1. A 56 year old male hypertensive complains of sudden onset of weakness in left upper and lower limbs preceded by headache. On examination he is drowsy and his mouth is deviated to the right side. Plantar reflex is extensor on left side.
What is the differential diagnosis?
Where is the lesion? What is the likely pathology?
Explain the pathophysiological basis for all the clinical features.
2. A 72 year old diabetic, hypertensive lady has complains of weakness in the right upper limb that started 4 days back, which started insidiously and has been worsening since then. Two days ago, she also noticed slurring of speech, and for the last one day, she is unable to speak, though she responds to motor commands. On examination, there is grade 3 power in right upper limb and grade 4 in right lower limb.
What is the differential diagnosis?
Where is the lesion? What is the likely pathology?
Explain the pathophysiological basis for all the clinical features.
3. A 35 year old lady, a known patient of mitral stenosis (MS) is brought to the emergency room with history of abrupt onset of left hemiparesis. She was reportedly climbing stairs when this happened. On examination, she is drowsy and has an irregularly irregular pulse and cardiovascular findings suggestive of MS. There is left sided weakness grade 3, hyporeflexia and hypotonia. Left plantar is extensor.
What is the differential diagnosis?
Where is the lesion? What is the likely pathology?
Explain the pathophysiological basis for all the clinical features.
4. A 18 year old boy has been admitted for unresponsiveness for a few hours. There is history of fever for 1 week and headache with vomiting for 2 days. On examination, he is comatose and has neck stiffness.
What is the differential diagnosis?
Where is the lesion? What is the likely pathology?
Explain the pathophysiological basis for all the clinical features.
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