AMLS Endocrine Emergencies 2

Question 1

Which blood glucose level generally defines symptomatic hypoglycemia requiring intervention in adults?

Accepted Answer

Below 70 mg/dL

Answer

A blood glucose below 70 mg/dL is the standard threshold defining clinically significant hypoglycemia requiring treatment, though symptoms can vary widely between individuals.

Question 2

When managing DKA, insulin infusion is typically withheld until the serum potassium is at least what level?

Accepted Answer

3.5 mEq/L

Answer

Insulin drives potassium intracellularly, so insulin infusion should be withheld until serum potassium is at least 3.5 mEq/L to avoid life-threatening hypokalemia and cardiac dysrhythmias.

Question 3

A type 2 diabetic on metformin presents with Kussmaul respirations, abdominal pain, and an anion gap metabolic acidosis, but blood glucose is only 130 mg/dL. Which diagnosis should be considered?

Accepted Answer

Euglycemic diabetic ketoacidosis

Answer

Euglycemic DKA occurs when patients (especially on SGLT-2 inhibitors) develop ketoacidosis with near-normal glucose, making it easy to miss; insulin deficiency and ketone production are present despite minimal hyperglycemia.

Question 4

In a patient with suspected adrenal crisis, which immediate treatment should be administered without waiting for confirmatory lab results?

Accepted Answer

IV dexamethasone or hydrocortisone plus fluid resuscitation

Answer

Adrenal crisis is rapidly fatal if untreated; IV corticosteroid replacement (hydrocortisone or dexamethasone) with aggressive fluid resuscitation must be given empirically without waiting for lab confirmation.

Question 5

Which clinical sign best distinguishes pheochromocytoma from other hypertensive emergencies?

Accepted Answer

Paroxysmal hypertension with diaphoresis, headache, and palpitations

Answer

Pheochromocytoma classically causes paroxysmal episodes of severe hypertension accompanied by the triad of diaphoresis, severe headache, and palpitations due to catecholamine surges from the adrenal tumor.

AMLS - Advanced Medical Life Support Practice Test

AMLS - Advanced Medical Life Support Practice Test

AMLS Endocrine Emergencies 2