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Old 11-10-2012
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Arrow Billy Step 1 Questions # 81

A 63-year-old homeless woman is brought to the emergency department by the police, who noted her to be disoriented and confused. On questioning, the patient appears to be having problem with her short-term memory, frequently forgetting what question she had been asked. She provides plausible details of the events prior to her coming to the hospital, but the police report to be untrue. On physical examination she is emaciated and has nystagmus and an unsteady gait. Examination of emergency department records reveals that she has presented multiple times in the past for alcohol withdrawal. The lesion accounting for the patient’s symptoms is located in which part of the brain?


(A) Basal ganglia
(B) Broca’s area
(C) Cerebellar vermis
(D) Mamillary bodies
(E) Wernicke’s area
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Default D?

Mamillary bodies??

Just guessing here. Neuro is still a weak point for me
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Default EE

E...confabulation
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E. Wernicke's area
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D. Mamillary bodies
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D......mamillary body
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Correct Answer D is correct

The patient presents with classic signs of Wernicke-Korsakoff encephalopathy, which is associated with thiamine deficiency in chronic alcohol abusers. The classic signs are confusion, disorientation,
anterograde amnesia, confabulation, oculomotor dysfunction, and motor ataxia. The lesion is located in the mammillary bodies.

Answer A is incorrect. Lesions in the basal ganglia are associated with movement disorders.

Answer B is incorrect. Lesions in Broca’s area are associated with a motor aphasia with good comprehension.

Answer C is incorrect. Lesions in the cerebellar vermis are associated with truncal ataxia and dysarthria.

Answer E is incorrect. Lesions in Wernicke’s area are associated with a sensory aphasia with poor comprehension
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