ERTTC Quiz

1. You are presented with a 34-year-old female patient who is a victim of a car accident. The patient’s vital signs are BP 100/P, HR 130, RR 20/min, and she is currently responsive. What stage of shock is she in?

Compensated

Cellular

Irreversible

Decompensated

2. You are flying an MVC patient from a small hospital to a regional trauma center 175 miles away. The patient is dyspneic and is suspected of having a right pneumothorax, which is not enlarging in size. In order to be transported to the trauma center, the patient must be flown from sea level to 3,000 feet in an unpressurized aircraft. Because of pressure variances during accent, the pneumothorax may:

Remain the same size.

Resolve completely.

Become larger.

Become smaller.

3. The primary role of the eustachian tubes is to:

Provide a means for interstitial drainage.

Equalize pressure in the middle ear.

Aid in the filtration of air.

Maintain nasopharyngeal continuity.

4. Factors that affect the “time of useful consciousness” for crew members during a rapid decompression include which of the following?

Altitude at which decompression occurs

Physical activity

Individual tolerance

All of the above

5. Women may elicit very ________ patterns of symptoms in a myocardial infarction.

Typical

Predictable

Atypical

Severe

6. Because of its size and large amount of myocardium it supplies, if LAD becomes totally occluded, the massive MI is termed a:

Moneymaker

Haymaker

Scarmaker

Widowmaker

7. The normal blood pH range is:

7.20-7.30.

7.00-8.00.

7.30-7.40.

7.35-7.45.

8. What is a normal PaCO2 value?

27 torr

40 mmHg

18 torr

56 mmHg

9. The respiratory pattern with rhythmic increase and decrease of rate and depth of respiration, then brief periods of apnea is known as:

Central neurogenic hyperventilation.

Cheyne-Stokes respirations.

Ataxic respirations.

Apneustic breathing.

10. Decreased respiratory effort can result in acidosis, which is caused by the body partaking in ________ metabolism.

Hydrogen

Anaerobic

Decreased

Aerobic

11. The clinical manifestations of Cushing’s triad are:

Headache, nucal rigidity, and hyperthermia.

Bradycardia, systolic hypertension, and widening pulse pressure.

Tachycardia, systolic hypotension, and tachypnea.

Bradycardia, aphasis, and visual field disturbances.

12. An alternate path of blood flow in the event of vascular occlusion is termed:

Pulmonary circulation

Systemic circulation

Collateral circulation

Central circulation

13. Hypoxia in the head-injured patient can cause a secondary injury, resulting in:

Cerebral edema.

Metabolic acidosis.

Hyperventilation.

Hypertension.

14. Transmural infarctions is literally translated as "________" infarctions.

Above the wall

Below the wall

Middle of the wall

Across the wall

15. Pulsus paradoxus is most often associated with what traumatic chest injury?

Traumatic asphyxia

Pericardial tamponade

Open pneumothorax

Hemothorax

16. Atrial contraction influences Starling’s law by:

Adding an atrial kick that increases ventricular diastolic volume.

Opening the AV valves at the same time.

Decreasing ventricular work.

Decreasing stretch on ventricular muscle fibers.

17. Which of the following is the most commonly injured abdominal organ in a pediatric patient?

Spleen

Stomach

Bladder

Intestine

18. What drug has the dose of 5-20 mg/kg/min?

Dobutamine

Norepinephrine

Nitroglycerine

Dopamine

19. What do pericardial tamponade, tension pneumothorax, and pulmonary embolism all have in common regarding hypoperfusion?

They all are caused by trauma.

They all are classified under “obstructive” shock.

They all will cause delayed hypoperfusion, days after the original insult.

The major problem with all of them is diminished atrial preload.

20. Positive chronotropic effects lead to a ________ in heart rate.

Increase

Lowering

Decrease

Stabilization

21. The point at which an arterial line is zeroed is called the:

Transducer point.

Henry’s point.

Phlebostatic line.

McCargar’s point.

22. After extrication from a bad MVC by a local fire department, the PASG is placed on the trauma patient to stabilize a suspected pelvic and lower extremity fracture. On ascent, the patient complains of increased pressure and pain under the PASG. This is best explained by:

Charles’ Law.

Henry’s Law.

Boyle’s Law.

Dalton’s Law.

23. According to the Mallampati classification system for airway assessment prior to intubation, the most challenging airway would receive what classification?

Class I

Class II

Class III

Class IV

24. Rate and depth of respirations in healthy patients respond to:

Carbon dioxide levels in the blood.

Oxygen levels in the blood.

Hemoglobin saturation levels.

Blood pressure.

25. Cardiogenic pulmonary edema is primarily due to:

Reductions in hydrostatic pulmonary pressures.

Left ventricular failure.

Right ventricular failure.

Poor capillary permeability.

26. Your patient’s blood gases present as: pH 7.25, PaCO2 55, PaO2 70, HCO3 -25. What is your patient most likely suffering from?

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

27. The coronary artery receives blood during:

Ventricular systole.

Diastole.

Atrial diastole.

Systole.

28. How are EtCO2 values commonly expressed?

As a percentage

As a decimal value

In cm H2O

In mmHg

29. Which of the following statements regarding cerebral perfusion pressure (CPP) is correct?

When the CPP equals the MAP, cerebral blood flow ceases.

The CPP in the average adult is approximately 150-160 mmHg

Neuronal ischemia and death occurs with a CPP less than 60 mmHg.

CPP is calculated as the difference between the mean arterial pressure (MAP) and the ICP.

30. The condition that occurs when systolic blood pressure drops abnormally with inspiration is:

Pulsus paradoxus.

Electrical paradoxus.

Pulsus alternans.

Electrical alternans.

31. ST segment elevation in the face of an anteroseptal MI would involve elevation if 1 mm or more in these leads.

V3, v4, v5, v6

V1, v2, v3, v4

V1, v2, v5, v6

II, III, aVF

32. Anterior MIs most often involve which artery?

Posterior descending artery

Marginal artery

Left coronary artery

Right coronary artery

33. A pulse oximetry reading of 90% typically corresponds with a PaO2 of what?

90 mmHg

100 mmHg

20 mmHg

60 mmHg

34. Which one of the following statements is true regarding pediatric thoracic trauma?

A fail chest is a common pediatric injury.

Pulmonary contusions are often seen with pediatric chest trauma

It is the #1 leading cause of death in pediatrics.

Pediatrics are susceptible to fractured ribs/sternum.

35. The cardiac enzyme creatine kinase levels will begin to rise approximately ________ after the onset of a myocardial infarction.

4-6 hours

10-20 minutes

40-60 minutes

1-2 hours

36. Adults may begin to develop sign and symptoms of hypoxia at what altitude in an unpressurized cabin?

12,000-16,000 feet

12,000-14,000 feet

8,000-10,000 feet

18,000-20,000 feet

37. ST elevation of 1 mm or more in these leads is indicative of a posterior MI.

V4, v5, v6

II, III, aVR

V1, v2, v3, v4

There are no facing leads for posterior MI.

38. Your patient’s ECG shows signs of ST elevation in leads II, III, AVF, and V4R. Which coronary artery is most likely occluded?

Left common coronary artery

Left anterior descending coronary artery

Left circumflex coronary artery

Right coronary artery

39. Atmospheric pressure is defined as:

1000 mmHg.

760 torr.

100 torr.

360 mmHg.

40. Right ventricular infarction is a complication that occurs in approximately ________% of inferior MIs.

20

40

70

90

41. Barotitis media would most likely occur in which one of the following situations?

Slow descent from 10,000 to 5,000 feet

Rapid ascent from 5,000 to 10,000 feet

Rapid descent from 8,000 feet to sea level

Rapid descent from 25,000 to 20,000 feet

42. Stimulation of alpha adrenergic receptor sites during sympathetic discharge causes what response?

Bronchodilation

Vasoconstriction

Increase heart rate

Vasodilation

43. Epinephrine can be deactivated if mixed with:

Acid agents

Antihypertensive agents

Dromotropic agents

Alkaline agents

44. In order to determine if the bundle branch block is either right or left sided, what lead is assessed?

V6

Lead II

V1

None of the above

45. The leads that are the reciprocal leads for a posterior MI are:

V5, v6, I, aVL

V1, v2, v3, v4

II, III, aVF

AVR, aVL, aVF

46. When using ditiazem, which drug or drugs may potentiate the seriousness of the side effects?

Beta blockers

Digitalis

Lasix

All the above

None of the above

47. Which of the following is not a sign of pure right heart failure?

JVD

Peripheral edema

Rales

Hepatomegally

48. Modified Central Lead 1 (MCL-1) is essentially a bipolar equivalent of ________.

I

V3

V1

II

49. The posterior lead that goes just to the left of the spine in the 5th intracostal place is:

V9

V7

V8

V10

50. The larynx lies at the level of:

C2-C4.

C1-C3.

C7-T2.

C4-C6.

51. Brain tissue that is threatened with cellular death from hypoperfusion, but has not yet become necrotic, is called the:

Ischemic circumflex.

Threatened ischemic tissue.

Zone of infarcion.

Penumbra.

52. The expansion of the lungs is partially dependent upon the adherence of two layers of pleura. This adherence is created by a small amount of lubricating fluid between the layers, combined with a subatmospheric air tight seal. The pleural layer that lines the interior of the thoracic cavity is called the:

Visceral pleura.

Parietal pleura.

Thoracic pleura.

Partial pleura.