A 4-Year-Old Boy Is Brought to the Emergency Department with Dehydration

A 4-year-old boy is brought to the emergency department with dehydration.  He has had several days of decreased oral intake, and today his parents could not get him to drink anything.  The patient has received no vaccinations due to parental beliefs.  Vital signs are normal except for mild tachycardia.  Physical examination shows decreased skin turgor and sunken eyes.  His jaw muscles are tight.  Neurologic examination shows increased tone throughout and 3+ patellar reflexes.  There is a small, healed puncture wound on his lower leg.  The father says that the boy fell on a piece of chain-link fence in their backyard last week.  Release of which of the following neurotransmitters is most likely to be directly impaired in this patient?

A) Acetylcholine
B) Dopamine
C) Glutamate
D) Glycine
E) Serotonin

Correct Answer:

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