AMLS Endocrine Emergencies 3

Question 1

A patient with type 1 diabetes presents with diaphoresis, tachycardia, and anxiety. Blood glucose is 45 mg/dL. After giving 25 g of D50W IV, glucose rises to 120 mg/dL. What should be done next?

Accepted Answer

Provide a complex carbohydrate snack and monitor for recurrence

Answer

After correcting acute hypoglycemia with D50W, a complex carbohydrate meal or snack is given to prevent rebound hypoglycemia, and the patient should be monitored because the original insulin or medication effect may outlast the glucose bolus.

Question 2

Which finding on an arterial blood gas (ABG) is most consistent with diabetic ketoacidosis (DKA)?

Accepted Answer

pH 7.22, PaCO2 20 mmHg, HCO3 8 mEq/L

Answer

DKA produces an anion-gap metabolic acidosis with low pH, low bicarbonate, and compensatory respiratory alkalosis (low PaCO2 from Kussmaul respirations), making option B the characteristic ABG pattern.

Question 3

A patient on long-term lithium therapy presents with hypothermia, altered mental status, macroglossia, periorbital edema, and bradycardia. What treatment should be initiated?

Accepted Answer

IV thyroid hormone (T4 or T3) replacement and supportive care

Answer

Myxedema coma requires IV thyroid hormone replacement (T4 with or without T3) along with supportive care including passive rewarming, airway management, and corticosteroids to address possible concurrent adrenal insufficiency.

Question 4

Which of the following is the most appropriate initial antihypertensive agent for a hypertensive emergency caused by pheochromocytoma?

Accepted Answer

IV phentolamine or IV nicardipine (alpha-blockade first)

Answer

In pheochromocytoma, alpha-blockade must precede beta-blockade because giving a beta-blocker first (without alpha-blockade) removes compensatory vasodilation and can cause paradoxical severe hypertension from unopposed alpha-adrenergic stimulation.

Question 5

Cushing's syndrome results from chronic excess of which hormone?

Accepted Answer

Cortisol (glucocorticoid excess)

Answer

Cushing's syndrome is caused by chronic excess cortisol, whether from endogenous overproduction (e.g., adrenal tumor, pituitary adenoma) or prolonged exogenous corticosteroid use, leading to central obesity, hypertension, hyperglycemia, and skin changes.

AMLS - Advanced Medical Life Support Practice Test

AMLS - Advanced Medical Life Support Practice Test

AMLS Endocrine Emergencies 3