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Previously healthy 47y.o male. 6 months Hx of progressive weakness that began in his R.leg and gradually spread to his other extremities. During this period he had mild difficulty swallowing solids and liquids. Exam:atrophy of the R.quadricepsand both deltoids, fasciculations in both quadriceps. Babinski present bilat. Electromyography and nerve conduction most likely show:
A.absence of bilat nerve sensory responses
B.fibrillation potential in multiple muscles of multiple extremities
C. myotonic discharges
D. normal spontaneous and insertional activity
E. short duration, low amplitude motor unit potentials
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This px has signs of both UMN and LMN problems - ALS
Fibrillation potential in multiple muscle of multiple extremities will be seen due to LMN damage
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what difficulty swallowing has to do with anything in the question? Do you know what disorders can be the answers for the other options? I was clueless on that question...
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Difficulty swallowing is due to weakness of the pharyngeal and esophageal muscles (since he has demyelination of the nerves)
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hey, thanks for posting these.
are these quoestions the difficult ones in form7 compared to other questions in this form? i am not taking NBME7 and i am glad you guys posted couple of questions to get the feel of thhis form....
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Thanks, umnlmn.
Nkc, the ones i posted are the ones i had wrong and don't know the correct answer to.
You would agree that we all have a different feel of what is hard and what is easy...
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Hi vitals05,
Can you or anybody who has the offline nbme 7 send it to me. My email is femiakinbode
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Forgive me, I sincerely posted this by mistake; I meant to post my own paraphrased version for discussion but somehow my files got mixed up. I just noticed this now and I sincerely regret posting. I cannot go back. I'm not sure if I could delete this post? I contacted the administrator to delete but so far no response. Please forgive me. This was an honest and sincere mistake on my part and I can guarantee his never happens again and to check my files before hitting submit.
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Hi umnlmn and vitals05,
Can you please send me NBME 7 with key and answers on gunnerstep2.
Thank you so much.
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Go to nbme.org
Click on the self assessment link and purchase the nbme
Ill be more than happy to help you with explanations after u take da nbme
Good Luck
