Neuroanatomy USMLE Step 1 Practice Question
A 56-year-old woman with metastatic breast cancer presents with progressive bilateral leg weakness and hyperreflexia. Vital signs show BP 128/82, HR 88, RR 16, temp 37°C, SpO2 98%. Neurologic exam reveals bilateral Babinski signs and spasticity. Pain and temperature sensation are intact bilaterally. MRI cervicothoracic spine demonstrates T6 spinal cord compression with cord signal abnormality. She takes tamoxifen and recently completed chemotherapy. Which spinal cord tracts are most likely affected?
Answer choices
- ASpinothalamic tracts bilaterally
- BDorsal columns (fasciculus gracilis and cuneatus)
- CCorticospinal tracts bilaterallyCorrect answer
- DSpinocerebellar tracts
- ELateral corticospinal and dorsal column tracts
- FAnterior horn cells at T6 with preservation of dorsal columns
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