A 60-Year-Old Professor Is Brought to the Emergency Department After

question 93

Multiple Choice

A 60-year-old professor is brought to the emergency department after developing right-sided weakness and numbness during a lecture an hour ago.  He also has nausea and confusion.  The patient smoked a pack of cigarettes daily for 20 years but quit 10 years ago.  He does not drink alcohol.  His father died of myocardial infarction at age 70.  Blood pressure is 190/100 mm Hg, and pulse is 60 /min.  On physical examination, there are no signs of head trauma.  There is diminished right-sided strength (1/5) and an upgoing plantar reflex.  Brain CT without contrast is obtained immediately.  The image is shown below. Which of the following is the most likely cause of this patient's condition?

• A)Arteriovenous malformation
• B)Cardiac embolism
• C)Carotid artery atherosclerosis
• D)Cerebral amyloid angiopathy
• E)Charcot-Bouchard aneurysm
• F)Hypertensive encephalopathy
• G)Hypoxic encephalopathy
• H)Large vessel arteritis
• I)Saccular aneurysm

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Definitions:

Assimilation

The cognitive process of integrating new information into existing cognitive structures and beliefs.

Accommodation

The process by which the eye's lens changes shape to focus near or far objects on the retina or can also refer to adjustments made in beliefs or behavior in response to new information or experiences.

Schematic Restructuring

A cognitive process involving the reorganization or modification of mental structures to incorporate new information or experiences.

Secondary Circular Reactions

The repetition of actions that produce an interesting effect, part of Piaget's theory of cognitive development in infants, occurring roughly between 4 to 8 months of age.