. 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?
Stroke
Migraine
Hypoglycemia
Transient ischemic Attack (TIA)
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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Correct Answer is D
Explanation
A. Hypotension: Patients with SIADH typically have fluid retention, which can lead to hypertension, not hypotension.
B. Dry mucous membranes: In SIADH, fluid retention is common, so mucous membranes are usually moist, not dry.
C. Increased thirst: While thirst can occur in various conditions, it is not a primary symptom of SIADH.
D. Confusion or altered mental status: Confusion or altered mental status may occur in SIADH due to hyponatremia from excessive water retention.
Correct Answer is A
Explanation
A. Otosclerosis. Otosclerosis is a common cause of conductive hearing loss, typically due to abnormal bone growth around the stapes in the middle ear.
B. Acoustic neuroma. Acoustic neuroma is associated with sensorineural hearing loss, not conductive hearing loss.
C. Meniere's disease. Meniere's disease usually causes sensorineural hearing loss, often accompanied by vertigo and tinnitus.
D. Presbycusis. Presbycusis is age-related sensorineural hearing loss and does not result in conductive hearing loss.