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NBME 17 Answers

nbme17/Block 0/Question#0 (5.8 difficulty score)
59-year-old comes to the physician... lack of ...
CerebellumπŸ”
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 +5 
submitted by cassdawg(957),

Looking at the symptoms, they fit with cerebellar issue, as the cerebellum is responsible for modulating movement and aiding in coordination and balance. [FA2020 p499]

She does not have paralysis or parasthesia but rather lack of control of movement, making injury to the cerebrum less likely. Further, her issues are not localized to the upper or lower extremity and do not fit with any syndrome of spinal cord. Ataxia is also typically a buzzword for associations with the cerebellum. In this case, her limb ataxia is likely from a metastasis to the left cerebellar hemisphere.

If you want to review:

Common brain lesions can be found FA2020 p511.

Spinal lesions can be found FA2020 p530.

waitingonprometric  Also for completeness--this lesion is probably in a lateral hemisphere of the cerebellum. From FA "Cerebellar hemispheres are laterally located--affect lateral limbs." Lesions to the central portion of the cerebellum (vermis) usually cause "truncal" ataxia. +2  



 +0 
submitted by prostar(2),

For the sake of completeness, this is paraneoplastic cerebellar degeneration due to breast cancer- Anti - Yo antibodies. (FA2019 Pg229)