A 65-year-old woman comes to the physician for the evaluation of sharp, stabbing pain in the lower back for 3 weeks. The pain radiates to the back of her right leg and is worse at night. She reports decreased sensation around her buttocks and inner thighs. During the last several days, she has had trouble urinating. Three years ago, she was diagnosed with breast cancer and was treated with lumpectomy and radiation. Her only medication is anastrozole. Her temperature is 37°C (98.6°F), pulse is 80/min, respirations are 12/min, and blood pressure is 130/70 mm Hg. Neurologic examination shows 4/5 strength in the left lower extremity and 2/5 strength in her right lower extremity. Knee and ankle reflexes are 1+ on the right. The resting anal sphincter tone is normal but the squeeze tone is reduced. Which of the following is the most likely diagnosis?
AAnterior spinal cord syndrome
BCauda equina syndrome
CConus medullaris syndrome
DCentral cord syndrome
EBrown-sequard syndrome
The surgical equipment used during a craniectomy is sterilized using pressurized steam at 121°C for 15 minutes. Reuse of these instruments can cause transmission of which of the following pathogens?
ANon-enveloped viruses
BSporulating bacteria
CPrions
DEnveloped viruses
EYeasts
A 45-year-old man is brought to the emergency department by ambulance after a motor vehicle collision. He is not responsive to verbal commands and is unable to provide any history. His pulse is 108/min and regular. Physical examination shows ecchymoses over the neck and back. Neurological examination indicates damage to the spinal cord at the level shown in the illustration. This patient's injury is most likely located at which of the following levels of the spinal cord?
AC2
BS2
CL4
DT6
ES4
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