Neurology : PreTest self-assessment and review by David Anschel; Franklin Chen; Brandon Hill; Alberto

By David Anschel; Franklin Chen; Brandon Hill; Alberto Ramos-Sepulveda; Mitchell S V Elkind

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Sample text

A 24-year-old woman abruptly loses all speech during the third trimester of an otherwise uncomplicated pregnancy. She has a history of severe migraines during which she occasionally develops a transient right hemiplegia. Her comprehension is good, and she is frustrated by her inability to speak or write. She is unable to repeat simple phrases, but she does begin to produce simple words within 5 days of the acute disturbance of language. (SELECT 1 DISTURBANCE) 70. A 78-year-old man suffers a cardiac arrest while being treated in an emergency room for chest pain.

The acidosis that is observed in this patient is inconsequential and is routinely found during the early postictal period after a generalized tonic-clonic seizure. 39. The answer is d. ) This man with fever, generalized seizure, lethargy, cough, headache, blurred vision, and progressive stupor probably has an acute bacterial meningitis. Given his age of 72 and history of probable upper respiratory infection, a pneumococcal meningitis is highly probable. In bacterial meningitis, the CSF typically exhibits an elevated protein content, no or few RBCs, an elevated opening pressure, milky or xanthochromic fluid, and a normal or slightly elevated gamma globulin content.

Deficits develop as the person matures and may be a consequence of focal ischemia in the cerebral cortex that underlies the leptomeningeal angioma. Hemangioblastomas are vascular tumors seen in association with polycystic disease of the kidney and telangiectasias of the retina (von Hippel-Lindau syndrome). Charcot-Bouchard aneurysms are very small and may be microscopic. They develop in patients with chronic hypertension and most commonly appear in perforating arteries of the brain.

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