Patient has a hoarse voice and has difficulty walking straight

Discussion in 'Plab 1 and 2 forum' started by Partha Sarkar, Jun 24, 2013.

  1. Q. A 34 year old air hostess is celebrating her one thousandth flight at a company reception when she suddenly develops pain in her left eye accompanied by double vision. The next day she visits her physician who noted that the patient has a hoarse voice and has difficulty walking straight. On examination he elicits numbness to prickling in the lower limbs. The next best test is

    a) laryngoscopy

    b) Computed tomography of the brain

    c) strobovideolaryngoscopy

    d) thyroid levels

    e) barium meal

    f) Gastroscopy

    g) magnetic resonance imaging of the brain

    h) allergy evaluation

    i) with 24-h Ambulatory Ph Monitoring

    j) chest x-ray
  2. the answer g

    The following are often initial symptoms of MS: hoarseness blurred or double vision red-green color distortion pain and loss of vision due to optic neuritis, an inflammation of the optic nerve difficulty walking paresthesia (abnormal sensation, or pain, such as numbness, prickling, or pins and needles) MRI (magnetic resonance imaging) is currently the preferred method of imaging the brain to detect the presence of plaques or scarring caused by MS. It is better at detecting plaques than CT scanning. Often brains that appear to be normal on CT scans will be shown to have plaques on MRI. Still, the diagnosis of MS cannot be made solely on the basis of MRI. There are other diseases that cause lesions-areas of damage-in the brain that look like those caused by MS. There are also spots found in healthy individuals, particularly in older persons, that are not related to any ongoing disease process. On the other hand, a normal MRI does not absolutely rule out a diagnosis of MS. About 5% of patients who are confirmed to have MS on the basis of other criteria, do not show any lesions in the brain on MRI. These people may have lesions in the spinal cord or may have lesions which cannot be detected by MRI.

Share This Page