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NBME 19 Answers

nbme19/Block 1/Question#24 (reveal difficulty score)
62 yo woman with sudden weakness of left leg; ...
Right anterior cerebral artery πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—monoloco(150),
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alnrunA enrcasap is eht lyon arewsn atth anuoctcs ofr eth ileb in the om;itv of teh icsoech, ti si hte oyln uocntristbo idatsl ot eerwh eibl serent het GI tctra.

submitted by βˆ—ajguard26(51),
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hsTi tapenit snrestep iwth cslcasi peupr rootm ernnuo oenisl msopms:ty eewk,snas xfar,lhiyeerep dan eescdadre ostisnne.a vo,eHrew hte equtsoin sastet ehs n"tonca tlel htrwhee her telf eatrg ote si irsdea ro seesdpedr" hwen rhe ysee era csledo, iwhhc aym kmae ouy nrrosdieec and think ehetr yma eb some pteppiriroevoc seissu hety era inytrg ot htin at. Thsi si tno het cesa. ialEyelspc eonc yeth otenmni eehrt ear on trohe nirioabstemal .,ei(. no reupp blmi tramlsiebnaoi ro tirgh sdeid eina)s.aobritml If sthi is teh saec, etreh is on aagdme to the tstcra ta lal hhc(wi aer itsll eircnsdedo UN.M)

reee,orhfT teh aagemd is yrluep tmroo nad sseorny in hte flte ,gle chwih si on eht iadmle csptea fo the rlntofa nad peairalt olebs prtie.sceyevl hTsi aaer is lppudeis yb het eraitron ecarelbr tra.yre

issamd1221  contralateral deficits +1  
cbay0509  thank you +1  
flapjacks  I think her 60 pack-year history suggests possible PAD and therefore loss of proprioception in the lower extremities, leading to an unfortunate distractor +1  
an_improved_me  I don't understand why you would consider the propioceptive deficit a distractor... doesn't the DCML (which carries propioceptive information) project to the primary somatosensory cortex (via the VPL?). In this case, a lesion to the right anterior cerebral artery, which supplies both motor and sensory information to the lower limb would lead to somatosensory, propioceptive, and motor deficits. +1  

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