A 70-Year-Old Man Is Brought to the Emergency Department Due

question 594

Multiple Choice

A 70-year-old man is brought to the emergency department due to left-sided weakness and slurred speech upon awakening 30 minutes ago.  The patient was asymptomatic when he went to bed last night.  Medical history includes type 2 diabetes mellitus, hypertension, and hyperlipidemia.  The patient is a former smoker with a 30-pack-year history.  Physical examination shows a right gaze preference, left lower facial droop, and hemiplegia and hemisensory loss on the left.  CT scan of the brain reveals early infarction in the right middle cerebral artery territory with no acute hemorrhage.  The patient is hospitalized for further management.  Several hours later, he becomes progressively obtunded with elevated intracranial pressure.  A repeat CT scan reveals edema in the region of acute infarction causing mass effect.  Which of the following is the primary contributor to the pathogenesis of this patient's raised intracranial pressure?

• A)Decrease in plasma oncotic pressure
• B)Failure of ATP-dependent ion transporters
• C)Inadequate absorption of cerebrospinal fluid
• D)Increase in capillary hydrostatic pressure
• E)Proliferation of astrocytes and microglia

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Definitions:

Angular Rocks

Rocks characterized by sharp edges and corners, typically resulting from mechanical weathering or fracturing.

Glacier

A moving mass of ice, snow, rock, and other sediment.

Mountain Front

The boundary where the steep slopes of a mountain range meet the adjacent relatively flat terrain or valley.

Evaporation

The process by which a substance passes from a liquid to a vapor.