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A patient has a stab wound to the left of the sternum in the 4th intercostal space. Which signs and symptoms would lead the paramedic to suspect a pericardial tamponade? (Select three correct answers)

En RouteIt is 0930 and you are staffing a 2-paramedic transporting ambulance. Your unit is dispatched for a 68-year-old female with shortness of breath, nausea, and generalized weakness. She has a history of diabetes, high cholesterol, and high blood pressure. It is a rainy spring night, and the temperature is 65F (18C). The response time is about 8 minutes. There is a community hospital about 15 minutes away, and a level 2 trauma center with most capabilities about 25 minutes away. Dispatch notes report that the patient has been “feeling off” for a few days, and it acutely worsened this morning.  On SceneThe husband leads you into the kitchen where you find the patient (60kg) sitting on a chair.  She makes eye contact when the crew arrives but appears tired. The patient states she has been “feeling off” for the last 2 days, and this morning she feels like she can’t catch her breath. The patient has no allergies to medications. Her medications include a baby aspirin, atorvastatin, Glucophage, and losartan. The patient’s skin is pale and clammy. There are no signs of trauma, the patient obeys motor commands, and reports she in nauseous. The patient can speak in full sentences and has minimal accessory muscle use when breathing. Eyes are open, pupils are 4mm and reactive to light. The vital signs are BP 142/100, P 98, R 26, SpO2 95% on room air, and T 98F (37C). The blood glucose is 120. The EtCO2 is 38. On further exam you note the patient has scattered fine basilar crackles. POST SCENEThe patient is given aspirin and nitroglycerin on scene. The patient is packaged onto the stretcher in a position of comfort and transport is initiated to the level 2 hospital. En route to the hospital, an IV is initiated. The patient remains fatigued and has an overwhelming sense that something is not right. Vital signs are BP 86/50, P 120, RR 24, SpO2 88% on room air. 

The paramedic is assessing an elderly patient with severe dyspnea. The patient is hypertensive, with rales noted on auscultation. What is the most probable pathophysiology associated with this disease process?

Law enforcement gained access to the patient’s medications and states the patient is taking aripiprazole, lorazepam, and atenolol. What comorbid conditions does this patient likely have? (Select two correct answers) 

The patient becomes more agitated and there is concern he could be aggressive towards crew. What is the best way to transport this patient?

The paramedic is first on scene of a multiple casualty incident. List the steps in order of importance the paramedic should perform. 

The epidermis of the skin consists of what tissue type?

In endochondral ossification cartilage is replaced with mature bone

An epithelial tissue with a single layer of flattened cells:

Ductless glands that secrete products directly into the bloodstream: