A 56 year old man with history of diabetes, stroke, and hypertension presents to the Emergency Room with a laceration to his forehead after a fall. Patient says he woke up in the morning and walked to the bathroom to get ready as usual for work. His spouse, who was with him during the episode, stated that the patient said he felt lightheaded, and hit the edge of the bed as he fell to the floor. There was some shaking of both arms and legs with unresponsiveness for about 5 seconds and the patient awoke quickly. Upon awakening, the patient complained of pain where he hit his head. He was able to answer questions and seemed back to his baseline. On arrival to the emergency room, he is awake and his neurological exam is intact. He denies any headache except for tenderness in the forehead. His brain scan shows only a scalp hematoma with no intracranial hemorrhage and an old infarct in the right basal ganglia. His labs and electrocardioagram are all within normal limits except an elevated blood sugar of 180 milligrams/deciliter (mg/dL) (normal<140 mg/dL). What is the most likely cause of his transient loss of consciousness?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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  1. A 56 year old man with history of diabetes, stroke, and hypertension presents to the Emergency Room with a laceration to his forehead after a fall. Patient says he woke up in the morning and walked to the bathroom to get ready as usual for work. His spouse, who was with him during the episode, stated that the patient said he felt lightheaded, and hit the edge of the bed as he fell to the floor. There was some shaking of both arms and legs with unresponsiveness for about 5 seconds and the patient awoke quickly. Upon awakening, the patient complained of pain where he hit his head. He was able to answer questions and seemed back to his baseline. On arrival to the emergency room, he is awake and his neurological exam is intact. He denies any headache except for tenderness in the forehead. His brain scan shows only a scalp hematoma with no intracranial hemorrhage and an old infarct in the right basal ganglia. His labs and electrocardioagram are all within normal limits except an elevated blood sugar of 180 milligrams/deciliter (mg/dL) (normal<140 mg/dL). What is the most likely cause of his transient loss of consciousness?
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