05-10-2007, 09:38 PM
A 57-year-old man is brought to the emergency department 6 hours after the onset of weakness of his right face, arm, and leg. Three days ago, he had an episode of sudden visual loss in his left eye that he describes as "a shade coming down." The episode resolved completely within 10 minutes. He has hypertension and type 2 diabetes mellitus, both poorly controlled with lisinopril and glyburide. Examination shows expressive aphasia and right lower facial droop. There is moderate weakness on the right, worse in the upper extremity than the lower extremity. Deep tendon reflexes are 3+ in the right extremities and 2+ in the left extremities. Babinski's sign is present on the right. Sensory examination shows no abnormalities.
For each patient with weakness, select the most appropriate test to establish the cause of the condition.
A
) Brain stem auditory evoked potentials
B
) Carotid ultrasonography
C
) Chromosomal analysis for trinucleotide repeat
D
) Electroencephalography
E
) Electromyography and nerve conduction studies
F
) MRI of the spine
G
) Muscle biopsy
H
) Repetitive nerve stimulation
I
) Somatosensory evoked potentials
J
) SPECT scan
K
For each patient with weakness, select the most appropriate test to establish the cause of the condition.
A
) Brain stem auditory evoked potentials
B
) Carotid ultrasonography
C
) Chromosomal analysis for trinucleotide repeat
D
) Electroencephalography
E
) Electromyography and nerve conduction studies
F
) MRI of the spine
G
) Muscle biopsy
H
) Repetitive nerve stimulation
I
) Somatosensory evoked potentials
J
) SPECT scan
K