MSFinals-4901

MSFinals-4901

A 28-year-old construction worker is brought to the emergency department after being found unconscious at his worksite by his colleagues. He was found with an empty bottle of an unknown substance. There is no past medical history of note and he takes no regular medications.

Upon examination, he is disoriented and restless with a GCS of 10. His eyes and nose are watering and there is dried vomitus around his mouth. There is reduced air entry bilaterally with a respiratory rate of 8 breaths/min and there is evidence of muscle fasciculations.

Based on the probable diagnosis, which of the following examination findings is most likely to be present?