5 Written Questions

1. • 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
2. • 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.
3. • A patient has small irregular pupils that constrict to accommodation but not to light; what structure is affected
4. • 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
5. • 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

5 Matching Questions

1. duchenne muscular dystrophy
2. narrow angle glaucoma
3. ganglion
4. pontomedullary junction
5. bells palsy

1. a female patient presents with a non tender swelling which is cystic on the dorsum of her wrist what is affected
2. b • 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
3. c 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
4. d • A patient presents with both 7th and 8th nerve palsy where is the lesion
5. e severe headache and eye pain and redness and sudden vision loss

5 Multiple Choice Questions

1. 50 yrs old European man, diabetic presents with flexion deformity of his fourth and fifth fingers and thick nodular cords of his palms
   1. achilles tear
   2. dupytrens contracture
   3. right optic tract
   4. vitreous hemorrhage
2. • 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
   1. axillary nerve
   2. achilles tear
   3. papilliedema pituitary tumor
   4. dupytrens contracture
3. • 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
   1. abducens nerve palsy
   2. schwannoma of 8th nerve
   3. bicipital tendonitis
   4. acoustic neuroma and NF type II
4. 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
   1. third nerve
   2. optic nerve
   3. menieres disease
   4. horners syndrome
5. • 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
   1. benign paroxsymal positional vertigo
   2. bicipital tendonitis
   3. right parietal lobe
   4. left hypoglossal nerve

5 True/False Questions

1. left hypoglossal 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

   True        False

2. absent gag reflex → • A patient presents with homonymous hemianopia with macular sparing

   True        False

3. anterior cruciate ligament tear → • 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

   True        False

4. 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

   True        False

5. optic nerve → A patient presents with uniocular blindness

   True        False