HY USMLE Q #1097 – Neuro

A 31-year-old woman comes to the physician for a 2-day history of urinary urgency and visual disturbance. She reports needing to run to the bathroom 8-12 times per day. There is a positive Babinski sign on the left. Ophthalmologic examination shows nystagmus in the left eye when looking to the left and impaired adduction in the right eye. Convergence is normal. Which of the following is most likely to be seen in this patient?

  Diminished muscarinic receptor activation
  Fasciculations
  Impaired oculomotor nerve activity
  T cell infiltration within endomysium
  T-cell-mediated destruction of myelin basic protein

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