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Kaplan Qbank USMLE



Author4 Posts
  #1

A 9-year-old boy presents with confusion and decreased school performance. He soon develops a spastic gait with dysarthria and dysphagia. He also develops visual loss. A magnetic resonance imaging(MRI) scan shows massive demyelination of the white matter in the posterior areas of hemispheres. Which of the following is the most likely diagnosis?

(A) Multiple Sclerosis
(B) Metachromatic leukodystrophy
(C) Adrenoleukodystrophy
(D) Subacute sclerosing panencephalitis
(E) Creutzfeldt-Jakob disease

___________________
Passed step1, Step2 CS. Now preparing for CK. Grad of Inha Univ. College of Medicine, South Korea.

  #2

B ?????

  #3

tamerbashir wrote:
B ?????


nodnodnod

___________________
GOAL: NEURO-2009, Creds: 2007 Grad, Need H1B/J1, Doing MPH, Step1:266, Step2CK:272, CS: Awaiting results, USCE (O'ship) & USLORs: + (Neuro), Trying to get into a clinical research in INR.

  #4

The answer is C.

Adrenoleukodystrophy is an X-linked disease that affects young males, usually beginning at 7 or 8 years of age. It is characterized by demyelination of the central nervous system(CNS), adrenal insufficiency, mental deterioration, aphasia, apraxia, and dysarthria. Approximately one-third of the patients with this disease also have loss of vision. Although multiple sclerosis(MS) [Choice A] is also a CNS-demyelinating disease, the clinical scenario with posterior hemisphere predominance best fits adrenoleukodystrophy. Metachromatic leukodystrophy (Choice B) generally presents with weakness and decreased reflexes instead of spasticity, and with symmetric CNS demyelination. Creutzfeldt-Jakob disease(Choice E) is a spongiform encephalopathy caused by proteinaceous infectious particles called prions. It occurs in adults and produces dementia. Subacute sclerosing panencephalitis(Choice D) is a slow viral disease caused by the measels virus.

___________________
Passed step1, Step2 CS. Now preparing for CK. Grad of Inha Univ. College of Medicine, South Korea.







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