Biloxi EMT CH 20 Endocrine and Hematologic Emergencies Flashcards

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1
Q

When the body’s cells do not receive the glucose they require, the body resorts to burning __________ for energy.

a. fats
b. proteins
c. blood cells
d. ketones

A

a. fats

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2
Q

Normal blood glucose levels range from _______ mg/dL.

a. 80 to 120
b. 90 to 140
c. 70 to 110
d. 60 to 100

A

a. 80 to 120

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3
Q

A sickle cell-related issue that results in unintentional clot formation is known as a(n):

a. hemolytic crisis
b. aplastic crisis
c. splenic sequestration crisis
d. vasoocclusive crisis

A

c. splenic sequestration crisis

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4
Q

Diabetes mellitus is a metabolic disorder in which the hormone _________ is missing or the body has become resistant to it.

a. estrogen
b. adrenaline
c. insulin
d. epinephrine

A

c. insulin

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5
Q

Emergency care of a patient with hematologic disorder includes all of the following EXCEPT:

a. rapid transport for patients with an altered mental status
b. providing supportive and symptomatic care
c. oxygen at 4 L/min for patients with inadequate breathing
d. placing patients in a position of comfort

A

c. oxygen at 4 L/min for patients with inadequate breathing

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6
Q

The accumulation of ketones and fatty acids in blood tissue can lead to a dangerous condition in diabetic patients known as:

a. diabetic ketoacidosis
b. insulin shock
c. hyperosmolar hyperglycemic nonketotic coma (HHNC)
d. hypoglycemia

A

a. diabetic ketoacidosis

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7
Q

The term for excessive eating as a result of cellular “hunger” is:

a. polyuria
b. polydipsia
c. polyphagia
d. polyphony

A

c. polyphagia

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8
Q

Insulin is produced by the:

a. adrenal glands
b. hypothalamus
c. spleen
d. pancreas

A

d. pancreas

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9
Q

The patient with diabetic ketoacidosis (DKA) will generally have a fingerstick glucose level higher than:

a. 100 mg/dL
b. 200 mg/dL
c. 300 mg/dL
d. 400 mg/dL

A

d. 400 mg/dL

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10
Q

Where is glycogen stored in the body?

a. Liver
b. Brain
c. Pancreas
d. Heart

A

a. Liver

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11
Q

A sweet or fruity odor on the breath of a patient is commonly found in what condition?

a. Hypoglycemia
b. Hyperglycemia
c. Hemophilia
d. Thrombophilia

A

b. Hyperglycemia

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12
Q

What condition increases a patient’s risk for developing thrombophilia?

a. Diabetes
b. Sickle cell disease
c. Cirrhosis of the liver
d. Cancer

A

d. Cancer

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13
Q

Oral diabetic medications do NOT include the following?

a. Micronase
b. Glucotrol
c. Januvia
d. insulin

A

d. insulin

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14
Q

Which of the following is a contraindication to the administration of oral glucose?

a. Inability to swallow
b. History of diabetic ketoacidosis
c. Active infection
d. Recent abdominal surgery

A

a. Inability to swallow

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15
Q

_________ is the hormone that is normally produced by the pancreas that enables glucose to enter the cells.

a. Insulin
b. Adrenaline
c. Estrogen
d. Epinephrine

A

a. Insulin

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16
Q

The term for excessive urination is:

a. polyuria
b. polydipsia
c. polyphagia
d. polyphony

A

a. polyuria

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17
Q

When fat is used as an immediate energy source, ___________ and fatty acids are formed as waste products.

a. dextrose
b. sucrose
c. ketones
d. bicarbonate

A

c. ketones

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18
Q

An African American patient complaining of severe, generalized pain may have undiagnosed:

a. sickle cell disease
b. type 1 diabetes
c. thrombopenia
d. hemophilia

A

a. sickle cell disease

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19
Q

The onset of hypoglycemia can occur within:

a. seconds
b. minutes
c. hours
d. days

A

b. minutes

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20
Q

Without __________, or with very low levels, brain cells rapidly suffer permanent damage.

a. epinephrine
b. ketones
c. bicarbonate
d. glucose

A

d. glucose

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21
Q

_____________ is/are a potentially life-threatening complication of hypoglycemia.

a. Kussmaul respirations
b. Hypotension
c. Seizures
d. Polydipsia

A

c. Seizures

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22
Q

Diabetic ketoacidosis may develop as a result of:

a. too little insulin
b. too much insulin
c. overhydration
d. metabolic alkalosis

A

a. too little insulin

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23
Q

Always suspect hypoglycemia in any patient with:

a. Kussmaul respirations
b. an altered mental status
c. nausea and vomiting
d. stridor

A

b. an altered mental status

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24
Q

The most important step in caring for the unresponsive diabetic patient is to:

a. give oral glucose immediately
b. perform a focused assessment
c. open the airway
d. obtain a SAMPLE history

A

c. open the airway

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25
Q

Determination of hyperglycemia or hypoglycemia should be:

a. made before transport of the patient
b. made before administration of oral glucose
c. determined by a urine glucose test
d. based on your knowledge of the signs and symptoms of each condition

A

d. based on your knowledge of the signs and symptoms of each condition

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26
Q

When obtaining the medical history of a patient experiencing a sickle cell crisis, you should:

a. determine the patient’s level of consciousness
b. ask the patient about recent illnesses or stress
c. take the patient’s vital signs
d. avoid asking about previous sickle cell crisis

A

b. ask the patient about recent illnesses or stress

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27
Q

A deep vein thrombosis (DVT) is a worrisome risk for patients who have had:

a. gallbladder surgery
b. alcoholism
c. pneumonia
d. joint replacement surgery

A

d. joint replacement surgery

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28
Q

When reassessing the diabetic patient after administration of oral glucose, watch for all of the following EXCEPT:

a. airway problems
b. seizures
c. sudden loss of consciousness
d. joint pain

A

d. joint pain

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29
Q

Signs and symptoms associated with hypoglycemia include:

a. warm, dry skin
b. slow pulse
c. Kussmaul respirations
d. anxious or combative behavior

A

d. anxious or combative behavior

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30
Q

Hospital interventions for hemophilia may include all of the following EXCEPT:

a. blood transfusions
b. analgesics for pain
c. intravenous (IV) therapy
d. decontamination

A

d. decontamination

31
Q

Because hyperglycemia is a complex metabolic condition that usually develops over time and involves all of the tissues of the body, correcting this condition may:

a. be accomplished quickly through the use of oral glucose
b. require rapid infusion of IV fluid to prevent permanent brain damage
c. take many hours in a hospital setting
d. include a reduction in the amount of insulin normally taken by the patient

A

c. take many hours in a hospital setting

32
Q

A patient with hypoglycemia or hyperglycemia may appear to be:

a. having a heart attack
b. perfectly normal
c. intoxicated
d. having a stroke

A

c. intoxicated

33
Q

True/False

When patients use fat for energy, the fat waste products increase the amount of acid in the blood and tissue.

A

True

34
Q

True/False

The life span of a normal red blood cell is approximately 50 to 75 days.

A

False

35
Q

True/False

If blood glucose levels remain low, a patient may lose consciousness or have permanent brain damage.

A

True

36
Q

True/False

Higher glucose levels in the blood cause the excretion of glucose in urine.

A

True

37
Q

True/False

People with hemophilia have an increased ability to create a clot after an injury.

A

False

38
Q

True/False

Diabetic emergencies can occur when a patient’s blood glucose level gets too high or drops too low.

A

True

39
Q

True/False

Diabetic patients may require insulin to control their blood glucose.

A

True

40
Q

True/False

Insulin is one of the basic sugars essential for cell metabolism in humans.

A

False

41
Q

True/False

A clot that forms deep in a vein is called an aplastic crisis.

A

False

42
Q

True/False

Diabetes can cause kidney failure, blindness, and damage to blood vessels.

A

True

43
Q

True/False

Most children with diabetes are insulin dependent.

A

True

44
Q

True/False

Within the red blood cells, leukocytes are responsible for carrying oxygen.

A

False

45
Q

True/False

Many adults with diabetes can control their blood glucose levels with diet alone.

A

True

46
Q

The full name of diabetes is ____________ ____________.

A

Diabetes mellitus

47
Q

____________ is a general term for many different conditions that result in the blood clotting more easily than normal.

A

thrombophilia

48
Q

Type 1 diabetes is considered to be a(n) __________ problem, in which the body becomes allergic to its own tissues and literally destroys them.

A

autoimmune

49
Q

An African American patient or any patient of __________ descent who complains of severe pain may have undiagnosed _________ _________ disease.

A

Mediterranean, sickle cell

50
Q

Diabetes is defined as a lack of or __________ action of insulin.

A

impaired

51
Q

In __________, the patient cannot drink enough fluid to keep up with the exceedingly high glucose levels in the blood.

A

HHNS (hyperosmolar hyperglycemic nonketotic coma)

52
Q

_________ is the study and prevention of blood-_________ diseases.

A

Hematology, related

53
Q

A patient with hypoglycemia needs __________ immediately, and a patient with hyperglycemia needs __________ and IV fluid therapy.

A

Sugar, insulin

54
Q

Diabetes is MOST accurately defined as a(n):

a. disorder of glucose metabolism.
b. abnormally high blood glucose level.
c. mass excretion of glucose by the kidneys.
d. lack of insulin production in the pancreas.

A

a. disorder of glucose metabolism.

55
Q

Type 1 diabetes:

a. is typically treated with medications such as metformin.
b. is a condition in which no insulin is produced by the body.
c. typically occurs in patients between 50 and 70 years of age.
d. is defined as a blood sugar level that is less than 120 mg/dL.

A

b. is a condition in which no insulin is produced by the body.

56
Q

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:

a. diet and exercise.
b. tolbutamide (Orinase).
c. glyburide (Micronase).
d. supplemental insulin.

A

d. supplemental insulin.

57
Q

The normal blood glucose level is between:

a. 60 and 80 mg/dL.
b. 80 and 120 mg/dL.
c. 130 and 150 mg/dL.
d. 160 and 200 mg/dL.

A

b. 80 and 120 mg/dL.

58
Q

Diabetic ketoacidosis occurs when:

a. blood glucose levels rapidly fall.
b. the cells rapidly metabolize glucose.
c. the pancreas produces excess insulin.
d. insulin is not available in the body.

A

d. insulin is not available in the body.

59
Q

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient’s clinical presentation, you should suspect that she:

a. is significantly hyperglycemic.
b. has a low blood glucose level.
c. has a urinary tract infection.
d. has overdosed on her insulin.

A

a. is significantly hyperglycemic.

60
Q

Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new onset type 1 diabetes?

a. Total lack of appetite
b. Weight gain and edema
c. Weight loss and polyuria
d. Low blood glucose level

A

c. Weight loss and polyuria

61
Q

Symptomatic hypoglycemia will MOST likely develop if a patient:

a. takes too much of his or her prescribed insulin.
b. markedly overeats and misses an insulin dose.
c. eats a regular meal followed by mild exertion.
d. misses one or two prescribed insulin injections.

A

a. takes too much of his or her prescribed insulin.

62
Q

When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:

a. if he or she has had any recent illnesses or excessive stress.
b. approximately how much water the patient drank that day.
c. if there is a family history of diabetes or related conditions.
d. the name of the physician who prescribed his or her insulin.

A

a. if he or she has had any recent illnesses or excessive stress.

63
Q

Which of the following conditions is the diabetic patient at an increased risk of developing?

a. Blindness
b. Depression
c. Alcoholism
d. Hepatitis B

A

a. Blindness

64
Q

In general, oral glucose should be given to any patient who:

a. has a blood glucose level that is less than 100 mg/dL.
b. has an altered mental status and a history of diabetes.
c. has documented hypoglycemia and an absent gag reflex.
d. is unresponsive, even in the absence of a history of diabetes.

A

b. has an altered mental status and a history of diabetes.

65
Q

Hemoglobin is:

a. the fluid portion of the blood that transports cells throughout the body.
b. essential for the formation of clots, such as when vessel damage occurs.
c. found within the red blood cells and is responsible for carrying oxygen.
d. a key component of the blood and is produced in response to an infection.

A

c. found within the red blood cells and is responsible for carrying oxygen.

66
Q

Which of the following statements regarding sickly cell disease is correct?

a. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.
b. In sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.
c. The red blood cells of patients with sickly cell disease are round and contain hemoglobin.
d. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.

A

b. In sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.

67
Q

Patients with thrombophilia are at an increased risk for:

a. various cancers.
b. hemorrhagic stroke.
c. acute arterial rupture.
d. pulmonary embolism.

A

c. acute arterial rupture.

68
Q

Patients with uncontrolled diabetes experience polyuria because:

a. they drink excess amounts of water due to dehydration.
b. excess glucose in the blood is excreted by the kidneys.
c. low blood glucose levels result in cellular dehydration.
d. high blood sugar levels cause permanent kidney damage.

A

b. excess glucose in the blood is excreted by the kidneys.

69
Q

Excessive eating caused by cellular “hunger” is called:

a. polyphagia.
b. polydipsia.
c. dysphasia.
d. dyspepsia.

A

a. polyphagia.

70
Q

Classic signs and symptoms of hypoglycemia include:

a. warm, dry skin; irritability; bradycardia; and rapid respirations.
b. cool, clammy skin; weakness; tachycardia; and rapid respirations.
c. warm, dry skin; hunger, abdominal pain; and deep, slow respirations.
d. cold, clammy skin; bradycardia; hunger, and deep, rapid respirations.

A

b. cool, clammy skin; weakness; tachycardia; and rapid respirations.

71
Q

When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:

a. patient’s mental status.
b. rate of the patient’s pulse.
c. presence of a medical identification tag.
d. rate and depth of breathing.

A

d. rate and depth of breathing.

72
Q

To which of the following diabetic patients should you administer oral glucose?

a. An unconscious 33-year-old male with cool, clammy skin
b. A conscious 37-year-old female with nausea and vomiting
c. A semiconscious 40-year-old female without a gag reflex
d. A confused 55-year-old male with tachycardia and pallor

A

d. A confused 55-year-old male with tachycardia and pallor

73
Q

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

a. assessing the patient’s mental status.
b. ensuring the absence of a gag reflex.
c. checking the medication’s expiration date.
d. requesting permission from medical control.

A

b. ensuring the absence of a gag reflex.