SHELF REVIEW SCENARIOS
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52 terms
Terms | Definitions |
|---|---|
 migraine | • An 18 yrs old lady presents for an evaluation of severe headache. Describes it as unilateral beginning with a dull steady ache and increasing to throbbing in several hrs, She experiences light flashes, zigzag lines, numbness and tingling in her face prior to the onset of pain. This pain is made worse by motion, noise and light so she prefers to lie down in a quite dark room during the headache |
| maxillary sinus | • A 20 yrs old patient complains of headache, facial pain over the cheeks, purulent nasal discharge, and chronic nasal congestion. O/E you elicit tenderness over his maxillary area and teeth and transillumination test appears opaque. |
| menieres disease | • A 30 yrs lady presents with episodes of severe vertigo, tinnitus and fluctuating hearing loss for the last 3 months off and on. She also has a sensation of fullness in her ears. |
| benign paroxsymal positional vertigo | • A 28 yrs old woman complains of a sudden attack of spinning all around her as she attempts to lie down for 30 secs and it's associated with nausea and vomiting. On examination nystagmus is noted when she attempts to lie down and she experiences the vertigo and is so afraid that she is reluctant to move. No tinnitus no hearing loss |
| acoustic neuroma and NF type II | • A 50 yrs pt complains of hearing loss and a whistling sound in his left ear and occasionally experiences vertigo. On examination webers test lateralizes to his rt ear and MRI shows abnormality at the lt cerebellopontine angle what genetic disease is this associated with |
| obstructive sleep apnea | • A 45 yrs old obese man presents with excessive day time sleepiness that has progressively worsened over 3 yrs. His wife says his snoring can be heard in the adjacent room and he intermittently appears to stop breathing at night. He has morning headaches |
| vitreous hemorrhage | • A patient who has diabetes poorly controlled presents with sudden painless loss of vision of her rt eye and you detect a red haze on fundoscopy. what is the cause |
| open angle glaucoma | • A 60 yrs old patient complains of progressive and painless blurred vision mainly of peripheral fields over a year or so and halos around lights at night. You detect raised intraocular pressure on tonometry and cupping of the disc on fundoscopy |
| narrow angle glaucoma | severe headache and eye pain and redness and sudden vision loss |
| retinitis pigmentosum | • A 16 yrs old male is referred for evaluation of progressively constricting visual field he says he sees as if he is looking through a narrow tube and he has a long history of night blindness and f/h of eye problems fundus shows bone spicule pigmentation in periphery |
| uveitis | • A patient complains of severe eye pain, blurred vision and photophobia with tearing She has Seronegative spondyloarthropathy. On examination you detect conjunctival congestion, miotic pupil and diminished visual acuity |
| retinoblastoma | • An 18 months old child presents with diminished visual acuity and a wandering rt eye that his mother noticed. examination reveals white pupillary reflex (cats eye reflex) in rt eye and strabismus retinal exam shows a whitish mass behind the lens |
| papilliedema pituitary tumor | • 14 A patient presents with severe headache and vomiting when he gets up in the morning for last 6 months also complains of blurred vision and you detect he has a bitemporal homonymous hemianopia, What disc changes do you expect to find |
| malignant hypertension | • In what other condition will you get papilloedema |
| retinal artery thrombosis | • An elderly man comes with an acute painless loss of vision of one eye. He was recently diagnosed with Giant cell Arteritis: |
| squamous cell carcinoma | • A 50 yrs old smoker and alcoholic complains of a painless lump on the rt side of his neck which has been increasing rapidly over 3 months, you detect non tender lymphadenopathy hard and fixed, What should you suspect |
| branchial cleft cyst | • If you feel a cystic mass which has been fluctuating in size |
| thyroglossal duct cyst | • If he complains of front neck swelling, painless that fluctuates in size becoming painful when she has a cold and you detect a cystic mass below the hyoid bone which moves up on swallowing and protrusion of the tongue |
| goiter | • A lady complains of wt loss, palpitation and heat intolerance. On exam you find a bounding pulse, tachycardia, exophthalmos and a swelling at the front of her neck which moves up with swallowing |
| peritonsillar abcess | • A child comes with fever, sore throat and difficulty in swallowing. He is unable to open his mouth fully and has submandibular tender lymph nodes |
| MCL tear | • A patient undergoes a lateral direct blow to the knee from clipping during a soccer game. He senses a pop and presents with swelling and pain. you detect increased lateral movement of the tibia on applying the valgus stress test |
| achilles tear | • A pt falls into a pothole, feels a pop and presents with pain, swelling and tenderness below his calf muscle |
| bicipital tendonitis | A man who recently started swimming and golfing presents with shoulder pain. The pain radiates down the arm and is worse on supination. You detect tenderness medial to glenohumeral joint |
| erbs paralysis | A woman undergoes a difficult labour with breech presentation and the new born baby has a weak right arm which is kept adducted, pronated and the wrist flexed. |
| medial meniscus tear | An year old boy playing soccer suddenly develops severe pain in the right knee and feels it give way. On examination, the doctor instructs the patient to lie supine and he flexes the right knee. He then rotates the right foot inward and flexes and extends the knee with the foot in this position. He also repeats the procedure with the right foot rotated outward. The patient feels excruciating pain when the knee is flexed and extended while the foot is rotated outward. What is the most probable diagnosis in this patient |
| anterior cruciate ligament tear | You are consulted by a 0 year old male college football player who sustained a knee injury whilst playing football.The knee appears swollen is painful and you find his tibia can be slided anteriorly over the femur |
| duchenne muscular dystrophy | A yrs old child is brought by his parents who complain that he is not walking and seems to have difficulty standing at once. he puts hands on his knees and then lifts his body. on exam he has large calf muscles and labs reveal increased Serum CPK what is the likely diagnosis |
| dupytrens contracture | 50 yrs old European man, diabetic presents with flexion deformity of his fourth and fifth fingers and thick nodular cords of his palms |
| ganglion | female patient presents with a non tender swelling which is cystic on the dorsum of her wrist what is affected |
| axillary nerve | patient presents with anterior shoulder dislocation.you detect numbness of the lateral aspect of the upper arm.which nerve has been affected |
| CN VII is affected | • A 67 yrs old man presents to his GP complaining of food having no taste. You detect absent corneal reflex on one side. He has no wrinkles on his forehead when he frowns. Physical examination will reveal what findings |
| absent gag reflex | • A 40 yrs old man presents having sustained a blow to his head recently. He has noticed a loss of bitter and sour taste. Which examination will be beneficial in confirming his nerve lesion |
| spinal accessory nerve | • A 40 yrs old man has difficulty turning his head to the right and has a left shoulder droop. Which nerve lesion does this finding indicate |
| afferent pupil defect | • A patient complains of diminished vision for 2 months o/e you shine a light on her rt eye and both pupils constrict. When you shine on the left eye the left eye dilates. back to the rt eye and both constrict |
| left hypoglossal nerve | • A patient gets a stroke and has slurred speech and has rt spastic paralysis. On examination his tongue is seen to deviate to the left side and is atrophied on left side. what nerve is affected |
| bells palsy | • A patient develops ear infection and one week later complains of inability to close his rt eye and water drools from his mouth when he drinks. On examination you detect ptosis, facial droop, and He cannot wrinkle his forehead on the rt side |
| pontomedullary junction | • A patient presents with both 7th and 8th nerve palsy where is the lesion |
| schwannoma of 8th nerve | • 40 yrs old man presents with tinnitus and dizziness and diminished hearing of his rt ear. Webers lateralizes to normal ear. CT scan shows enlarged int acoustic meatus |
| left sided glossopharyngeal nerve palsy | • A pt has a stroke and presents with difficulty in swallowing and phonation. you test the gag reflex and its absent and his uvula is deviated to the rt. taste sensation is lost posterior 1/3 of the tongue |
| abducens nerve palsy | • A diabetic presents with diplopia. His lateral gaze is gone and he gets diplopia on looking outwards(laterally). On examination he cannot abduct his rt eye |
| occulomotor palsy | • A victim of a car accident presents with injury to the rt eye.complains of diplopia and upward gaze is gone. On exam his rt eye is deviated outwards and downwards and his pupil is dilated. He also has mild ptosis |
| tell to clench teeth | • A victim of a car accident presents with injury to the rt eye.complains of diplopia and upward gaze is gone. On exam his rt eye is deviated outwards and downwards and his pupil is dilated. He also has mild ptosis |
| right optic tract | • A patient presents with contralateral homonymous hemianopia( loss of both left side eye fields) what is the site of lesion |
| optic chiasm | • A patient presents with inability to see objects on the outward side of both eyes. On examination he has bitemporal heteronemous hemianopia what is the site of lesion |
| visual cortex | • A patient presents with homonymous hemianopia with macular sparing |
| right temporal lobe | • A patient presents with left superior quadrantopia |
| right parietal lobe | A patient presents with left inferior quadrantopia |
| optic nerve | A patient presents with uniocular blindness |
| horners syndrome | patient has a car accident and hits the dashboard. Two days later presents with rt frontal severe headache and weakness of lt arm. On examination you detect ptosis and miosis, of rt eye. What is the cause |
| posterior dorsal columns | • A patient has small irregular pupils that constrict to accommodation but not to light; what structure is affected |
| third nerve | • A 37 yrs female attends the Er with severe occipital headache for a few hrs. she has been suffering from migraine but this seems different. On exam you detect no findings and discharge her with analgesics. She is brought back 6 hrs later by the ems unconsiouss. now you detect a fixed dilated pupil on the rt with the eye deviated outward and downwards. Which nerve is affected |
| internuclear opthalmoplegia | 32 yrs old woman presents with double vision when she looks to the far left side, Examination reveals Rt eye cannot adduct when asked to look far left. but can abduct when asked to look far right. covergence is normal |
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