Download Quiz - CDH EMS

Region VIII January 2017 EMS CE Post-Test
Pediatric Chest Pain
1. Which of the following is the new term that replaces Apparent Life Threatening Event?
a. Bad Resounding Unusual Entity
b. Brief Resolved Unexplained Event
c. Brief Resolved Unusual Adventure
d. Bad Recent Unexplained Event
2. Drug-induced esophagitis may occur in pediatric patients taking medication in tablet or capsule
forms. Which of the following is primarily responsible for drug induced esophagitis?
a. Salicylates
b. Non-steroidal anti-inflammatory drugs
c. Benzodiazepines
d. Corticosteroids
3. Which of the following conditions is characterized by unilateral, sharp, stabbing pain that is
exacerbated by deep breathing, lasting a few seconds to minutes?
a. Costochondritis
b. Tietze Syndrome
c. Slipping Rib Syndrome
d. Myocarditis
4. Pediatric CPAP is rapidly gaining acceptance in the pediatric population. It allows
a. The conversion of rapid little “fish puffs” into fuller breaths with better gas exchange
b. Valued therapy for the unresponsive, non- breathing child
c. CPAP is never indicated for the pediatric patient
d. Can only be utilized in the 12-15 year old age group
5. What condition may be exacerbated by eating a heavy meal, coughing and bending or rotating
movements?
a. Slipping Rib Syndrome
b. Pleurisy
c. Xiphodynia
d. Staph Infection
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Region VIII January 2017 EMS CE Post-Test
Pediatric Chest Pain
6. Approximately 1/3 of adolescents complaining of chest pain may have a history of stressful life
events, panic disorders or anxiety that have occurred either in their family or at school
a. True
b. False
7. Alternative sites for pulse oximetry may include but are not limited to
a. Ear lobes
b. chest
c. abdomen
d. chin
8. Marfan syndrome is a genetic tissue disorder affecting 1in 5000 individuals. Additional
characteristics include but not limited to:
a. Affects young males only
b. No one individual has every feature of the syndrome
c. Severity of the condition is the same for all those who are affected
d. Features and characteristics appear at birth
9. Factors that can affect the accuracy of pulse oximetry include:
a. Motion, poor lighting
b. Ambient light, moisture
c. Press on nails ,coffee
d. Skin pigmentation, ambient light
10. Characteristics of pericarditis include:
a. Increase in the heart’s ability to function
b. Decrease in pain when taking a deep breath
c. High grade fever
d. Increase in pain when lying supine
***BLS STOP HERE***
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Region VIII January 2017 EMS CE Post-Test
Pediatric Chest Pain
11. EMS responds to a 15 year old with complaints of mid-sternal back pain radiating between the
scapula for 1 hour. Past medical history includes Marfan syndrome, and he currently is taking a
beta blocker. Vital signs are Pulse 108, BP 138/92, RR 20, SpO2 98% on room air. You suspect
his pain may be caused by
a. Aortic dissection
b. Acute chest syndrome
c. Pericarditis
d. Pleurisy
12. Along with pain which is characterized as pleuritic and retrosternal, this sign may also be
present with spontaneous pneumomediastinum:
a. Odynophagia
b. Gastroesophageal reflux
c. Esophageal spasm
d. Subcutaneous emphysema
13. In pericarditis the pericardium becomes inflamed and fluid increases between the inner and
outer layer causing
a. Compression of the heart muscle
b. Relaxation of the heart muscle
c. Improvement in the heart’s ability to function
d. Irregular heart rate
14. Per region 8 SOP’s If probable SVT, the initial dose for Adenocard (Adenosine) in the pediatric
patient is:
a. 0.1mg/kg rapid IV/IO
b. 0.2mg/kg rapid IV/IO
c. 6mg rapid IV/IO
d. 12 mg rapid IV/IO
15. Respiratory infections are the leading cause of acute chest syndrome.
a. True
b. False
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Region VIII January 2017 EMS CE Post-Test
Pediatric Chest Pain
16. Potentially reversible causes of pediatric tachycardia may include but not limited to:
a. Hyperthermia
b. Hyperglycemia
c. Hyperoxia
d. Hypovolemia
17. Common symptoms of Exercise Induced Asthma include:
a. Rales, rhonchi
b. Decreased endurance, chest tightness
c. Acid reflux, coughing
d. Sore throat, pedal edema
18. You respond to the grade school for the seizure patient. Upon arrival you are taken to the
school nurse’s office where you find a 10 year old male who is currently post ictal. The nurse
tells you she administered the child’s Diastat prescription for the seizure. Your next steps
would be:
a. Reassess, monitor airway, oxygen, obtain blood glucose, transport
b. Reassess, oxygen, transport
c. Reassess, check blood glucose and leave in care of school nurse
d. Reassess , obtain blood glucose, oxygen, transport
19. Psychogenic chest pain is often recurrent with particular stressors. This may be accompanied
by:
a. Decrease in heart rate and mental status
b. Dizziness, hypoventilation
c. Increase in heart rate and energy
d. Difficulty in breathing, chest pain
20. Pectus excavatum is also known as funnel chest. It is a congenital chest wall deformity which
pushes the sternum inward potentially causing:
a. Need for immediate surgical intervention
b. Increase in lung capacity
c. Has no effect on patient outcomes
d. Chest pain and exercise intolerance
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Region VIII January 2017 EMS CE Post-Test
Pediatric Chest Pain
21. A 12 year old girl complains of intermittent chest pain for the past 5 days that localizes to the
left upper sternal border. The pain is sharp and stabbing, rated at 5/10, increases with deep
breathing, and lasts for less than a minute. The patient has no history of fever, cough, exercise
intolerance, palpitations, dizziness, or syncope. Upon examination, she is in no distress and has
normal vital signs for her age. Examination of her chest reveals no signs of inflammation or
redness but she does have tenderness over the left second and third costochondral junctions.
She states she has had this pain on and off for the last 5 days. You suspect which of the
following conditions?
a. Costochondritis
b. Myocarditis
c. Slipping rib syndrome
d. Tietze syndrome
22. You respond to a 14 year old male at a school who “passed out.” Upon arrival, he is alert,
oriented x4 with vital signs of P 88, RR16, BP 112/68 and SpO2 of 98% on room air. Witnesses
report there was no trauma, and he was unconscious for less than 10 seconds. He has no past
medical history, takes no medications. He described sudden midsternal chest pain and
dizziness prior to passing out. He denies any complaints now. Per region 8 SOP’s, which of the
following is appropriate?
a. Obtain a blood glucose level, high flow oxygen
b. Obtain a 12 lead ECG, assess for potential causes
c. Nitroglycerine 0.4mg SL, 324 mg Baby ASA
d. Supplemental oxygen at high flow FiO2
23. Based on the above scenario, you perform a 12 lead ECG, which shows sinus rhythm with
peaked R waves, ST segment depression, and T wave inversion in leads V5 and V6. Which of
the following is most appropriate?
a. Administer 324 mg aspirin and 0.4mg Nitrogylcerine
b. Contact medical control for refusal to transport
c. Administer IV fluid bolus at 20ml/kg and reassess
d. Contact medical control for transport to the closest most appropriate facility
24. Dryness of the air, rather than the temperature is the most likely trigger of exercise induced
asthma
a. True
b. False
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Region VIII January 2017 EMS CE Post-Test
Pediatric Chest Pain
25. Tietze syndrome is a rare inflammatory disorder involving specific inflammation of the first two or
three costochondral articulations, specifically where the ribs attach to the sternum. It is usually
characterized by:
a. Trauma to portion of the rib cage
b. Improvement with deep inspiration
c. Warmth, swelling and tenderness
d. Ecchymosis, tenderness
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