A patient presents to the emergency department (ED) with a two-hour history of hemiparesis of the right arm and leg. Also, it is noted during assessment (examination) that the left side of her face moves normally, but the other side droops. Identify the item which helps to explain the connection between the pathophysiology of this illness and the pattern of signs and symptoms (555)

Ischemia of the brain tissue is causing cellular injury, swelling and malfunction of the contralateral side

The functioning of the right cranial nerve controlling facial movement is compromised by cerebral edema

The sensorimotor tracts leading from the brain to the body decussate and control the arm and leg on the same side as the lesion,

The corticospinal tracts leading from the brain to the body decussate and control the ipsilateral arm and leg.

Answer and Explanation

The Correct Answer is A

A. Ischemia of the brain tissue is causing cellular injury, swelling, and malfunction of the contralateral side: Hemiparesis occurs on the side opposite to the brain lesion due to the crossing (decussation) of motor pathways.

B. The functioning of the right cranial nerve controlling facial movement is compromised by cerebral edema: While facial nerve involvement can cause drooping, the hemiparesis suggests a central (brain) rather than peripheral issue.

C. The sensorimotor tracts leading from the brain to the body decussate and control the arm and leg on the same side as the lesion: This is incorrect because the tracts control the contralateral side of the body.

D. The corticospinal tracts leading from the brain to the body decussate and control the ipsilateral arm and leg: This is incorrect; the corticospinal tracts control the contralateral side.

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Correct Answer is D

Explanation

A. Hyperproteinemia and increased drug effect: In cirrhosis, hypoproteinemia (low protein levels) occurs due to decreased protein synthesis by the liver, and drug metabolism is often impaired, leading to increased drug effects, but hyperproteinemia is not a typical finding.

B. Hyperkalemia and fluid retention: While fluid retention is common due to hypoalbuminemia and portal hypertension, hyperkalemia is not a direct consequence of hepatocyte dysfunction.

C. Hypercortisolism and increased infection risk: Hypercortisolism is not typically associated with cirrhosis. However, increased infection risk is common due to compromised immune function.

D. An elevated blood glucose and ammonia level: In cirrhosis, the liver's ability to metabolize ammonia is impaired, leading to elevated levels. Additionally, impaired glucose metabolism can result in hyperglycemia.

A. adherence to a low-fat diet. B. the administration of clot busting drugs. C. reporting any signs of heat or cold intolerance. D. avoiding red wine and chocolate.

Correct Answer is A

Explanation

A. Adherence to a low-fat diet: The patient likely experienced a transient ischemic attack (TIA), which is a warning sign for future strokes. A low-fat diet is recommended to help manage cholesterol and reduce the risk of atherosclerosis and stroke.

B. The administration of clot-busting drugs: Clot-busting drugs (thrombolytics) are used in the acute management of a stroke, but this patient’s symptoms resolved spontaneously, and the focus is on prevention.

C. Reporting any signs of heat or cold intolerance: This is unrelated to the prevention of stroke or management after a TIA.

D. Avoiding red wine and chocolate: While moderation in alcohol and certain foods is generally advised for overall health, this specific recommendation does not address the primary concern of preventing future cerebrovascular events.

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A. High unconjugated, low direct: In liver disease, both conjugated (direct) and unconjugated bilirubin levels are typically elevated.

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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