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Mr. Jenkins was brought to the emergency department by his daughter, who reports that he has been increasingly lethargic over the past two days. He has complained of abdominal discomfort, particularly in the upper abdomen, and has been less responsive today. She also notes that his skin feels dry, and he has mentioned numbness and tingling in his fingers. He has a history of chronic obstructive pulmonary disease (COPD), Diabetes Mellitus type 2, and chronic back pain. He has been using opioid pain medication more frequently over the past week due to worsening back pain. Medication History: Oxycodone 10 mg PO every 4–6 hours PRN for chronic back pain Albuterol inhaler PRN for COPD Tiotropium inhaler once daily Omeprazole 20 mg PO daily for GERD Multivitamin daily Insulin sliding scale Physical Examination: General: Appears drowsy, slow to respond to questions Skin: Dry, cool to touch Neurological: Decreased sensation in fingertips bilaterally Abdomen: Mild tenderness in the epigastric region, no rebound or guarding, moderate emesis overnight, 350ml, nasogastric tube in place to low intermittent suction, 100ml output over the last 2 hours. Respiratory: Shallow breathing, diminished breath sounds bilaterally Cardiovascular: Regular rhythm, no murmurs Vital Signs: Temperature: 98.2°F (36.8°C) Heart Rate: 88 bpm Respiratory Rate: 10 breaths/min Blood Pressure: 132/78 mmHg Oxygen Saturation: 91% on room air Laboratory Findings: Arterial Blood Gas (ABG): pH: 7.28 PaCO₂: 58 mmHg HCO₃⁻: 26 mmol/L PaO2: 80mmHg blood glucose 101 mg/dL Based on your assessment the patient is most likely experiencing [BLANK-1] secondary to [BLANK-2] Blank 1 Blank 2 metabolic acidosis opioid use respiratory acidosis recent emesis metabolic alkalosis diabetic ketoacidosis metabolic acidosis nasogastric loss

The calcareous sieve opening into the water vascular system of echinoderms is called the_____________________ but structures that keep the body surface clean of debris and protect the skin gills of sea stars are called __________________________.

Which neurological condition is characterized as a progressive, degenerative disease affecting both the UMN and LMN (sensory system remains intact) with cause of death most often attributed to respiratory failure? 

A disease characterized by a triad of symptoms including polyarthritis, urethritis, and conjunctivitis is 

What test is considered the gold standard for the diagnosis of meningitis? 

Which of the following neurological conditions is most likely expected in an individual who experiences dizziness, slurred speech, limb weakness, and brief loss of consciousness with symptom resolution within 24-48 hours? 

Which of the following types of seizures is characterized by loss of consciousness, stiffness and shaking, loss of bladder control? 

Which of the following spinal pathologies is a fracture resulting in anterior slippage of the superior vertebral disk on the lower vertebral disk, creating a “Scotty Dog” appearance? 

High doses of acetaminophen can be especially toxic to the:

Which of the following brain structures serves as a relay station for sensory pathways and receives input from teh sensory cortex (hint: We talked about this being like a mail center separating priority from regular mail)?