NBME3-neuropatho - azaaza

[ArchivalUser]

58 yo male had progressive weakness over the past 8 months. PE shows weakness and muscle atrophy in the upper and lower extremities. Muscle stretch reflexes are decreased in the upper extremities and increased in the lower extremities. He ahs no sensory deifict. Which is most likely?
a.cystic lesion involving midline structures and both vental horns in the cervical enlargement
b.demyelination of the left corticospinal tract at all levels of the cord
c.lesion of the left anterolateral quadrant at C2
d.loss of myelin in the dorsal column white matter
e.loss of myelin in the lateral column white matter and loss of ventral horn motoneruon

[ArchivalUser]

D..

[ArchivalUser]

Impossible to be D because he has no sensory deficit, right?

[ArchivalUser]

C?

[ArchivalUser]

it look AML loss of myelin in the lateral column white matter and loss of ventral horn motoneruon

[ArchivalUser]

Is it ALS ? C

[ArchivalUser]

Yes, E is the given answer.
I was distracted by the difference between upper and lower extremities.

[ArchivalUser]

Hey Azaaza..easy way to remember ALS is an Upper motor lesion of the LL and Lower Motor Neuron lesion of the UL..hope it helps

[ArchivalUser]

Thanks, I will remember it.