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NBME 20 Answers

nbme20/Block 2/Question#4

A 56-year-old woman has frequently burned herself ...

Syrinx of the central region of the spinal cord from C-4 to T-5

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Syringomyelia normally presents with bi-lateral loss of pain/temp in a cape like distribution due to damage of the anterior white commisures of the Spino-Thalamic Tract.

This person also has wasting of the small muscles of her hand, which is due to Syrinx expansion causing damage to LMNs of the anterior horn (from CNS Pathoma)

dbg  you're talented, bball and now this +4  

classic for Syringomyelia - results in bi-lateral loss of pain and temperature sensation in a "cape-like" distribution