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The answer is c.
The patient never got a finger stick at triage. Hypoglycemia can mimic a cerebrovascular accident or seizure. Therefore, it is critical that all patients who present with altered mental status get a finger stick glucose. It should be considered a vital sign. Hypoglycemia is a common problem in patients with type 1 diabetes. The clinical presentation of hypoglycemia is caused by increased secretion of epinephrine and CNS dysfunction. They include diaphoresis, nervousness, tremor, tachycardia, hunger, and neurologic symptoms ranging from confusion, bizarre behavior to seizures and coma.
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