A 33-Year-Old Female Complains of Episodes of Weakness of the Left

question 6

Multiple Choice

A 33-year-old female complains of episodes of weakness of the left side of the face.Drooping of the left eyelid and weakness of the jaw muscle develops gradually throughout the day,and it is worse at night than the morning.The patient has a medical-surgical history of cholecystectomy at age 30.Otherwise,patient has no history of illness and takes no medications.Denies use of tobacco or alcohol.On physical examination,vital signs are T 98 degrees,18 resps/min,pulse 66,and BP 110/60.Ptosis of the left eyelid is noted.Vision: 20/20 os,20/20 od,and 20/20 ou.Heart: regular rate and rhythm,no murmurs.Lungs are clear to auscultation.Abdomen is non-tender with no organomegaly.Extremities: Skin is pink,cool to touch,and intact bilaterally.Left and right quadriceps muscle strength 5/5.DTRs left and right + 2/4.No clonus.Negative Homan's and Babinski's sign.Sensation to pinprick and cotton ball intact in extremities and equal bilaterally.Dorsalis pedis pulses +1/4 bilaterally.Eyelids: left-sided ptosis.No facial droop.Left and right cheek sensation to pinprick and cotton ball intact.Masseter muscle: 2/5 left versus 5/5 on right.EOMs intact.Gag reflex: uvula midline gag intact.Shrug and sternocleidomastoid muscle strength 5/5 bilaterally.Tongue: midline and strength 5/5 bilaterally.The following disorder(s) should be considered in the diagnosis:

• A) Bell's palsy
• B) Stroke
• C) Myasthenia gravis
• D) Multiple sclerosis

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Definitions:

Elaboration

The process of adding more detail or information to something, often used to enhance memory or understanding.

First Five Presidents

Refers to the initial five presidents of the United States: George Washington, John Adams, Thomas Jefferson, James Madison, and James Monroe, who served in office from 1789 to 1825.

Selective Attention

The cognitive process of focusing on a specific aspect of information while ignoring other perceivable information.

Divided Attention

Refers to the ability to process two or more responses or react to two or more different demands simultaneously.