nbme 6 - sheetal044

[ArchivalUser]

A 67 year-old male comes to the emergency department 1 hour after the onset of vertigo, nausea and imbalance. He has a 20 year history of poorly controlled hypertension. Pulse 70, reap 20, BP 210/115. Examination shows a small right pupil, mild right ptosis and nystagmus. Neuro exam shows weakness of right palate. Sensation to pinprick is decrease over right side of face and left extremities. There is incoordination on finger-nose testing and heel-knee-shin testing on the right. Which of the following arteries is most likely occluded?

a) anterior spinal
b) basilar
c) lt ant cerebral
d) lt internal carotid
e) lt middle cerebral
f) lt post cerebral
g) lt vertebral
h) post sinal
i) rt ant cerebral
j) rt internal carotid
k) rt middle cerebral
l) rt vertebral

[ArchivalUser]

L right vertebral. lesion of the lateral medulla gives homolateral face and cerebellar symptoms, and contralateral body sensorial deficits (spinotalamic tract)- PICA involvement is the second most common