![]() ![]() Key idea: Meningismus (pain with neck movements) can be seen in both meningitis (due to inflammation/infection of meninges) AND subarachnoid hemorrhage (due to blood accumulation in subarachnoid space irritating meninges)ģ) An 80-year-old man briefly loses consciousness and falls to the floor in a grocery store.Key idea: Parasympathetic fibers run in Periphery of CN3 whereas Motor fibers run in the Middle, which is why compression of CN3 typically first leads to loss of parasympathetic function before causing “down and out” eye.Key idea: Aneurysms of the posterior communicating arteries commonly compress cranial nerve 3 and therefore lead to loss of parasympathetic tone to the eye, leading to mydriasis. ![]() Middle aged woman presents with “worst headache of her life” while exercising with exam notable for blown right pupil + meningismus most concerning for subarachnoid hemorrhage in setting of ruptured posterior communicating artery aneurysm.NM Junction –> Myasthenia gravis, Lambert-Eaton, botulismĢ) A 47-year-old woman is brought to the emergency department 1 hour after the onset of a severe headache that began….CN 6 –> Unilateral issues with eye abduction.CN 4 –> Trouble walking down stairs or reading (impaired lateral eye movements when looking down).CN 3 –> “Down and out” eye +/- blown pupil (loss of parasympathetic tone) +/- ptosis.Cerebellar lesion –> Ataxia (wide-based gait, impaired finger-nose testing).Internuclear ophthalmoplegia: One eye cannot fully adduct on lateral eye movements.Optic neuritis: Unilateral eye pain and visual problems.Key idea: 2 eye conditions that are quite specific for multiple sclerosis include:.Young woman presents with unilateral eye pain associated with a central scotoma, most concerning for multiple sclerosis complicated by optic neuritis (which is due to inflammation of the optic nerve (CN 2)).Good luck with your exams!ġ) A 22-year-old woman comes to the physician because she has had a black spot that occludes her vision in her right eye… #BPPV USMLE PRACTICE TEST FOR FREE#Lastly, please check out my Youtube channel ( ) and the “Biostatistics Curriculum” option above for free videos and practice questions reviewing all the essential biostatistics topics covered on NBME exams. I also offer reasonably priced tutoring, so please reach out using the “Step 1, Step 2 and Shelf Exam Tutoring” menu option listed above if you would like personalized support.įurthermore, I offer personal statement and application review services for residency applicants, so please reach out using the “Residency Advising and Application Preparation” menu option above if interested. However, given multiple email requests, I will post my Venmo if you want to send a few dollars to show your support for the website. These answer explanations are and always will be free. ![]()
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