Dysfunction of what area of the brain is noted by the four Ds (dysphagia, dysarthria, diplopia, and dysmetria)?
A. Dysfunction of the medulla
B. Dysfunction of the thalamus
C. Dysfunction of the brainstem
D. All of the above
ANS: C
Rationale: Dysphagia, dysarthria, diplopia, and dysmetria are the cardinal signs of brainstem dysfunction. Dysphagia is difficulty in swallowing; dysarthria is difficulty in speaking; diplopia is double vision; and dysmetria is the inability to control the distance of movements.
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