APEA PRE-PREDICTOR
Save
In myasthenia gravis, Muscle fasciculations
weakness is a result of
insufficient acetylcholine
transmission at the
neuromuscular junction;
however, weakness can
also occur with
overdosing of the
cholinergic medications
used to treat myasthenia.
What symptom helps
differentiate a myasthenic
crisis from a cholinergic
crisis?
A 74-year-old man Nimodipine (CCB)
presents after his wife
witnessed him grab his
head in pain and fall to the
floor. He has not regained
consciousness. His current
blood pressure is 150/96
mm Hg, and his heart rate
is 65 bpm. Emergent head
CT shows a subarachnoid
hemorrhage.
,A 75-year-old man is central cord syndrome
involved in a motor
vehicle accident and
strikes his forehead on the
windshield. He complains
of neck pain and severe
burning in his shoulders
and arms. His physical
examination reveals
weakness of his upper
extremities. What type of
spinal cord injury does this
patient have?
,A 37-year-old man fell Epidural hematoma
from a ladder as he
finished hanging the
Christmas lights on his
house. The right side of his
head hit the alley cement,
and he lost consciousness
for about 1 minute; he
woke up with a headache,
but he had no other
complaints. A few hours
later, the patient is
brought to the emergency
room by his neighbor
because of an intense
headache, confusion, and
left hand hemiparesis. On
examination, the patient
has a bruise located over
the right temporal region,
mydriasis, and right
deviation of the right eye,
papilledema, and left
extensor plantar response.
An emergency CT scan of
the head without contrast
reveals a lens-shaped
hyper-density under the
right temporal bone with
mass effect and edema.
What is the most likely
diagnosis?
, A 1-year-old boy presents Infection
with increasing lethargy.
He is barely responsive,
and his parents deny any
trauma or injury. What is
the most common cause
of nontraumatic altered
levels of consciousness?
A 44-year-old man starts Antibodies to the acetylcholine receptor
to notice that his eyelids
are drooping. Some time
afterwards, his jaw
becomes weak. He has
difficulty swallowing and
also experiences
weakness in his limbs. He
is quite embarrassed when
he eats because he must
use his hand to help
support his jaw. His
weakness gets
progressively worse.
Finally, he seeks medical
attention. His physical
examination demonstrates
the weakness in his limbs;
however, no sensory
defects are present. A
Tensilon test is done and is
positive. His doctor is
concerned about an
associated malignancy.
What is the underlying
pathology of this disease?
Save
In myasthenia gravis, Muscle fasciculations
weakness is a result of
insufficient acetylcholine
transmission at the
neuromuscular junction;
however, weakness can
also occur with
overdosing of the
cholinergic medications
used to treat myasthenia.
What symptom helps
differentiate a myasthenic
crisis from a cholinergic
crisis?
A 74-year-old man Nimodipine (CCB)
presents after his wife
witnessed him grab his
head in pain and fall to the
floor. He has not regained
consciousness. His current
blood pressure is 150/96
mm Hg, and his heart rate
is 65 bpm. Emergent head
CT shows a subarachnoid
hemorrhage.
,A 75-year-old man is central cord syndrome
involved in a motor
vehicle accident and
strikes his forehead on the
windshield. He complains
of neck pain and severe
burning in his shoulders
and arms. His physical
examination reveals
weakness of his upper
extremities. What type of
spinal cord injury does this
patient have?
,A 37-year-old man fell Epidural hematoma
from a ladder as he
finished hanging the
Christmas lights on his
house. The right side of his
head hit the alley cement,
and he lost consciousness
for about 1 minute; he
woke up with a headache,
but he had no other
complaints. A few hours
later, the patient is
brought to the emergency
room by his neighbor
because of an intense
headache, confusion, and
left hand hemiparesis. On
examination, the patient
has a bruise located over
the right temporal region,
mydriasis, and right
deviation of the right eye,
papilledema, and left
extensor plantar response.
An emergency CT scan of
the head without contrast
reveals a lens-shaped
hyper-density under the
right temporal bone with
mass effect and edema.
What is the most likely
diagnosis?
, A 1-year-old boy presents Infection
with increasing lethargy.
He is barely responsive,
and his parents deny any
trauma or injury. What is
the most common cause
of nontraumatic altered
levels of consciousness?
A 44-year-old man starts Antibodies to the acetylcholine receptor
to notice that his eyelids
are drooping. Some time
afterwards, his jaw
becomes weak. He has
difficulty swallowing and
also experiences
weakness in his limbs. He
is quite embarrassed when
he eats because he must
use his hand to help
support his jaw. His
weakness gets
progressively worse.
Finally, he seeks medical
attention. His physical
examination demonstrates
the weakness in his limbs;
however, no sensory
defects are present. A
Tensilon test is done and is
positive. His doctor is
concerned about an
associated malignancy.
What is the underlying
pathology of this disease?
