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. A 65-year-old patient presents to the emergency department with sudden numbness and weakness in the face, arm, and leg on one side of the body difficulty speaking, and severe headache with no known cause. Which of the following is the most likely diagnosis?

A.

Stroke

B.

Migraine

C.

Hypoglycemia

D.

Transient ischemic Attack (TIA)

Answer and Explanation

The Correct Answer is A

A. Stroke: The sudden onset of one-sided weakness, numbness, difficulty speaking, and severe headache are classic symptoms of an acute stroke, where blood flow to part of the brain is interrupted, leading to neurological deficits.

 

B. Migraine: While migraines can cause headache and some neurological symptoms, they usually include visual disturbances, nausea, or photophobia rather than one-sided weakness and numbness.

 

C. Hypoglycemia: Hypoglycemia can cause confusion, weakness, and headache, but it typically lacks the focal neurological symptoms, like one-sided weakness and numbness.

 

D. Transient Ischemic Attack (TIA): A TIA can cause similar symptoms, but the deficits are usually transient and resolve within 24 hours without lasting neurological damage. Persistent symptoms are more indicative of a stroke.


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View Related questions

Correct Answer is B

Explanation

A. Inflammation of the motor cortex leads to decreased coordination and balance. Parkinson’s disease is not caused by inflammation in the motor cortex; it primarily involves the loss of dopamine-producing neurons.

B. Degeneration of dopamine-producing neurons in the substantia nigra of the brain leads to motor dysfunction. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the substantia nigra, leading to motor symptoms such as tremors, rigidity, and bradykinesia.

C. A loss of acetylcholine in the brain leads to memory problems and cognitive decline. While a loss of acetylcholine is associated with Alzheimer’s disease, it is not the primary issue in Parkinson’s disease.

D. Excess production of dopamine in the basal ganglia leads to tremors and muscle rigidity. In Parkinson’s disease, there is a decrease, not an excess, in dopamine production, which contributes to motor symptoms.

Correct Answer is B

Explanation

A. Keep the patient NPO (nothing by mouth) until the T-tube is removed. Patients are generally kept NPO initially but may resume clear liquids and progress to a regular diet based on tolerance; NPO status is not required until the T-tube is removed.

B. Monitor the tube drainage and document the amount and color. Monitoring and documenting drainage from the T-tube is crucial to assess biliary function and ensure that the bile is draining properly, indicating no obstruction.

C. Ensure the tube is clamped for 8 hours each day. Clamping may be done before tube removal to test the body’s tolerance to bile drainage, but it should be done only as per physician orders, not routinely for 8 hours each day.

D. Flush the T-tube with normal saline every 4 hours. Flushing a T-tube is generally not done routinely as it could disrupt the flow of bile and cause complications.

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