nbme 4 question

[firstaid2012]

---

Members don't see this ad.

the one with a picture of a brain section, pointing right side of the cerebellar hemisphere by arrow*)
A 10-year-old boy is evaluated for progressive headaches over the past 3 months. An MRI of the head shows a lesion in the structure indicated by the arrow* in the section of a normal brain. Which of the following is the most likely associated symptom?

A) Contralateral dysmetria
B) Contralateral gaze-evoked nystagmus
C) Ipsilateral hypertonia
D) Ipsilateral intention tremor
E) Truncal ataxia

please explain

 

[Myxedema]

1. Cerebellar lesions are almost always ipsilateral, so you can eliminate A and B.
2. Hypotonia is seen in lesions with LMN involvement, so you can eliminate C
3. Truncal ataxia is seen in lesions of cerebellar vermis, not hemispheres; so you can eliminate E.

Ipsilateral intention tremor can be seen in lesions of cerebellar hemispheres.

 

[thehundredthone]

2. Hypotonia is seen in lesions with LMN involvement, so you can eliminate C

His option says hypertonia though, which is a UMN sign, hence eliminating it. Hypotonia can be seen with cerebellar lesions.

 

[Myxedema]

His option says hypertonia though, which is a UMN sign, hence eliminating it. Hypotonia can be seen with cerebellar lesions.

Heh, yes it does say hypertonia, and like you've said that's why that choice can be eliminated. I've thought about editing my previous post, but I guess I'll let it stay that way as a warning for checking what you've written before you hit the reply button.