A pt with hepatocellular ca has raised levels of ferritin. What is the most probable cause?
A woman has electric pains in her face that start with the jaw and move upwards. Her corneal reflexes are normal. What is the most likely dx?
A 32yo man presented with slow progressive dysphagia. There is past hx of retro-sternal discomfort and he has been treated with prokinetics and H2 blockers. What is the probably dx?
A 56yo man comes with hx of right sided weakness & left sided visual loss. Where is the occlusion?
Q. 1. What is the key? Q. 2. How will you differentiate between middle cerebral artery occlusion from anterior cerebral artery occlusion? Ans. 1. The key is d. Carotid artery. [Carotid artery divides to internal and external carotid of which internal continues as middle cerebral ultimately. But just before it becomes middle cerebral internal carotid gives rise to ophthalmic branch. So middle cerebral occlusion may give partial visual loss but not complete mono-ocular blindness. For complete mono-ocular blindness occlusion should be proximal to ophthalmic artery i.e. either in internal carotid or more proximally to carotid artery]. Ans. 2. Middle cerebral artery occlusion: paralysis or weakness of contralateral face and arm (faciobracheal). Sensory loss of the contralatera face and arm. Anterior cerebral artery occlusion: paralysis or weakness of the contralateral foot and leg. Sensory loss at the contralateral foot and leg.
