Archives: Medical Student Finals

MSFinals-2972

A 40-year-old woman presents to the Neurology Clinic with a complaint of droopy eyelids that have been present for the past 6 months. She reports experiencing intermittent double vision that varies in severity. She has also noticed difficulty swallowing her food at times. Upon examination, she displays mild weakness in eyelid closure bilaterally and mild lower facial weakness. Additionally, there is mild weakness in neck flexion and bilateral shoulder abduction. Reflexes are normal throughout, and the remainder of the examination is unremarkable. Electromyography is performed, revealing a 30% decrease in the compound motor action potential (CMAP) upon repetitive nerve stimulation (right abductor pollicis brevis muscle). Single-fibre electromyography shows normal fibre density and jitter. What is the most likely diagnosis?

MSFinals-2973

A 50-year-old woman is experiencing a difficult separation from her spouse. She presents with a 2-week history of increasing headaches that are affecting her entire head. The headaches worsen when she strains. She is also experiencing more frequent nausea. Although she is neurologically intact, there is slight papilloedema noted on fundoscopy. Other than that, her examination is unremarkable. In her medical history, she had a deep vein thrombosis (DVT) in her calf when she was in her 30s, for which she received 6 months of treatment. She has not taken any significant medications recently. A non-contrast CT scan of her brain is performed and comes back normal. What is the probable diagnosis?

MSFinals-2974

A 35-year-old woman comes to her General Practitioner complaining of sudden onset of complete right-sided facial weakness that started yesterday. There are no other neurological symptoms observed during the examination. The patient denies any hearing loss and reports only drooling of saliva. Other than that, she is healthy and has no other complaints. An ear examination reveals no abnormalities.
What is the probable diagnosis?

MSFinals-2975

A 35-year-old female patient, who smokes and is taking the combined oral contraceptive pill, reports experiencing pain and swelling in her right calf for the past two days. She also presents with sudden onset weakness on her right side. Upon examination, she displays a dense hemiplegia, with upper motor neuron signs and weakness in her right hand. Additionally, evidence of a deep vein thrombosis in her right calf is observed. What is the probable diagnosis?

MSFinals-2976

A 36-year-old man came to the Emergency Department complaining of a severe headache, neck stiffness, and photophobia. He had not experienced any recent foreign travel or trauma. Upon examination, he had a fever but no rash or focal neurology. The medical team suspected bacterial meningitis and began treatment. They also requested a lumbar puncture. What is the appropriate spinal level and dural space for the needle to be advanced to during a lumbar puncture?

MSFinals-2977

What is the mechanism by which a neuron controls its membrane potential?

MSFinals-2978

In what way does an ion affect the overall membrane potential of a neuron?

MSFinals-2979

A 26-year-old female presents to the hospital with a sudden and severe occipital headache while decorating at home. She experienced vomiting and a brief loss of consciousness. Upon examination, her Glasgow coma scale (GCS) score is 15, and she has a normal physical exam except for an abrasion on her right temple. She is afebrile, has a blood pressure of 146/84 mmHg, and a pulse rate of 70 beats/minute. What investigation would be the most beneficial?

MSFinals-2980

A 28-year-old woman comes to the clinic complaining of sudden-onset painful right eye and visual loss. Upon examination, the doctor observes visual loss to counting fingers on the right, right eye proptosis, conjunctival injection, and acute tenderness on palpation. The patient’s erythrocyte sedimentation rate (ESR) is 12 mm/hour. What is the most probable diagnosis?

MSFinals-2981

A 38-year-old computer programmer had been experiencing increasing right-hand pain during the last 3 months, accompanied by loss of strength in his thumb. He was referred to a neurologist who ordered radiographic studies.
Which condition does this man most likely have?