27
More recently data from the Established Populations for Epidemiologic Studies in the Elderly (EPESE) demonstrate that in individuals over the age of 65, elevations of DBP actually decline substantially as a cardiovascular risk factor while elevations of SBP continue as a significant risk factor into advanced old age.


Answer
True or False
1 points  
Question 28
Diazoxide is an indirect-acting arteriole vasoconstrictor that increases peripheral resistance, increases cardiac output and maintains or increases renal plasma flow.

Answer
True or False
1 points  
Question 29
Hypertension is the commonest symptom of an anaphylactic reaction: 

Answer
True or False
1 points  
Question 30
The term anaphylactoid is used to refer to reactions in which there appears to be a possibility of an immune basis: 


Answer
True or False
1 points  
Question 31
RSI can be carried out by anyone deemed competent in intubation skills: 

Answer
True or False
1 points  
Question 32
Non Depolarising Neuromuscular Agents must be ‘reversed’ prior to extubation: Answer
True or False
1 points  
Question 33
Vecuronium Bromide is a Depolarising Neuromuscular Agent: 


Answer
True or False
1 points  
Question 34
Digoxin is an Inotropic agent: 


Answer
True or False
1 points  
Question 35
Inotropic agents effect skeletal muscle tonicity: 
Answer
True or False
1 points  
Question 36
Atrovent is an anticholinergic agent:
 
Answer
True or False
1 points  
Question 37
Non-invasive ventilation can reduce the need for endotracheal intubation, length of hospitalisation, and mortality rates in selected respiratory failure patients.




Answer
True or False
1 points  
Question 38
IPPV may cause a reduction in venous return and a rise in pulmonary vascular resistance cause a reduction in cardiac output. In patients with heart failure there is often a paradoxical rise in blood pressure and cardiac output with IPPV.



Answer
True or False
1 points  
Question 39
The acronym PEEP stands for Peak Expiratory End tidal Pressure


Answer:
True or False
1 points  
Question 40
The aim of PEEP to is to decease partial pressures in the lungs allowing aveoli to re-expand. 


Answer: 
True or False
1 points  
Question 41
Biochemically, DIC is characteristically indicated with the simultaneous presence of plasmin and prothrombin  


Answer:
True or False
1 points  
Question 42

  Disseminated intravascular coagulation (DIC) is a pathological syndrome of activated coagulation that manifests with bleeding or thrombosis. Patients with DIC have a loss of balance between the clot-promoting and lysing systems. This syndrome can have a clinical spectrum ranging from bleeding to a prothrombotic state. 



Answer
True False
1 points  
Question 43

  Opioid agonists act against pain by....


Answer
a.
Binding to receptors on neural terminals, mediate endogenous transmitters producing or inhibiting a signal

b.
Decrease the amount of serotonin on the neural terminals, 

c.
Block the receptor site on the motor neural terminals preventing  the painful stimulus


d.
Destroy the receptor site

1 points  
Question 44

  Opioid agonists create… 




Answer
a.
Hyperventilation, hyper-vigilance
b.
Increased pain stimuli


c.
Analgesia, sedation, decreased concentration, euphoria
d.
decreased pain stimuli and hyperventilation
1 points  
Question 45

  When titrating Opioid agents for analgesic effect subsequent doses following the initial loading dose may need to be…




Answer
a.
Lower
b.
Higher
c.
Same

d.
Double
1 points  
Question 46

  Opiate receptors are found in the...


Answer
a.
All of the above
b.


Medulla

c.
Cerebral cortex and spinal cord
d.
Hypothalamus and thalamus
1 points  
Question 47

  Fentanyl has a potency of …………times that of Morphine


Answer
a.
300
b.
10
c.
50-100
d.
two

1 points  
Question 48

  Like other opiate agonists Morphine can cause…..


Answer
a.
Hypotension, respiratory depression and euphoria
b.
Hyperglycaemia and mitosos
c.
Hypertension and respiratory depression
d.
Dysphoria, hypotension and increased gastric motility
1 points  
Question 49

  The specific types of nerve fibres important in nocioception are….
Answer
a.
A-delta
b.
B-delta
c.
C
d.
a and c
1 points  
Question 50

  The tracts that carry the Nocioceptive stimuli from the dorsal horn to the central structures of the CNS are called the…
Answer
a.
Descending tracts
b.
Ascending tracts
c.
Spinothalamic tracts
d.
Medullary tracts
1 points  
Question 51

  The area(s) of the brain controlling heart rate and blood vessel diameter in response to pain is/are the .....

Answer
a.
Reticular Formation
b.
Medulla
c.
Thalamus
d.
a and b
1 points  
Question 52

  Pulmonary oedema may occur in response to severe asthma as a result of…




Answer
a.
low intra thoracic pressures
b.
Mast cell degranulation
c.
humoral mediated responses
d.
high negative intra-thoracic pressures
1 points  
Question 53

  The mainstay for the pharmacological treatment of severe acute asthma is..
Answer
a
Beta 2 antagonists
B
Beta 2 agonists
c
steroids
d
antihistamines
1 points  
Question 54
IPPV can cause derimental effects because of
Answer
a.
improving the pressure gradient in the the thoracic cavity
b.
increasing the pressure gradient in the the thoracic cavity
c.
maintaining the pressure gradient in the the thoracic cavity

d.
reversing the pressure gradient in the the thoracic cavity
1 points  
Question 55

  Pulmonary oedema may occur in patients after severe central nervous system trauma such as cerebral haemorrhage, stroke, tumour, or increased intracranial pressure and appears to be mediated…
Answer
a
Neurologically via androgenic hypersensitivity 
b
Hydrostatic mechanisms
c
Damage to the pulmonary membrane
d
All of the above
1 points  
Question 56

  The immune response resulting in anaphylaxis is initiated via a mast cell/antibody/antigen process, the antibody implicated in this physiological response is:
Answer
a.
IgA
b.
IgE
c.
IgM
d.
IgG
1 points  
Question 57

  The pathology of pulmonary oedema of a non cardiac aetiology is damage, whether physical or chemical, to the endothlial membrane of the lungs. The major causes of this include

Answer
a.
Near drowning, barotrauma and rapid accents.
b.
Burns, smoke inhalation, and toxins
c.
Sudden increase in blood pressure, pregnancy, thyroid storm
d.
a & b
e.
a & c
1 points  
Question 58

  A condition resulting from over stimulation of the blood clotting mechanisms in response to a disease or injury that may be fatal is…
Answer
a.
ADHD
b.
SIDS
c.
DIC
d.
ARDS
1 points  
Question 59

  When utilizing PEEP pressures of ________ to _______ Cm H20 are most commonly employed
Answer
a.
5-15
b.
20-30
c.
5-10
d.
25-35
1 points  
Question 60

  The FICK Principle or Law is defines which of the following?
Answer
a.
Ventilatory effort
b.
Cardiac output
c.
PEEP
d.
Renal output
1 points  
Question 61

  The most common site for an arterial pressure line is:
Answer
a.
Sub-clavian artery
b.
Carotid Artery
c.
Femoral Artery
d.
Radial Artery
1 points  
Question 62

  An understanding of VQ mismatch is vital in the critical care setting as the cause of the VQ mismatch may be correctable by the Paramedic. Examples of this include:
Answer
a.
Needle decompression of a tension pneumothorax


b.
Non-invasive ventilation with CPAP or BIPAP to decrease the work of breathing
c.
Altering patient position
d.
all of the above
Question 63

  The VQ ratio represents the balance between aveolar ventilation and
Answer
Capillary blood flow
Aveolar dead space
Minute volume
Bronchiolar efficiency
1 points  
Question 64
Which of the following is not an indication for Sedation and Mechanical Ventilation
Answer
A.
Acute respiratory failure
B.
Impending respiratory failure
c.
Hypercapnia
d.
Hypocapnia
1 points  
Question 65
The major goal of inotropic therapy in a patient suffering hypovolaemic shock is:
Answer
a.
Improve ventilation
b.
Increase cardiac output
c.
Increase cardiac oxygen demand
d.
Increase myocardial refractory period
1 points  
Question 66
CPAP is analogous with ______________ when a patient is spontaneously breathing via a face mask
Answer
a.
IPPV
b.
IPV
c.
PEEP
d.
PPV
1 points  
Question 67

  Esmolol can be described as...

Answer
a.
a slow release alpha stimulant
b.
an ultra-short-acting, beta1-adrenergic blocker.
c.
A rapid acting bet2-androgenic stimulator
d.
a slow acting beta1 androgenic stimulating agent
1 points  
Question 68

  In a study by Montgomery et.al., less than _____% mortality in ARDS was due to irreversible respiratory failure.


Answer
a.
60%
b.
50%
c.
30%
d.
20%
1 points  
Question 69

  Which of the following chemical mediators are not implicated in the allergic response:

Answer
a.
Noradrenaline
b.
Prostaglandins
c.
Histamine
d.
Cycloxygenase
1 points  
Question 70

  Any condition that increases carbonic acid, or decreases the base bicarbonate, causes…
Answer
a.
Metabolisis
b.
Alkalosis
c.
Hypoglycaemia
d.
Acidosis
1 points  
Question 71

  When applying PEEP pressures of 5-10cm as most common. Pressures greater than this may cause...
Answer
a.
a reduction in cardiac out put
b.
Aveoli collapse
c.
Barotrauma
d.
a & b
e.
a & c
1 points  
Question 72

  Pulmonary artery (PA) catheters should routinely be placed in patients with suspected ARDS in order to:
Answer
a.
serve as a diagnostic tool to assess vascular filling

  

b.
allow management of oxygen and PEEP levels


c.
 provide information necessary for appropriate fluid management
d.
all of the above
1 points  
Question 73

  A patient that is exhibiting anxiety, confusion, irritability, muscle cramps, seizures and tetany should be suspected of suffering from…
Answer
a.
Hypercalcaemia
b.
hyperkalaemia
c.
hypolipidaemia
d.
hypocalcaemia Read More
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