A 45-Year-Old Previously Healthy Man Is Brought to the Emergency

question 1245

Multiple Choice

A 45-year-old previously healthy man is brought to the emergency department due to headaches and confusion for 2 days.  He has no focal weakness or sensory symptoms.  The patient has no significant past medical history and does not take any medications.  He does not use tobacco, alcohol, or illicit drugs. Temperature is 37.9 C (100.2 F) , blood pressure is 140/86 mm Hg, pulse is 96/min, and respirations are 16/min.  Mild icterus is present.  His neck is supple and without rigidity.  Cardiopulmonary and abdominal examinations are normal.  Neurologic examination shows no focal deficits.  Laboratory results are as follows: A peripheral blood smear shows many fragmented red blood cells.  The prothrombin time is normal.  Which of the following is the most appropriate next step in the management of this patient?

• A)Cryoprecipitate infusion
• B)Hemodialysis
• C)MRI of the brain
• D)Packed red blood cell transfusion
• E)Plasma exchange
• F)Platelet transfusion
• G)Urine drug screen
• H)Whole blood transfusion

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Definitions:

Denial

A defense mechanism in which confrontation with a personal problem or with reality is avoided by denying the existence of the problem or reality.

Parietal Lobe

A region of the brain associated with processing sensory information regarding the location of parts of the body as well as visual information.

Hockey Player

An athlete who participates in the sport of hockey.

Brain Damage

Injury to the brain that impairs its functions, possibly resulting from trauma, disease, or other health conditions, affecting cognitive, physical, or emotional well-being.