Weak 2

Blood & Lymphoreticular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This 45 year old lady has developed acute flaccid paralysis of both her left upper limb, and right lower limb; there are no cerebellar signs, and sensation is unaffected, as are the cranial nerves.\n\nThese clinical findings are most suggestive of a stroke involving both cerebral hemispheres; this is confirmed by MRI imaging of the brain, which reveals bilateral cortical infarcts.\n\nNote that relatively few etiologies can give rise to multiple bilateral strokes; predominantly among these are cardiac thromboembolism and thrombophilic states.\n\nHowever, her examination and an ECG reveal no evidence of cardiac rhythm abnormalities, while echocardiography shows no structural cardiac defects or intracardiac thrombi.\n\nIn addition, while she is obese (note that the BMI ranges are different for South Asians), she is not diabetic or hypertensive, and has no other obvious cardiovascular risk factors.\n\nA vast range of genetic and acquired thrombophilias exist; however, relatively few of these give ri"}]}

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