NBME CK correctly answered

NBME CK Right Vertebral -Causes lateral medullary syndrome (AKA Wallenberg) -Can also be caused by PICA -Symptoms include: --1) Contralateral sensory of body --2) Ipsilateral sensory of face --3) Ipsilateral cranial nerves (Vagus & glossopharyngeal) ---Dysphagia ---Nystagmus ---Weakness palate ---Dysarthria --4) Ataxia Anterior spinal artery -Affects the: --1) Lateral Corticospinal tract → Contralateral hemiparesis in UE & LE --2) Medal lemniscus → Decreased contralateral proprioception --3) Hypoglossal nerve → ipsilateral paralysis of tongue Posterior spinal artery -Supplies dorsal columns of the Spinal cord → lead to sensory less - correct answer A 67M, presents to the ED 1 hour after the onset of vertigo, nausea, & imbalance. He has a 20-yrs Hx of HTN. His pulse is 70/min, RR 20/min, & BP is 210/115. Exam shows a small right pupil, mild right ptosis, & nystagmus. Neuro exam shows weakness of the right palate. Sensation to pinprick is decreased over the right side of the face & left extremities. There is incoordination on finger-nose testing & heel-knee-shin testing on right. Which of the following arteries is most likely to be occluded? (Right Vertebral OR Anterior spinal) Decreased androgens -Testosterone is the most influential hormone for sexual desire in men & women -Pathophysio → Pt is taking conjugated estrogen → this increases the amount of SHB which then binds testosterone & DHT Decreased LH -LH would be increased d/t neg feedback from the decreased testosterone - correct answer A 52F, presents b/c decreased libido; this symptom began 8 months ago, after she underwent a TAO-BSO for leiomyomata uteri & menorrhagia. She has been taking hormone replacement therapy w/ conjugate estrogen since the operation. Exam shows a moist, rugated vagina. Which of the following is the most likely cause of these findings? (Decreased androgens OR Decreased LH) Insulin -Pt has insulin resistance (b/c of obesity & high blood sugar) → Insulin is elevated in this pt Ketones -Uncommon in DM II (Only seen in pts w/ DM I & only when they are in emergency situations →aka DKA) - correct answer A previously healthy 52M, presents b/c a 3-months Hx of increased urinary volume & increased urinary frequency at night. He has had a 15-lbs wt loss during this period despite no change in appetite. His father has HTN, & his mother has HTN & DM II, He currently weighs 210-lbs & is 70-in tall. His BP is 160/85 in both arms. Exam shows no other abnormalities. His non-fasting serum glucose is 280.