MCQ Medicine Answer 6

Ataxia, lightning pains, a positive Romberg sign, areflexia, and a lack of vibratory or position sensation can all be seen with tabes dorsalis which is due primarily to the involvement of the dorsal roots.

A patient with Friedreich's ataxia (choice a) will also present with a loss of position and vibratory sensation in the lower extremities as well as a positive Romberg sign, however, the age of the patient is not consistent with a diagnosis of Friedreich ataxia. Friedreich ataxia usually begins when patients are children and there is ataxia in very young adulthood. It leads to patients being wheelchair bound or bedridden in young adulthood, which was not the case here.

The deep tendon reflexes would be present or increased in amyotrophic lateral sclerosis (choice c). Typically there is a lack of sensory changes with ALS as well.

Cerebellar ataxia (choice d) is not affected by visual input. Since his swaying was present only with his eyes closed, cerebellar ataxia is not correct.

Polio (choice e) is a disease that affects that anterior horn and therefore motor function is affected; strength would not be adequate. Although ataxia can be seen with polio, the sensory changes in this scenario would not be found.

Category: Internal Medicine MCQs , Medicine MCQs