to snoo-finity ... and beyond!
Welcome to k_tron_3000's page.
Contributor score: 21
This is a great rationale. I would like to add on that D is wrong because Radicular Neuropathy of the anterior lumbar roots would (1) be painful [radicular neuropathy is characterized by radiating pain (hence the word “Radicular”); this patient has numbness and tingling, not pain] and (2) because the anterior lumbar roots are the motor roots and do not carry sensory innervation. This patient is having a problem with his dorsal spinal cord (not anterior/ventral).
Want to clarify that "radiculopathy" is not synonymous with pain. Radiculopathy can cause pain, weakness, or numbness.
I think the only reason Choice D. was incorrect because it discussed the "anterior lumbar roots", which would affect motor function.
Radiculopathy is damage to the actual nerve itself, wouldnt that make it a LMN lesion and babinski would be negative?
UW QID: 12035 explains what you are testing with Romberg sign
Also explains the splenomegaly. If you have thrombosed splenic vein, the blood will pool in the spleen, can also cause expansion of red pulp of spleen.
I picked splenic vein because of this ^^ association. However, why is the patient vomiting blood if there isn't a backup of blood into the left gastric/esophageal veinous system?
The splenic vein drains the fundus of the stomach. So, splenic vein thrombosis can cause gastric fundal varices, which explains his bloody vomit.