USMLE-Rx Step 1 Qmax Challenge #4094

Check out today’s Step 1 Qmax Question Challenge.

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USMLE-Rx Step 1 Qmax Challenge #4094A 55-year-old woman has received treatment for years to manage a chronic, progressive disease. Since her mid-40s the patient has had difficulty initiating movements. She has a shuffling gait, an expressionless face, and tremor in her hands and fingers at rest. Over the years she has tried many medications but with little relief of her symptoms, and instead has experienced severe adverse effects. She is referred for possible ablation surgery. The neurosurgeon explains the different pathways involved in initiation and inhibition of movement, the foundation of her disease. The neurosurgeon explains that by nullifying or accentuating some of the pathways, some of her symptoms may be alleviated.

The introduction of an ablative lesion into which structure labeled in the image would be expected to improve this patient’s bradykinesia?

A. A
B. B
C. C
D. D
E. E


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11 thoughts on “USMLE-Rx Step 1 Qmax Challenge #4094”

  1. Ahmed Magdi Youssef

    A. Ablation of globus pallidus internus disinhibits the thalamus with resultant enhancement of the direct pathway.

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