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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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hiTs si lataelr amu/bCl/WnraIlgPlerleedAy nreym.dso ehT nawom sah aadmge in eth tpecasithmy nicah syr(nsoe ysnrseodm rae arltlae iangrocdc to teh reul of 4s) gseirnult in orrHen sednoym,r omnilihtcsapa ractt p/i(mneatp hcwih rae aosl ren)sy,so and NC XI adn CN X syoudfctnin gsriulten ni eht agtsryaiiparsd/yhhad ph(esl us laielzoc ot het l.au)elmd

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nala_ula  ,Aols sjut to ,dda FA cseepisif hatt ecNuslu uuisamgb feefcst hpas,ai(ydg s,soehseanr earscddee gag e)xflre aer icepifsc ot CIAP noe.sils +2
cienfuegos  Tknsha fro the putn.i I evha aswlay dnufo stih cpoti to eb kitrcy nad tjus amec roassc tihs ealirct ttah edpelh me tou a nto radigegrn eht rleu of s'4 semchnoayi mnistoen aveob. pLr/tu:cbshOe/.jd/btB +9
lovebug  FA 0219 !52gp0 +
pfebo  to'Dn" CIPA seroh o(rea)hsesns ttah ta'nc ate a(shidy"p)ga +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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