Archives: Medical Student Finals

MSFinals-3042

A 19-year-old woman is admitted to the hospital three days after becoming confused, disoriented, and having an unsteady gait. During the past four months she has been depressed and has declined food. She has lost approximately 12 kg in weight.

She appears thin and is disoriented in time and place. She reports having double vision. Neither eye abducts normally. Her gait is unsteady although the limbs are strong. The liver and spleen are not enlarged.

What would be the most appropriate initial step in her treatment?

MSFinals-3043

Which statement about the facial nerve is accurate in terms of its paragraph structure?

MSFinals-3044

A 10-year-old girl is referred to the neurologist by her GP. She loves playing basketball, but is worried because her teammates have been teasing her about her appearance. They have been making fun of her in the locker room because of the spots she has under her armpits and around her groin. They have also been teasing her about her height, as she is the tallest girl on the team. During a skin examination, the doctor notices evidence of inguinal and axillary freckling, as well as 9 coffee-colored spots on her arms, legs, and chest. An eye exam reveals iris hamartomas.

What is the mode of inheritance for the underlying condition?

MSFinals-3045

A 10-year-old girl is referred to the neurologist by her GP. She loves playing basketball, but is worried because her teammates have been teasing her about her appearance. They have been making fun of her in the locker room because of the spots she has under her armpits and around her groin. They have also been teasing her about her height, as she is the tallest girl on the team. During a skin examination, the doctor finds evidence of inguinal and axillary freckling, as well as 9 coffee-colored spots on her arms, legs, and chest. An eye exam reveals iris hamartomas.

What is the mode of inheritance for the underlying condition?

MSFinals-3046

A 65-year-old patient complains of back pain that extends to the left leg. The patient reports decreased sensation on the lateral aspect of the left calf and lateral foot. Which nerve roots are likely to be affected in this case?

MSFinals-3047

A 25-year-old married shop assistant presents to the Emergency Department with a presumed seizure, where her hands and feet shook and she bit her tongue. This is the second such event in the past 6 months and she was due to see a neurologist in a month’s time. Computed tomography (CT) brain was normal. Electroencephalogram (EEG) was normal, albeit not performed during the ‘seizure’ activity. Her doctor believes she has epilepsy and is keen to commence anticonvulsive therapy. She is sexually active and uses only condoms for protection.
Which one of the following drugs would be most suitable for this particular patient?

MSFinals-3048

A senior citizen visits his GP with a complaint of left facial weakness. He reports difficulty in removing food from his mouth while eating. Which muscle is most likely affected?

MSFinals-3049

A 70-year-old hypertensive, diabetic smoker presents with sudden onset unilateral facial weakness, hemiparesis of the upper and lower limbs and sensory disturbance. All symptoms are on the same side. Global aphasia is also noted on examination. CT brain is normal. An ischaemic cerebrovascular accident (CVA) is diagnosed.
What is the most likely vascular territory involved?

MSFinals-3050

A 67-year-old patient comes in with a spastic hemiparesis on the left side, a positive Babinski sign on the left, and facial paralysis on the left lower two-thirds. However, the patient’s speech is fluent and they have normal comprehension of verbal and written commands. Which cerebral artery is likely blocked?

MSFinals-3051

A 62-year-old man is recuperating in the hospital after experiencing a stroke. During the examination, it is revealed that he has a right homonymous superior quadrantanopia. What is the location of the lesion responsible for this visual field impairment?