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Which one of the following signs would you expect to find in this 76-year-old woman with anemia? A) Bulbar palsy B) Flaccid paralysis of the upper extremities C) Lower-extremity spasticity D) Lower-extremity thermoanesthesia E) Romberg's sign

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SUGGESTIVE OF E.. ROMBERG'S SIGN .. IN. M R. I.... WITH PERNICIOUS. ANEMIA
A- Bulbar palsy Because spinal cord compression is at very high level near C1- C2 level
Also adjoining medulla is involved
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Ans B flaccid paralysis of upper extremities
Thanx dr Ashok Leel
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A) Bulbar palsy
A. Bulbar palsy
) BULBAR PALSY
Thanks Dr Dinesh Gupta
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I think it has to be C- lower limb spasticity. Patient has SACD, ie subacute combined degeneration. Due to b12 deficiency Patients will present with features of macrocytic anemia, glossitis and spasticity, ataxia and quadriparesis. Inj b12 is curative for the early disease.
B) flaccid paralysis of the upper extremities
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