BLS Questions

1. What is the initial treatment for this patient? a. Glucose b. Glucagon c. Oxygen d. Orange juice    

2. With diabetes mellitus, the pancreatic islets do not produce enough of one of the following? a. Insulin b. Glucagon c. Glucose d. Oxygen    

3. What differential diagnosis could you derive from this patient? a. Diabetic ketoacidosis b. Dehydration c. Non-ketonic hyper­glycemic hyperosmolar coma d. All of the above    

4. What are the complications of diabetes mellitus? a. Retinopathy b. Nephropathy c. Atherosclerotic artery disease d. All of the above e. None of the above    

5. Which of the following should be closely monitored after a diabetic episode in the prehospital setting? a.  Blood glucose levels b.  EKG c.  EGG d.  EEG  

6. Which one of the following is hyperglycemia often confused with? a.  ETOH intoxication b. Myocardial infarction c.  Sepsis d.  All of the above 

7. What could be the cause of the fruity odor on the patient’s breath? a.  Chocolate b.  Ketones c.  Peanuts d.  Vomit    

8. Which of the following is not a diabetic medication? a. Insulin b. Diabeta c. Slow K d. Cimetidine    

9. Why are diabetics prone to vasculature problems? a. Increase in viscosity of the blood b. Decrease in viscosity of the blood c. Appendicitis d. Cholelithiasis    

10. Why do alcoholics have problems with their diabetes mellitus? a. Repeated vomiting and not eating properly b. Alcohol increases glucose production c. Alcohol increases potassium levels d. Yeast in the alcohol increases glucose production    

ALS Questions

11. DKA is characterized by? a. Hypoglycemia b. Hyperglycemia c. Metabolic acidosis d. Hyperkalemia e. All of the above    

12. If this patient weighs 100 kg, what would the fluid challenge be? a. 2000 mls b. 1000 mls c. 800 mls d. 1600 mls    

13. In addition to the fluid challenge, what is the IV maintenance fluid rate for this patient (100 kg weight)? a. 100 mls/hr b. KVO c. 140 hr/hr d. 80 hr/hr    

14. In the pancreatic islets, which of the following cells produce insulin? a. Alpha b. Beta c. Gamma d. Omega    

15. You could expect this patient to be in: a. Respiratory acidosis b. Metabolic alkalosis c. Respiratory acidosis with decompensating metabolic alklosis d. Metabolic acidosis with compensating respiratory acidosis      

16. What could cause this patient to go into non-ketonic hyperglycemic hyperosmolar coma? a. Increased administration of IV glucose b. Increased insulin intake c. Vitamin K supplement d. Increased Slow K intake at home    

17. Which one of the following would be an indication to cease fluid administration? a. Normotension b. Normal blood glucose levels c. Pulmonary edema d. Adequate urination e. All of the above 

18. If protocols exist, which of the following would be the recommended initial type and dose of insulin? a. Insulin L @ 100 units IVP b. Insulin N @ 5O units IVP c. Insulin R @ 10 units IVP d. Insulin U @ 10 units IVP    

19. What are the goals in treating DKA? a. Increase glucose levels b. Improve circulating volume and tissue perfusion c. Increase insulin levels d. Increase synthesis of glycogen by glucagon in the liver    

20. What could be a pre­disposing factor of DKA? a. Trauma b. Infection c. Dehydration d. External insulin pump malfunction e. All of the above    

Please keep in mind the answers to these questions are to industry standards and may not necessarily be correct according to local protocol. If there is any discrepancy between these answers and local protocol, please follow the protocol for your area as set out by your Medical Director.

Submitted by students enrolled in the Paramedicine III program at Holland College, Charlottetown P.E.I. To offer feedback on the quiz or for information on the Paramedicine Programs at Holland College, e-mail them at: sccoulter@ ccgw.cc.hollandc.pe.ca

This Article is reprinted by permission of the Canadian Emergency News. It originally appeared in the April - May 2000 issue (volume 23, number 2).