Q2, 3

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Posted by Veronica from IP on October 09, 2013 at 16:22:24:


A 50-year-old homeless woman was addmited to the hospital with ulcerations on her feet. She
complained on burning in her feet and lower legs, but did not localize the pain to where her skin was
ulcerated. She was unable to stand with her eyes closed and her feet together. Her deep tendon reflexes
were diffuselly hypoactive. On systematic testing of her strength and sensation, decreased pain,
position and vibration sense were evident in her hands and feet. she also had weakness on dorsiflexion
of her ankles and wrists.
Choose the single study that is most likely to establish the Ds and the direct futher treatment:

a MRI of the brain
b Brain biopsy
c Nerve conduction studies
f Serum creatine phosphokinase
g cerebral angyography
h myelography of the spinal canal
i cranial CT
j Skull X-ray
k Visual revoke responses
l Nerve biopsy

Q3 (the same answer choices)

A 70-year-old right handed woman with the history of polio described one mo of increasing difficulty
rising from a chair and walking. She also had trouble combing her hair and cooking, and there was mild
swalloing trouble, but only with solids. Her legs and upper arms were painful and mildly swollen.
Periungual telangiectasias were seen. ESR was 61.

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