NU 518 Exame 2 Study Questions and solutions
A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
not as severe. She does not know of any inciting factors. There has been no change in the frequency of her
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
headaches. She usually takes an over the-counter analgesic, and this results in resolution of the headache.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Based on this description, what is the most likely diagnosis of the type of headache?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Tensionji
B) Migraine
ji
C) Cluster ji
D) Analgesic rebound - answersB
ji ji ji ji
A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Based on this description, what is your
ji ji ji ji ji ji ji ji
most likely diagnosis? ji ji
A) Tensionji
B) Migraine
ji
C) Cluster ji
D) Analgesic rebound - answersA
ji ji ji ji
Which of the following is a symptom involving the eye? ji ji ji ji ji ji ji ji ji
A) Scotomas
ji
B) Tinnitus
ji
C) Dysphagia ji
D) Rhinorrhea - answersA
ji ji ji
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
information that the dizziness is a spinning sensation of sudden onset, worse with head position changes.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji
A) Benign positional vertigo
ji ji ji
B) Vestibular neuronitis
ji ji
C) Ménière's disease
ji ji
D) Acoustic neuroma - answersA
ji ji ji ji
A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first episode started
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with vomiting; the episode resolved
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
spontaneously. He has had five episodes in the past 1½ weeks. He does note
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Nystagmus is present. Based on this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji ji ji ji ji
,A) Benign positional vertigo
ji ji ji
B) Vestibular neuronitis
ji ji
C) Ménière's diseaseji ji
D) Acoustic neuroma - answersC
ji ji ji ji
A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not on any medications
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
and does not take herbs or supplements. She has no chronic medical conditions. She does not smoke or drink
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
alcohol. She walks into the examination room with slow movements and shuffling steps. She has decreased
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
facial mobility and a blunt expression,
ji ji ji ji ji ji ji
without any changes in hair distribution on her face. Based on this description, what is the most likely reason
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
for the patient's symptoms?
ji ji ji ji
A) Cushing's syndrome
ji ji
B) Nephrotic syndrome
ji ji
C) Myxedema ji
D) Parkinson's disease - answersD
ji ji ji ji
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Ptosis ji
B) Exophthalmosji
C) Ectropion ji
D) Epicanthus - answersB
ji ji ji
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
lesion. Based on this description, what is the
ji ji ji ji ji ji ji ji ji
most likely diagnosis? ji ji
A) Dacryocystitis
ji
B) Chalazion ji
C) Hordeolum ji
D) Xanthelasma - answersC
ji ji ji
A 15-year-old high school sophomore presents to the emergency room with his mother for evaluation of an
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
area of blood in the left eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
denies visual disturbances, eye pain, or discharge from the eye. On physical examination, the pupils are
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
equal, round, and reactive to light, with a visual acuity of
ji ji ji ji ji ji ji ji ji ji ji
20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the lateral
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
aspect of the base of the left eye. The cornea is clear. Based on this description, what is the most likely
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
diagnosis?
ji
A) Conjunctivitis
ji
B) Acute iritisji ji
C) Corneal abrasion ji ji
D) Subconjunctival hemorrhage - answersD
ji ji ji ji
A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history of eye trauma. He
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
denies any visual changes. You inspect his eyes and find a triangular thickening of the bulbar conjunctiva
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
across the outer surface of the cornea. He has a normal pupillary reaction to light and accommodation. Based
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
on this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji
A) Corneal arcus
ji ji
B) Cataracts ji
,C) Corneal scarji ji
D) Pterygium - answersD
ji ji ji
Which of the following is a "red flag" regarding patients presenting with headache?
ji ji ji ji ji ji ji ji ji ji ji ji
A) Unilateral headache
ji ji
B) Pain over the sinuses
ji ji ji ji
C) Age over 50 ji ji ji
D) Phonophobia and photophobia - answersC
ji ji ji ji ji
A sudden, painless unilateral vision loss may be caused by which of the following?
ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Retinal detachment
ji ji
B) Corneal ulcer
ji ji
C) Acute glaucoma
ji ji
D) Uveitis - answersA
ji ji ji
Sudden, painful unilateral loss of vision may be caused by which of the following conditions?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Vitreous hemorrhage
ji ji
B) Central retinal artery occlusion
ji ji ji ji
C) Macular degeneration
ji ji
D) Optic neuritis - answersD
ji ji ji ji
Diplopia, which is present with one eye covered, can be caused by which of the following problems?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Weakness of CN III
ji ji ji ji
B) Weakness of CN IV
ji ji ji ji
C) A lesion of the brainstem
ji ji ji ji ji
D) An irregularity in the cornea or lens - answersD
ji ji ji ji ji ji ji ji ji
A patient complains of epistaxis. Which other cause should be considered?
ji ji ji ji ji ji ji ji ji ji
A) Intracranial hemorrhage
ji ji
B) Hematemesis
ji
C) Intestinal hemorrhage
ji ji
D) Hematoma of the nasal septum - answersB
ji ji ji ji ji ji ji
Glaucoma is the leading cause of blindness in African Americans and the second leading cause of blindness ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
overall. What features would be noted on funduscopic examination?
ji ji ji ji ji ji ji ji ji
A) Increased cup-to-disc ratio
ji ji ji
B) AV nicking
ji ji
C) Cotton wool spots
ji ji ji
D) Microaneurysms - answersA
ji ji ji
Very sensitive methods for detecting hearing loss include which of the following?
ji ji ji ji ji ji ji ji ji ji ji
A) The whisper test
ji ji ji
B) The finger rub test
ji ji ji ji
C) The tuning fork test
ji ji ji ji
D) Audiometric testing - answersD
ji ji ji ji
Which area of the fundus is the central focal point for incoming images?
ji ji ji ji ji ji ji ji ji ji ji ji
A) The fovea
ji ji
B) The macula
ji ji
C) The optic disk
ji ji ji
D) The physiologic cup - answersA
ji ji ji ji ji
, A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil contracts as well,
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
though it is not exposed to bright light. Which of the following terms describes this latter phenomenon?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Direct reaction
ji ji
B) Consensual reaction
ji ji
C) Near reaction
ji ji
D) Accommodation - answersB
ji ji ji
A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) She obtains a 20% correct score at 100 feet.
ji ji ji ji ji ji ji ji ji
B) She can accurately name 20% of the letters at 20 feet.
ji ji ji ji ji ji ji ji ji ji ji
C) She can see at 20 feet what a normal person could see at 100 feet.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
D) She can see at 100 feet what a normal person could see at 20 feet. - answersC
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
On visual confrontation testing, a stroke patient is unable to see your fingers on his entire right side with either
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
eye covered. Which of the following terms would describe this finding?
ji ji ji ji ji ji ji ji ji ji ji
A) Bitemporal hemianopsia
ji ji
B) Right temporal hemianopsia
ji ji ji
C) Right homonymous hemianopsia
ji ji ji
D) Binasal hemianopsia - answersC
ji ji ji ji
You note that a patient has anisocoria on examination. Pathologic causes of this include which of the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
following?
ji
A) Horner's syndrome
ji ji
B) Benign anisocoria
ji ji
C) Differing light intensities for each eye
ji ji ji ji ji ji
D) Eye prosthesis - answersA
ji ji ji ji
A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
following have you essentially excluded from your differential?
ji ji ji ji ji ji ji ji
A) Retinoblastoma
ji
B) Cataract
ji
C) Artificial eye
ji ji
D) Hypertensive retinopathy - answersD
ji ji ji ji
A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
normal. What diagnosis would you assign this patient?
ji ji ji ji ji ji ji ji
A) Otitis media
ji ji
B) External otitis
ji ji
C) Perforation of the tympanum
ji ji ji ji
D) Cholesteatoma - answersB
ji ji ji
A patient with hearing loss by whisper test is further examined with a tuning fork, using the Weber and Rinne
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
maneuvers. The abnormal results are as follows: bone conduction is greater than air on the left, and the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
patient hears the sound of the tuning fork better on the left. Which of the following is most likely?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Otosclerosis of the left ear
ji ji ji ji ji
B) Exposure to chronic loud noise of the right ear
ji ji ji ji ji ji ji ji ji
C) Otitis media of the right ear
ji ji ji ji ji ji
D) Perforation of the right eardrum - answersA
ji ji ji ji ji ji ji
A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
not as severe. She does not know of any inciting factors. There has been no change in the frequency of her
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
headaches. She usually takes an over the-counter analgesic, and this results in resolution of the headache.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Based on this description, what is the most likely diagnosis of the type of headache?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Tensionji
B) Migraine
ji
C) Cluster ji
D) Analgesic rebound - answersB
ji ji ji ji
A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Based on this description, what is your
ji ji ji ji ji ji ji ji
most likely diagnosis? ji ji
A) Tensionji
B) Migraine
ji
C) Cluster ji
D) Analgesic rebound - answersA
ji ji ji ji
Which of the following is a symptom involving the eye? ji ji ji ji ji ji ji ji ji
A) Scotomas
ji
B) Tinnitus
ji
C) Dysphagia ji
D) Rhinorrhea - answersA
ji ji ji
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
information that the dizziness is a spinning sensation of sudden onset, worse with head position changes.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji
A) Benign positional vertigo
ji ji ji
B) Vestibular neuronitis
ji ji
C) Ménière's disease
ji ji
D) Acoustic neuroma - answersA
ji ji ji ji
A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first episode started
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with vomiting; the episode resolved
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
spontaneously. He has had five episodes in the past 1½ weeks. He does note
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
Nystagmus is present. Based on this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji ji ji ji ji
,A) Benign positional vertigo
ji ji ji
B) Vestibular neuronitis
ji ji
C) Ménière's diseaseji ji
D) Acoustic neuroma - answersC
ji ji ji ji
A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not on any medications
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
and does not take herbs or supplements. She has no chronic medical conditions. She does not smoke or drink
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
alcohol. She walks into the examination room with slow movements and shuffling steps. She has decreased
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
facial mobility and a blunt expression,
ji ji ji ji ji ji ji
without any changes in hair distribution on her face. Based on this description, what is the most likely reason
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
for the patient's symptoms?
ji ji ji ji
A) Cushing's syndrome
ji ji
B) Nephrotic syndrome
ji ji
C) Myxedema ji
D) Parkinson's disease - answersD
ji ji ji ji
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
A) Ptosis ji
B) Exophthalmosji
C) Ectropion ji
D) Epicanthus - answersB
ji ji ji
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
lesion. Based on this description, what is the
ji ji ji ji ji ji ji ji ji
most likely diagnosis? ji ji
A) Dacryocystitis
ji
B) Chalazion ji
C) Hordeolum ji
D) Xanthelasma - answersC
ji ji ji
A 15-year-old high school sophomore presents to the emergency room with his mother for evaluation of an
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
area of blood in the left eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
denies visual disturbances, eye pain, or discharge from the eye. On physical examination, the pupils are
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
equal, round, and reactive to light, with a visual acuity of
ji ji ji ji ji ji ji ji ji ji ji
20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the lateral
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aspect of the base of the left eye. The cornea is clear. Based on this description, what is the most likely
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diagnosis?
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A) Conjunctivitis
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B) Acute iritisji ji
C) Corneal abrasion ji ji
D) Subconjunctival hemorrhage - answersD
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A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history of eye trauma. He
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denies any visual changes. You inspect his eyes and find a triangular thickening of the bulbar conjunctiva
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across the outer surface of the cornea. He has a normal pupillary reaction to light and accommodation. Based
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on this description, what is the most likely diagnosis?
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A) Corneal arcus
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B) Cataracts ji
,C) Corneal scarji ji
D) Pterygium - answersD
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Which of the following is a "red flag" regarding patients presenting with headache?
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A) Unilateral headache
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B) Pain over the sinuses
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C) Age over 50 ji ji ji
D) Phonophobia and photophobia - answersC
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A sudden, painless unilateral vision loss may be caused by which of the following?
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A) Retinal detachment
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B) Corneal ulcer
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C) Acute glaucoma
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D) Uveitis - answersA
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Sudden, painful unilateral loss of vision may be caused by which of the following conditions?
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A) Vitreous hemorrhage
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B) Central retinal artery occlusion
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C) Macular degeneration
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D) Optic neuritis - answersD
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Diplopia, which is present with one eye covered, can be caused by which of the following problems?
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A) Weakness of CN III
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B) Weakness of CN IV
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C) A lesion of the brainstem
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D) An irregularity in the cornea or lens - answersD
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A patient complains of epistaxis. Which other cause should be considered?
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A) Intracranial hemorrhage
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B) Hematemesis
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C) Intestinal hemorrhage
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D) Hematoma of the nasal septum - answersB
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Glaucoma is the leading cause of blindness in African Americans and the second leading cause of blindness ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
overall. What features would be noted on funduscopic examination?
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A) Increased cup-to-disc ratio
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B) AV nicking
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C) Cotton wool spots
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D) Microaneurysms - answersA
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Very sensitive methods for detecting hearing loss include which of the following?
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A) The whisper test
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B) The finger rub test
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C) The tuning fork test
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D) Audiometric testing - answersD
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Which area of the fundus is the central focal point for incoming images?
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A) The fovea
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B) The macula
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C) The optic disk
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D) The physiologic cup - answersA
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, A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil contracts as well,
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though it is not exposed to bright light. Which of the following terms describes this latter phenomenon?
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A) Direct reaction
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B) Consensual reaction
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C) Near reaction
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D) Accommodation - answersB
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A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?
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A) She obtains a 20% correct score at 100 feet.
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B) She can accurately name 20% of the letters at 20 feet.
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C) She can see at 20 feet what a normal person could see at 100 feet.
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D) She can see at 100 feet what a normal person could see at 20 feet. - answersC
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On visual confrontation testing, a stroke patient is unable to see your fingers on his entire right side with either
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eye covered. Which of the following terms would describe this finding?
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A) Bitemporal hemianopsia
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B) Right temporal hemianopsia
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C) Right homonymous hemianopsia
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D) Binasal hemianopsia - answersC
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You note that a patient has anisocoria on examination. Pathologic causes of this include which of the
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following?
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A) Horner's syndrome
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B) Benign anisocoria
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C) Differing light intensities for each eye
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D) Eye prosthesis - answersA
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A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the
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following have you essentially excluded from your differential?
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A) Retinoblastoma
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B) Cataract
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C) Artificial eye
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D) Hypertensive retinopathy - answersD
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A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left
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ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The
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canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is
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normal. What diagnosis would you assign this patient?
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A) Otitis media
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B) External otitis
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C) Perforation of the tympanum
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D) Cholesteatoma - answersB
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A patient with hearing loss by whisper test is further examined with a tuning fork, using the Weber and Rinne
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maneuvers. The abnormal results are as follows: bone conduction is greater than air on the left, and the
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patient hears the sound of the tuning fork better on the left. Which of the following is most likely?
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A) Otosclerosis of the left ear
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B) Exposure to chronic loud noise of the right ear
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C) Otitis media of the right ear
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D) Perforation of the right eardrum - answersA
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