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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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iThs si letlraa eallbgrmelrWdIPane/yCuAl/ rnd.omsey The mnoaw ahs agdmea ni eth eamsypctthi aichn syon(res sseymodnr are lraetla dcgnoacri to hte luer of 4)s tguesnlir in roreHn ,ronemysd cmatnisahplio arctt iapt(e/mnp hwchi rea aslo o)ser,sny nad CN XI adn CN X noyfcuntisd gtluirnes in eth sirhsaaydadyitpghr/a eph(ls us eaollczi ot teh l)ldemu.a

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nala_ula  ,lsAo usjt ot ,dad AF fesiepcis ttah Ncsulue ibmsuaug efcfets ,ah(dapsygi hnsar,osese radedseec gga )eerxlf are epsicifc ot CAIP oslnsei. +2
cienfuegos  hsakTn ofr eht ntup.i I aehv laaysw duonf sthi pciot to be kcyitr dna tujs eacm oasscr stih eicartl hatt edehpl me tou a ton nerrgdgai eht rule of 's4 aehyciomsn smtneoni va.eob BOb:ct/L.d/trs/juehpb +9
lovebug  AF 2190 0gp5!2 +
pfebo  ont"D' CPIA ersho ars(s)ehsnoe that 'acnt ate gpyhsid("a)a +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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