Question

A 74 year old man in the ER has had a severe MI, which led to Vfib. He then had a several- minute period of pulselessness & apnea before his breathing was finally restored. His BP is 78/56. He is unconscious and unresponsive to any kind of stimulus.

Choose from this list for questions 10 & 11:

A. decorticate posturing of the right arm and leg; left side normal.

B. symmetric decerebrate posturing of arms and legs.

C. complaint of severe nausea and dizziness.

D. asymmetric grip strength.

E. garbled speech. F. bilateral positive plantar reflexes. G. positive Babinski on the right, negative on the left. H. Cheyne-Stokes respirations. I. “upgoing big toe” bilaterally.

10. Additional S&S most consistent with the correct answer in #9 include (choose one)

a. A

b. B

c. E

. G

11. Additional S&S most consistent with the correct answer in #9 include (choose one) a. C b. D c. A d. F

Answer 1

In this patient, several minutes v-fib and pulselessness and apnea resulted in hypoxia and brain damage.

A- it is unlikely that he will have unilateral brain damage because of cerebral hypoxia. this occurs most commonly in stroke or head injury.

B- can occur in brain damage due to hypoxia.

C- since he is unresponsive, he won't be complaining about any nausea and vomiting

D- checking the grip strength is not possible because he is unresponsive and unconscious.

E- he won't speak because he is unconscious.

F- bilateral positive plantar reflex is seen in a patient with coma and bilateral upper motor neuron damage. so it is likely in this case.

G- unilateral Babinski positive is seen in stroke.

so answer to 10 will be B and 11 will be F.