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Retired NBME 21 Answers

nbme21/Block 2/Question#41 (reveal difficulty score)
A 75-year-old woman has the sudden onset of ...
Posterior inferior cerebellar ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: neuro strokes

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 +4  upvote downvote
submitted by โˆ—hyoscyamine(59)
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ishT is llarate m/geeauyaCIrldlAbn/PlelWr dy.norsme heT nmwao ash edamag ni het iatmcspyhet nihca rsneo(sy nssdoyrem aer laetral ocicgrnda ot teh lrue of 4s) greuitsnl ni enHrro dymorens, licnpoaismhat atcrt imnppe/t(a wichh ear sloa no,)seysr adn CN IX nda CN X dnsyonuicft nrisgtlue in teh apshidaydigrsyahtr/a lhsp(e us czllaieo to the .ulmd)ela

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nala_ula  Alos, juts to dd,a AF scsfpieei ttha Nusucel uaismugb tesfecf dh(ya,saigp ssn,earoesh daerseecd gga )xeelrf rae ficpseci ot PAIC eloissn. +2
cienfuegos  ahnkTs rof hte n.ptui I hvea aysalw nuodf stih ctopi ot be rtyikc dna utjs eamc ocsras hits ictrlea that hlpeed me out a ton darrggnie eht uelr of '4s yhmaconise temoinns .bvaeo .hsLb/jBt/d/tcberupO: +9
lovebug  AF 0192 02p5!g +
pfebo  o"Dtn' PICA sroeh s)nasee(rhos ttha cna't eat gpyh"as()iad +2

if you learn the rule of 4 its going to make this question really easy and almost a free mark. I learned it from Boards and beyond but I'm sure you can find it in other resources. so, horner is sympathetic damage--> s is on the side loss of pain and temp--> sensory--> s is on the side so we know its lateral now which cranial nerves are affected? dysphagia and speaking are both symptoms of damage to cranial n. X. rule of four says the first 4 cranial nerves are above pons, the second 4 are in pons and the last 4 are in medulla. so this is a lateral medullary syndrome.

+3/- meryen13(48)


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