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Questions and answers on advanced medical life support (AMLS) protocols, useful for pretest review. Topics include respiratory alkalosis, shock, meningitis, jellyfish stings, COPD, anaphylaxis, pulmonary embolism, subdural hematoma, hyperosmolar hyperglycemic state, hypothermia, liver failure, neurogenic shock, stroke, appendicitis, metabolic acidosis, cardiac tamponade, tuberculosis, asthma, kidney stones, and more. The answers offer concise guidance on actions and diagnoses, a valuable resource for medical students and professionals preparing for AMLS certification or recertification. It provides insights into decision-making in emergencies, enhancing preparedness and competence in patient care. This review covers a wide range of emergency scenarios, providing a comprehensive overview of AMLS protocols.
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What may cause primary respiratory alkalosis
Fever
Quadriplegic male is experiencing difficulty breathing and restlessness. His skin is warm and his urine is dark yellow and cloudy. Vital signs are BP 86/68, P 128, R 24, temperature 101.2 F. What type of shock should you suspect?
Septic
20 year old male college student complains of acute onset of fever, headache, vomiting, and malaise. He appears ill and has a petechial rash on his extremities. What do you suspect?
Meningitis
A 20 year old male complains of sever pain after a jellyfish sting. He has a red, swollen ankle and foot. What should you do?
Wash the area and administer an analgesic
The renin-angiotensin-aldosterone system is activated during shock in order to cause which of the following?
Increase in preload, afterload, and reabsorption of sodium
An elderly COPD patient complains of difficulty in breathing upon exertion. She has a 1 - week history of productive cough. She has pursed lip breathing. She is prescribed a bronchodilator as needed. Vital signs are BP 132/70, P 88, R 20 with rhochi. What should you suspect?
Chronic bronchitis
An anxious 32 year old female complains of chest pain with palpitations. She has a history of Graves' disease. She reports she was seen in the ED earlier that day and
What finding is unique in pericarditis?
Diffuse ST segment elevation
A 21 year old male complains of sharp pain and shortness of breath. The symptoms started when he lifted a heavy object. Vital signs are BP 152/96, P 108, R 24 and diminished on the left. What should you suspect?
Spontaneous pneumothorax
A 72 year old female complains of a sudden onset of burning sensation to the left side of her forehead and blurred vision. She wants to follow up with her primary care physician tomorrow. Vital signs are BP 150/70, P 80, R 16. What should you do?
Encourage her to be transported by ambulance to the hospital.
An anxious 61 year old male complains of severe shortness of breath and localized chest pain with blood-tinged sputum. His dyspnea started when he stood up from watching television all day and increased in severity as he moved around. Vital
signs are BP 104/60, P 98 and irregular, R 26 and labored. What should you suspect?
Pulmonary Embolism
Anaphylaxis is most commonly associated with which physiological event?
Vasodilation
A confused 67 year old male has vomited multiple times prior to EMS arrival. He was involved in a car crash 48 hours prior. Bystanders state he became increasingly confused and lost coordination since the crash. Vitals signs are BP 150/88, P 72, R 18 BGL 92
Subdural Hematoma
What condition causes paroxysmal nocturnal dyspnea
Left-sided heart failure
A 22 year old male has recently undergone a surgical procedure to repair an injury to thoracic vertebrae T1-T2. Assessment indicates the patient is alert and oriented, bradycardic, hypotensive, and has warm, dry skin. Which type of shock is most likely occuring?
Neurogenic
It is 0600 hours and you are treating a 63 year old female with slurred speech, facial droop, and altered mental status. At 0400 hours, her husband her go to the bathroom. At 2300 hours they went to bed and everything was fine.
Continuous positive airway pressure would be most beneficial in treating what kind of patient
A 22 year old with sever asthma that is unresponsive to albuterol treatments
A 27 year old male is breathing fast and deep. He works at a preschool and believes that the children plan to harm him. Which of the following statements is most helpful when treating this patient?
I understand that you are concerned. Please tell me more about why you feel this way?
A 15 year old male complains of lower abdominal pain with nausea. He is in the fetal position and states, "It hurts to walk." What should you suspect?
Appendicitis
A 26 year old male has abdominal pain. He is able to pinpoint exactly where it hurts, experiences rebound tenderness on physical exam, and guards the affected area. Which type of pain should you suspect?
Somatic
A 52 year old male is suffering from acute chest pain after physical exercises. He is pale, cool, and clammy
Acquire a 12 lead ECG
What respiratory changes are common in obese patients?
Decreased tidal volue
A 30 year old female complains of acute chest tightness, shortness of breath, and a nonproductive cough. She states that this happens frequently and usually resolves after using her "inhaler." What should you suspect?
Asthma
A 44 year old female complains of a sudden onset of sharp pain in her right flank that radiates to her groin area. Intermittently the pain becomes very severe. She also reports nausea. Vital signs are BP 152/94, P 104, R 16, SpO2 98%. What is the most likely cause?
Kidney Stones
A 13 year old male has been skateboarding in temperatures of 100 F and has been drinking caffeinated soft drinks. He complains of palpitations. The cardiac monitor displays a narrow-QRS tachycardia at a rate of 150 BPM. Vital signs are BP 108/62, R24. What should you do?
Transport the patient by ambulance, monitor closely, and administer fluids enroute.
An 82 year old female complains of foul smelling diarrhea, abdominal cramping, and loss of appetite. She developed an infection following knee surgery 2 weeks ago. She is prescribed antibiotics. What should you suspect?
Clostridium difficile (C-Diff)
A 62 year old female presents with severe nausea and blurred vision that began while watching TV. She describes the headache as the worst headache she has ever had in her life. Vital signs are BP 194/110, P 98, R 20. What should you suspect
Subarachnoid Hemorrhage
A 33 year old female is threatening suicide because her partner left her. Which of the following would be an appropriate response?
A 68 year old female who has a history of COPD may rely on what breathing mechanics?
A decrease in the oxygen level in the blood as the stimulus to breathe
What is a hallmark sign of tricyclic antidepressant toxicity?
Dysrhythmias
An alert 22 year old male complains of a "lump in his throat" and a hoarse voice after a failed suicide attempt. He unsuccessfully attempted to hang himself with a bed sheet. Vital signs are BP 150/80, P 120, R 16, SpO2 88%. ETCO2 40 mmHg. What should you do?
Administer oxygen and transport to a trauma center
A 45 year old female reports a headache, vertigo, and leg cramps after exercising. Vital signs are BP 108/62, P 124, R 18, Temp 100.6 F and SpO2 98%. What should you do?
Provide oral fluid replacement
A 60 year old female complains of indigestion and mild upper abdominal discomfort. What should you do?
Acquire a 12 lead ECG and transport to a cardiac center.
A 49 year old male presents in a tripod position with audible stridor and marked respiratory distress. His skin is flushed, and he complains of dysphagia. What should you suspect?
Epiglottitis
A patient complains of nausea and is passing black, tarry stools. What should you suspect?
Upper GI bleeding