Medical Emergencies · single question
A patient develops diaphoresis (sweating) and begins to convulse in the dental chair. What is the most likely diagnosis?
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Correct answer: C. Hypoglycemic emergency (insulin shock)
Acute onset of diaphoresis (adrenergic response to low blood glucose) followed by seizures in the dental chair strongly suggests HYPOGLYCEMIA (low blood sugar). The adrenergic surge causes sweating, tremor, and anxiety; severe hypoglycemia causes neurological symptoms including seizures and loss of consciousness.
- A. ❌ Vasovagal syncope presents with pallor, bradycardia, and brief LOC — not diaphoresis followed by seizures.
- B. ❌ DKA has a gradual onset with polyuria, dehydration, fruity breath — not acute diaphoresis-seizure.
- C. ✅ Hypoglycemia — acute diaphoresis (adrenergic response) followed by seizures is the classic severe hypoglycemia pattern.
- D. ❌ Idiopathic epilepsy does not begin with the characteristic adrenergic diaphoresis of hypoglycemia.
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