USMLE Step 1 High Yield Question with complete solution 2023

USMLE Step 1 High Yield Question with complete solution 2023Klüver Bucy syndrome Hyperorality, hypersexuality, disinhibited behavior. Associated with HSV-1 Gerstmann Syndrome Lesion of the parietal-temporal cortex. Agraphia, acalculia, finger agnosia, and left-right disorientation. Wernicke-Korsakoff Syndrome Confusion, ophtalmoplegia, ataxia, memory loss (anterograde and retrograde amnesia), confabulation, personality changes. Wernicke problems come in a CAN of beer: Confusion, Ataxia, Nystagmus. Paramedian pontine reticular formation lesion. Eyes look away from side of lesion Frontal eye field lesion Eyes look toward lesion Central Pontine myelinolysis Correcting serum Na+ too fast: From low to high your pons will die (CPM). From high to low your brain will blow (cerebral edema/herniation) Lenticulo-striate artery Lesion in lacunar infracts 2ndary to unmanaged htn. Contralateral hemiparesis/hemiplegia MCA stroke Contralateral sensory and motor loss of upper limb. Wernicke and broca aphasia. ACA stroke Motor/sensory loss contralateral lower limb. Anterior spinal artery (ASA) stroke Contralateral hemiparesis upper and lower limbs. Decr. Contralateral propioception. Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally). PICA stroke (Wallenberg syndrome) Vomiting, vertigo, nystagmus, decr. Pain and temp. Sensation from ipsilateral face and contralateral body. Dysphagia, hoarseness, decr. Gag reflex. Ipsilateral horner syndrome, ataxia and dysmetria. "Don't pick a (PICA) horse (hoarseness) that can't eat (dysphagia)". AICA stroke Vomiting, vertigo, nystagmus, decr. Pain and temp. Paralysis of the face decr. Lacrimation, salivation, decr. Taste from Anterior 2/3 of the tongue, decr. Corneal reflex. Face decr. Pain and temp. Ipsilateral decr. hearing. Ipsilateral horner syndrome, ataxia and dysmetria. "Facial droop means AICA's pooped". Pcomm stroke CN III palsy- eye is down and out with ptosis and pupil dilation. Charcot-Bouchard microaneurysm Associated with chronic htn; affects small vessels eg. Basal ganglia and thalamus Spinal muscular atrophy (werdnig-hoffmann disease) Congenital degeneration of anterior horns of spinal cord lead to LMN lesion. Floppy baby syndrome. Histologic changes after a MI 0-4 hours: minimal change or Normal. 4-12 hours: early coagulation, necrosis, edema, hemorrhage, wavy fibers. 12-24 hours: coagulation necrosis and marginal contraction band necrosis. 1-5 days: coagulation necrosis and neutrophillic infiltrate. 5-10 days: macrophage phagocytosis of dead cells. 10-14 days: granulation tissue and neovascularization. 2 weeks: collage (type 1) deposits/ scar formation. MCC of dead after a MI 0-24 hours: arrythmia (Vfib), HF, cardiogenic shock. 3-14 days: free wall rupture cardiac tamponade. 2 weeks: Dressler syndrome: autoimmune attack to healed tissue. Pulsus Paradoxus decrease in amplitude of systolic blood pressure by 10 mmHg during inspiration. seen in cardiac tamponade, asthma, obstructive sleep dyspnea, pericarditis, and croup.