2022-2023 AMLS - Study Guide with Answers (371 Solved Questions)

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AMLS - STUDY GUIDE QUESTIONS
WITH 100% CORRECT ANSWERS
2022\2023
List 7 Red Flags for Breathing - ANSWER-1. Reduced consciousness
2. Cyanosis
3. SpO2 29
5. Asymmetrical movement
6. Tracheal deviation and distress
7. Inability to count to five in a single breath
List 7 Red Flags for Circulatory Problems - ANSWER-1. Reduced consciousness
2. Profound pallor
3. Marked sweating
4. Systolic BP 140
6. Skin mottling
7. Dysrhythmia & hypotension
List 5 Red Flags for Airway Assessment - ANSWER-1. Reduced consciousness
2. Stridor
3. Snoring
4. Voice change
5. Tongue swelling
List 5 Red Flags of Disability Assessment - ANSWER-1. Hypoglycaemia
2. Reducing level of consciousness
3. Persistent fitting
4. Progression of signs (e.g. headache, lateralization)
5. P,U or not localizing pain

List 3 Red Flags on General Assessment - ANSWER-1. Purpuric rash
2. Erythrodermia
3. Core temperature 40deg
List 11 immediately life-threatening causes of airway obstruction - ANSWER-1. Tongue
swelling (pharynx)
2. Swelling of the epiglottis or soft tissues (pharynx)
3. Oedema of the larynx
4. Laryngospasm (spasm of the vocal cords)
5. Foreign body in larynx
6. Laryngeal trauma
7. Subglottic secretions or foreign body
8. Subglottic swelling
9. Bronchial aspiration
10. Tension pneumothorax
11. Bronchial foreign body
List 7 immediately life-threatening causes of breathlessness - ANSWER-1. Airway
obstruction
2. Acute severe asthma
3. Acute exacerbation of COPD
4. Pulmonary oedema
5. Tension pneumothorax
6. Critical oxygen desaturation
7. Circulatory shock
List 5 Life-threatening conditions that present with cutaneous manifestations -
ANSWER-1. Anaphylaxis
2. Angio-oedema

3. Meningococcal sepsis
4. Gonococcal sepsis
5. Cellulitis
6. Erythroderma
List 10 danger signs/reasons to admit a severe asthmatic to ICU - ANSWER-1.
Hypoxaemia (PaO2 0,6)
2. Hypercapnia (PaCO2 > 6 kPa)
3. Acidaemia
4. Exhaustion
5. Altered level of consciousness (confused, drowsy, unconscious)
6. Respiratory arrest
7. Silent chest
8. Tachycardia > 130/min
9. Bradycardia
10. Peak expiratory flow < 33% of predicted
List 5 medicines that cause dilatation of the pupils - ANSWER-1 Tricyclic
antidepressants
2. Anticholinergics
3. Antihistamines
4. Ephedrine
5. Amphetamines
6. Cocaine
List 5 substances that can cause coma - ANSWER-1. Barbiturates
2. Tricyclic antidepressants
3. Opioids
4. Benzodiazepines

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5. Ethanol
List 5 non-traumatic life-threatening disorders of the circulatory system - ANSWER-1.
Airway obstruction
2. Acute severe asthma
3. Pulmonary oedema
4. Tension pneumothorax
5. Circulatory shock
Name 5 non-traumatic life threatening disorders of the neurological system~1. Stroke
2. Subarachnoid haemorrhage
3. Meningitis
4. Encephalitis
5. Cerebral abscess
6. Cerebral malaria
7. Intracerebral tumour
List 8 life-threatening conditions presenting with abdominal pain - ANSWER-1.
Gastrointestinal bleeding
2. Aortic dissection
3. Ectopic pregnancy
4. Acute pancreatitis
5. Small bowel infarction
6. Sepsis
7. Acute myocardial infarction
8. Diabetic ketoacidosis
A 28 year old female is being evaluated for an acute onset of an alteration in mentation.
She complained of a stiff neck and persistent headache. Vital signs are P112, R22 and
regular, BP 144/88, SpO2 95% and T 102.3°F (39°C). The healthcare provider should
observe for which complication? - ANSWER-Seizure

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A 45 year old patient is found supine on the floor of the Triage area. Healthcare
providers note pinpoint pupils, shallow respirations and vomitus in and around the
mouth. What course of action should be implemented next? - ANSWER-Supplemental
oxygen and suction
Patients with a history of chronic bronchitis that present with shortness of breath are
likely to have which condition? - ANSWER-Pulmonary embolism
Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological
change? - ANSWER-Breakdown of the alveolar-capillary membrane
An anxious male complains of a sore throat, fever, chills, dental pain and dyspnea. the
patient has a firm, red pronounced swelling in the sublingual anterior throat area and
tongue. What diagnosis is most likely? - ANSWER-Ludwig's angina
Patients on mechanical ventilation may have hypoxemia due to alveolar collapse from
mucous plugging. The best treatment for this is: - ANSWER-Administer PEEP
Anaphylaxis is most associated with which physiological event? - ANSWER-
Vasodilation
An elderly patient in an assisted living facility presents with a diminished level of
consciousness and elevated white blood count. Assessment reveals pale, clammy skin
and a urinary catherter with dark colored urine. Vital signs are P132, R 38 and shallow,
BP 78/46, SpO2 91% and T 100.8°F (32.8°C). What classification of shock is the patient
most likely experiencing? - ANSWER-Distributive
Healthcare providers are assessing a patient with pronounced jugular vein distention
and muffled heart tones. Vitals are P 128, R 26, BP 74/52. What classification of shock
should be suspected? - ANSWER-Obstructive
During compensatory shock, the renin-angiotensin-aldosterone system is activated to
cause a/an: - ANSWER-Increase in preload, afterload and re-absorption of sodium
A 42 year old patient with a history of rheumatoid arthritis is taking glucocorticoids. Over
the past two weeks, she complains of chronic fatigue, weakness, and loss of appetite
with weight loss. Lab results indicate hyponatremia and hyperkalemia. What underlying
diagnosis is suspected? - ANSWER-Adrenal insuffiency
Which condition should the healthcare provider consider to usually be a non-emergent,
non-life threatening illness? - ANSWER-Thoracic outlet syndrome
Healthcare providers should use extreme caution with nitroglycerin when ST elevation is
present in which ECG leads? - ANSWER-II, III, aVF

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Which is a high-risk factor for intracerebral hemorrhage? - ANSWER-Cocaine drug
abuse
What is the initial treatment for a patient experiencing Hyperosmolar Hyperglycemic
Nonketotic Syndrome (HHNS)? - ANSWER-Crystalloid IV fluid resuscitation
What condition is most likely to cause respiratory acidosis? - ANSWER-narcotic
overdose
What is the most effective treatment for an unconscious patient in respiratory acidosis?
- ANSWER-Assisted bag-mask ventilation
An autoimmune disease which produces antibodies that mimic the role of TSH and
cause an increase in thyroid hormones is: - ANSWER-Grave's disease
Glucagon may not be effective treatment for a patient with hypoglycemia if they also
have which underlying illness? - ANSWER-Alcoholism
A 24 year old has completed a triathlon on a hot, humid day. The athlete complains of a
severe headache, muscle cramps and abdominal pain. As the patient history is
obtained, the athlete becomes lethargic. What underlying electrolyte disturbance should
the healthcare provider most likely suspect? - ANSWER-Hyponatremia
What is the sign on the ECG that will indicate a patient is experiencing hyperkalemia? -
ANSWER-Peaked T waves
An 82 year old alcoholic complains of nausea, non-bloody vomiting and severe
epigastric and right upper quadrant pain that radiates to the back. Palpation reveals
epigastric tenderness without peritoneal signs. What working diagnosis should be
considered most likely? - ANSWER-Acute pancreatitis
A 23 year old male complains of a productive cough, fever, chills and pleuritic chest
pain that has worsened over 3 days. A physical exam reveals unilateral wheezing with
shallow respirations. Vitals are P 128, R 26, BP 144/88, SpO2 90%, and T 102°F
(38.8°C). What treatment should be performed? - ANSWER-Supplemental oxygen and
immediate transport
A patient with suspected gallbladder disease is asked to take a deep breath while the
provider presses upward into the upper right quadrant. If the patient ceases inspiration
due to increase pain while being examined, this is known as: - ANSWER-Muphy's sign
The patient is alert and oriented presenting with hypotension, bradycardia, normal
capillary refill and warm, dry skin. These are cardinal signs of which type of distributive
shock? - ANSWER-Neurogenic

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During what period of the communicable disease process will antibodies begin to reach
detectable levels and the infected blood will test positive for exposure to a pathogen? -
ANSWER-Incubation
The patient presents with a history of headache, weight loss, chest discomfort, night
sweats and a persistent cough for several weeks. Which infectious disease is most
likely occurring? - ANSWER-Tuberculosis
A lethargic patient presents with dilated pupils and vital signs of P 122, R 26 and BP
130/80. He admits to excessive ingestion of diphenhydramine. What response is the
cause for the presenting signs and symptoms? - ANSWER-Anticholinergic
Organophosphate poisoning will present with which signs and symptoms? - ANSWER-
Salivation and incontinence of urine and liquid stool
What medication classification should be administered to an uncooperative, agitated
patient? - ANSWER-Benzodizepine
A patient presents with mildly decreased mental status, slow respirations, bradycardia,
hypotension, has a blood sugar of 42mg/dl (2.3 mmol/L). This is most likely caused from
excessive ingestion of: - ANSWER-Beta blockers
The patient complains of a deep burning discomfort diffusely throughout the
epigastrium. This is an example of which type of pain? - ANSWER-Visceral
A 24 year old female presents with lower right quadrant abdominal pain. Her skin is hot
to the touch and she exhibits a Psoa Sign. She complains of nausea and vomiting for 2
days. What diagnosis is suspected? - ANSWER-Appendicitis
A known chronic alcoholic complains of the constant, severe mid-epigastric pain,
nausea and blood-streaked emesis. The patient has a temperature of 101.9°F (38.8°C)
and severe abdominal tenderness. What underlying diagnosis should be suspected? -
ANSWER-Pancreatitis
What component of a patient's past medical history is most helpful in considering
myocardial infarction as a working diagnosis? - ANSWER-Familial heart disease history
A patient describes an "aching" sensation in his chest. It occurred suddenly while
resting and radiates to the jaw. He self administered 1 nitroglycerin tablet without relief
and the 12 lead reveals a normal sinus rhythm with ST elevation in leads II, III, and aVF.
What working diagnosis is most likely? - ANSWER-Inferior wall myocardial injury
Healthcare providers are managing a patient presenting with substernal chest
discomfort. They describe the pain as "pressure-like" and it radiates to the jaw and left
arm. The discomfort subsides with rest, oxygen and administration of nitroglycerin.
What is the most likely working diagnosis? - ANSWER-Myocardial infarction

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Which infectious disease must have oxygen present to survive? - ANSWER-
Tuberculosis
Which best practices help to prevent the spread of infectious disease? - ANSWER-
Handwashing before and after all patient contact and standard precautions.
Continuous positive airway pressure would be most appropriate in treating which
patient? - ANSWER-22 year old with severe asthma and not responding to nebulizer
treatments
A patient has attempted suicide by ingesting ethylene glycol about 20 hours prior to
arriving for treatment. Lung sounds reveal bilateral crackles and respirations of 30 with
symptoms of pulmonary edema and cyanosis of the lips. The ECG reveals ventricular
tachycardia. Which stage of ethylene glycol poisoning has occurred? - ANSWER-2
A patient with a history of Grave's disease presents with anxiety, profuse sweating and
a palpable goiter. Vitals are P 151, R 35 and labored, BP 84/42. Which working
diagnosis is most likely? - ANSWER-Thyrotoxicosis
A patient experiences unilateral facial weakness and droop, garbled speech, altered
sense of taste and no extremity weakness. The patient has a history of Lyme's disease.
What condition is the patient likely experiencing? - ANSWER-Meningitis
Which component of the history is most crucial when assessing a potential stroke
patient? - ANSWER-Time of onset
The determination of a working diagnosis is dependent on the provider's assessment,
critical thinking and ____________________ __________________________ skills. -
ANSWER-Pattern recognition
When performing a patient assessment, what information provides the most essential
information in determining a working diagnosis? - ANSWER-Medical history
Clinical reasoning requires the healthcare provider to: - ANSWER-Process relevant
information, filter out irrelevant information
According to the AMLS Assessment Pathway, determining whether a patient is "Sick or
Not Sick" is initially done which component of the assessment process? - ANSWER-
First impression
Select an example of a communication barrier that impairs an efficient and thorough
assessment process. - ANSWER-The patient can't find his hearing aid
Healthcare providers are treating an unresponsive patient who overdosed on
lorazepam. What intervention should be initiated? - ANSWER-Airway support

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Addison Disease s/s - ANSWER-chronic fatigue, and weakness, loss of appetite with
consequent weight loss, hyperpigmentation of the skin
Aldosterone - ANSWER-causes the kidneys to reabsorb sodium from the renal tubules,
sodium carries water back into the vasculature to help increase BP, also creates
sensation of thirst which is the first sign of shock.
Alpha & Beta Response to Shock - ANSWER-Alpha1-triggers vasoconstriction
Beta 1- stimulates heart rate and cardiac contractility
Anaphylactic Treatment - ANSWER-Epi: 1:1,000- 0.3-0.5mg SQ every 5-15min prn
Epi: 1:10,000-0.3-0.5mg IV ovr 3-10 min every 15min prn
Bendryl 25-50mg
Angioedema - ANSWER-sudden swelling of head or neck structure such as
lip,earlopes,tongue,uvula, assoc. with rash,dyspnea,anxiety,stridor,wheezing
BP for fluid challenge - ANSWER-80-90 Systolic
BP for Neuro Problems - ANSWER-110-120 Systolic
Cardiogenic Shock - ANSWER-cool,clammy,pale,cyanotic,tachypnea,tachycardia or
abnormal rythm, decreased BP
TX-5-10 ML/KG fluid challenge
Cauda Equina Syndrome - ANSWER-nerves exiting the lumbar spine become
compressed, causing lower extremity pain, paralysis from trauma,tumor,disk hernaition
Criteria to Establish Ventilation - ANSWER-Paco2 <55 mm Hg
Paco2 > 50
PH < 7.32
Croup - ANSWER-Infection leading to swelling in the throat, pt presents with "barking"
cough, stridor, hoarseness
Distributive Shock (dilated vessels) - ANSWER-Septic,anaphylactic,neurogenic,toxins
Graves Disease - ANSWER-increase in thyroid hormones, an autoimmune disease
which disease which produces antibodies
Head Injuries with Increasing Icp - ANSWER-Hyperventilate
Hypercarbia - ANSWER-Physical condition of having the presence of an abnormally
high level of carbon dioxide in the circulating blood.

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Hyponatremia - ANSWER-Is an electrolyte disturbance in which the sodium ion
concentration in the serum is lower than normal.
Hypovolemic Shock - ANSWER-cool,clammy,pale,cyanotic,decreased
BP,ALOC,decreased cap. refill
TX-20 ML/KG fluid challenge
Life Threats - ANSWER-Upper Airway Obstruction (noise/swelling)
Severe decrease in consciousness
Ludwigs Angina - ANSWER-infection of the anterior neck below the mandible
swelling of the tongue,drooling,airway obstruction
Normal Capnography Reading - ANSWER-32-43 mm HG.
Obstructive Shock - ANSWER-Decreased BP, difficulty breathing,
tachycardia,tachypnea,JVD,decreased breath sounds,muffled heart tones.
PEEP Common Settings - ANSWER-5-20 cm H2O
PEEP - ANSWER-Positive End Expiratory Pressure delivered at the end of exhalation.
Pericarditis S/S - ANSWER-sitting forward or sleep propped up with pillows
fever,chills,fatigue,malaise, global ST elevation
Pert. Negative & Positives - ANSWER-Recent Illness/Injury
N/V
Head Ache/Chills
Abdom. Pain/Chest Pain/SOB
Pedal Edema
Stool & Urine Normal
Eat & Drinking Normally
Renin-Angiotensin - ANSWER-renin-angiotensin-tirggers vasoconstriction to vessels
farthest away from vital organs, to keep perfusion going to brain,heart,lungs and liver
causing other organs to become ischemic
ABDOMEN:
Boerhaaves Syndrome - ANSWER-Spontaneous rupture of the esophagus
S/S - mediastinitis, sepsis, and shock. Swallowing often aggravates the pain
ABDOMEN:
Cholangitis - ANSWER-infection of the common bile duct; the tube that carries bile from
the liver to the gall bladder
ABDOMEN:

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Coffee Ground Emesis - ANSWER-Vomiting of partially digested blood - (GI
BLEEDING)
ABDOMEN:
Colitis - ANSWER-Clostridium difficile (C. diff)
a. s/s - n/v, foul smelling, watery, green, diarrhea, fever, loss of appetite, abd pain
b. Tx - PPE, IV clean all equipment very good
c. Antibiotic therapy, which suppresses the normal flora in the GI tract and allows C. diff
to predominate
ABDOMEN:
Cullen Sign - ANSWER-bruising around the belly button that may indicate intra-
abdominal bleeding or PANCREATITIS.
-Cullen's got the belly button tattoos (bruises) and pancreas is in the middle
ABDOMEN:
Diverticultis - ANSWER-Diverticulum is a weak area in the colon that begins to have
small outcroppings that turn into pouches. These become inflamed.
ABDOMEN:
Feculant Vomiting - ANSWER-- Foul Smelling vomit with a feculent odor- (BOWEL
OBSTRUCTION)
ABDOMEN:
Gray turners sign - ANSWER-bruising in the flanks, indicative of pancreatitis
ABDOMEN:
Hemataemesis- - ANSWER-vomiting of blood-(UPPER GI BLEEDING)
BRIGHT RED - INDICATIVE OF ACTIVE BLEEDING
ABDOMEN:
Hematochezia - ANSWER-bright red blood in the stool. (LOWER GI BLEEDING)
INDICATIVE OF ACTIVE BLEEDING
ABDOMEN:
Hepatic Encephalopathy - ANSWER-Decreased brain function caused by diminished
liver functions
S/S: confusion, LOC, Coma, as a result of liver failure
ABDOMEN:
Identify the Signs/Symptoms and Treatment for the following medical condition:
Appendicitis - ANSWER-INFLAMMATION OF THE APPENDIX:
periumbilical pain. n/v, low grade fever, loss of appetite. Pain rlq, rebound tenderness
-Fecal matter or other material accumulates in the appendix. Pressure builds and
decreases blood flow. This causes an uncontrolled rise in bacteria

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TX: pain and anti nausea meds
ABDOMEN:
Identify the Signs/Symptoms and Treatment for the following medical condition: Bowel
Obstruction - ANSWER-S/S: crampy abdominal pain, constipation or diarrhea, inability
to pass flatus, distended abdomen, absent or high-pitched bowel sounds.
tx: administer oxygen, place pt in comfortable position, establish iv, give nothing PO
ABDOMEN:
Identify the Signs/Symptoms of Gastroenteritis - ANSWER-Abdominal pain/tenderness,
myalgia, and headache. Vomiting may occur, followed by colitis, which causes visible
Blood in the stool. (3-7 days). Watery, yellow, green, or bloody stool, or stools
containing pus. Also look for signs of dehydration or shock
ABDOMEN:
Kehrs Sign - ANSWER-Abdominal pain that radiates to the Left Shoulder, could indicate
irritation of the DIAPHRAGM OR SPLEEN INVOLVEMENT (Irritants in the peritoneal
cavity)
-Steve Kerr shoots the ball goofy and from his abdomen to the left shoulder
ABDOMEN:
Liver Abscess - ANSWER-puss-filled mass inside the liver
ABDOMEN:
Mallory Weiss Syndrome - ANSWER--A condition in which the junction between the
esophagus and the stomach (Cardiac Sphincter) tears, causing severe bleeding and
potentially death
-Secondary to eating disorders, caused by alcoholism, retching, coughing or vomiting.
ABDOMEN:
Melena - ANSWER-black tarry feces that contains digested blood - (UPPER GI
BLEEDING).
ABDOMEN:
Murphy's Sign - ANSWER-Press firmly upward into the RUQ and ask the patient to take
a deep breath. Arrest of inspiration because of pain is a positive finding. This could
indicate a GALL BLADDER OR HEPATIC PROBLEM
-Dale Murphy took a fastball in RUQ and knocked wind out of him (RUQ is where gall
bladder is)
ABDOMEN:
Pancreatitis - ANSWER-S/S- pain to epigastric area or RUQ, radiate to back, n/v fever,
tachycardia, hypotension, muscle spasms to ext, Cullen, grey turners
TX:- IV, pain management.

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