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NBME 19 Answers

nbme19/Block 1/Question#24 (14.0 difficulty score)
62 yo woman with sudden weakness of left leg; ...
Right anterior cerebral arteryπŸ”,πŸ“Ί
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 +5 
submitted by ajguard26(40),
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rerf,eeoTh the amdgea is lryepu omort dna nrsyseo in eht tfel ,leg hhcwi is on hte aemldi satecp fo the atrfnol nda atraipel sebol pyterc.evelsi ihTs eara si splipedu yb eht notierar arleberc yater.r

issamd1221  contralateral deficits +  
cbay0509  thank you +  
flapjacks  I think her 60 pack-year history suggests possible PAD and therefore loss of proprioception in the lower extremities, leading to an unfortunate distractor +  
an_improved_me  I don't understand why you would consider the propioceptive deficit a distractor... doesn't the DCML (which carries propioceptive information) project to the primary somatosensory cortex (via the VPL?). In this case, a lesion to the right anterior cerebral artery, which supplies both motor and sensory information to the lower limb would lead to somatosensory, propioceptive, and motor deficits. +