USMLE Forum Archives - USMLE Step 1 - Pathology 3
Pathology 3
Kimo - 01-06-08 16:35
A 42 yr old man who works in a kitchen as a chef complains that he burns his hands without feeling any pain. An exam reveals abnormal deep tendon reflexes limited to the upper extremity, atrophy of the intrinsic muscles of the hand, and decreased pain and temperature sensation in upper extremities. which of the following is most likely the Diagnosis?
A. Multiple Sclerosis
B. Spinal Cord Tumor
C. Syringomyelia
D. Vitamin B12 Deficiency
E. Amyotrophic Lateral Sclerosis
Kimo - 01-06-08 16:35
A 42 yr old man who works in a kitchen as a chef complains that he burns his hands without feeling any pain. An exam reveals abnormal deep tendon reflexes limited to the upper extremity, atrophy of the intrinsic muscles of the hand, and decreased pain and temperature sensation in upper extremities. which of the following is most likely the Diagnosis?
A. Multiple Sclerosis
B. Spinal Cord Tumor
C. Syringomyelia
D. Vitamin B12 Deficiency
E. Amyotrophic Lateral Sclerosis
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#2
Re: Pathology 3 isha52ke - 01-07-08 15:43 B spinal cord tumor. These tumors can give weakneses, sensory disturbances & reflex changes below the level of the lesion.
#3
Re: Pathology 3 InSitu - 01-07-08 15:45 C it is. Pericentral canal Syringomyelia and spinothalamic tracks involved.
#4
Re: Pathology 3 InSitu - 01-07-08 15:47 someone needs to explain the muscle atrophy :) lets wait and see
#5
Re: Pathology 3
Kimo - 01-07-08 17:45 correct answer is C: syringomyelia
def: Fluid filled cavity within the Cervical Spinal Cord
clinical features:
-enlargement of the cervical cord
-associated with Arnold-Chiari Malformation
-Loss of pain and temperature sensation: Disruption of the crossed lateral spinothalamic tracts
-Atrophy of the intrinsic muscles of the hand
a. Destruction of anterior horn cells
b. confused with ALS (no sensory changes in ALS)
-patient burns hands without even knowing it!!!
#12
Re: Pathology 3 InSitu - 01-11-08 02:20 
posted by Alexandre on 01-11-08 01:25
ah ok!! ahssan nass!! thanx Kimo
ah ok!! ahssan nass!! thanx Kimo
:) are you from egypt Alexandre? Izzaiak? :)
#15
Re: Pathology 3 galaxy - 05-27-10 20:02 A 42 yr old man who works in a kitchen as a chef complains that he burns his hands without feeling any pain. An exam reveals abnormal deep tendon reflexes limited to the upper extremity, atrophy of the intrinsic muscles of the hand, and decreased pain and temperature sensation in upper extremities. which of the following is most likely the Diagnosis?
C. Syringomyelia
#16
Re: Pathology 3 babbu5508 - 06-21-10 15:14 C. Syringomyelia..a cyst or cavity forms within the spinal cord. syringomyelia spares the dorsal column/medial lemniscus of the spinal cord, leaving pressure, vibration, touch and proprioception intact in the upper extremities.
#17
Re: Pathology 3 bingousmle - 06-30-10 22:14 abnormal deep tendon reflexes limited to the upper extremity, atrophy of the intrinsic muscles of the hand, and decreased pain and temperature sensation in upper extremities point to syringomyelia inwhich htere is dialtion of central canal producing pressure atrphy
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