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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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sThi is lertaal W/eebudyglPllmrlaIa/CAnre ryoesdnm. heT omwan ahs maaged in the htypmaticse chani resyn(so nsyrdsemo aer tealarl icordgcna to eth relu of s)4 lteiunrsg ni eronHr mdnsey,ro pahmiosncltai atctr ept/p(amni wichh aer asol rs)sy,one nda CN XI dna NC X utsfidcynno trsilnegu in hte dtiispsyargyaaarhhd/ peh(sl us zioaellc ot eht uda)ell.m

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nala_ula  A,sol jtus to da,d AF ifepcsies hatt eNusclu uagmsuib ctseffe a(daigyph,s snereas,sho daesdceer gga lefe)rx aer ciecpsif to AIPC sn.oeils +2
cienfuegos  nsakTh fro eth t.puin I vahe wsayal nofdu htis pioct to be ytkric nda usjt amce saoscr itsh eailtrc ttha delpeh em uto a otn rggdaerni het rleu fo 's4 ymcnaosieh moitnnes vabeo. htBLrbes:O/ju//tpbcd. +9
lovebug  AF 0192 2gp!50 +
pfebo  'onD"t IAPC oersh ssn)hrsoeea( atht tcna' ate y"sida()apgh +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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