. 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 B
Explanation
A. The gallbladder became infected by a virus and needs to be removed. Gallstones are not caused by viral infections; they typically develop from an imbalance in the substances that make up bile, such as cholesterol and bilirubin.
B. The gallbladder has become inflamed due to the cholesterol in the gallstones. Cholesterol is a common component of gallstones, and these stones can cause inflammation of the gallbladder (cholecystitis), leading to the need for removal.
C. The gallbladder has become blocked by a tumor and is no longer working. Tumors can obstruct the gallbladder, but this is not the cause of gallstones or the primary reason for a cholecystectomy.
D. The gallbladder has become inflamed due to a build-up of gallstones that are blocking the common bile duct. This describes choledocholithiasis, a condition where gallstones block the common bile duct, but it is not the primary cause of gallbladder inflammation requiring a cholecystectomy.
Correct Answer is B
Explanation
A. Conjunctivitis. Conjunctivitis generally presents with redness and discharge but does not cause elevated intraocular pressure, severe pain, or visual disturbances like halos.
B. Acute angle-closure glaucoma. Acute angle-closure glaucoma is characterized by sudden severe eye pain, blurred vision, halos around lights, nausea, and vomiting, along with elevated intraocular pressure and a cloudy cornea.
C. Retinal detachment. Retinal detachment may cause sudden vision loss or flashing lights but typically lacks pain, nausea, or vomiting, and does not affect intraocular pressure.
D. Migraine with aura. A migraine with aura may cause visual disturbances but does not present with eye pain, red eye, or elevated intraocular pressure.