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* nbme 4 1 7
 #443455  
  zoh - 09/01/09 16:25
 
 
7. A 27-year-old woman is brought to the physician because of a 3-day history of visual loss and aching discomfort in her right eye. Three years ago. she had vertigo. diplopia.
and an ataxic gait and was diagnosed with an inner ear infection. Her symptoms resolved within 1 month without treatment. Examination today shows markedly reduced visual
acuity on the right: the peripheral visual fields are full to confrontation. Colorvision is decreased in the right eye. The right eye does not react to direct light but has a normal
consensual response. Funduscopic examination shows no abnormalities. She has an ataxic gait. Babinski sign is present bilaterally. Which ofthe following is the most
appropriate next step in diagnosis?
O A) Carotid ultrasonography
O B) Electromyography
O C) Visual evoked potentials
O D) CT scan ofthe head with contrast
O E) MRl ofthe brain with contrast
 
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* Re:nbme 4 1 7
#1862729
  ali2009 - 09/01/09 18:47
 
  cccc
ms
 
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* Re:nbme 4 1 7
#1867311
  zoh - 09/04/09 13:01
 
  i think it is ee  
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* Re:nbme 4 1 7
#1885126
  katolove - 09/16/09 14:23
 
  I chose E because based on the signs and symptoms the patient has Multiple Sclerosis. An MRI would show various areas of demyelination and support the following symptoms.  
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* Re:nbme 4 1 7
#1885211
  omegamd - 09/16/09 15:21
 
  this is a tricky queston becasue both MRI w/ contrast and evoked visual potentials are useful in making the Dx of MS....I would go with E since it is now considered standard of care and it is the most sensitve test but I can see how anyone can also choose C if you dont go all the way through the answer choices and feel good about it.....  
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* Re:nbme 4 1 7
#1885279
  mos11 - 09/16/09 16:18
 
  E)
http://emedicine.medscape.com/article/793013-diagnosis
 
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