study_ing
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this question has been discussed a lot of times but the more i go thru the discussions on them, the more indecisive i feel...is it A or B
24. A 35-year-old woman comes to the physician because of intermittent tingling and numbness of her feet during the past 6 months. She has a 30-year history of type 1 diabetes mellitus. Sensation of joint position is decreased in the toes and ankles, and vibration sense is decreased in the feet. There are decreased ankle jerks bilaterally. Pathologic changes of which of the following most likely occurred in this patient?
A ) Dorsal columns of the spinal cord
B ) Large-diameter axons of the distal portions of peripheral nerves
C ) Motoneurons of the lumbosacral spinal cord (DUZNT EXPLAIN LOSS IN SENSATION)
D ) Spinocerebellar tracts of the spinal cord ( NO ATAXIA, NCOORDINATION ETC)
E ) Spinothalamic tract neurons of the dorsal horn (NO LOSS OF PAIN AND TEMP)
PLEASE PROVIDE UR REASONING
Thanx
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| robin082006
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B
peripheral nerve is affected in DM.
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| star1
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B 
peripheral neuropathy due to osmotic damage to shawann cell
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| tolito
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B.
she has peripheral neuropathy. specifically the option is talking about the Abeta fibres. these nerves subserve both touch and pressure and joint and vibration sense. A is a distractor. DM does not cause dorsal colum disease to our knowledge.
what i do with these kinds of confusing questions is to go by the law of what is more common or more likely. with my qbank experience, i get more than 85% questions right when i do that.
this link has a simple explanation of the fibres of the peripheral nerves.
http://www.medoc-web.com/chronicpain.html
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| mjl1717
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Good info t!
this is what I got from the article --EMG and studys do not evaluate the smaller fibers. So only the large A- beta fibers which affect vibration, joint position, touch and mild pressure are really evaluated. {Id say joint position and vibration hits the nail on the head!!!!}
As for the main distractor dorsal colums--tabes dorsalis is the main disease that I know of which could take years to develop, anyone know of any dorsal column diseases??..
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| Cedrick
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I agree peripheral neuropathy
B
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| study_ing
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thanx a million guys
i was confused as i tot vit b12 deficiency occurs more in diabetics hence A wud apply
BUT i think B is gud enuff
btw u ppl are THE BEST
hope u get 99.9999999999s
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| pallav
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guys reading ur explanation tells me that you are
working really hard
and i feel really really low.
but it was a wongerful exp
even i was distracted by (a
thanx a lot
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