AEMT Chapter 23 Pre-Test

Questions and Answers

Which of the following refers to destruction of beta cells of the pancreas, resulting in insufficient insulin production? (Select all that apply)

Type 2 diabetes

Gluconeogenesis

Hyperglycemia

Type 1 diabetes (correct)

Which of the following typically occurs in middle-aged, obese individuals and is usually controlled by diet, exercise, weight loss, and oral medications?

Hypoglycemia

Type 2 diabetes (correct)

Diabetic ketoacidosis

Type 1 diabetes

In which of the following can BGLs reach levels of up to 1,000 mg/dL?

Hypoglycemia

Diabetic ketoacidosis

Hyperosmolar hyperglycemic state (correct)

Hyperglycemia

Which of the following is a form of hyperthyroidism that results from an autoimmune disorder that causes increased production of thyroid hormones?

Graves' disease Signup and view all the answers

The preferred fuel of body cells is:

glucose Signup and view all the answers

Which of the following BEST explains the role of insulin in the body?

When insulin binds to cellular receptors, the entry of glucose into the cell is facilitated. Signup and view all the answers

Which of the following BEST explains Kussmaul respirations in hyperglycemia?

It is the body's attempt to increase pH. Signup and view all the answers

Which of the following is secreted in response to rising BGLs?

Insulin Signup and view all the answers

Which of the following BGLs falls within a normal range?

70 mg/dL Signup and view all the answers

What is the range for a normal BGL?

70 to 110 mg/dL Signup and view all the answers

Which of the following BEST describes the condition that occurs when the blood glucose level reaches 300 to 500 mg/dL?

Diabetic ketoacidosis Signup and view all the answers

Which of the following BEST describes the condition that occurs when the blood glucose level goes above 500 mg/dL?

Hyperosmolar hyperglycemic state Signup and view all the answers

Without a constant supply of __________, brain cells cannot function.

glucose Signup and view all the answers

Which type of cells do NOT require insulin for glucose to cross the cell membrane?

brain Signup and view all the answers

Brain cells cannot switch to another source of energy when __________ levels are low.

glucose Signup and view all the answers

Which of the following is NOT an expected short-term effect of the lack of glucose to the brain?

Fruity odor breath Signup and view all the answers

The primary storage reservoir for glycogen is the:

liver Signup and view all the answers

Glycogen is a more complex molecule than the molecule from which it is synthesized, which is:

Glucose Signup and view all the answers

Glycogen is broken down into glucose in a process called:

glycogenolysis Signup and view all the answers

What process is used to create glucose from amino acids and fatty acids?

Gluconeogenesis Signup and view all the answers

Which of the following BEST characterizes the conditions created by untreated type 1 diabetes?

High BGL, dehydration, acidosis Signup and view all the answers

Which of the following is associated with hypoglycemia but not hyperglycemia?

Rapid onset of signs and symptoms Signup and view all the answers

Which of the following has a sudden onset of altered mental status or bizarre behavior?

Hypoglycemia Signup and view all the answers

You are called to care for a patient who complains of headache, weakness, and loss of coordination. He appears irritable and has a weak, rapid pulse. His skin is pale, cool, and diaphoretic. You suspect:

hypoglycemia Signup and view all the answers

Which of the following BEST describes the onset of signs and symptoms of a hyperglycemic emergency?

Gradual, over hours to days Signup and view all the answers

Which one of these characteristics would be helpful in distinguishing between hyperosmolar hyperglycemic state and diabetic ketoacidosis?

Acetone odor to the breath Signup and view all the answers

A blood glucose level of 1,000 mg/dL would be MOST consistent with:

hyperosmolar hyperglycemic state Signup and view all the answers

Which condition is MOST associated with hyperosmolar hyperglycemic state?

Type 2 diabetes Signup and view all the answers

Which of the following findings should you MOST expect to find in a patient with hyperglycemia?

Warm, dry skin Signup and view all the answers

Which of the following should you MOST expect to find in a patient with hypoglycemia?

Tachycardia Signup and view all the answers

Which of the following questions is MOST important in helping you determine whether a diabetic patient is at risk for hypoglycemia?

What type of insulin do you take? Signup and view all the answers

Which of the following recent events in a diabetic patient's history should increase your suspicion of a hyperglycemic emergency?

An infected ulcer on his foot Signup and view all the answers

Which of the following is NOT a complication of type 1 diabetes?

Obesity Signup and view all the answers

All of the following are complications of diabetes EXCEPT:

Alzheimer's disease Signup and view all the answers

Which of the following is a complication of diabetes?

blindness Signup and view all the answers

All of the following are complications of type 1 diabetes EXCEPT:

nonketotic hyperosmolar coma Signup and view all the answers

You are responding to a call for a patient with an altered mental status and a history of hyperglycemia. Which treatment is needed by both patients with diabetic ketoacidosis and patients in a hyperosmolar hyperglycemic state?

bolus of isotonic crystalloid IV fluids Signup and view all the answers

You have responded to a college lecture hall for an unresponsive person. The patient is a college-age male who is unresponsive. Witnesses state that he became confused, pale, and sweaty while working with classmates on a project. He is pale, and his clothing is damp with perspiration. He has snoring respirations at 16 per minute; the snoring stops when you manually position the airway, and there is no indication of cyanosis. As you check the radial pulse, you notice a medical bracelet that indicates the patient is diabetic. The radial pulse is present and regular at 100 beats per minute. Which of the following should you do first?

Obtain a BGL Signup and view all the answers

A 45-year-old man became disoriented and agitated while playing golf. When you arrive, he is awake and agitated, screaming and swearing at his golf partners, who are trying to keep him from wandering off. He appears excessively sweaty, even for a warm day, and does not acknowledge your arrival. One of the golfers tells you the man is diabetic. They have been trying to get him to eat a candy bar and drink some soda, but he is uncooperative. Your first priority is:

Plan an approach that will minimize the patient's ability to injure himself Signup and view all the answers

A 26-year-old woman with a history of diabetes was found unresponsive at home. When you arrive, the patient is unresponsive to pain and has snoring respirations at 12 per minute. Her skin is pale and cool, and she has a thready radial pulse of 112 beats per minute. Her BGL is 32 mg/dL. You have tried three times to start an IV, but all attempts were unsuccessful. You should:

administer 1-mg glucagon IM. Signup and view all the answers

What is the minimum size of IV catheter that should be used to push 50 percent dextrose?

18 Gauge Signup and view all the answers

What is the typical dose of 50 percent dextrose in the adult patient?

25g Signup and view all the answers

How soon should you see improvement in the patient's condition after administration of 50 percent dextrose?

one to two minutes Signup and view all the answers

What medication may be used in the unresponsive hypoglycemic patient when there is no IV access?

Glucagon Signup and view all the answers

You have administered 50 percent dextrose IV to a 30-year-old man who is a type 1 diabetic and was found unresponsive at home. The patient is now alert and oriented. How often should this patient be reassessed during transport?

Every 15 minutes Signup and view all the answers

How often should you reassess a critical patient having an endocrine emergency?

every five minutes Signup and view all the answers

Which of the following is NOT generally reassessed during the transport of a critical patient with an endocrine emergency?

Complete head-to-toe survey Signup and view all the answers

Your patient suffers from altered mental status secondary to mild hypoglycemia. You have administered oral glucose and the patient has shown improvement. How frequently should you reassess this patient while en route?

every 15 minutes Signup and view all the answers

You have administered 50 percent dextrose IV to a 30-year-old man who is a type 1 diabetic and was found unresponsive at home. The patient is now alert and oriented and is refusing transport to the hospital. A neighbor found the patient but is unable to stay with him. Which of the following is the BEST solution to this situation?

Assist the patient in making a sandwich or snack that contains meat, cheese, or another good source of protein. Recheck the patient's BGL before leaving. Advise the patient of the risks of refusal, particularly because he does not have someone to stay with him, and allow him to sign a refusal form. Signup and view all the answers

Your patient refuses transport. In addition to having the patient sign a refusal form, you would document all of the following EXCEPT:

your speculation as to why the patient might have refused transport. Signup and view all the answers

What mnemonic may be used to remember causes of altered mental status?

AEIOU TIPS Signup and view all the answers

What source of information regarding medical information is NOT typically used when your patient is unresponsive?

The patient's family physician Signup and view all the answers

Which of the following signs or symptoms should you anticipate in hyperthyroidism?

Tachycardia Signup and view all the answers

____________ is a severe, immediately life-threatening form of hyperthyroidism.

Thyrotoxicosis Signup and view all the answers

Your patient has a history of Graves' disease. When you assess her, you note that she has the protrusion of the eyes characteristic of this disease. What is this called?

Exophthalmos Signup and view all the answers

Nonpitting tissue swelling associated with severe hypothyroidism is known as:

myxedema Signup and view all the answers

Destruction of the adrenal cortex is a cause of:

Addison's disease Signup and view all the answers

Which of the following characteristics is associated with Cushing's syndrome?

"moon face" appearance Signup and view all the answers

Which of the following is associated with Cushing's disease?

Increased ACTH Signup and view all the answers

Which of the following would occur if a patient who has taken corticosteroids for an extended period of time suddenly stops taking them?

Signs and symptoms of Addison's disease Signup and view all the answers

Study Notes

Diabetes Types

Type 1 diabetes is characterized by the destruction of beta cells in the pancreas, leading to insufficient insulin production.
Type 2 diabetes typically occurs in middle-aged, obese individuals and is manageable through lifestyle changes, including diet, exercise, and oral medications.

Hyperglycemia Conditions

Blood glucose levels (BGLs) can reach up to 1,000 mg/dL in a hyperosmolar hyperglycemic state.
Diabetic ketoacidosis occurs when BGLs reach between 300 to 500 mg/dL.
Hyperosmolar hyperglycemic state is characterized by BGLs above 500 mg/dL.

Insulin Function

Insulin facilitates the entry of glucose into cells by binding to cellular receptors.
Rising BGLs stimulate the secretion of insulin, while glucose is the preferred fuel for body cells.

Kussmaul Breathing

Kussmaul respirations occur as the body tries to correct acidosis by increasing pH.

Glucose Homeostasis

Normal BGL ranges from 70 to 110 mg/dL, with 70 mg/dL considered within normal limits.
Lack of glucose impairs brain function; brain cells cannot utilize fatty acids or amino acids for energy when glucose is insufficient.

Symptoms and Signs of Diabetes Emergencies

Hypoglycemia leads to rapid onset of symptoms, while hyperglycemia develops gradually over hours to days.
Symptoms of hypoglycemia include altered mental status, dizziness, headache, weakness, irritability, and pale, cool skin.
Warm, dry skin is often seen in patients with hyperglycemia.

Treatment and Management

In cases of altered mental status and suspected hypoglycemia, always check BGL first and consider administering oral glucose or 1-mg glucagon if IV access is not available.
50% dextrose should be pushed through at least an 18-gauge IV catheter, with a typical adult dose of 25g.
Reassess patients every 15 minutes after improvement from hypoglycemia and every 5 minutes for critical endocrine emergencies.

Complications of Diabetes

Complications include diabetic ketoacidosis, hyperosmolar hyperglycemic state, blindness, and characters like a “moon face” in Cushing's syndrome.
Patients refusing transport must be informed about possible risks, and their refusals documented without speculation.

Thyroid Disorders

Graves’ disease is an autoimmune disorder causing hyperthyroidism, characterized by excess thyroid hormones and exophthalmos (protrusion of the eyes).
Myxedema is nonpitting tissue swelling linked to severe hypothyroidism, whereas thyrotoxicosis represents a severe form of hyperthyroidism.
Addison's disease arises from destruction of the adrenal cortex, with symptoms mirroring those of an adrenal crisis if corticosteroid treatment is suddenly halted.

Mnemonics and Mental Status

AEIOU TIPS is a useful mnemonic for the causes of altered mental status.

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Description

Test your knowledge on Chapter 23 of the AEMT course with these flashcards. This quiz focuses on the various types of diabetes and their characteristics. Perfect for preparing for exams and understanding critical concepts in emergency medical training.

AEMT Chapter 23 Pre-Test

Questions and Answers

Which of the following refers to destruction of beta cells of the pancreas, resulting in insufficient insulin production? (Select all that apply)

Which of the following typically occurs in middle-aged, obese individuals and is usually controlled by diet, exercise, weight loss, and oral medications?

In which of the following can BGLs reach levels of up to 1,000 mg/dL?

Which of the following is a form of hyperthyroidism that results from an autoimmune disorder that causes increased production of thyroid hormones?

The preferred fuel of body cells is:

Which of the following BEST explains the role of insulin in the body?

Which of the following BEST explains Kussmaul respirations in hyperglycemia?

Which of the following is secreted in response to rising BGLs?

Which of the following BGLs falls within a normal range?

What is the range for a normal BGL?

Which of the following BEST describes the condition that occurs when the blood glucose level reaches 300 to 500 mg/dL?

Which of the following BEST describes the condition that occurs when the blood glucose level goes above 500 mg/dL?

Without a constant supply of __________, brain cells cannot function.

Which type of cells do NOT require insulin for glucose to cross the cell membrane?

Brain cells cannot switch to another source of energy when __________ levels are low.

Which of the following is NOT an expected short-term effect of the lack of glucose to the brain?

The primary storage reservoir for glycogen is the:

Glycogen is a more complex molecule than the molecule from which it is synthesized, which is:

Glycogen is broken down into glucose in a process called:

What process is used to create glucose from amino acids and fatty acids?

Which of the following BEST characterizes the conditions created by untreated type 1 diabetes?

Which of the following is associated with hypoglycemia but not hyperglycemia?

Which of the following has a sudden onset of altered mental status or bizarre behavior?

You are called to care for a patient who complains of headache, weakness, and loss of coordination. He appears irritable and has a weak, rapid pulse. His skin is pale, cool, and diaphoretic. You suspect:

Which of the following BEST describes the onset of signs and symptoms of a hyperglycemic emergency?

Which one of these characteristics would be helpful in distinguishing between hyperosmolar hyperglycemic state and diabetic ketoacidosis?

A blood glucose level of 1,000 mg/dL would be MOST consistent with:

Which condition is MOST associated with hyperosmolar hyperglycemic state?

Which of the following findings should you MOST expect to find in a patient with hyperglycemia?

Which of the following should you MOST expect to find in a patient with hypoglycemia?

Which of the following questions is MOST important in helping you determine whether a diabetic patient is at risk for hypoglycemia?

Which of the following recent events in a diabetic patient's history should increase your suspicion of a hyperglycemic emergency?

Which of the following is NOT a complication of type 1 diabetes?

All of the following are complications of diabetes EXCEPT:

Which of the following is a complication of diabetes?

All of the following are complications of type 1 diabetes EXCEPT:

You are responding to a call for a patient with an altered mental status and a history of hyperglycemia. Which treatment is needed by both patients with diabetic ketoacidosis and patients in a hyperosmolar hyperglycemic state?

What is the minimum size of IV catheter that should be used to push 50 percent dextrose?

What is the typical dose of 50 percent dextrose in the adult patient?

How soon should you see improvement in the patient's condition after administration of 50 percent dextrose?

What medication may be used in the unresponsive hypoglycemic patient when there is no IV access?

You have administered 50 percent dextrose IV to a 30-year-old man who is a type 1 diabetic and was found unresponsive at home. The patient is now alert and oriented. How often should this patient be reassessed during transport?

How often should you reassess a critical patient having an endocrine emergency?

Which of the following is NOT generally reassessed during the transport of a critical patient with an endocrine emergency?

Your patient suffers from altered mental status secondary to mild hypoglycemia. You have administered oral glucose and the patient has shown improvement. How frequently should you reassess this patient while en route?

Your patient refuses transport. In addition to having the patient sign a refusal form, you would document all of the following EXCEPT:

What mnemonic may be used to remember causes of altered mental status?

What source of information regarding medical information is NOT typically used when your patient is unresponsive?

Which of the following signs or symptoms should you anticipate in hyperthyroidism?

____________ is a severe, immediately life-threatening form of hyperthyroidism.

Your patient has a history of Graves' disease. When you assess her, you note that she has the protrusion of the eyes characteristic of this disease. What is this called?

Nonpitting tissue swelling associated with severe hypothyroidism is known as:

Destruction of the adrenal cortex is a cause of:

Which of the following characteristics is associated with Cushing's syndrome?

Which of the following is associated with Cushing's disease?

Which of the following would occur if a patient who has taken corticosteroids for an extended period of time suddenly stops taking them?

Study Notes

Diabetes Types

Hyperglycemia Conditions

Insulin Function

Kussmaul Breathing

Glucose Homeostasis

Symptoms and Signs of Diabetes Emergencies

Treatment and Management

Complications of Diabetes

Thyroid Disorders

Mnemonics and Mental Status

Studying That Suits You

Description

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