Questions and Answers
A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardic. The EMT should suspect:
A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:
A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:
A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:
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A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?
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An important aspect in the treatment of a patient with severe abdominal pain is to: ________.
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For a patient with a gastrointestinal complaint, it is MOST important for the EMT to _________.
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Most patients with abdominal pain prefer to:
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Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: ________.
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Peritonitis may result in shock because ________.
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Urinary tract infections are more common in __________.
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When assessing a patient with abdominal pain, you should: ________.
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Which of the following helps filter the blood and has no digestive function?
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Which of the following is correct about the secondary assessment for a high-priority patient?
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Which of the following may help reduce your patient's nausea?
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Which of the following organs lies in the retroperitoneal space?
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Which of the following statements regarding dialysis is correct?
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Which of the following statements regarding the acute abdomen is correct?
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Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect __________.
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Your patient complains of chronic 'burning' stomach pain that improves after eating. You should suspect: ________.
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Study Notes
Gastrointestinal Emergencies
- Severe vomiting in pregnant women can indicate a Mallory-Weiss tear, characterized by vomiting blood and signs of shock such as cool, pale skin and tachycardia.
- History of alcoholism in patients presenting with bright red blood vomiting and low blood pressure raises suspicion for gastrointestinal bleeding; airway protection is crucial.
Abdominal Pain Assessments
- Always be alert for signs of shock in patients with severe abdominal pain; distention and guarding of the abdomen can indicate serious pathology.
- Restlessness and diaphoresis, combined with abdominal pain and a pulsating mass, suggest a potentially life-threatening condition, necessitating immediate transport and oxygen administration.
Pain Management
- Costovertebral angle tenderness often points to kidney involvement, requiring further investigation.
- Emotional support is vital for patients with severe pain during transport to the hospital.
Transport Decisions
- Rapid transport may be necessary for patients with gastrointestinal concerns; assess the need for immediate transport based on the patient's condition.
Patient Comfort and Positioning
- Patients with abdominal pain generally find relief by lying on their side with knees drawn up, promoting comfort.
Types of Abdominal Pain
- Referred pain occurs when pain is perceived at a distant location, not necessarily at the point of the issue.
- Peritonitis may lead to shock due to fluid shifting from circulation into tissues.
Gender Differences in Conditions
- Women are more prone to urinary tract infections due to anatomical and physiological differences.
Assessment Techniques
- When examining a painful abdomen, palpate in a clockwise direction, starting from the quadrant adjacent to the one indicated by the patient.
Organ Functions
- The spleen plays a role in filtering blood but has no digestive functions, differentiating its medical relevance from abdominal organs involved in digestion.
- The pancreas is situated in the retroperitoneal space, separate from the digestive organs.
Dialysis Considerations
- Patients missing dialysis treatments often report weakness, highlighting the importance of regular treatment for kidney function.
Characteristics of Acute Abdomen
- Pain associated with an acute abdomen initially tends to be vague, making early diagnosis challenging; it can become more localized over time.
Specific Conditions
- Symptoms of gallbladder issues include abdominal pain after consuming fatty foods, often indicating cholecystitis.
- Chronic "burning" stomach pain that eases with food intake is suggestive of peptic ulcer disease.
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Description
Test your knowledge on the critical cases covered in EMT Chapter 18. This quiz focuses on identifying severe medical conditions related to vomiting and their potential diagnoses. Enhance your understanding of emergency medical scenarios and patient assessment techniques.
