Archives: Medical Student Finals

MSFinals-3055

A 10-year-old child is brought to the general practitioner by his mother. He complains of loss of sensation over the dorsal aspect of his right forearm and hand for the last few days. His mother also states that he cannot extend his fingers and wrist after she pulled her son’s right hand gently while crossing a street 4 days ago. He had pain in his right elbow at that time but did not see a doctor immediately. On examination, there is loss of sensation and muscle weakness over the extensor surface of his right forearm and hand.
Which of the following nerves is most likely to be injured in this patient?

MSFinals-3056

A 9-year-old boy comes to his general practitioner complaining of severe pain in his right elbow area. He reports falling off his bike and landing on his outstretched arm.
During the examination of the affected limb, the radial pulse appears normal. The patient experiences weakness in finger flexion at the proximal interphalangeal joints in all digits, with the index and middle fingers showing particular weakness. The patient has no feeling in the palmar aspect of the thumb, index finger, and middle finger. Finger extension and abduction remain unaffected.
Which of these findings is most likely to be linked to this injury?

MSFinals-3057

A 63-year-old woman comes to the clinic with a complaint of unilateral facial droop. Upon examination, it is noted that she is unable to fully close her left eye. She has no significant medical history but reports having a recent viral upper respiratory tract infection. Her husband is worried that she may have had a stroke, but there are no other focal neurological deficits found except for the isolated left-sided facial nerve palsy.
What clinical finding would you anticipate during the examination?

MSFinals-3058

A patient attends the neurology clinic following a referral from the GP due to difficulty with eating and chewing food. A neurologist performs a cranial nerve assessment and suspects a lesion of the right trigeminal nerve.
Which of the following is a clinical feature of a trigeminal nerve palsy in an elderly patient?

MSFinals-3059

A patient attends the Neurology clinic following a referral from the general practitioner due to difficulty with eating and chewing food. A neurologist performs a cranial nerve assessment and suspects a lesion of the left-sided trigeminal nerve.
Which of the following is a clinical feature of a trigeminal nerve palsy?

MSFinals-3060

A 30-year-old woman visits her doctor, reporting a progressive weakness on the left side of her face for the past 48 hours. What symptom would be indicative of Bell’s palsy in this case?

MSFinals-3061

A 29-year-old woman presents to the Emergency Department with a sudden-onset headache that began 12 hours ago. She describes it as ‘an explosion’ and ‘the worst headache of her life’. She denies any vomiting or recent trauma and has not experienced any weight loss. On examination, there are no cranial nerve abnormalities. A CT scan of the head shows no abnormalities. She has no significant medical or family history. The pain has subsided with codeine, and she wants to be discharged.

What is the most appropriate course of action for this patient?

MSFinals-3062

A 29-year-old woman presents to the Emergency Department with a sudden-onset headache that began 12 hours ago. She describes it as ‘an explosion’ and ‘the worst headache of her life’. She denies any vomiting or recent trauma and has not experienced any weight loss. On examination, there are no cranial nerve abnormalities. A CT scan of the head shows no abnormalities. She has no significant past medical history or family history. The pain has subsided with codeine, and she wants to be discharged.

What is the most appropriate course of action for this patient?

MSFinals-3063

A 48-year-old woman presents with sudden-onset severe headache. She complains of pain behind the eyes and photophobia. She has vomited twice since the headache came on. She says it is the worst headache she has ever had by far. There is no past history of migraine. Examination reveals no neurological deficit.
What is the most appropriate initial investigation?

MSFinals-3064

An 80-year-old male comes to the clinic with sudden vision loss in his right eye and a relative afferent pupillary defect. He has uncontrolled systemic hypertension and elevated cholesterol levels. What is the probable cause of his condition?