Approach to hypoglycemia Quiz: Ace Your Exams
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A 66-year-old man is brought by ambulance to the emergency department for evaluation of altered mental status. EMS reports the patient was found down at home by his neighbor who checked on him after not hearing from him for several days. The patient has a past medical history of hypertension, hyperlipidemia, recently diagnosed severe depression, and osteoarthritis. Medications include metoprolol, ketorolac, simvastatin, and sertraline. The patient has a history of alcohol use disorder and smokes 1-2 packs of cigarettes daily. Temperature is 35.6°C (96°F), blood pressure is 85/60 mmHg, pulse is 47/min, respiratory rate is 12/min, and oxygen saturation is 92% on room air. The patient appears pale, diaphoretic and unable to be aroused. Fingerstick blood glucose is 33 mg/dL. IV glucose is administered, with subsequent improvement in mentation. Which of the following is the most likely cause of this patient's presentation?
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