06-22-2014, 06:17 AM
8. A 77-year-old woman is brought to the emergency department by paramedics 1 hour after the sudden onset of right-sided weakness and difficulty speaking. Her son found her at home after he became concerned because he did not get his usual morning phone call. She has a history of hypertension and hypercholesterolemia treated with a β-adrenergic blocking agent and a lipid-lowering agent. Her pulse is 72/min, and blood pressure is 160/90 mm Hg. During examination, she is only able to give single-word answers with many paraphasic errors. She has good comprehension. Examination shows normal visual fields. There is weakness of the right side of the mouth. Muscle strength of the right upper extremity is 2/5. There is mild weakness of flexion of the right hip; muscle strength of the right lower extremity is otherwise normal. Sensation to pinprick is decreased over the right upper extremity. Deep tendon reflexes are more brisk on the right side than the left, and Babinski sign is present on the right. Which of the following arteries is most likely to be occluded?
A
) Basilar
B
) Left anterior cerebral
C
) Left internal carotid
D
) Left middle cerebral
E
) Left ophthalmic
F
) Left posterior cerebral
G
) Right anterior cerebral
H
) Right internal carotid
I
) Right middle cerebral
J
) Right ophthalmic
K
) Right posterior cerebral
A
) Basilar
B
) Left anterior cerebral
C
) Left internal carotid
D
) Left middle cerebral
E
) Left ophthalmic
F
) Left posterior cerebral
G
) Right anterior cerebral
H
) Right internal carotid
I
) Right middle cerebral
J
) Right ophthalmic
K
) Right posterior cerebral