Neurological Manifestation of systemic dysfunction

Deficiency of which of the following substances caused the patient’s clinical presentation? 

• 1. Vitamin A

• 1. Thiamine (B1)

• 1. Cobalamin

• Folic acid

What is the most likely cause of this patient’s clinical presentation?

• Staphylococcus Aureus septicemia

• 1. Infection with the pork tapeworm Taenia Solium 

• Brain metastasis from a cardiac malignancy

• Hereditary neurocutaneous disease with intracranial neoplasms

Which of the following is the mechanism of action of the most appropriate acute treatment of this patient’s condition?

• 1. Acidification of colonic contents, causing ammonium trapping

• Decreasing substrate for ammonia-producing reactions

• Eliminating colonic flora and decreasing their subsequent ammonia production

• Facilitating the binding of GABA to GABA receptors

What is the proper initial management in this patient?

• 1. Administer IV mannitol infusion

• 1. Emergency neurosurgery consultation

• Bolus insulin infusion followed by continuous infusion of insulin

• 1. Restart the patient on dialysis 

Low serum levels of which of the following compounds are most likely to be found in this patient’s blood?

• Sodium

• Potassium

• Cortisol

• Aldosterone

Which of the following is the most likely explanation for the patient’s neurologic symptoms?

• Encephalopathy due to accumulation of toxic metabolites

• Increased viscosity of blood resulting in tissue hypoperfusion

• Impaired oxygen transport in  RBCs due to structural abnormalities

• 1. Chronic environmental exposure to carbon monoxide 

Which of the following procedures is most likely to be diagnostic in this patient?

• 1. Arthrocentesis

• 1. Mesenteric angiogram

• Temporal artery biopsy

• 1. Testing for anti-double-stranded DNA and antinuclear antibody levels