Cerebrovascular Disease USMLE Step 1 Practice Question
A 52-year-old man with a history of untreated syphilis presents with progressive gait instability and lightning-like pains in both legs over 3 months. Vital signs: BP 145/92 mmHg, HR 78/min, RR 16/min, Temp 37.2°C. Examination reveals positive Romberg sign, loss of vibration sense in lower extremities, and Argyll Robertson pupils. CSF VDRL is positive. He denies visual complaints. Which of the following is the most likely diagnosis?
Answer choices
- ASubacute combined degeneration
- BGuillain-Barre syndrome
- CAmyotrophic lateral sclerosis
- DMyasthenia gravis
- ETabes dorsalisCorrect answer
- FNeurosyphilitic optic atrophy
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