AMLS Endocrine Emergencies 1

Question 1

A 28-year-old type 1 diabetic presents with Kussmaul respirations, fruity breath odor, polyuria, and a blood glucose of 480 mg/dL. Which condition is most likely?

Accepted Answer

Diabetic ketoacidosis (DKA)

Answer

DKA classically presents with Kussmaul respirations, fruity (acetone) breath, polyuria, and markedly elevated blood glucose, predominantly in type 1 diabetics due to absolute insulin deficiency and ketone production.

Question 2

A patient with altered mental status has a blood glucose of 38 mg/dL. IV access cannot be established. What is the most appropriate next intervention?

Accepted Answer

Intramuscular glucagon 1 mg

Answer

When IV access is unavailable in a hypoglycemic patient with altered mental status (making oral glucose unsafe), IM glucagon stimulates hepatic glycogenolysis to raise blood glucose.

Question 3

Which laboratory finding best differentiates diabetic ketoacidosis (DKA) from hyperosmolar hyperglycemic state (HHS)?

Accepted Answer

Presence of significant ketonemia and metabolic acidosis

Answer

DKA is characterized by significant ketonemia and anion-gap metabolic acidosis, whereas HHS features extreme hyperglycemia and hyperosmolality without significant ketosis or acidosis.

Question 4

A 55-year-old patient on long-term corticosteroids presents with hypotension, weakness, nausea, and hypoglycemia after abruptly stopping their medication. Which condition is most likely?

Accepted Answer

Addisonian (adrenal) crisis

Answer

Adrenal crisis occurs when exogenous corticosteroids are abruptly withdrawn, causing acute adrenal insufficiency with hypotension, weakness, nausea, vomiting, and hypoglycemia due to loss of cortisol and aldosterone.

Question 5

A patient presents with fever of 104°F, tachycardia (HR 148), atrial fibrillation, agitation, and exophthalmos. Which endocrine emergency should be suspected?

Accepted Answer

Thyroid storm (thyrotoxic crisis)

Answer

Thyroid storm presents with hyperpyrexia, extreme tachycardia, dysrhythmias (especially atrial fibrillation), agitation, and signs of hyperthyroidism such as exophthalmos, reflecting life-threatening excess thyroid hormone activity.

AMLS - Advanced Medical Life Support Practice Test

AMLS - Advanced Medical Life Support Practice Test

AMLS Endocrine Emergencies 1