You are on-scene with an adult patient exhibiting unusual activity and appears to be intoxicated. He is anxious and hyperactive. His heart rate and respirations are fast, but his blood pressure remains within normal range for his age. The patient denies alcohol or drug consumption but reports he has diabetes. His blood glucose level is found to be 54 milligrams per deciliter. How would hypoglycemia cause the patient to present with the above findings?

Correct Answer: A

Rationale: The correct answer is A because hypoglycemia triggers a physiological response known as the sympathoadrenal response. When blood sugar levels drop, the sympathetic nervous system is activated, leading to the release of epinephrine from the adrenal glands. Epinephrine promotes liver glycogenolysis, which is the breakdown of stored glycogen into glucose, thereby increasing blood sugar levels. This process helps to counteract the effects of hypoglycemia and provide energy to the body. The other choices are incorrect because: B: Elevated insulin levels would not mimic alcohol intoxication; instead, hypoglycemia causes neuroglycopenic symptoms due to inadequate glucose supply to the brain. C: Adipose tissue does not play a significant role in correcting hypoglycemia through glucose uptake; it is primarily the liver that releases glucose in response to low blood sugar levels. D: Glucagon is released by the pancreas to raise blood sugar levels in response to

Correct Answer: D

Rationale: The correct answer is D: Colloid solution. Colloid solutions contain large molecules like proteins that are too big to pass through the capillary membrane. These large molecules create osmotic pressure, helping to retain fluid within the blood vessels. Hypertonic solutions (A) have higher solute concentration, hypotonic solutions (B) have lower solute concentration, and crystalloid solutions (C) contain small molecules that can easily pass through the capillary membrane.

Correct Answer: C

Rationale: The correct answer is C: Sodium bicarbonate and calcium chloride. During cardiac arrest, the priority is to correct metabolic acidosis and provide adequate calcium for cardiac function. Sodium bicarbonate helps in correcting metabolic acidosis, while calcium chloride supports cardiac contractility. A: Sodium bicarbonate and magnesium sulfate - Magnesium sulfate is not indicated during cardiac arrest, and sodium bicarbonate alone may not address the calcium needs for cardiac function. B: Amiodarone and magnesium sulfate - Amiodarone is used for ventricular arrhythmias, not for asystole, and magnesium sulfate is not the priority in this scenario. D: Potassium and dopamine - Potassium can exacerbate the situation, and dopamine is not recommended as a first-line drug during cardiac arrest. In summary, the correct answer provides the necessary interventions to address metabolic acidosis and support cardiac function during the resuscitation attempt.

Correct Answer: D

Rationale: The correct answer is D because spinal cord injuries can sometimes exist without visible fractures on x-ray studies. It is important to consider the possibility of spinal cord injury even in the absence of objective findings on x-ray. This is because spinal cord injuries can result from trauma that does not necessarily cause bony damage. Therefore, relying solely on x-ray studies to diagnose spinal cord injury may lead to missed or delayed diagnosis. Options A, B, and C are incorrect because central cord syndrome, MRI, and CT-scan are not definitive for ruling out spinal cord injury in the absence of visible fractures.

Correct Answer: D

Rationale: The correct answer is D because diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury. This is due to the fact that unconscious patients rely on their diaphragm for breathing rather than their chest muscles, indicating potential spinal cord trauma affecting the chest muscles' innervation. A: A normal lateral c-spine film does not completely exclude injury, as some injuries may not be visible on imaging. B: Vertebral injury can occur without immediate physical findings of a cord injury. C: Immobilization on a short spine board may not be necessary for all patients with suspected spinal injury, as it depends on individual assessment.