Weakness and Dizziness 379357.A 46-year-old woman presents to the ED with her husband complaining
of flu-like symptoms, headache, vomiting, and dyspnea. She states that she
never had similar symptoms in the past and that her husband is getting sick
with similar symptoms as well but refuses to see a doctor. She reports feeling
well yesterday and even helped her husband set up a home generator in
their garage. Her BP is 142/85 mm Hg, HR is 97 beats per minute, temperature
is 100.6°F, and RR is 20 breaths per minute. On examination the patient is
slow to respond to questions. Which of the following is the most appropriate
diagnostic test?
a. Send blood to check the white blood cell (WBC) count.
b. Order a head CT scan.
c. Send blood to check the carboxyhemoglobin level.
d. Perform an LP.
e. No testing is necessary at this point.
358.An 82-year-old right-handed woman is brought to the ED by her
daughter stating that her mother has not been able to walk after waking up
from a nap 30 minutes ago. The patient has a history of hypertension and
diabetes. Her BP is 179/76 mm Hg, HR is 91 beats per minute, temperature is
98.9°F, and RR is 14 breaths per minute. On examination, you elicit neurologic
deficits and emergently bring her to the CT scanner. The radiologist tells you
there is an abnormality in the left parietal lobe and a likely middle cerebral
artery stroke. Which of the following motor deficits are you likely to find in this
patient?
a. Right sensorimotor deficit in arm greater than leg and aphasia
b. Left sensorimotor deficit in arm greater than leg and aphasia
c. Right sensorimotor deficit in leg greater than arm, slowed response to questions,
and impaired judgment
d. Right motor deficit and left facial droop
e. Right leg hemiplegia only