Archives: Medical Student Years 1-3

MS-4077

A 37-year-old woman presents with blurring of vision on lateral gaze. She had a previous episode of pain on eye movement and difficulty seeing red colors six months ago, which resolved on its own after a week.

She sought consultation with a neurologist who conducted an examination. The left eye failed to adduct on rightward gaze, while the right eye exhibited nystagmus. Leftward, upward, and downward gazes were unremarkable. The pupils were equal and reactive to light.

Peripheral examination yielded no significant findings. An MRI brain scan was ordered, and the results are pending.

Based on this presentation, where is the most likely location of the lesion?

MS-4078

A 63-year-old woman with a longstanding history of type 2 diabetes mellitus, hypertension, and hypercholesterolemia experienced sudden weakness in her right lower leg while preparing breakfast. She had a similar episode two days ago, which resolved after an hour. Her son brought her to the emergency department, where she reported her symptoms to the attending physician. The patient can speak well and fully comprehend what the doctor tells her. Upon examination, the doctor noted decreased touch sensation in her right leg. A non-contrast computed tomography (CT) scan was unremarkable, but a repeat CT scan after 12 hours revealed an area of hypo-attenuation in a region of the brain. Which artery of the cerebral circulation is most likely to be occluded in this patient?

MS-4061

A 68-year-old male comes to the emergency department with hemiparesis. During your conversation with him, you discover that his speech is fluent but his repetition is poor. He is conscious of his inability to repeat words accurately but persists in trying. You suspect that a stroke may be the cause of this condition.

Which region of the brain has been impacted by the stroke?

MS-4063

An 80-year-old woman with a history of hypertension is brought to the emergency department after falling at home. She reports experiencing a loss of sensation on her right side.

Upon examination, you confirm the loss of sensation in the right arm and leg. Additionally, you note that the right arm has 3/5 power and the right leg has 2/5 power. In contrast, the limbs on the left side have 5/5 power and intact sensation.

Based on these findings, which artery is most likely affected?

MS-4064

A 50-year-old motorcyclist is seeking treatment at your clinic after a bike accident that occurred 10 months ago. The patient suffered a significant pelvic fracture, which has since healed. However, he is worried about the persistent numbness in his right leg. During the examination, he experiences difficulty in adducting his right hip against resistance and has reduced sensation around the medial aspect of his right thigh. Which nerve is most likely to have been affected?

MS-4059

As a neurology doctor, you have been requested to assess a 36-year-old woman who was in a car accident and suffered a significant head injury.

Upon arrival, she is unconscious, and there are some minor twitching movements in her right arm and leg. When she wakes up, these movements become more severe, with her right arm and leg repeatedly flinging out with different amplitudes.

Based on the likely diagnosis, where is the lesion most likely located?

MS-4056

A 50-year-old man visits the clinic with a complaint of gradual hearing loss over the past nine months. He works in construction and initially attributed it to the use of loud power tools, despite always wearing ear protection. He also reports experiencing a high-pitched ringing in his ears for the same duration. Recently, he has been experiencing episodes of dizziness where he feels like the room is spinning. Otoscopy reveals no abnormalities. During the Rinne and Weber tests, the Rinne test is positive bilaterally, and the sound is louder on the left. What conclusions can be drawn from these findings?

MS-4057

A 13-year-old girl is brought to the first-seizure clinic by her parents after experiencing multiple seizures in the past two weeks. According to her parents, the girl loses consciousness, becomes rigid, and falls to the ground while shaking for about two minutes during each episode. They also report that she has been experiencing urinary incontinence during these seizures.

The specialist decides to prescribe an antiepileptic medication.

What is the likely diagnosis for this patient, and what is the mechanism of action of the prescribed drug?

MS-4058

A 36-year-old woman presents to her general practitioner with sudden-onset painful red-eye and blurred vision in her left eye. She reports that the pain started suddenly while she was out for lunch with her friends. On examination, a hypopyon is present in the left eye, which is also red and has a small and irregularly shaped pupil. Ophthalmoscopy cannot be performed due to photophobia. The patient is diagnosed with anterior uveitis. What medical history might be observed in this patient’s past?

MS-4060

A 32-year-old woman who is a primigravida at 15 weeks gestation presents to the emergency department with drooped features on the left side of her face and a runny nose. She noticed this in the morning when washing her face. There is no limb weakness, visual disturbance, or dysphagia noted.

What other symptoms would be indicative of this diagnosis?