You are seeing a patient in clinic who presents with complaints of weakness. Her physical exam is notable for right sided hyperreflexia, as well as the reflex finding shown in the image below. Where is the most likely location of this patient's lesion?
APostcentral gyrus
BNeuromuscular junction
CLateral geniculate nucleus
DInternal capsule
ESubthalamic nucleus
A 57-year-old man presents to his primary care physician with a 2-month history of right upper and lower extremity weakness. He noticed the weakness when he started falling far more frequently while running errands. Since then, he has had increasing difficulty with walking and lifting objects. His past medical history is significant only for well-controlled hypertension, but he says that some members of his family have had musculoskeletal problems. His right upper extremity shows forearm atrophy and depressed reflexes while his right lower extremity is hypertonic with a positive Babinski sign. Which of the following is most likely associated with the cause of this patient's symptoms?
AHLA-DR2 haplotype
BMutation in SOD1
CViral infection
DHLA-B8 haplotype
EMutation in SMN1
A 54-year-old man comes to the physician for the evaluation of difficulty swallowing of both solids and liquids for 1 month. During the past 5 months, he has also had increased weakness of his hands and legs. He sails regularly and is unable to hold the ropes as tightly as before. Ten years ago, he was involved in a motor vehicle collision. Examination shows atrophy of the tongue. Muscle strength is decreased in the right upper and lower extremities. There is muscle stiffness in the left lower extremity. Deep tendon reflexes are 1+ in the right upper and lower extremities, 3+ in the left upper extremity, and 4+ in the left lower extremity. Plantar reflex shows an extensor response on the left foot. Sensation to light touch, pinprick, and vibration is intact. Which of the following is the most likely diagnosis?
AAmyotrophic lateral sclerosis
BInclusion-body myositis
CSubacute combined degeneration of spinal cord
DSyringomyelia
ECervical spondylosis with myelopathy
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