Final Practice Questions Flashcards
(188 cards)
1
Q
63 yo male with shortness of breath, and cough productive small amounts of blood in sputum. This condition is intermittently through last several months
A
Could be TB or bronchogenic carcinoma
2
Q
56 yo male with acute chest pain. Started one week ago with no trauma and steady course. Pain is 7-8/10, retrosternal and at the front chest area and the left sternal margin. Patient is a smoker for 25 years and smokes up to a pack a day. Pain is associated with cough productive with mucopurulent sputum that started one week ago. 140/90 BP, oral temp 101, pulse 90 bpm.
A
Pneumonia (most appropriate dx)
3
Q
When auscultating for the carotid artery which part of the stethoscope is best used?
A
Diaphragm and the Bell (for bruits)
4
Q
Which of the following may indicate fracture of base of skull
A
Battle Sign
5
Q
Which of the following valvular lesions can cause pulmonary congestion?
A
Mitral stenosis
This leads to left atrial enlargement
and will cause a murmur that is increased during expiration
6
Q
Tricuspid stenosis may lead to
A
Right atrial enlargement
and
Will cause a murmur that is increased during inspiration
7
Q
Pulmonic stenosis may lead to —– enlargement
A
RV enlargement
8
Q
In hyperthyroidism which of the following is likely to happen?
A
Tachycardia
Increased metabolic rate
9
Q
Pitting edema associated with pathology in ___, ___, and ____
A
heart, liver, and kidney
10
Q
Stabbing pain –>
A
Pleurisy
11
Q
Most significant fault in Tetralogy of Fallot that causes cyanosis at birth?
A
Aortic valve overriding on both ventricles
12
Q
WOTF blood changes usually accompany emphysema?
A
Increased RBC number
13
Q
Sound normally heard over trachea and main bronchi of lung is
A
bronchial
14
Q
Emphysema is accompanied by _______ of fingernails, _________ note upon percussion, and decreased tactile _________.
A
clubbing of fingernails, hyperessonant note upon percussion, decreased tactile fremitus
15
Q
56 yo male with chest pain. Started one week ago, no trauma and steady course. Pain is 7-8/10, retrosternal and at the front chest area and the left sternal margin. Patient is a smoker for 25 years and smokes up to a pack a day. Pain is associated with cough productive with mucopurulent sputum that started one week ago. 140/90 BP, oral temp 99.6, pulse 90 bpm.
The pain is stabbing, localized above the left costal margin, aggravated by deep breathing. Recent onset, 4 days, associated with dry cough that started one week ago. Cough aggravates the condition.
Most appropriate impression ________
Next step?
A
Pleurisy (Stabbing, knife-like pain localized above the left costal margin, aggravated by deep breathing)
Patient may continue with his chiropractic care and closely observe the progress of symptoms and signs with recommendation to see a family physician if the condition worsened
16
Q
Precordial heaving is a sign of
A
Cor Pulmonale
17
Q
TB and bronchogenic carcinoma cause
A
hemoptysis
18
Q
High fevers over 101
“ P, T, N”
A
Pneumonia, Tonsillitis, Nephritis
19
Q
Carotid artery auscultation – mainly for carotid artery calcification
Is this the only way to dx cacification?
What does the patient do during this exam
and do you use both the diaphragm and bell?
A
Only way to diagnose is stethoscope over carotid
Pt turns head and holds breath
Use both diaphragm and bell
20
Q
What is the most common valvular lesion of the heart
A
Mitral stenosis caused by pulmonary congestion
21
Q
FYI Slide
Pitting edema caused by hydrostatic (heart pumping has been compromised – left ventricular failure = orthostatic edema) or loss of osmotic pressure inside BV (albumin – keeps fluid inside) if you lose albumin you lose osmotic pressure and will diffuse into interstitial tissue (liver failure or kidney) liver is sole producer of albumin
Kidney – normal protein but losing it from nephritis = proteinuria hypoalbuminemia
A
Pitting edema caused by hydrostatic (heart pumping has been compromised – left ventricular failure = orthostatic edema) or loss of osmotic pressure inside Blood vessels (albumin – keeps fluid inside)
If you lose albumin you lose osmotic pressure and plasma proteins will diffuse into interstitial tissue (common in liver failure or kidney failure )
Liver is sole producer of albumin
Kidney – normal protein but losing it from nephritis = proteinuria hypoalbuminemia
22
Q
Night fever and night sweats caused by
A
Hodgkin’s disease and TB
23
Q
Reed Sternberg cells is an associated histopathological finding of which condition?
A
Hodgkin’s
24
Q
What is the triad of pancytopenia?
A
Leukopenia, thrombocytopenia, anemia
25
Tetralogy of Fallot
________ ventricular hypertrophy
Ventricular septal defect – movement of blood between Left Ventricle and Right Ventricle – mixing of oxygenated and deoxygenated blood
________ stenosis
most significant fault in the tetralogy is an _____ ______
Right ventricular Hypertrophy
VSD mixing of O2 and DeO2 blood
Pulmonary Stenosis
Overriding Aorta
26
Systems hypertension may lead to _____ enlargement
Left Ventricular Enlargement
27
Decreased tactile fremitus, breath sounds, chest expansion
Emphysema
28
```
Malaise (lack of energy)
Polycythemia
Hyperresonant
Usually older patient with Hx of smoking
No movement during respiratory excursion
Barrel chest with decreased chest expansion
```
Emphysema
29
MC organ abdominal injury is spleen
blunt trauma MVA or fall
30
Bluish coloration around umbilicus indicating
| Intra abdominal hemorrhage
Cullen’s sign
31
Melena – peptic/gastric ulcer True or False
True
32
10 yo girl presents with a 4 day history of pain in the knees, hips, shoulders, and wrists. The joints are not swollen, red, or tender. Her temperature is 102. Her mother states that her daughter’s only recent illness was a sore throat 1 month ago. Auscultation of the chest reveals an apical systolic murmur. What does she have?
Rheumatic fever
33
As it relates to Rheumatic fever .....
The causative organism is __________
Antistreptolysin O = ASO positive
This may lead to mitral ______ ______
This can cause ________ congestion
Beta hemolytic strep group A
Mitral valve stenosis
Pulmonary Congestion
34
The ________ impulse is visible, palpable pulsating force against the chest wall caused by Left ventricular contraction and is associated with the S1 sound
Apical
35
Liver cirrhosis ---> esophageal varices --> hematemesis (lethal)
Indicating Advanced ______ failure
Liver failure
36
Hep A – transmitted by food, will go away with 0 complications, with proper
handwashing
37
Hep B – transmitted by ______, blood transfusion, sex, mother to child, post hepatitis cirrhosis/fibrosis, condom use/abstinence
blood
38
separation of rectus abdominis – weak abdominal muscles
Diastasis recti
39
Caput medusa – associated with ______ ______ and liver cirrhosis
portal hypertension – liver cirrhosis
40
Helicobacter pylori is strongly related to _______ ulcer – and has melena and hematemesis
peptic ulcer
melena
hematemesis
41
Virchow lymph nodes = gastric carcinoma and
| Left ______ _________
supraclavicular nodes
42
You are assessing a patient with abdominal pain and fever. You are performing an abdominal examination to assess for peritoneal signs. WOTF is not a peritoneal sign?
Voluntary guarding
43
In liver disease, the A/G ratio is altered due to decreased amount of __________ __________
serum albumin
44
WOTF lab findings is associated with hepatic jaundice?
Direct bilirubin
45
MCC of bleeding per rectum
Hemorrhoids
46
MC underlying factor for pancreatitis
Alcohol abuse
47
Spasmodic flank pain that radiates to the groin and is accompanied by mild hematuria is most suggestive of
ureteral stone
48
15 yo student presents to the clinic with a 1 day history of nausea and anorexia. He describes the pain as generalized yesterday, but today it has localized to the right lower quadrant. You palpate the left lower quadrant and the patient experiences pain in the right lower quadrant. What is the name of this sign?
Rovsing’s Sign
49
25 yo female veterinarian presents to the clinic for evaluation of flank pain, dysuria, nausea, and fever. A urine pregnancy test is negative. A urine dipstick is positive for leukocytes. On physical examination, what would be the most likely sign expected?
Murphy’s punch
50
40 yo flight attendant presents with abdominal pain. It is worse after eating, especially if she has a meal that is spicy or high in fat. She has tried OTC antacids, but they have not helped the pain. After examining her abdomen, you strongly suspect a condition that requires which sign on examination?
Murphy’s sign
51
Cardiac examination
Apex beat is formed by ___ ______ contraction
Apex beat is normally located at the ____ left ICS mid-clavicular
left ventricular
5th
52
AIDS diagnosis is based on HIV positive status and CD4 count below ____
The time for seroconvergence to HIV positive is believed to be within ___ months
Time of clinical latency which could last up to 10-15 years
Average range of CD4 is ___-____ /mL
200/ml
The time for seroconvergence to HIV positive is believed to be within 3 months
Time of clinical latency which could last up to 10-15 years
Average range of CD4 is 500-1500/mL
53
Headaches
Classic migraine is preceded by an _____
Tension headache has a _____ _____ type pain
The muscle that is implicated in cervicogenic headache is
________ and lacrimation are associated with cluster headaches
Aura
Hat Band
Rectus Capitis Posterior Minor
Rhinorrhea and lacrimation are associated with Cluster headaches
54
MC congenital heart defect
| 70% of the cases close spontaneously within 2 years
VSD
55
25 yo male with acute abdominal discomfort for several days. Initial evaluation revealed that a tinge of yellowish discoloration in his sclera. Examination reveals tenderness in the right upper quadrant.
Which of the following systems may be suspected as a cause of jaundice?
WTOF inquiries is relevant in the patient’s history?
What is the nature of this jaundice?
GI system
Sexual history and illicit drug use
History of ingestion of contaminated food
Infectious
56
Sense of spinning = vertigo and is highly suggestive of
inner ear issue
57
Cone of light 7 o’clock
Otoscopic exam
58
Are there any sympathetic Cranial Nerves?
No
59
What are the Autonomic Cranial Nerves?
3, 7, 9, 10 – autonomic Cranial nerves
60
otitis media, wax infiltration, fungus infection that doesn’t affect inner ear
Conductive problem in hearing
61
otitis externa due to constant dampness
Swimmer’s ear – otitis externa due to constant dampness
62
exostosis due to cold weather
Surfer’s ear – exostosis due to cold weather
63
The ear structure that reflects the light while performing otoscopic examination
tympanic membrane
64
Which of the following nerves is not associated with ear pain?
5,7,9, 10, 12
CN XI
5, 7, 9 are associated
65
With of the following will cause lateralization of sound to the right ear during Weber’s Test?
Sensorineural loss in the left ear
Conductive hearing loss – sound goes to bad ear
Sensorineural hearing loss – sound goes to good ear
66
The structure that changes the mechanical impulse into a nerve impulse is the
inner ear (ossicles)
67
WOTF conditions is often a result of surfing/surfer’s ear
Exostoses
68
The structure that is responsible for maintaining the pressure integrity of the middle ear cavity is
Eustachian tube
69
Meniere’s is characterized by
Vertigo, hearing loss, and tinnitus
70
This condition can be described as an abnormal perception of rotation
Vertigo
71
Sudden attacks of whirling vertigo associated with tinnitus and hearing loss with nausea and vomiting at the height of the experience, with hearing loss that persists after the attack best describes
Meniere’s disease
72
WOTF conditions usually presents with vertigo that climaxes in 24-40 hrs with the patient experiencing nausea and vomiting at the height of the problem and finds that being in the horizontal position to limit the problem while raising the head induces the problem?
Acute toxic labyrinthitis
73
This condition is a result of repeated trauma to the pinna and bleeding between the cartilage and the perichondrium
Cauliflower ear
74
In which of the following conditions is a decrease of sodium in the patient’s diet recommended?
Meniere’s Disease
75
While testing the vibration sense, which of the following vibrating tuning fork is applicable?
128 Hz
512 Hz is used for hearing
76
Tinea varcicolor, Monoliasis, Athlete’s foot are three conditions that are caused by
a fungus
77
A white patch that can be found on mucous membranes
Usually found in the mouths of heavy smokers
Premalignant
Leukoplakia
78
WOTF glands are involved in acne vulgaris?
Sebaceous
79
The area in the fundus that represents the highest visual acuity
Macula
80
The area in the fundus that represents the blind spot is
the disc
81
The normal reaction to the ciliospinal reflex is
mydriasis = pupillary dilation
82
The MC pathological condition affecting visual acuity in elderly is
presbyopia
83
MS is a neurological disorder characterized by.
WOTF vitamin deficiency has been recently implicated in MS?
patchy sclerosis of the CNS
Vitamin D
84
The conjunctiva covers some or all parts except
The lid
It does cover the cornea and sclera
85
The term presbyopia is referring to a
disorder of the lens
86
This condition often accompanies lipid disorders and presents as a slightly raised yellow flat well-circumscribed plaque in the skin
xanthelasma
87
A patient suffers from left homonymous hemianopia. You suspect a lesion of the?
Right optic tract
88
Which muscle is involved with extraocular motion of the right eye towards the right inferior gaze?
Superior oblique – down and out
Inferior oblique – up and in
89
Glaucoma is an eye disorder characterized by all of the following except?
Papilledema
It is characterized by increased cup:disc ratio, decreased field of vision, and increased intra ocular pressure
90
Hypersecretion of the thyroid gland will lead to
Graves Disease
91
WOTF is associated with exophthalmos?
Hyperthyroidism
92
The cause of exophthalmos in hyperthyroidism is due to proliferation of the
retro bulbar fat
93
Horner’s syndrome is not associated
with syphilis
94
WOTF is not a CN lesion?
Horner’s syndrome
95
Which CN is involved with extraocular motion of the right eye towards the left lateral gaze?
Oculomotor nerve
96
Which muscle is involved with extraocular motion of the right eye towards the left superior gaze?
Inferior oblique = up and in
97
The red light reflex is a reliable way to detect the presence of
cataract
98
Angular stomatitis (cheilosis) is associated with WOTF vitamin deficiency?
Riboflavin = vitamin B2
99
Vitamin B3 deficiency (Niacin)
pellagra
100
B12 vitamin deficiency
pernicious anemia, demyelination disease
101
What vitamin is associated with night vision?
Vitamin A
102
What is the most common type of stoke?
Embolic
103
What color changes are associated with Raynaud’s disease?
White, blue, red
104
Scurvy is a disorder of the gum due to deficiency of WOTF vitamins?
L-ascorbic "Vitamin C"
105
WOTF fundoscopic exam nerve may indicated an increase intracranial pressure?
Papilledema
106
The most abundant hormone secreted by the anterior pituitary gland is GH
Growth Hormone
107
The pathway for direct light reflex is
```
Afferent = 2
Efferent = 3
```
108
Glaucoma is medically managed by
Mydriatic eye drops == to dilate the eye to restore fluid flow within the eye
109
Argyll Robertson pupils =
neurosyphilis – responds well to dark
110
Right eye, right lateral gaze, what muscle?
Abducens
111
Accommodation pathway (Afferent and Efferent)
2 afferent 3 efferent
112
What CN's supply the eye?
2-7 CN’s supply the eye
113
20/40 vision
person can see at 40 ft what a normal person sees at 20 feet
114
Which lab value would you use for Reiter’s?
HLA B27
It is associated with Chlamydia
115
Rhomberg’s (dorsal column) =
joint position/pallesthesia
116
Lateral column =
pain and temperature
117
Light touch =
anterior/posterior columns
118
Poliomyelitis – LMNL or UMNL
LMNL
119
Beam of light will follow:
C, AC, L, VC
cornea, anterior chamber, lens, vitreous humor
120
Bell’s Palsy – _____ of facial nerve
Hemiplasia – UMNL from stroke affecting _____ nerve
LMNL
Hemiplasia – UMNL from stroke affecting facial nerve
121
spastic, decreased muscle strength without atrophy, path reflex
Right side of brain affects left side of body (Vice versa)
UMNL
122
Any lesion from brain to pyramidal tract which synapses in anterior horn cell then it becomes
LMNL
123
flaccid muscles, no patho reflex, muscle wasting/atrophy, absent reflex
LMNL
124
Olfactory center is found in the ______ in the temporal lobe
Uncus
125
Temporal lobe migraine where aura is olfactory in origin
Temporal lobe epilepsy
Smell something then go into epileptic fit
Due to uncus irritation
126
Visual cortex in
occipital lobe
127
Horner’s syndrome =
ptosis, miosis, anhydrosis
128
spirochete hidden for several years and likes the CNS – neurosyphilis
Tabes dorsalis
129
Lose cerebellum – you will have robotic movements
Dysdiadochokinesia – lost the ability to perform repeated movements such as
Cerebellum controls the ________ side
pronation supination / patting
ipsilateral
130
Biggest diseases affect cerebellum
MS likes the optic nerve (optic neuritis) and the ______
stroke and MS
Cerebellum
131
Homan’s sign is involved in the diagnosis of
DVT
132
While testing hearing, the ______ tuning fork is used
512 Hz
133
The facial nerve controls the _____ muscle which raises _______
fronatalis
raises the eyebrows
134
Corneal reflex
Afferent =
Efferent =
A- 5
| E-7
135
Patient presents with hearing loss in his right ear due to Meniere’s disease (SENSORINEURAL) during Weber’s test where would the vibration lateralize?
Left ar
136
Parkinson’s disease is characterized by what type of tremors?
static/resting tremors
137
A patient suffers from optic chiasm lesion may present with
bitemporal hemianopsia
138
L’Hermitte’s sign may indicate _____
Brudzinski’s sign indicates involvement of the ________
L’Hermitte’s sign may indicate MS
Brudzinski’s sign indicates involvement of the meninges
139
If a patient experiences difficulty in hip abduction, which DISC is most likely involved?
L4 disc L5 NR
140
WOTF describes grade 3 reflex status?
Slightly _________ response, possibility of disease pathology exists
increased
141
The autonomic sympathetic nervous system originates from the ____ and _____ regions of the spine
thoracic and lumbar
142
WOTF lines is best diagnosis for spinal stenosis?
Eisenstein’s
143
Constant low-back pain which is unrelieved by position, activity, or rest is most likely the result of
visceral disease
144
WOTF is considered a common and serious complication in patients with Bell’s palsy that requires immediate referral with co-management?
Corneal irritation/ulceration
145
29 yo male with left sciatic pain shooting down the lateral aspect of the leg and the top of the foot with antalgic lean to the left. The following tests were positive: Valsalva, SLR on the left, Bragard’s on the left, Kemp’s test the pain is exaggerated upon leaning the patient to the right
What is the clinical impression?
Left medial disc L4
146
Which disease affects the anterior horn of the spinal cord?
Poliomyelitis
147
Guillan-Barre syndrome is an
infectious polyneuritis, ascending type
148
WOTF tests may indicate radiculitis due to neural sleeve adhesions?
Shoulder depressor test
149
WOTF may constitute precaution to chiropractic management?
Purpura low platelets = easy bruising / poor clotting – can cause hemarthrosis
150
Which neurological disorder has a regressive course?
Bell’s Palsy
151
Parkinson’s disease is characterized by all of the following except
Degeneration of the frontal lobe
It is characterized by static tremors, dull mask-like expression, rigidity and weakness
152
WOTF is an UMN in nature
Cervical myelopathy
153
The prevalence of instability syndrome associated with long-term RA is believed to be?
50%
154
Wolf’s law governs the deposition of calcium in bones through the piezoelectric effect (the bones will remodel in accordance with the stress imposed upon them). WOTF is applicable to soft tissue?
Davis’s law
155
Patient presents with claudication, impotence and coldness of the extremities. This is most characteristic of a
vascular condition
156
WOTF is the MC presenting complaint of a patient with multiple myeloma?
back pain
157
WOTF conditions is characterized by pain that reaches its full intensity almost immediately after its first appearance?
Dissecting aneurysm
158
Chest pain that is exacerbated by exercise and is relieved by rest is most likely due to
coronary ischemia
159
in a normal heart, the S2 heart sound is the loudest in the
aortic and pulmonic areas
160
WOTF is the most likely finding when examining a patient with emphysema?
Hyperresonant percussive note
161
WOTF types of skin lesion is commonly associated with psoriasis?
SCALES
162
A 35 yo female who is pregnant for the first time presents with frequent severe headaches that are sometimes accompanied by visual disturbances. She has recently been examined by her obstetrician and has gained 70 lbs during the pregnancy. She appears to have some puffiness of the face, fingers, and ankles
Which of the vital signs presented is most significant?
WOTF initial screening procedures is indicated?
WOTF immediate sequela gives the poorest prognosis in this case?
WOTF is the most appropriate initial case management?
BP = 140/90
UA
Oliguria
Refer patient to a specialist for further evaluation
163
48 yo female with right-sided low back pain following a misstep off a curb. She has numbness over the right buttock, but the patient’s posture is not antalgic
WOTF is the most accurate initial neurological screening procedure?
WOTF clinical procedures most accurately distinguishes between lumbar joint and sacroiliac involvement?
WOTF complications requires a second opinion or consultation?
Deep tendon reflex
Goldthwait’s test
Deterioration of neurological signs
164
36 yo male with low back and right leg pain following a fall off a ladder. He has numbness over the right malleolus and lateral aspect of the small toe of the right foot. The patient’s posture is antalgic with the trunk inclined toward the left.
WOTF examination procedures most effectively tests the motor level corresponding to the dermatome pain pattern described in the case history?
WOTF procedures most accurately determines the presence of increased intrathecal pressure?
WOTF is the most likely location of the nerve root impingement?
WOTF complications is a contraindication to rotational adjustments of the lumbar spine?
Achilles tendon reflex
Valsalva maneuver
Lateral to the S1 nerve root
Neurological deficit
165
24 yo male presents with right leg pain. The pain originates on the lateral aspect of his posterior thigh and crosses over to the medial side of his lower leg at the knee. When the pain is most severe, it extends down to the medial aspect of his ankle. He also has vague paresthesias on the medial side of his knee. Examination reveals that light touch, pin prick, and two-point discrimination are decreased on the medial side of the lower leg. He states that he experienced moderate low-back pain for two months and currently the low back pain has subsided considerably; the leg pain has increased. Examination consisting of resisted dorsiflexion and inversion reveals a grade 3/5 weakness on the right side
WOTF muscles is being tested by resisted dorsiflexion and inversion?
WOTF neurological level is the most likely source of these findings?
WOTF screening tests is most likely to demonstrate motor weakness?
A four week treatment program consisting of side-posture spinal adjustments three times per week fails to provide any symptomatic or functional improvement. WOTF courses of action is most appropriate?
Tibialis anterior
L4
Heel walk/ Squat and rise
To order additional diagnostic tests and re-evaluate
166
48 yo female complaining of headaches for several months. Her job involves typing, copying, and filing. The headaches started 3 months ago with slow and progressive course. She got worse in the last month. Head movement, leaning forward, coughing and sneezing tend to worsen the attacks. Headache is partially relieved by OTCs. The headaches are mostly behind the eyes, temporal and occipital areas and associated with visual difficulties. Headache is worse in the morning and sometimes during night time. She has a hard time sleeping. No past history of headaches, no trauma, no hospitalization or major illness. Family history: mother used to have headaches and she has a medicine cabinet full of headache pills, father is hypertensive. No other health issues.
WOTF would be the most appropriate initial clinical impression?
What is the appropriate management?
Space occupying lesion
Refer to a MD for further evaluation
167
A patient complains of nervousness, fatigue, and weight loss. WOTF systems review findings would support a thyroid dysfunction as the principal mechanism for this condition?
Fine tremors, insomnia, and slight bulging of the eyes
168
Patient presents with periodic attacks of vertigo that occurs in the form of a series of attacks over a period of the last 3 months, with few periods of remission of variable duration. The attack consists of dizziness or vertigo. The sensation of spinning may produce nausea, vomiting, sweating, and all they symptoms normally associated with extreme motion sickness. The onset of vertigo may be preceded by a sensation of fullness or pressure in the ear, hearing loss, and ringing of the right ear as described by the patient. The onset is frequently sudden, reaching peak intensity within minutes and lasting for an hour or more before subsiding. Unsteadiness may persist for the following hours or days. Vertigo is specially aggravated by movement.
What is the most appropriate diagnosis?
The proper management for case
Meziere’s disease
Initiate chiropractic care
Dietary recommendation
169
45 yo woman noted decreased temperature sensation in her left foot in 2003, which slowly progressed until 2005 when she experienced loss of temperature sensation and noted numbness and a tight feeling below the left L2 dermatome. In the spring of 2006, she noticed motor weakness in her right lower extremity and a burning sensation on the left side that extended over the T10 and L1 dermatomes. She denied any history of trauma or surgery involving the spine. Neurological exam revealed that her right lower extremity was moderately weak. The right patellar and Achilles tendon reflexes were slightly hyperactive and a Babinski sign was present on the right side. She complained of numbness, tightness, and loss of temperature sensation below T6 on the left side, vibration sense is lost at the right malleoli and right tibial tubercle.
What is your diagnostic impression?
What is etiology and pathophysiological mechanism of this case?
Brown Sequard Syndrome same side cord compression
Loss of pain and temperature on the opposite side
Motor loss on the same side
Right sided cord hemi compression
170
The MC malignancy of the spine is
Multiple Myeloma
171
62 yo male with past history of chronic alcoholism with multiple episodes of liver trouble in the form of hepatitis B and few episodes of jaundice. He was recently diagnosed by his physician and lab work as compensated liver cirrhosis. A tinge of jaundice is observed in his sclera.
WOTF lab findings may be associated?
WOTF lab findings may be associated?
Decreased amount of serum albumin
Serum alkaline phosphatase
Altered A/G ratio
Elevated both direct and indirect bilirubin
172
30 yo male with swelling at the angle of the mandible, slight fever, malaise of three day duration. Upon examination there is hotness, redness, and tenderness with obvious swelling of the right cheek and mandibular angle area.
WOTF lab findings is most likely to help in establishing a clinical impression?
Lipase and amylase
| Leukocytosis with lymphocytosis (for mumps)
173
45 yo male presented with foot pain about two days ago. Patient wakes up in the mornings with redness and tenderness of the big toe. He can barely walk. Patient indicated that he had several episodes of the same condition in the last six months. Aggravating factors are alcohol and high protein diet
Gout
174
14 yo boy presented with multiple episodes of asthmatic attacks. His mother also indicated that he is developing a form of skin rash of which her physician determined it as a possible allergy.
Eosinophils
175
19 yo male of Italian descent complaining of acute torticollis which happened yesterday. After initial chiropractic screening and first aid chiropractic management in the form of passive gentle neck mobilization and resisted active neck muscle contraction. He has dramatic improvement. Upon system review he revealed that he gets episodes of yellowish discoloration (jaundice once or twice a year) usually brought on by stress or infection. Currently he has a tinge of jaundice in his sclera. Examination of the liver and gall bladder revealed no abnormalities or tenderness
Hemolytic jaundice = increased indirect bilirubin and total bilirubin
176
General osteopenia, mild ESR elevated, 50 yo female, small lytic lesions around pelvis, skull sternum
Next lab test?
Dx?
Next test to order = A/G ratio
| Would have hyperglobulinemia!!
177
ANA test lupus
ANA test lupus
178
High reticulocytic count =
Reticulocytes – RBC with nucleus still in cell
pathopneumonic for hemolytic jaundice/anemia
179
Zollinger-Ellison tumor is associated with what?
Peptic ulcer
180
Brown Sequard syndrome is associated with WOTF?
Upper motor neuron lesion on the same side of lesion
Loss of pain and temperature on the opposite side of lesion
It is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection of the spinal cord
Brown Sequard syndrome is associated with WOTF?
Upper motor neuron lesion on the same side of lesion
Loss of pain and temperature on the opposite side of lesion
It is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection of the spinal cord
181
WOTF presentations can cause a conductive hearing loss?
Tympanosclerosis
182
Which muscle is involved with extraocular motion of the right eye towards the right superior gaze?
Superior rectus
183
WOTF valvular lesions can cause drop attacks (blackouts)?
Aortic stenosis
This leads to Left ventricular enlargement
Will cause a murmur that is increased during expiration
184
The normal reaction to pupillary light reflex is?
Bilateral miosis and convergence of the eye
185
WOTF will not be found in the eyelid?
Pinguecula – a slow growth caused by the degeneration of the conjunctiva’s collagen fibers.
186
WOTF is associated with leukemia?
Marked increase in WBC
187
MC form of skin malignancy =
rodent ulcer
188
WOTF will cause lateralization of sound to the left ear during Weber’s Test?
Perforated ear drum in left ear conductive hearing loss
| Tympanosclerosis is conductive hearing loss
