weakness

Practice targeted AMC-style multiple-choice questions on weakness.

A 72-year-old woman is admitted to the hospital with increasing confusion and generalized weakness over the past week. Her medical history includes hypertension, for which she takes hydrochlorothiazide 25mg daily. On examination, she is lethargic and disoriented. Her blood pressure is 110/70 mmHg, heart rate is 88 bpm, and respiratory rate is 16 breaths per minute. Neurological examination reveals decreased reflexes. Initial laboratory investigations reveal the following: Sodium: 118 mmol/L Potassium: 3.8 mmol/L Chloride: 85 mmol/L Bicarbonate: 24 mmol/L Blood Urea Nitrogen (BUN): 25 mg/dL Creatinine: 1.1 mg/dL Glucose: 95 mg/dL Urine osmolality is 600 mOsm/kg. Serum osmolality is 250 mOsm/kg. Which of the following is the most appropriate initial management strategy?

A. Initiation of desmopressin (DDAVP) therapy to reduce free water excretion.

B. Administration of intravenous hypertonic saline (3% NaCl) at a rate of 50 mL/hour.

C. Administration of a loop diuretic (e.g., furosemide) to promote free water excretion.

D. Administration of intravenous normal saline (0.9% NaCl) at a rate of 100 mL/hour.

E. Fluid restriction to 800-1000 mL/day and monitoring of serum sodium levels every 4-6 hours.

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

A 60-year-old man with a Popeye deformity has no pain but reports mild weakness in supination. What is the most appropriate management?

A. Surgical repair

B. NSAIDs

C. Corticosteroid injection

D. Observation

E. Physical therapy

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

A 75-year-old obese man with a history of hypertension and chronic lower limb skin changes, swelling, tingling, and weakness presents with sudden onset inability to stand or move his legs, accompanied by a loss of sensation extending up to his waist. On examination, he has flaccid paralysis of both lower limbs, absent deep tendon reflexes in the legs, and a sensory level at the umbilicus. Which of the following is the most appropriate initial investigation?

A. Urgent MRI of the spine

B. Electromyography and nerve conduction studies

C. CT angiography of the aorta and iliac arteries

D. Lumbar puncture

E. Urgent CT scan of the spine

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

Post-embolization arteriogram showing coiled aneurysm (indicated by yellow arrows) of the posteriorcerebral artery with a residual aneurysmal sac.

Image by Promod Pillai, Aftab Karim, Anil Nanda — CC BY 2.0 · Source

A 72-year-old male with a history of hypertension presents with a sudden onset of right-sided weakness and expressive aphasia. He underwent endovascular coiling for a PCA aneurysm 1 year ago. The attached image was obtained. What is the MOST likely cause of his current presentation?

A. Seizure activity causing postictal paralysis

B. Thromboembolic event related to aneurysm recurrence

C. Vasospasm of the posterior cerebral artery

D. New aneurysm formation in the anterior circulation

E. Hemorrhagic conversion of a previous infarct

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

A 72-year-old woman is admitted to the hospital with increasing confusion and generalized weakness over the past week. Her medical history includes hypertension, for which she takes hydrochlorothiazide 25mg daily. On examination, she is lethargic but arousable. Her blood pressure is 110/70 mmHg, heart rate is 88 bpm, and respiratory rate is 16 breaths per minute. Neurological examination reveals decreased reflexes. Initial laboratory investigations reveal the following: Sodium 118 mmol/L, Potassium 3.8 mmol/L, Chloride 85 mmol/L, Bicarbonate 24 mmol/L, BUN 15 mg/dL, Creatinine 0.8 mg/dL, Glucose 90 mg/dL. Urine osmolality is 600 mOsm/kg. Serum osmolality is 250 mOsm/kg. Which of the following is the most appropriate initial management strategy?

A. Fluid restriction and monitoring of sodium levels

B. Administration of desmopressin (DDAVP)

C. Administration of intravenous normal saline at a rapid infusion rate

D. Administration of a loop diuretic such as furosemide

E. Administration of intravenous 3% hypertonic saline at a rate of 50 mL/hour

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

A 50-year-old man presents with a deformity of his right arm. On examination, there is a bulge in the mid-arm, and the shoulder appears flattened. He reports weakness when flexing his elbow. What is the most likely diagnosis?

A. Rupture of the long head of the biceps tendon.

B. Acromioclavicular joint injury

C. Glenohumeral arthritis

D. Anterior shoulder dislocation

E. Rotator cuff tear

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

weakness

Related Topics