Which of the following synovial joints would be an example of a condylar joint?
A) Hip
B) Interphalangeal joints of the hand
C) Temporomandibular joint
D) Intervertebral joint
D) Intervertebral joint
Susanne is a 27 year old who has had headaches, muscle aches, and fatigue for the last 2
months. You have completed a thorough history, examination, and laboratory workup but
have not found a cause. What would your next action be?
A) A referral to a neurologist
B) A referral to a rheumatologist
,C) To tell the patient you can't find anything
D) To screen for depression
D) To screen for depression
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With
further questioning, she is able to relate that the pain is worse in the neck, shoulders,
hands, low back, and knees. She denies swelling in her joints; she states that the pain is
worse in the morning; there is no limitation in her range of motion. On physical
examination, she has several points on the muscles of the neck, shoulders, and back that
are tender to palpation; muscle strength and range of motion are normal. Which of the
following is likely the cause of her pain?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Fibromyalgia
D) Polymyalgia rheumatica
C) Fibromyalgia
A 17-year-old high school student is brought in to your emergency room in a comatose
state. His friends have accompanied him and tell you that they have been shooting up
heroin tonight and they think their friend may have had too much. The patient is
unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and he
is breathing through the ventilator. He is not posturing and he does not respond to a
sternal rub. Preparing to finish the neurologic examination, you get a penlight.
What size pupils do you expect to see in this comatose patient?
,A) Pinpoint pupils
B) Large pupils
C) Asymmetric pupils
D) Irregularly shaped pupils
A) Pinpoint pupils
You ask a patient to hold her arms up, with her palms up, and then to close her eyes. The
right arm begins to move downward after a few seconds and her thumb rotates upward.
This is most likely a problem with which part of the nervous system?
A) Corticospinal tract
B) Spinothalamic tract
C) Thalamus
D) Dorsal root ganglion
A) Corticospinal tract
Two weeks ago, Mary started a job which requires carrying 40-pound buckets. She
presents with elbow pain worse on the right. On examination, it hurts her elbows to
dorsiflex her hands against resistance when her palms face the floor. What condition
does she have?
A) Medial epicondylitis (golfer's elbow)
B) Olecranon bursitis
C) Lateral epicondylitis (tennis elbow)
D) Supracondylar fracture
, C) Lateral epicondylitis (tennis elbow)
Steve has had a stroke and comes to you for follow-up today. On examination you find
that he has increased muscle tone, some involuntary movements, an abnormal gait, and a
slowness of response in movements. He most likely has involvement of which of the
following?
A) The corticospinal tract
B) The cerebellum
C) The cerebrum
D) The basal ganglia
D) The basal ganglia
A 41-year-old real estate agent comes to your office, complaining that he feels like his
face is paralyzed on the left. He states that last week he felt his left eyelid was drowsy
and as the day progressed he was unable to close his eyelid all the way. Later he felt like
his smile became affected also. He denies any recent injuries but had an upper
respiratory viral infection last month. His past medical history is unremarkable. He is
divorced and has one child. He smokes one pack of cigarettes a day, occasionally drinks
alcohol, and denies any illegal drug use. His mother has high blood pressure and his
father has sarcoidosis. On examination you ask him to close his eyes. He is unable to
close his left eye. You ask him to open his eyes and raise his eyebrows. His right forehead
furrows but his left remains flat. You then ask him to give you a big smile. The right corner
of his mouth raises but the left side of his mouth remains the same.
What type of facial paralysis does he have?
A) Hip
B) Interphalangeal joints of the hand
C) Temporomandibular joint
D) Intervertebral joint
D) Intervertebral joint
Susanne is a 27 year old who has had headaches, muscle aches, and fatigue for the last 2
months. You have completed a thorough history, examination, and laboratory workup but
have not found a cause. What would your next action be?
A) A referral to a neurologist
B) A referral to a rheumatologist
,C) To tell the patient you can't find anything
D) To screen for depression
D) To screen for depression
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With
further questioning, she is able to relate that the pain is worse in the neck, shoulders,
hands, low back, and knees. She denies swelling in her joints; she states that the pain is
worse in the morning; there is no limitation in her range of motion. On physical
examination, she has several points on the muscles of the neck, shoulders, and back that
are tender to palpation; muscle strength and range of motion are normal. Which of the
following is likely the cause of her pain?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Fibromyalgia
D) Polymyalgia rheumatica
C) Fibromyalgia
A 17-year-old high school student is brought in to your emergency room in a comatose
state. His friends have accompanied him and tell you that they have been shooting up
heroin tonight and they think their friend may have had too much. The patient is
unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and he
is breathing through the ventilator. He is not posturing and he does not respond to a
sternal rub. Preparing to finish the neurologic examination, you get a penlight.
What size pupils do you expect to see in this comatose patient?
,A) Pinpoint pupils
B) Large pupils
C) Asymmetric pupils
D) Irregularly shaped pupils
A) Pinpoint pupils
You ask a patient to hold her arms up, with her palms up, and then to close her eyes. The
right arm begins to move downward after a few seconds and her thumb rotates upward.
This is most likely a problem with which part of the nervous system?
A) Corticospinal tract
B) Spinothalamic tract
C) Thalamus
D) Dorsal root ganglion
A) Corticospinal tract
Two weeks ago, Mary started a job which requires carrying 40-pound buckets. She
presents with elbow pain worse on the right. On examination, it hurts her elbows to
dorsiflex her hands against resistance when her palms face the floor. What condition
does she have?
A) Medial epicondylitis (golfer's elbow)
B) Olecranon bursitis
C) Lateral epicondylitis (tennis elbow)
D) Supracondylar fracture
, C) Lateral epicondylitis (tennis elbow)
Steve has had a stroke and comes to you for follow-up today. On examination you find
that he has increased muscle tone, some involuntary movements, an abnormal gait, and a
slowness of response in movements. He most likely has involvement of which of the
following?
A) The corticospinal tract
B) The cerebellum
C) The cerebrum
D) The basal ganglia
D) The basal ganglia
A 41-year-old real estate agent comes to your office, complaining that he feels like his
face is paralyzed on the left. He states that last week he felt his left eyelid was drowsy
and as the day progressed he was unable to close his eyelid all the way. Later he felt like
his smile became affected also. He denies any recent injuries but had an upper
respiratory viral infection last month. His past medical history is unremarkable. He is
divorced and has one child. He smokes one pack of cigarettes a day, occasionally drinks
alcohol, and denies any illegal drug use. His mother has high blood pressure and his
father has sarcoidosis. On examination you ask him to close his eyes. He is unable to
close his left eye. You ask him to open his eyes and raise his eyebrows. His right forehead
furrows but his left remains flat. You then ask him to give you a big smile. The right corner
of his mouth raises but the left side of his mouth remains the same.
What type of facial paralysis does he have?
