MSFinals-3141
Which of the following characteristics is absent in a corticospinal lesion?
Archives: Medical Student Finals
MSFinals-3142
A 36-year-old man is discharged from hospital after an episode of meningitis. The organism was diagnosed as being Streptococcus pneumoniae after a lumbar puncture and the patient was treated with ceftriaxone. On discharge, his observations were normal. He has a past medical history of asthma treated with salbutamol and low-dose inhaled corticosteroids. He has no known drug allergies.
A few days following his discharge, he started experiencing postural headaches that were worse when sitting upright. He grades his pain as 7/10. He has been feeling nauseated, although has had no vomiting episodes. He also has some minor neck stiffness and is not confused. He attends A&E, as he is worried about his new symptoms. There is evidence of extrathecal cerebrospinal fluid (CSF). Diagnosis is confirmed on a computed tomography (CT) myelogram.
What is the most likely cause of this patient’s headache?
MSFinals-3103
A 55-year-old man has been referred to you due to a personality change that has been going on for a year. He has become loud, sexually flirtatious, and inappropriate in social situations. He has also been experiencing difficulties with memory and abstract thinking, but his arithmetic ability remains intact. There is no motor impairment, and his speech is relatively preserved. Which area of the brain is most likely affected?
MSFinals-3104
A 42-year-old woman comes to her doctor complaining of drooling from one side of her mouth and inability to raise the left corner of her mouth when she smiles. During the examination, the doctor observes dryness and scaling on her left cornea. Which nerve is likely affected in this case?
MSFinals-3105
Which of the following indicates a psychiatric illness rather than an organic brain disorder?
MSFinals-3106
An action potential reaches the presynaptic membrane of a central neurone’s axon. What is the primary effect it produces?
MSFinals-3107
A 35-year-old homeless man with known human immunodeficiency virus (HIV) infection presents to the Emergency Department with complaints of headache, neck stiffness, and photophobia for the past 3 weeks. He is unsure if he has had fevers but has experienced chills. He has a history of intravenous drug abuse and hepatitis C. On examination, he appears uncomfortable and avoids light. A lumbar puncture is performed, and India ink highlights several round, thickly encapsulated organisms in his cerebrospinal fluid (CSF).
What is the expected CSF finding pattern in this case?
MSFinals-3108
A 12-year-old girl comes to the clinic complaining of a headache and homonymous superior quadrantanopia. What is the most probable diagnosis?
MSFinals-3109
A 4-year-old girl without past medical history is brought to the General Practitioner (GP) by her mother with 24 hours of headache and fever. She has also had two episodes of non-bloody vomiting this morning and states that ‘both legs are sore all over’. She is up to date with all of her vaccinations and has never been hospitalised in the past. No one in the child’s social circle has been unwell recently and she has no travel history. She has no drug allergies.
On examination, discrete lesions of approximately 1–2 mm are visible, present on the trunk and legs. This rash is non-blanching. The mucous membranes are moist without lesions present. Her hands are cool to touch with a capillary refill time of three seconds. She is unable to fully flex her neck. Her observations are shown below:
Temperature 38.2 °C
Blood pressure 100/59 mmHg
Heart rate 107 beats per minute
Respiratory rate 22 breaths per minute
Sp(O2) 98% (room air)
Which of the following is the most appropriate next step in management?
MSFinals-3110
A 30-year-old man is referred to a Rapid Access Neurology Service due to severe headache. He gives a history of recurrent rapid-onset severe right-sided headache and eye pain. It sometimes wakes him up at night. He claims the eye itself becomes watery and red during the periods of pain. He also claims that side of his face feels hot and painful during episodes. They normally last 60 minutes. However, he says they can be shorter or longer. There is no significant medical history. He is a smoker. He is pain-free during the consultation and examination is non-contributory.
Which of the following is most likely to be of value in relieving pain?