Region VIII July 2017 EMS CE Post-Test

Sepsis

  1. The signs and symptoms of sepsis include:
  2. Shortness of breath, low heart rate, change in mental status
  3. Cold dry skin, elevated heart rate, confusion
  4. Extreme pain, warm dry skin, shivering
  5. Fever, confusion, elevated heart rate (Slide 17)
  1. Vulnerability to sepsis is becoming more widespread due to:
  2. Rising antibiotic resistant organisms (Slide 20)
  3. Less invasive procedures being preformed
  4. Decrease in use Corticosteroids
  5. Decrease in infection rates in the elderly
  1. Which of the following is not a component of the AVPU assessment?
  2. Unresponsive
  3. Alert
  4. Verbal
  5. Posturing(April CE)
  1. SIRS is defined as two or more of the following:
  2. Fever of >100.4 and heart rate of <70
  3. Respiratory rate of >20 and heart rate >90 bpm (Slide 12)
  4. Heart rate <60bpm and fever of <98.6
  5. Respiratory rate <8 and fever< 98.6
  1. Signs of poor perfusion in the pediatric patient include:
  2. Low urine output and rapid capillary refill
  3. Warm extremities and weak brachial pulses
  4. Bounding pulse and decrease in mental status
  5. Weak pulses and delayed capillary refill (Slide 40)
  1. The primary cause of septic shock is bacteria? (Slide 23)
  2. True
  3. False
  1. Cushing’s Triad, indicative of increasing intracranial pressure, includes all but which of the following;
  2. Bradycardia
  3. Muffled Heart Tones (April CE)
  4. Irregular Respiratory Patterns
  5. Hypertension
  1. The CHART Mnemonic can be utilized to help an EMS provider to think of sepsis in the pediatric patient. It stands for:
  2. Complaint, hives, asymptomatic, rash, time
  3. Complaint, history, assessment, red flags, treatment (Slide 42)
  4. Cause, history, assessment, rashes, temperature
  5. Complaint, histotoxins, altered mental status, rash, treatment
  1. Syndromes that mimic sepsis include:
  2. Hypoglycemia, fluid overload
  3. Acute cholecystitis, COPD
  4. Anemia, stroke
  5. Hypovolemia, diabetic ketoacidosis (slide 10)
  1. Severity of septic shock is often missed in infants and children due to poor compensatory mechanisms: (Slide 39)
  2. True
  3. False (Slide 39)

***BLS STOP HERE***

  1. Waveform capnography is:
  2. Reliable for lactate monitoring in detecting metabolic distress (Slide 34)
  3. Has no clinical indicators for use in the septic patient
  4. Indicates if the patient becomes lactic alkalotic
  5. Indicate when lactate levels decrease due to organ hypo perfusion.
  1. Sepsis is a life threatening condition that arises when the body’s response to infection injures its own tissues and organs
  2. True (slide 14)
  3. False
  1. EMS should be considering sepsis or septic shock if the child has suspected or proven infection and at least two of the following:
  2. GCS 14, febrile
  3. Muscle spasms, GCS 15
  4. Extreme or unexplained irritability, GCS of 10 (Slide 48)
  5. Irregular heart rate, bradycardia
  1. Which of the following is NOT considered a contraindication for tPA or thrombolytic therapy?
  2. Current intracranial hemorrhage
  3. Severe uncontrolled hypertension
  4. Intracranial neoplasm or arteriovenous malformation
  5. Head injury > 12 months ago (April CE)
  1. The Broselow system is based on the relationship between age and weight.
  2. True
  3. False (Slide 60)
  1. When administered to hypoglycemic patients ,Dextrose 10% reduces the risk of:
  2. Rebound hypoglycemia
  3. Tissue damage from extravasation
  4. Vessel injury
  5. All of the above (Slide 64)
  1. One of the body’s responses to attempt to compensate for increasing lactic acid levels is to:
  2. Decrease heart rate
  3. Increase respiratory rate (Slide 35)
  4. Decrease respiratory rate
  5. Increase heart rate
  1. An adult male patient suffered significant head injury while playing football. He was removed from play and evaluated. Initially the patient showed minimal neurologic abnormalities and no deficits. Approximately 12 hours later, the patient became confused and lethargic, and was vomiting. The patient then experienced a generalized seizure. Based on this information, which type pf intracranial hemorrhage would you suspect?
  2. Epidural Hematoma
  3. Subarachnoid Hemorrhage
  4. Subdural Hematoma (April CE)
  5. Intraventricular/ Intraparenchymal Hemorrhage
  1. Older patients may present with atypical symptoms or an absence of symptoms when developing sepsis. Atypical symptoms may include:
  2. An Increase in appetite, absence of fever
  3. Delirium, Malaise (Slide 19)
  4. Hyperthermia, hypoglycemia
  5. Bradycardia, muscle spasms
  1. You respond for the 65 y/o male thatcut his finger trimming bushes. He washed and covered the wound and noticed several days later the finger to be red, swollen and a having pus like drainage. He saw his physician who prescribed an antibiotic which he stopped taking it after 3 days because he felt better. Today a relative called 911 because the man is confused with a fever, chills and a fast heart rate. His vital signs are as follows Temp 102.2, HR 110, BP 88/60, RR 22 and O2 saturation of 92%. Further assessment reveals skin in warm and moist, lungs clear, finger is reddened and swollen with capillary refill of >3secs. What would be your next steps in treating this patient?
  2. Rapid transport ,need for immediate surgical intervention
  3. Fluid bolus 20mL/hour, notify ECRN of stroke alert
  4. Oxygen, fluid bolus 500cc, notify ECRN ofsepsis alert (slide 33)
  5. Oxygen, saline lock, monitor, transport
  1. The FAST exam has been shown to have sensitivity for CVA of ____%.
  2. 50%
  3. 85% (April CE)
  4. 25%
  5. 99%
  1. You respond for the 40 y/o male at a rehab facilitythat has a two day history of fever, chills, cough and right- sided pleuritic pain. The staff noted he is more lethargic and dizzy today and falling frequently. His vital signs are : Temp 101.5, HR 120 BPM, RR 30, Blood pressure 70/30mm/Hg and oxygen saturation of 82% on room air. His chest x-ray from yesterday indicates that he has a right lower lobe infiltrate. This patient’s condition can best be defined as;
  2. Severe sepsis (Slide 22)
  3. Sepsis
  4. Septic shock
  5. Systemic inflammatory response syndrome (SIRS)
  1. What is the first step in the initial management of the above patient?
  2. Antibiotic therapy
  3. Intravenous fluid resuscitation
  4. Administration of a vasopressor like dopamine
  5. Supplemental oxygen and airway management (Slide 220
  1. Drug resistant bacteria is one of the root causes of infections that trigger sepsis:
  2. True(Slide 7)
  3. False
  1. Common locations for a primary infection leading to sepsis include:

a. Urinary Tract

b. Lungs

c. Brain

d. All of the Above (Slide 16)

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