Demyelinating disorders Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 63-year-old woman is brought to the emergency department by her partner due to progressive lethargy and confusion. The patient was recently diagnosed with metastatic small cell carcinoma of the lung and has refused all treatment, wishing to pursue only “comfort care measures.” She has been smoking a pack of cigarettes per day for the last 45 years. Vital signs are within normal limits. Physical examination shows no abnormalities. Serum studies show the following:  
 Laboratory value  Result  Reference Range 
 Sodium   108 mEq/L  136-146 mEq/L 
 Potassium   4.2 mEq/L  3.5-5 mEq/L 
 Chloride   95 mEq/L  95-105 mEq/L 
 Creatinine   0.9 mg/dL  0.6-1.2 mg/dL 
 Albumin   3.2 g/dL  3.5-5.5 g/dL 
     
The patient is started on hypertonic saline. On the second day of treatment, the partner notices the patient is unable to move, but she is able to blink in response to questions. Which of the following is the most likely location of the brain lesion in this patient?

A sagittal M R I of a human head shows brain structures. A points to the cerebral cortex, B to the corpus callosum, C to the cerebellum, D to the pons, and E to the medulla.
Image reproduced from Wikimedia Commons

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