Homework SourseMuscle Weakness and Difficulty Walking Mrs B is an overweigh
Muscle Weakness and Difficulty Walking
Mrs. B. is an overweight 71-year-old white female. Upon hospital admission, she exhibited slurred speech and some se¬vere right-handed numbness with a weak hand grip on the right. Her smile was asymmetric with right-sided facial weak¬ness that had persisted for 48 hours. Mrs. B. has a history of smoking for 50 years.
Her family history includes:
Mother had adult ¬onset diabetes and died of breast cancer at age 62
Sister died of a subarachnoid hemorrhage at age 63
Another sister is hemiparetic due to a CVA
Brother is hypertensive
Her exam and laboratory testing revealed Vital signs – T 98.9, HR 115, BP 195/110, RR 34
Lumbar puncture was negative for blood with normal protein and glucose levels
EKG was normal EEG showed localized activity in the left hemisphere
CT scan showed increased density in the left posterior hemisphere
Blood chemistry was normal except for elevated glucose
1. Evaluate the lab values (normal, high, low)
Temperature:
Heart rate:
Blood pressure:
Respiratory rate:
2. List 3 differential diagnoses and include your reasoning behind each.
3. What is the best diagnosis? Explain how you came to this conclusion.
4. Explain the pathophysiology of the following signs/symptoms:
1) Slurred speech:
2) Right sided hand grip weakness:
3) Right-handed numbness:
Based on her symptomatology where would be expect the area of injury to be in the brain?
Solution
1.Temperature: 98.9 normal temperature
Heart rate: 115 , high , normal rate 60 -100
Blood pressure: 195/110, high, Normal 120/80
Respiratory rate:34 , high,Normal 12-20.
2. 3 differential diagnoses
Stroke: Due to one sided paralysis, slurred speech and right handed numbness.
Traumatic brain injury-Due to weak hand grip, slurred speech and numbness.
Bells palsy: -Due to single side facial pararlysis and muscle weakness.
3. The best diagnosis would be stroke as there is single sided paralysis, muscle weakness and numbness, smile asymmetric.
