ALS Quiz

[sdadam]

Ok so in the spirit of the BLS cardiac quiz that was posted I thought I would put up a few questions of my own.

I am currently in medic school and I have to say I have been very disappointed in how in depth we have been getting in to subjects.

The A&P that we seem expected to know is barely above EMT-B level, with the exception of a small amount of in depth knowledge of the sympathetic and parasympathetic divisions of the autonomic nervous system.

Here are a few questions I would like to see if some paramedics on the board know.

1) Describe the physiologic process of the SA node pacing the heart.

2) Describe the pharmacology of adenosine (hint don't answer that it isn't well understood.) Extra credit; what is the function of endogenous adenosine in the body (not ATP, ADP, AMP but just adenosine alone).

3) Describe the pharmacology of Glucagon in relation to its treatment of a beta blocker overdose.

4) What is the name of the main conduction pathway between the right and left atria.

4) Describe a situation in which a patient could experience hypoxia but not hypoxemia.

Ok, have at it.

I know, I sound like a stuck up, I think I'm smarter than everyone *** hole.

But I studied text books, and journals, and anything else I could get my hands on for the two years I was an EMT preparing for medic school and I want to know if it is just my school, or if the scope of knowledge in paramedic school is just less than I thought.

Adam

 

[dmiracco]

Glucagon for Beta Blocker OD
Glucagon does not actually reverse the effects of the beta blocker but actually helps in these particular patients because glucagon has helpful properties like positive inotropic and chronotropic effects.
Glucagon takes the same channel as beta blockers in to the cells but does not work on the same receptor sites so it is not affected when given.
Beta blockers when given appropriately for HTN and Acute MI etc is definately helpful in that it decreases the HR and the contractility thus decreasing the O2 demand on the heart, BP, etc. However when to much is taken of course there is a negative effect on the body.
We clinically see hypotension, brady, heart blocks, and ultimately decrease cardiac function to the point where the heart can not meet the metabolic demands of the body (tissues and cells) Not good
So glucagon increases the cardiac output.
Some institutions aslo use Epi, Dextrose, and Insulin. :wacko:
Also Bachmans Bundle is a main electrical conduction pathway for the atria.
Ill let other individuals answer some of the other stuff, Im not greedy ha.

 

[Sasha]

Nevermind, read that wrong.

 

[Ridryder911]

But I studied text books, and journals, and anything else I could get my hands on for the two years I was an EMT preparing for medic school and I want to know if it is just my school, or if the scope of knowledge in paramedic school is just less than I thought.

Adam

If Paramedic programs were created equal, then this study quiz would be a refresher or be useless as all the questions were really very simplistic in nature. Unfortunately though, they are not all created equal.

Technically, one should NOT have to study before entering Paramedic school, as all this material should be covered in co and prerequisite courses and in much more detail in the Paramedic course.

R/r 911

 

[dmiracco]

well put ryderh34r:

 

[fma08]

2) Adenosine slows conduction through the AV node to help convert PSVT to normal sinus, can work in PSVT related to reentry pathway problems such as WPW too, but not for 2nd or 3rd degree blocks. Can help diagnose Rapid a-flutter or a-fib with RVR. And for the extra credit, are you referring to the deoxyadenosine 5 prime phosphate and adenosine 5 prime phosphate nucleotieds of DNA and RNA (respectively)... also known as adenine?


Wait... forget about my answer to the extra credit question. I forgot my o-chem for a minute, they are both forms of AMP... so I have no idea on that part.

 

[knxemt1983]

If Paramedic programs were created equal, then this study quiz would be a refresher or be useless as all the questions were really very simplistic in nature. Unfortunately though, they are not all created equal.

Technically, one should NOT have to study before entering Paramedic school, as all this material should be covered in co and prerequisite courses and in much more detail in the Paramedic course.

R/r 911

you are right, they are not all created equal. the only pre-req's we had was EMT-B, but all this and tons more was covered in our class. Well I take that back, we didn't cover much about glucagon, only it's use in low bgl.

 

[tydek07]

#4 (the first number 4)

Bachmann's Bundle

 

[tydek07]

#4 (the second one)

Anemia ?

 

[Sasha]

4) Describe a situation in which a patient could experience hypoxia but not hypoxemia.

CO poisioning? CO binds to the hemoglobin, kicking the O2 off, so technically there is oxygen in the blood but it isnt being used in the cells, so they are hypoxic.

 

[reaper]

2) Adenosine slows conduction through the AV node to help convert PSVT to normal sinus, can work in PSVT related to reentry pathway problems such as WPW too, but not for 2nd or 3rd degree blocks. Can help diagnose Rapid a-flutter or a-fib with RVR. And for the extra credit, are you referring to the deoxyadenosine 5 prime phosphate and adenosine 5 prime phosphate nucleotieds of DNA and RNA (respectively)... also known as adenine?
.

Remember to be very cautious using Adenosine with WPW. If they have a hx or signs of A-fib or A-flutter, It can be very dangerous!

 

[Ridryder911]

Truthfully, there is many times ones is hypoxic, but may not be hypoxemia. As one may be low in oxygen concentrations but is able to deliver enough oxygen by combined amount of RBC to the tissues. Albeit, it will not be long until the tissue will be hypoxemic.

R/r 911

 

[fma08]

#4 (the second one)

Anemia ?

I'm thinking that as well, for example sickle cell, the RBC's break down faster plus they can bunch up and get stuck in the capillaries, so plenty of O2 in the arteries... just no perfusion to the tissues and organs.

 

[fma08]

Ok, I give up... What's the purpose of endogenous adenosine in the body?