NBME 2 block1-44 - doubleblessing

[ArchivalUser]

44. A 67-year-old man is brought to the emergency department 2 hours after the onset of weakness and double vision. He has hypertension and hyperlipidemia treated with metoprolol, captopril, and atorvastatin. His blood pressure is 190/106 mm Hg. Neurologic examination shows left-sided facial weakness including the forehead.
There is palsy of left conjugate gaze, and the left eye fails to adduct on right gaze.
Vertical eye movements are intact. Muscle strength is 3/5 in the right upper and lower extremities. Deep tendon reflexes are brisk, and Babinski's sign is present on the right. Which of the following is the most likely location of this patient's lesion?

A) Bilateral thalamic

B) Left frontal

C) Left pontine

D) Right caudate

E) Right midbrain

[ArchivalUser]

shold be left pontine brain stem lesion.whats the answer

[ArchivalUser]

I would consider left side problem since the right side paresis, and left eye problem, answer in the download was D, but don't know why

[ArchivalUser]

ru sure about the answer?i mean thats strange to know that the answer is right caudate.

[ArchivalUser]

I don't think that's correct, that's why I post here to get more opinion

[ArchivalUser]

i think we should read about pontine haemorrhage from some site.dou believe thats this is abrain stem hemorrhage.if so then brainstem lesion always presents as alternate syndrome

[ArchivalUser]

what's the correct answer for this one?

[ArchivalUser]

left pontine lesion: paralysis of
ispilateral facial and contralateral limbs