Cranial Nerve for Tongue/Speech CN XII (Hypoglossal Nerve) = motor control of the tongueAlso know: - CN X (Vagus): speech/swallowing - CN IX (Glossopharyngeal): gag reflex, taste Patient Already Triaged “Red” Becomes Unresponsive Answer: Immediate BLS or ALS resuscitation→ Priority transport 🧠 Triage is dynamic. You always reassess. Don’t leave a red patient dying just because triage is "complete." 💔 Aortic Dissection Clue: Unequal BP in arms + tearing chest/back pain Other signs: - Pulse deficits - New murmur - Neurologic symptoms Transport to surgical center. Avoid excessive fluid bolus if hypertensive. 💢 Epidural vs Subdural Hematoma Epidural: - Arterial bleed - Lucid interval - Rapid decline - Temporal fracture → middle meningeal artery Subdural: - Venous bleed - Gradual onset - Elderly, alcoholics, falls 🧠 Lucid interval = Epidural 📈 Inferior Wall of LV – Which Lead? Correct: Lead II, III, and aVF 🧠 You chose aVF — that is correct. All three monitor inferior wall supplied by RCA. 🦠 What Kills C. difficile? Correct: Chlorine-based disinfectantsAlcohol-based sanitizers do not kill spores. Use: - Bleach - EPA-registered sporicidal agents ☠️ Cushing Reflex Classic triad (↑ ICP): 1. Hypertension 2. Bradycardia 3. Irregular respirations 🧠 This = brainstem herniation risk. Needs rapid airway, ventilation, and hospital intervention. Left-Sided vs Right-Sided Heart Failure Left-Sided Heart Failure Failure of the left ventricle → blood backs up into lungs. Signs/Symptoms - Dyspnea - Orthopnea - Crackles - Pulmonary edema - Pink frothy sputum Key Mechanism↓ Cardiac output → ↑ pulmonary pressure Right-Sided Heart Failure Failure of right ventricle → blood backs up into systemic circulation. Signs/Symptoms - JVD - Peripheral edema - Hepatomegaly - Ascites Often caused by: - Left-sided failure - Pulmonary hypertension - COPD (cor pulmonale) Pulse Pressure Pulse pressure = Systolic − Diastolic

I made my calendar and followed it mostly to that plan. I busted my ass and went into it more confident than I had on previous attempts. I walked out of the testing center thinking it could go either way. Twenty minutes later I got the email saying that I passed!! I want to thank you for what you do and your help getting me on the right path. Thank you Mike!!