Tia Lauren, a 95 year-old female, presents to the Emergency Department (ED) with, what daughter thought, were stroke-like symptoms that began approximately 6 hours ago. She is brought in by her daughter who she lives with. Her daughter states the symptoms are starting to go away. The daughter also states that maybe she made a mistake thinking her mom may have had a stroke since the symptoms are resolving.
What type of stroke is the patient most likely experiencing and which of the following are common symptoms? (Select all that apply)
Transient Ischemic Attack (TIA)
Hemorrhagic Stroke
Severe vision loss in both eyes
Sudden loss of consciousness
Sudden severe headache with vomiting
Ischemic Stroke
Sudden weakness or numbness, often on one side of the body
Correct Answer : A,G
A. Transient Ischemic Attack (TIA): A TIA presents with stroke-like symptoms that resolve within minutes to hours without permanent damage. Ms. Lauren’s symptom resolution within 6 hours and return to baseline strongly suggests a TIA. Prompt recognition is essential, as TIAs are often precursors to future strokes and require further evaluation.
B. Hemorrhagic Stroke: Hemorrhagic strokes typically present with sudden, severe symptoms such as intense headache, vomiting, or rapid loss of consciousness. These symptoms usually do not resolve quickly. Ms. Lauren’s gradual symptom resolution and stable vital signs are not consistent with this type of stroke.
C. Severe vision loss in both eyes: While visual disturbances can occur during strokes, bilateral severe vision loss is less common and would typically be seen in strokes involving the occipital lobes or vertebrobasilar system. Ms. Lauren’s case does not provide evidence of this symptom, hence an unlikely feature here.
D. Sudden loss of consciousness: Loss of consciousness is more common in massive strokes, particularly hemorrhagic ones or those involving the brainstem. Ms. Lauren remained awake and was able to report symptoms and anxiety, which rules out this presentation.
E. Sudden severe headache with vomiting: This symptom combination is more typical of a hemorrhagic stroke or subarachnoid hemorrhage. Ms. Lauren did not report a headache or vomiting, which makes this an unlikely symptom in her current presentation.
F. Ischemic Stroke: Ischemic strokes result in prolonged neurological deficits lasting more than 24 hours. Since Ms. Lauren’s symptoms are resolving within a short window and she is returning to baseline, this is less likely than a TIA in her situation.
G. Sudden weakness or numbness, often on one side of the body: This is a hallmark sign of a TIA or stroke. Ms. Lauren’s initial symptoms were stroke-like and likely included unilateral weakness or numbness, which are classic indicators of a TIA.
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Related Questions
Correct Answer is C
Explanation
A. Tubular necrosis: Tubular necrosis refers to the death of tubular epithelial cells in the kidneys, commonly due to ischemia or toxins. This is not the primary defect in Potter syndrome, which involves developmental abnormalities rather than acute tubular injury.
B. Renal hyperplasia: Hyperplasia means increased cell number leading to organ enlargement. Potter syndrome typically involves renal hypoplasia or agenesis rather than hyperplasia, so this is not consistent with the syndrome’s defect.
C. Renal failure: Potter syndrome primarily results from bilateral renal agenesis or severe renal dysplasia, leading to absent or nonfunctional kidneys and subsequent renal failure. The lack of functional kidneys leads to oligohydramnios and the characteristic features of Potter syndrome.
D. Renal metaplasia: Metaplasia refers to abnormal transformation of one differentiated tissue type into another. This process is not the main defect in Potter syndrome, which is related to kidney development failure rather than abnormal tissue differentiation.
Correct Answer is C
Explanation
A. Androgens (sex hormones): These are produced in the zona reticularis of the adrenal cortex. They contribute to the development of secondary sex characteristics and have a minor role compared to gonadal hormones.
B. Glucocorticoids (cortisol): Cortisol is synthesized in the zona fasciculata of the adrenal cortex. It regulates metabolism, immune responses, and the stress response, making it a key adrenal cortical hormone.
C. Epinephrine: This hormone is produced by the adrenal medulla, not the cortex. It plays a major role in the fight-or-flight response, increasing heart rate and blood glucose levels during stress.
D. Mineralocorticoids (aldosterone): Aldosterone is produced in the zona glomerulosa of the adrenal cortex. It is essential for sodium retention, potassium excretion, and blood pressure regulation.
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