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A young woman undergoes cranial nerve testing. On touching the soft
palate, her uvula
deviates to the left. Which of the following is likely?
A) CN IX lesion on the left
B) CN IX lesion on the right
C) CN X lesion on the left
D) CN X lesion on the right ---------CORRECT ANSWER-----------------D) CN
X lesion on the right
The failure of the right side of the palate to rise denotes a problem
with the right
10th cranial nerve. The uvula deviates toward the properly functioning
side.
A college student presents with a sore throat, fever, and fatigue for several
days. You notice exudates on her enlarged tonsils. You do a careful
lymphatic examination and notice some scattered small, mobile lymph
nodes just behind her sternocleidomastoid muscles
bilaterally. What group of nodes is this?
A) Submandibular
B) Tonsillar
C) Occipital
D) Posterior cervical ---------CORRECT ANSWER-----------------D) Posterior
cervical
The group of nodes posterior to the sternocleidomastoid muscle is
the posterior cervical chain. These are common in mononucleosis.
,You feel a small mass that you think is a lymph node. It is mobile in both
the up-and-down and side-to-side directions. Which of the following is most
likely?
A) Cancer
B) Lymph node
C) Deep scar
D) Muscle ---------CORRECT ANSWER-----------------B) Lymph node
A useful maneuver for discerning lymph nodes from other masses in
the neck is to check for their mobility in all directions. Many other
masses are mobile in only two directions. Cancerous masses may
also be "fixed," or immobile.
You are conducting a pupillary examination on a 34-year-old man. You
note that both pupils dilate slightly. Both are noted to constrict briskly when
the light is placed on the right
eye. What is the most likely problem?
A) Optic nerve damage on the right
B) Optic nerve damage on the left
C) Efferent nerve damage on the right
D) Efferent nerve damage on the left ---------CORRECT ANSWER-------------
----B) Optic nerve damage on the left
Because both pupils can constrict, efferent nerve damage is unlikely.
When the light is placed on the left eye, neither a direct nor a
consensual response is seen. This indicates that the left eye is not
perceiving incoming light.
A 73-year-old nurse comes to your office for evaluation of new onset of
tremors. She is not
,on any medications and does not take herbs or supplements. She has no
chronic medical conditions. She does not smoke or drink alcohol. She
walks into the examination room with slow
movements and shuffling steps. She has decreased facial mobility and a
blunt expression, without any changes in hair distribution on her face.
Based on this description, what is the most likely reason for the patient's
symptoms?
A) Cushing's syndrome
B) Nephrotic syndrome
C) Myxedema
D) Parkinson's disease ---------CORRECT ANSWER-----------------D)
Parkinson's disease
This is a typical description for a patient with Parkinson's disease.
Facial mobility is
decreased, which results in a blunt expression—a "masked"
appearance.
A 29-year-old physical therapist presents for evaluation of an eyelid
problem. On
observation, the right eyeball appears to be protruding forward. Based on
this description, what
is the most likely diagnosis?
A) Ptosis
B) Exophthalmos
C) Ectropion
D) Epicanthus ---------CORRECT ANSWER-----------------B) Exophthalmos
Feedback: Exophthalmos is the condition when the eyeball protrudes
forward. If it is bilateral, it suggests the presence of Graves' disease.
If it is unilateral, it could still be caused by Graves' disease.
Alternatively, it could be caused by a tumor or inflammation in the
orbit.
, A 12-year-old presents to the clinic with his father for evaluation of a painful
lump in the left
eye. It started this morning. He denies any trauma or injury. There is no
visual disturbance. Upon
physical examination, there is a red raised area at the margin of the eyelid
that is tender to
palpation; no tearing occurs with palpation of the lesion. Based on this
description, what is the
most likely diagnosis?
A) Dacryocystitis
B) Chalazion
C) Hordeolum
D) Xanthelasma ---------CORRECT ANSWER-----------------C) Hordeolum
A hordeolum, or sty, is a painful, tender, erythematous infection in a
gland at the margin of the eyelid.
A 15-year-old high school sophomore presents to the emergency room with
his mother for evaluation of an area of blood in the left eye. He denies
trauma or injury but has been coughing
forcefully with a recent cold. He denies visual disturbances, eye pain, or
discharge from the eye.
On physical examination, the pupils are equal, round, and reactive to light,
with a visual acuity of 20/20 in each eye and 20/20 bilaterally. There is a
homogeneous, sharply demarcated area at the
lateral aspect of the base of the left eye. The cornea is clear. Based on this
description, what is
the most likely diagnosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage ---------CORRECT ANSWER-----------------
D) Subconjunctival hemorrhage
A subconjunctival hemorrhage is a leakage of blood outside of the
vessels, which