A 65-year-old man with insulin-dependent diabetes mellitus of 10 years' duration awakes one morning with pain and weakness of the right leg. The patient has difficulty walking and states that he tripped while walking up the stairs to his home. The patient denies dysarthria, bladder and bowel dysfunction.
The general examination is unremarkable up to the Neurologic exam. He has significant weakness of the right peronei, tibialis anterior, and extensor hallucis longus muscles. Straight leg raise on the right is positive for pain.
Power in both arms and his left leg are intact. Sensation to pain, temperature, and light touch is diminished over the lateral aspect of the right leg. Reflexes are intact in the arms but and 0 at the right ankle, the plantar responses are flexor. He has a right foot drop. The remainder of the neurologic exam, including palpation of the spine, is unremarkable.
Question:
What is the most likely diagnosis?
A. L4/L5 Disc Herniation
B. Diabetic Mononeuropathy
C. Infarction of the Anterior horn of the spinal cord
D. L5/S1 Disc Herniation
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Answer: D
67 year old female with a 20 pack year history of smoking, COPD and Pedal edema. She denies SOB except at night. She sleeps with 3 pillows.
Based on the following EKG, what would you expect on CXR?
A. LVH
B. RAH and RVH
C. CHF
D. Pneumothorax
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Answer: B.
