NBME 4 question - uworld23

[ArchivalUser]

27 yrd old lady with 3 day hx of visual loss and aching discomfort in the right eye. 3 years ago she had diplopia, vertigo and ataxic gait and was diagnosed with inner ear infection. Her symptoms resolved in 1 month. Exam today shows marked reduced visual acuity on right , peripheral fields are full to confrontation. Color vison is decreased on right. The right eye does not react to direct light , but has a normal consensual response. fundoscopic exam shows no abn. She has an ataxic gait. Bilateral babinski positive. What is the next step in diagnosis?

a. carotid ultrasound
b. Electromyography
c. Visual evoked potentials
d. CT scan of head with contrast
e. MRI brain with contrast

[ArchivalUser]

MRI brain with contrast

MS

[ArchivalUser]

D Pca stroke..

[ArchivalUser]

@dr_gastro if PCA stroke is the cause, can you go for CT with CONTRAST or without constrat.

is it ischemic or hemorrhagic infarctions PCA stroke?

3 day hx of visual loss, 3 years ago she had diplopia, vertigo and ataxic gait ---> MS

I think C or E but E is the best answer.

[ArchivalUser]

various lesions at various times,not specific to a particular brain area
E...........??

[ArchivalUser]

i m pretty sure this is PCA stroke....and we do mri if the signs and sym last fr more than 24 hrs.....

[ArchivalUser]

e optic neuritis
ms