Critical Care Paramedic Review Flashcards

Preparing for your Critical Care Paramedic certification exam? MedicNerd.com now offers you the time-tested technique of flashcards. Despite their name, flashcards are not flashy, but they accomplish two vital things:

  1. Flashcards weed out the fluff & help you focus strictly on essential information
  2. Flashcards repetitively force your brain to recall that information when questioned

These are the very cards that MedicNerd.com’s Founder used to prepare and pass his Critical Care Paramedic certification exam.

You now have 24/7 access to our constantly updated CCP Review Flashcards…currently over 230 cards!

Now get to work below & invest the time in your education to pass your Critical Care Paramedic exam!

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how do you calculate MAP?

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[(diastolic x 2)+systolic]/3

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What does “SIADH” stand for?

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syndrome of inappropriate ADH (antidiuretic hormone)

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Lab Values: What is the normal range for Calcium (Ca++)?

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8.2 – 10.2 mg/dL

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Lab Values: What is the normal range for Magnesium (Mg)?

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1.3 – 2.1 mEq/L

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Outside pediatrics, Ketamine is considered the drug of choice for patients presenting with which medical condition?

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asthma

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List three treatments for diabetes insipidus (DI)

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give ADH (pitressin), give fluids, monitor ECG for ischemia

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Lab Values: What is the normal range for Sodium (Na+)?

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136 – 142 mEq/L

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What is an appropriate treatment for brain herniation?

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hyperventilation

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List 2 classic presentations of Digitalis toxicity

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flu-like signs/symptoms and visual disturbances (yellow/orange halos)…think of Van Gogh’s ‘Starry Night’

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Use of magnesium sulfate is common in women who are in pre-term laobr. If _________ are absent due to magnesium toxicity, turn the infusion off.

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deep tendon reflexes (DTR’s)

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A patient exposed to a burned carpet complains of SOB and coughing, what may be the cause?

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cyanide poisoning

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What is the antidote for a Heparin overdose?

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protamine sulfate

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describe compartment syndrome

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compression of nerves and blood vessels within the injured area

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FiO2 stands for?

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fraction of inspired oxygen

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What is the normal expected urinary output for a pediatric patient?

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1 – 2 ml/kg/hour

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What is the normal stroke index?

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25 – 45ml per meter squared

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Ventilators: What does PIP stand for?

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Peak inspiratory pressure

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For what degree burns do you use in the parkland formula?

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2nd and 3rd degree burns only

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Spinal cord injuries: Describe how a central cord injury usually occurs

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usually occurs with hyperextension or flexion of the cervical region

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How does succinylcholine work?

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by causing rapid and continued depolarization of the acetylchonline receptors

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Describe HHNK breathing

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LTBB…lucky to be breathing!

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What is fetal hydrops (hydrops fetalis)?

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a condition in which abnormal amounts of fluid build (edema) up in two or more body areas of a fetus or newborn

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What is the usual BGL for a patient experiencing HHNK?

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1000-2000

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List two medications frequently used in pre-term labor

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magnesium sulfate and terbutaline

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OB: treatment for late deceleration

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prepare for immediate delivery, administer oxygen, and IV fluid boluses

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With a patient in HHNC, are excess ketones detected?

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no

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What is the normal cardiac index?

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2.5 – 4.2 liters per minute per meters squared

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CAMTS: driving records should be reviewed how often?

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every year

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Mixed Venous Blood Gases: What is the normal range for HCO-3?

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22 – 26 mEq/L

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What does CVP stand for?

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central venous pressure

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What is the term used to describe typical DKA breathing?

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kussmaul

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Ventilators: What is the expected dead space?

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approximately 2mL/kg or weight in pounds

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What is the core body temperature range for moderate hypothermia?

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30 – 34 C

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OB: During or after delivery, mother becomes acutely anxious, dyspneic, complains of chest pain, accompanied by tachycardia, tachypnea & hypotension…what do you suspect?

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amniotic fluid embolism

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DOPE stands for?

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dislodgment, obstructions, pneumothorax, equipment

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What two electrolyte abnormalities should you expect to find in a treated burn patient (especially when normal saline is used)?

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hyperkalemia (elevated potassium) and hypernatremia (elevated sodium)

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What are used to prevent closure of PDA’s in patient’s with other underlying issues (i.e., transposition of great vessels)?

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prostaglandins

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Ketamine provides a reliable level of sedation and has ________ properties

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bronchodilator

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What is the usual level of dehydration during HHNK?

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6-8 liters

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After traumatic injury to a long bone, your patient experiences acute dyspnea, hypoxia, neurologic system changes, coma, and even death…what do you suspect?

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fat emboli

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Why would a treated burn patient be hypernatremic?

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from the retention of salt contained in IV fluids used for fluid resuscitation

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List 3 relative contraindications to fibrinolytic therapy

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HTN, pregnancy, recent trauma

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pH below normal value…is this acidic or alkaline?

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acidic

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This injury involves severe mechanical disruption of the axons in both cerebral hemispheres & often extends to the brainstem

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diffuse axonal injury (DAI)

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What is Transposition of the Great Areries (TGA) or Transposition of the Great Vessels?

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cyanotic heart defect where the great vessels of the heart are switched and adequate oxygenated blood does not circulate throughout the body; requires surgery to fix the abnormality; prostaglandins are used to prevent closure of the PDA until after the surgery

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What IV fluid is used in burn patients?

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LR

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Lab Values: What is the normal range for Chloride (Cl-)?

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96 – 106 mEq/L

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OB: what is the preferred medication to treat pre-term labor for a patient with a cardiac history?

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terbutaline

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Ventilator issues: What is the most common cause of high pressure alarms?

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asynchronous breathing (the patient breathing against or out of sync with the ventilator)

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What does ICP stand for?

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intracranial pressure

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What do we call the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream?

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rhabdomyolysis

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Where are Bark Scorpions primarily found?

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Arizona and Mexico

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List four treatments for hypernatremia (high sodium)

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sodium bicarb, insulin, dextrose, kayexalate

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What is the treatment of a pit viper bite?

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ABC’s, keep the patient calm, administer CroFab anti-venom

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When treating elevated ICP, what medication can be considered?

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osmotic diuretics (ie, Mannitol)

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Capnography: square pattern is:

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normal breathing

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Vent settings: What is the goal plateau pressure setting?

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less than 30cm of water

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What is the treatment for mild hypothermia?

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passive re-warming, active external re-warming

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What is the normal amount of cardiac output per minute for an adult?

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4 – 8 liters per minute

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List two causes of diabetes insipidus (DI)

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head problem, dilantin (remember starts with “DI”)

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Increased AHD effects on sodium level, osmolality, and urinary output:

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decreased sodium levels, decreased osmolality, decreased urinary output

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What is the only depolarizing agent used in the United States?

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succinylcholine

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Rhabdomyolysis is most harmful to what organ?

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kidney

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When administering meds, is delivery to circulation faster via the IV or IO route?

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neither, they are both effective means of vascular access

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With Aspirin overdose, which ABG abnormality will be noted first?

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metabolic acidosis

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What are the signs and symptoms of pit viper bite?

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local pain, edema, tachycardia, numbness, parasthesias, bleeding disorder, vomiting, confusion

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Ventilators: To what is the Tidal Volume (Vt) usually set?

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7 – 10 mL/kg of ideal body weight

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OB: early decelerations are associated with what and seen when?

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associated with head compression and seen in active labor and mirrors contractions

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What is normal CVP?

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dehydration…(2 – 8)…fluid overload

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What is the treatment for Bark Scorpion sting?

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suction secretions and secure the airway

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List 3 causes of SIADH

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oat meal cell carcinoma, viral pneumonia, head problem

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Mixed Venous Blood Gases: What is the normal range for PO2?

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35 – 40 mm Hg

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Adrenaline is released during what, to stimulate the liver to release glycogen (glucose)?

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hypoglycemia… “they suga’s be low!!”

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What is the minimum goal coronary perfusion pressure?

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50

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Aspirin over dose results in metabolic ________.

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acidosis

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Repeated doses of Etomidate can result in what condition?

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acute adrenal insufficiency

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CAMTS: EVOC should be repeated how often?

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every 4 years

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Lab Values: What is the normal range for Platelets (Plt)?

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150 – 350 × 10³/µL

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Anticonvulsants: list the 4 anticonvulsants used for pediatrics

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valium, versed, ativan, cerebyx

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Arterial lines (aka art lines): the most common cause of dampened wave form is…?

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air in or crimping/occlusion of the tubing

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When using the Parkland formula, how much and when is the fluid administered?

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1/2 of the volume given in the first 8 hours from time of burn; the remaining volume is given over the next 16 hours

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What is the normal ejection fraction for an adult?

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55 – 70%

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Name two tests used to diagnose pulmonary emboli (PE)

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VQ lung scan & CT of lungs

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What is the core body temperature range for mild hypothermia?

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34 – 36 C

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When treating patients with thoracic or abdominal aortic aneurysm, what is the preferred drug of choice?

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beta-blockers (labetalol, esmolol)

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With a patient in DKA, are excess ketones detected?

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yes

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What is the usual level of dehydration during DKA?

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4-6 liters

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What does CPP stand for?

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cerebral perfusion pressure

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How do you calculate CPP?

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MAP – ICP

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If someone is injured at the knee, with no distal pulses, what artery is affected?

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popliteal artery

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Lab Values: What is the normal range for Potassium (K+)?

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3.5 – 5.0 mEq/L

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Aspirin overdose is treated with:

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sodium bicarb

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Who are most at risk from Bark Scorpion stings?

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Crumb-Crunchers and Old Farts

(the very young and the elderly)

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Patient presents with unconsciousness, posturing, signs/symptoms of increased ICP, but has a normal CT scan…what do you suspect?

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DAI (diffuse axonal injury)

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Decreased ADH effects on sodium level, osmolality, and urinary output:

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increased sodium levels, increased serum osmolality, increased urine output

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OB: treatment of variable decelerations

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reposition the mother

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DKA is caused by:

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lack of insulin

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List two presentations of placenta previa

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bright red blood and painless

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What is your RSI induction medication of choice for a young pediatric patient with exacerbation of asthma?

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Ketamine

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How is bacterial meningitis treated?

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antibiotics such as Rocephin

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What is the treatment for organophosphate poisoning?

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Atropine 2mg and Pralidoxime 1-2G

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Seizure: What is the pediatric dosage for Ativan?

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0.05-0.1 mg/kg

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Wolf-Parkinson-White (WPW) Syndrome is indicated on an ECG by what?

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delta wave (produced by early depolarization)

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In treating hyperglycemia, administering insulin will result in a decrease of what (not BGL) and ought to be supplemented?

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potassium and no more than 10 mEq IV per hour

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list three treatments for SIADH

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fluid restriction, 3% sodium chloride (hypertonic solutions), no hypotonic solutions

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Capnography: elevated baseline indicates:

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re-breathing of CO2

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Is a patient in DKA acidotic or not?

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acidotic

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Define: metabolic acidosis

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HCO3 below normal value

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What is the treatment for severe hypothermia?

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active re-warming, warm IV fluids, warm/humidified oxygen, handle gently

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What is the usual BGL for a patient experiencing DKA?

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400-900

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OB: late deceleration is associated with?

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PIH, placenta previa, and placenta abruption

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List two presentations of placental abruption (abruptio placentae)

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dark red blood and shearing pain

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List 3 classic presentations of aspirin toxicity

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flu-like signs/symptoms, hearing disturbances (tinnitus), and tachypnea

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What is the treatment for compartment syndrome?

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emergency fasciotomy

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CAMTS: standards for passengers who accompany patients

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must be properly identified and listed by name (in compliance with HIPAA regulations) in the communications center by the transport coordinator

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What is the core body temperature range for severe hypothermia?

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less than 30 C

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What is the normal range for tidal volume?

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5 to 8 ml/kg

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What lab test is used for monitoring Heparin therapy?

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PTT

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Describe Marfan’s Syndrome

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genetic disorder causing tall stature; long forearms, legs, and fingers; and a concave chest (pectus excavatum)

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Describe stagnent hypoxia

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reduction in cardiac output or circulatory system malfunction

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Lab Values: What is the normal range for Creatinine (Cr)?

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0.6 – 1.2 mg/dL

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Which of the following can result in low-pressure alarms? hypovolemia, connections, pneumothorax, obstructions

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hypovolemia and connections

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Lab Values: What is the normal range for Blood Urea Nitrogen (BUN)?

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8 – 23 mg/dL

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What are the basic vital sign goals when treating a patient with a thoracic or abdominal aortic aneurysm?

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HR of 60-80 bpm, SBP of 100-110 mm Hg, MAP of 70-75

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What is normal inspiratory:expiratory (I:E) ratio?

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1:2

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Is a patient in HHNK acidotic or not?

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not acidotic

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Vt stands for?

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tidal volume

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List four common treatments for marked hyperkalemia (i.e., renal patient who missed dialysis)

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IV insulin, D50, calcium chloride, sodium bicarb

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What is the normal expected urinary output for an adult?

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30 – 50 ml/hour

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What is normal positive end-expiratory pressure (PEEP)?

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3 cm H2O

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Seizure: What is the pediatric dosage for valium?

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0.1-0.3 mg/kg

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What is the lab test used for monitoring Coumadin therapy?

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PT

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In rhabdomyolysis, what are the muscle fiber contents that are released into the bloodstream when muscle fibers are broken down?

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myoglobin

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What is the normal expected urinary output for an adult patient with electrical burns?

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50 – 100 ml/hour

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Where is the preferred location for chest tube placement?

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anterior, mid axillary line

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Long term use of Nitroprusside can lead to what type of poisoning?

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cyanide

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List contraindications to using succinylcholine?

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patients with glaucoma or ocular injuries, crush injuries, patient’s with burns older than 48 hours, stroke, spinal cord injuries less than 6 months previously, degenerative muscle diseases (ie: ALS, muscular dystrophy), and known hyperkalemia

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What is Wolf-Parkinson-White (WPW) Syndrome?

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the heart has an extra electrical pathway (circuit); can lead to episodes of rapid heart rate

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Which of the following can result in high-pressure alarms? hypovolemia, connections, pneumothorax, obstructions

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connections, pneumothorax, obstructions

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Arterial lines (aka art lines): the transducer should be maintained at the level of the…?

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phlebostatic axis

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What is Brudzinski’s sign?

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flexion of the neck that results in flexion of the hip; indicates meningitis

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OB: This presents during or after delivery when amniotic fluid enters maternal circulation from a tear in the placenta, often from placenta previa or placenta abruption

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amniotic fluid embolism

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Arterial Blood Gases: What is the normal range for pH?

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7.35-7.45

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Capnography: shark fin indicates:

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bronchospasm

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Seizure: What is the pediatric dosage for Cerebyx?

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10-20 mg/kg

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what is normal CPP?

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70-90

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Post-partum complications: What is the most common cause of maternal death?

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pulmonary embolism

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What is the treatment of rhabdomyolysis?

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early and aggressive fluids (hydration)

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What is the sedative of choice for children?

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Ketamine

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What is a typical injury associated with direct blunt force trauma to the abdomen of a gravid uterus?

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uterine rupture

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Describe the injury caused by an alkali burn (pH greater than 7)

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leads to saponification (hydrolysis) of lipids (fats) and causes fatty tissue to lose its function

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Spinal cord injuries: How would a central cord injury present?

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weakness or parasthesias in the upper extremities

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pH above normal value…is this acidic or alkaline?

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alkaline

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Aspirin overdose results in respiratory _________.

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alkalosis

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Pediatric Scenario: you have a 4kg female seizing, what is your Cerebyx dosage?

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80 mg

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What is Beck’s triad?

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JVD, muffled heart tones, narrowed pulse pressure…indicates cardaic tamponade, usually resulting from penetrating chest trauma

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Succinylcholine should be avoided in what patients because it causes prolonged paralysis?

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organophosphate poisonings

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f stands for?

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frequency (or rate)

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What are four types of people who typically experience HHNK?

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old farts, diet controlled diabetes, total parenteral nutrition, pancreatitis

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What medication is used to close PDA’s in premature infants?

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indocin (indomethacin)

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List 3 classic signs of meningitis

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fever, nuchal rigidity (stiff neck), and Brudzinski’s sign

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Neonatal conditions: what is Tetrology of Fallot?

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a cyanotic heart defect that results in poor oxygenation of the blood; requires surgery to correct

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Describe the injury caused by an acid burn (pH less than 7)

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causes denaturation of proteins and damage of the cell surface

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Ventilators: What does Pplat stand for?

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End-expiratory plateau pressure

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List 3 signs of brain herniation

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unequal or pinpoint pupils, coma, decorticate/decerebrate posturing

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What is the Parkland formula?

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4ml x kg x %burn

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What kind of dressing do you place over a burn?

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sterile dry

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What is the normal expected urinary output for a pediatric patient with electrical burns?

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2 – 4 ml/kg/hour

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A patient suffers a crush injury after a stack of wood fell onto his lower extremity. After the wood is removed, the patient’s extremity is ashen in color and pulseless. What do you suspect?

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compartment syndrome

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You are transporting a patient who was just recently paralyzed for intubation. He becomes tachycardic, presents with significant muscle rigidity, his ETCO2 is noted to climb despite proper ETT placement, and becomes hyperthermic. What emergent condition should you suspect and how to treat?

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malignant hyperthermia, treated with dantrolene

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Why would a treated burn patient be hyperkalemic?

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caused by tissue and cell destruction

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HHNC is caused by:

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increased glucose levels often secondary to stress; patient still makes insulin

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In new borns, what is patent ductus arteriosus (PDA)?

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when the ductus arteriosus does not close allowing some oxygenated blood to to move back into the heart rather than enter circulation

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What is the only pit viper that injects neurotoxic venom?

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Mojave rattlesnake

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List two treatments for HHNK treatment

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fluids, little insulin

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Arterial Blood Gases: What is the normal range for PCO2?

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35 – 45

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Pit vipers inject what kind of venom?

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hemotoxic venom

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Mixed Venous Blood Gases: What is the normal range for PCO2?

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40 – 50

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Spinal cord injuries: What causes Brown-Sequard Syndrome?

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