WBR1041

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Author [[PageAuthor::Ahmed Zaghw, M.D. [1]]]
Exam Type USMLE Step 2 CK
Main Category Internal medicine
Sub Category Head and Neck, Neurology
Prompt A 55 year old male came to clinic with a mild headache for the last three months. The headache has been getting worse over time. Recently he noticed a progressive numbness in his left leg. He denies any motor or gait abnormality. He reports falling while playing with grand son 4 months on backyard. He is taking aspirin 80 mg, plavix 75 mg, propranolol 20 mg, insulin lantos injection for the last 1o years. He takes long acting analgesics for chronic back pain. The pin brick test reveals bilateral loss of fine sensation till knee level.His surgical history includes two time retinal laser surgery for retinal detachment and hemorrhage.What would be the underlying lesion?
Answer A Middle vessel disease
Answer A Explanation [[AnswerAExp::Incorrect-[[]]]]
Answer B Microangiopathy
Answer B Explanation [[AnswerBExp::Incorrect-[[]].]]
Answer C Nerve degeneration and microcapillary occlusion
Answer C Explanation [[AnswerCExp::Correct-[[]]]]
Answer D Microcapillary occlusion
Answer D Explanation [[AnswerDExp::Incorrect-[[]].]]
Answer E Terminal nerve degeneration
Answer E Explanation [[AnswerEExp::Incorrect-[[]]]]
Right Answer C
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