#january2020mccqe1
A 70-year-old man is brought to the emergency department by his family because of the rapid onset of rightsided weakness and confusion. On arrival, the patient is drowsy, but examination confirms a right hemiparesis associated with left deviation of the eyes. The patient is admitted with a preliminary diagnosis of cerebral infarction. A CT scan of the head performed 12 hours following symptom onset reveals changes consistent with ischemic necrosis in the territory of the middle cerebral artery. The patient’s neurologic status deteriorates rapidly on the third hospital day, and he lapses into coma. He dies the next day. An autopsy confirms a large infarct in the territory of the middle cerebral artery, associated with massive swelling of the left hemisphere, transtentorial herniation, and pontine Duret hemorrhages. Which of the following treatments might have prevented such an outcome?
(A) Anticoagulants
(B) Barbiturates
(C) Calcium channel blockers
(D) Corticosteroids
(E) NMDA receptor antagonists
A 70-year-old man is brought to the emergency department by his family because of the rapid onset of rightsided weakness and confusion. On arrival, the patient is drowsy, but examination confirms a right hemiparesis associated with left deviation of the eyes. The patient is admitted with a preliminary diagnosis of cerebral infarction. A CT scan of the head performed 12 hours following symptom onset reveals changes consistent with ischemic necrosis in the territory of the middle cerebral artery. The patient’s neurologic status deteriorates rapidly on the third hospital day, and he lapses into coma. He dies the next day. An autopsy confirms a large infarct in the territory of the middle cerebral artery, associated with massive swelling of the left hemisphere, transtentorial herniation, and pontine Duret hemorrhages. Which of the following treatments might have prevented such an outcome?
(A) Anticoagulants
(B) Barbiturates
(C) Calcium channel blockers
(D) Corticosteroids
(E) NMDA receptor antagonists
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