All right, welcome to episode 560 of the Divine Intervention Podcasts. In today's podcast,

we're going to be continuing the series on the step 3, 3, 3137. This is going to be part

7. Again, if you're studying for step 2, CK, you really should listen to this as well, because

chances are by the time you get ready to take step three a new free 137

will have been released okay let's so we're going to be doing hopefully you know god willing 61 to

70 today so let's jump right into it so a 56 year old man comes to the office because of a three-week

history of right arm weakness and drooping of his right eyelid okay medical? Medical history is significant for hypertension and dyslepidemia,

but he takes no medications.

He has smoked one half pack of cigarettes daily for the past 40 years.

BMI is 26.

His temperature is 99.0 degrees Fahrenheit, pulses 82 per minute,

and respirations at 20 per minute,

and blood pressure is 138 over 74 millimeters of mercury.

Physical examination shows toosis on the right side.

The left pop pill measures 5 millimeters in diameter, and the right pop pill measures 4 millimeters

in diameter.

Both poppils are reactive to light and accommodation.

Muscle strength is 3 out of 5 in the right finger flexors and hand grip.

Muscle strength and deep tendon reflexes are otherwise normal. Finger stick blood glucose is

119. Which of the following is the most likely diagnosis. Option is, so let's frame this question.

So this is a person that has smoked a lot. And you're noticing that this person seems to have some signs of Horner's syndrome.

So, you know, they have, they appear to have toses.

...