Paramedics Exam Medical Emergencies and Obstetrics 5 — Questions and Answers
Question 1: A 25-year-old female at 34 weeks presents with sudden severe headache, visual disturbances, and BP of 168/114, but no seizures. What is this condition?
- Eclampsia
- Gestational hypertension
- Severe preeclampsia (Correct answer)
- HELLP syndrome
Correct answer: Severe preeclampsia
Severe preeclampsia is characterized by BP ≥160/110 with symptoms like headache and visual changes, but without the seizures that define eclampsia.
Question 2: You respond to a call where a patient with asthma is sitting upright, has a respiratory rate of 34/min, is using accessory muscles, and can only speak 1-2 words at a time. SpO2 is 88%. How would you classify this exacerbation?
- Mild exacerbation
- Moderate exacerbation
- Severe exacerbation (Correct answer)
- Life-threatening exacerbation
Correct answer: Severe exacerbation
Severe asthma exacerbation is characterized by inability to speak full sentences, accessory muscle use, SpO2 <90%, and RR >30/min.
Question 3: A construction worker is found unresponsive after suspected carbon monoxide exposure. His skin appears cherry red. SpO2 reads 99%. What is the CORRECT interpretation?
- The patient is adequately oxygenated
- SpO2 is falsely elevated due to carboxyhemoglobin (Correct answer)
- The patient is hyperoxic and oxygen should be withheld
- The reading confirms CO poisoning
Correct answer: SpO2 is falsely elevated due to carboxyhemoglobin
Pulse oximetry cannot differentiate oxyhemoglobin from carboxyhemoglobin, so it reads falsely high in CO poisoning — treat with 100% O2 regardless.
Question 4: A 19-year-old male with known sickle cell disease presents with severe bone pain in his lower extremities, fever of 38.8°C, and tachycardia. He is fully conscious. What is the prehospital priority?
- Administer hydroxyurea IM
- Provide high-flow oxygen, IV fluids, and pain management (Correct answer)
- Apply ice packs to affected extremities
- Administer sodium bicarbonate to prevent acidosis
Correct answer: Provide high-flow oxygen, IV fluids, and pain management
Sickle cell vaso-occlusive crisis is managed with oxygen, IV hydration to reduce blood viscosity, and analgesics for pain control.
Question 5: A newborn is delivered with meconium-stained amniotic fluid. The infant is vigorous, crying, and has good muscle tone. What is the APPROPRIATE action?
- Immediate intubation and tracheal suctioning
- Routine care without tracheal suctioning (Correct answer)
- Aggressive bulb syringe suctioning of the oropharynx
- Administer blow-by oxygen for 5 minutes then reassess
Correct answer: Routine care without tracheal suctioning
Current neonatal resuscitation guidelines no longer recommend routine intubation for meconium if the infant is vigorous — provide routine care and observe.
Question 6: A 55-year-old male presents with syncope. His ECG shows a regular rate of 38 bpm with P waves that have no relationship to QRS complexes. What rhythm is this?
- Second-degree AV block Type I (Wenckebach)
- Second-degree AV block Type II
- Third-degree (complete) AV block (Correct answer)
- Junctional escape rhythm
Correct answer: Third-degree (complete) AV block
Third-degree AV block shows complete dissociation between P waves and QRS complexes — the atria and ventricles beat independently.
Question 7: During a difficult delivery, you note resistance after the head delivers and the head retracts back against the perineum (turtle sign). What maneuver should be performed FIRST?
- Fundal pressure to push the baby out
- McRoberts maneuver with suprapubic pressure (Correct answer)
- Zavanelli maneuver to replace the head
- Episiotomy to widen the outlet
Correct answer: McRoberts maneuver with suprapubic pressure
McRoberts maneuver (hyperflexion of maternal thighs onto abdomen) combined with suprapubic pressure is the first-line intervention for shoulder dystocia.
Paramedics Exam Medical Emergencies and Obstetrics 5
A 25-year-old female at 34 weeks presents with sudden severe headache, visual disturbances, and BP of 168/114, but no seizures.
What is this condition?