USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 20-year-old man comes to the clinic because of shortness of breath on exertion. He says he has felt short of breath for three weeks and also had a rash occasionally. His temperature is 36.6 °C (97.9°F), pulse is 68/min, respirations are 18/min, and blood pressure is 130/78 mm Hg. Physical examination shows a raised erythematous macular rash. A chest x-ray shows bilateral hilar lymphadenopathy and his serum angiotensin converting enzyme is elevated. A biopsy of his rash shows multiple non-caseating granulomas with multinucleated giant cells. Which of the following is most likely to be seen on neurological examination?