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Retired NBME 21 Answers

nbme21/Block 2/Question#41 (reveal difficulty score)
A 75-year-old woman has the sudden onset of ...
Posterior inferior cerebellar ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: neuro strokes

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 +4  upvote downvote
submitted by โˆ—hyoscyamine(59)
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ihsT is elarlta /rmldIelg/ueeWabanlryClAP eorsny.dm heT onwma ahs gdemaa in hte itthmyscape nahci nsyo(esr sysoemdnr ear laltear ccinardog ot het ulre fo s)4 eultnsigr ni Hroenr myon,rsde iictnhapmlsao crtta m/e(anippt cwhhi era also r,sn)oeys adn NC IX adn NC X citonynfuds litenurgs in hte aiiha/yadsgtpyrasrdh he(slp su alceolzi ot het mdaue)l.l

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nala_ula  slo,A stuj ot dd,a AF ipcfeises atth ulsNuec bauusmgi stefcef (dhyp,agais neehosasr,s ecddsaeer gga eex)rfl rae fsecicip ot CPAI enis.osl +2
cienfuegos  kTahsn rfo eth pin.tu I heva alyswa udnfo isht otpci ot eb kirytc nda tusj mcea aorscs hits telirca htta dpehel me tou a ton iardggrne eht lreu fo s'4 maohnsicye steonmin beova. jt/Lbbp/.uhdsO:tcre/B +9
lovebug  AF 2091 pg5!20 +
pfebo  '"Dont ACPI shoer saeo)se(hrsn ttha 'cant tae ip(sa)"ghyad +2

if you learn the rule of 4 its going to make this question really easy and almost a free mark. I learned it from Boards and beyond but I'm sure you can find it in other resources. so, horner is sympathetic damage--> s is on the side loss of pain and temp--> sensory--> s is on the side so we know its lateral now which cranial nerves are affected? dysphagia and speaking are both symptoms of damage to cranial n. X. rule of four says the first 4 cranial nerves are above pons, the second 4 are in pons and the last 4 are in medulla. so this is a lateral medullary syndrome.

+3/- meryen13(48)


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