A 48-year-old female patient develops an acute, severe and isolated right C6 radiculopathy affecting both the motor and sensory roots. She is examined in an EMG clinic 3 weeks after the onset of symptoms. Which of the following statements is true? A. Absent sensory nerve potentials would be expected on examination of the thumb and index finger on the right. B. A repeat examination 12 months later is likely to reveal rapidly recruited low amplitude short duration motor units in the clinically involved muscle on EMG. C. Fibrillation potentials would be expected in the right brachioradialis and abductor pollicus brevis. D. Triceps tendon jerk is likely to be depressed or absent. E. Voluntary motor unit activity may be absent in the right biceps.

A 48-year-old female patient develops an acute, severe and isolated right C6 radiculopathy affecting both the motor and sensory roots. She is examined in an EMG clinic 3 weeks after the onset of symptoms. Which of the following statements is true? A. Absent sensory nerve potentials would be expected on examination of the thumb and index finger on the right. B. A repeat examination 12 months later is likely to reveal rapidly recruited low amplitude short duration motor units in the clinically involved muscle on EMG. C. Fibrillation potentials would be expected in the right brachioradialis and abductor pollicus brevis. D. Triceps tendon jerk is likely to be depressed or absent. E. Voluntary motor unit activity may be absent in the right biceps.
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A 73-year-old man presents with an abrupt onset of double vision and left leg weakness. Examination shows weakness of abduction of the right eye, right-sided facial weakness affecting upper and lower parts of the face. He also has a left hemiparesis. Where is the lesion? A. left frontal lobe B. left lateral medulla C. right corpus striatum D. right midbrain E. right pons

Description : A 73-year-old man presents with an abrupt onset of double vision and left leg weakness. Examination shows weakness of abduction of the right eye, right-sided facial weakness affecting upper and lower ... frontal lobe B. left lateral medulla C. right corpus striatum D. right midbrain E. right pons

Last Answer : Ans: E

Which of the following would be the result of a spinal lesion at the level of C8? A. a reduced brachioradialis reflex B. inability to abduct the shoulder C. loss of sensation over the lateral aspect of the arm D. winging of the scapula E. weakness of finger flexion

Description : Which of the following would be the result of a spinal lesion at the level of C8? A. a reduced brachioradialis reflex B. inability to abduct the shoulder C. loss of sensation over the lateral aspect of the arm D. winging of the scapula E. weakness of finger flexion

Last Answer : Ans: E

A patient of megaloblastic anaemia was treated with oral folic acid 5 mg daily. After 2 weeks he reported back with cognitive deficit, sensory disturbance, depressed knee jerk, while blood picture and haemoglobin level were improved. What could be the most likely explanation: A. Folic acid was not adequately absorbed resulting in partial response B. Folate therapy has precipitated vitamin B12 deficiency in the neural tissue C. Folate therapy has unmasked pyridoxine deficiency D. Patient has folate reductase abnormality in the nervous system

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Last Answer : D. Patient has folate reductase abnormality in the nervous system

An incision biopsy of an ulcerated and intruded clinically suspicious lesion in a 50 years-old female reveals chronic inflammation; you would:** A. Inform the patient and her physician of your findings and instruct the patient to return in six months B. Surgically excise the entire lesion since you know it is not malignant C. Dismiss the patient with instructions for warm saline rinses and re-examination D. Repeat the biopsy

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Last Answer : D. Repeat the biopsy

Which nerve is assessed when the nurse asks the patient to dorsiflex the ankle and extend the toes? a) Peroneal The motor function of the peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes while the sensory function is assessed by pricking the skin between the great and center toes. b) Radial The radial nerve is assessed by asking the patient to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. c) Median The median nerve is assessed by asking the patient to touch the thumb to the little finger. d) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation.

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Last Answer : a) Peroneal The motor function of the peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes while the sensory function is assessed by pricking the skin between the great and center toes.

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Description : Which nerve is assessed when the nurse asks the patient to spread all fingers? a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation ... The median nerve is assessed by asking the patient to touch the thumb to the little finger.

Last Answer : a) Ulnar Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve.

Which of the following features would be expected on lipid analysis in a 57 year old female with two year history of primary biliary cirrhosis? 1) A lipaemic appearance of the serum would be expected. 2) is treated with clofibrate therapy 3) is characteristically associated with tendon xanthomas 4) is characteristically associated with palmar xanthomas 5) No evidence of a dyslipidaemia would be expected with this short a duration of disease

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After 48 hours of a cataract extraction operation, a patient complained of ocular pain and visual loss. On examination, this eye looked red with ciliary injection, corneal oedema and absent red reflex. The first suspicion must be: a. Secondary glaucoma. b. Anterior uveitis. c. Bacterial endophthalmitis. d. Acute conjunctivitis

Description : After 48 hours of a cataract extraction operation, a patient complained of ocular pain and visual loss. On examination, this eye looked red with ciliary injection, corneal oedema and absent red ... a. Secondary glaucoma. b. Anterior uveitis. c. Bacterial endophthalmitis. d. Acute conjunctivitis  

Last Answer : ANSWER: C

Which ONE of the following would be expected in a third nerve palsy? A. Enophthalmos B. Constricted pupil C. Convergent strabismus D. Increased lacrimation E. Unreactive pupil to light

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A female patient 18 years old, who is contact lens wearer since two years, is complaining of redness, lacrimation and foreign body sensation of both eyes. On examination, visual acuity was 6/6 with negative fluorescein test. The expected diagnosis can be: a. Acute anterior uveitis. b. Giant papillary conjunctivitis. c. Bacterial corneal ulcer. d. Acute congestive glaucoma

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Last Answer : ANSWER: B 

Structural and motor changes related to aging that may be assessed in geriatric patients during an examination of neurologic function include which of the following? a) Decreased or absent deep tendon reflexes Structural and motor changes related to aging that may be assessed in geriatric patients include decreased or absent deep tendon reflexes.

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In which phase of the trajectory model of chronic illness are the symptoms under control and managed? a) Stable The stable phase indicates that the symptoms and disability are under control or managed. b) Acute The acute phase is characterized by sudden onset of severe or unrelieved symptoms or complications that may necessitate hospitalization for their management. c) Comeback The comeback phase is the period in the trajectory marked by recovery after an acute period. d) Downward The downward phase occurs when symptoms worsen or the disability progresses despite attempts to control the course through proper management.

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Which of the following terms refers to disease of a nerve root? a) Radiculopathy When the patient reports radiating pain down the leg, he is describing radiculopathy.

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A 19 year-old female is referred following a visit to the dentist where marked erosion of her teeth was noted. She was entirely asymptomatic and her only medication was the oral contraceptive pill. On examination her blood pressure was 110/70 mmHg and her body mass index was 21.5 kg/m2 (18 - 25). Investigations sodium 135 mmol/l potassium 2.1 mmol/l bicarbonate 42 mmol/l urea 2.6 mol/L corrected calcium 2.08 mmol/ alkaline phosphatase 201 iu/l (50-110) What is the most likely diagnosis? 1) Bulimia nervosa 2) Conn's syndrome 3) Laxative abuse 4) Pregnancy 5) Primary hypoparathyroidism

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Which of the following terms is used to describe a tachycardia characterized by abrupt onset, abrupt cessation, and a QRS of normal duration? a) Paroxysmal atrial tachycardia PAT is often caused by a conduction problem in the AV node and is now called AV nodal reentry tachycardia. b) Sinus tachycardia Sinus tachycardia occurs when the sinus node regularly creates an impulse at a faster-than-normal rate. c) Atrial flutter Atrial flutter occurs in the atrium and creates an atrial rate between 250-400 times per minute. d) Atrial fibrillation Atrial fibrillation causes a rapid, disorganized, and uncoordinated twitching of atrial musculature.

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Which of the following drugs is a class III antiarrhythmic agent that is effective in the acute management of atrial fibrillation or atrial flutter of recent onset ? (a) Bretylium (b) Lbutilide (c) Metoprolol (d) Disopyramide

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When up to a 6-month period elapses between the experience of trauma and the onset of symptoms of posttraumatic stress disorder (PTSD), the episode is termed a) delayed. In the case of delayed PTSD, there may be up to a 6-month period of time that elapses between the trauma and the manifestation of symptoms. b) acute. Acute PTSD is defined as the experience of symptoms for less than a 3-month period. c) chronic. Chronic PTSD is defined as the experience of symptoms lasting longer than 3 months. d) primary. The concept of primary disease is not used in relation to PTSD.

Description : When up to a 6-month period elapses between the experience of trauma and the onset of symptoms of posttraumatic stress disorder (PTSD), the episode is termed a) delayed. In the case of delayed PTSD, there ... than 3 months. d) primary. The concept of primary disease is not used in relation to PTSD.

Last Answer : a) delayed. In the case of delayed PTSD, there may be up to a 6-month period of time that elapses between the trauma and the manifestation of symptoms.

Which of the following would be expected following distal occlusion of the posterior cerebral artery? A. cerebellar ataxia B. contralateral hemiplegia C. dysarthria D. homonymous hemianopia E. palatal palsy

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Last Answer : Ans: D

What are the branches of the trigeminal nerve (CNV)?

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Last Answer : answer:Nerve supply to the face & scalp Diagram of trigeminal nerve

Which of the following statements about the presence of gallstones in diabetes patients is/are correct? A. Gallstones occur with the same frequency in diabetes patients as in the healthy population. B. The presence of gallstones, regardless of the presence of symptoms, is an indication for cholecystectomy in a diabetes patient. C. Diabetes patients with gallstones and chronic biliary pain should be managed nonoperatively with chemical dissolution and/or lithotripsy because of severe complicating medical conditions and a high operative risk. D. The presence of diabetes and gallstones places the patient at high risk for pancreatic cancer. E. Diabetes patients with symptomatic gallstones should have prompt elective cholecystectomy, to avoid the complications of acute cholecystitis and g

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Last Answer : Answer: E DISCUSSION: Gallstones have been found to be very prevalent in patients with type II (non-insulin-dependent) diabetes mellitus, perhaps related to the dyslipoproteinemia in ... added mortality associated with it. There is no causal relationship between diabetes and pancreatic cancer

A patient complains of sensitivity, on examination you find a composite filling restoring a good cavity preparation without any secondary caries; what is your next step: A. Extirpate the pulp that is obviously inflamed B. Place ZOE dressing to sedate the pulp C. Ask patient to come back in six months D. Repeat restoration

Description : A patient complains of sensitivity, on examination you find a composite filling restoring a good cavity preparation without any secondary caries; what is your next step: A. Extirpate the pulp that is obviously ... to sedate the pulp C. Ask patient to come back in six months D. Repeat restoration

Last Answer : B. Place ZOE dressing to sedate the pulp

A 15-year-old girl was seen by her family physician because of increasing lethargy. She had a recent history of the "flu". Biochemistry tests show that she has renal impairement. serum sodium 140 mmol/L (137 - 144) serum potassium 4.2 mmol/L (3.5 - 4.9) serum urea 28 mol/L (2.5 - 7.5) serum creatinine 280 µmol/L (60 - 110) Her condition does not improve after several weeks on corticosteroid therapy, so a renal biopsy is performed. The biopsy demonstrates the presence of segmental sclerosis of 3 of 10 glomeruli identified in the biopsy specimen. Immunofluorescence studies and electron microscopy do not reveal evidence for immune deposits. What is the most appropriate advice to give regarding her condition? 1) She has an underlying malignancy 2) She may require a renal transplant in 10 years

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A 55-year-old patient with severe posthepatitis cirrhosis is started on a diuretic for another condition. Two days later he is found in a coma. The drug most likely to cause coma in a patient with cirrhosis is (a) Acetazolamide (b) Amiloride (c) Furosemide (d) Hydrochlorothiazide (e) Spironolactone

Description : A 55-year-old patient with severe posthepatitis cirrhosis is started on a diuretic for another condition. Two days later he is found in a coma. The drug most likely to cause coma in a patient with cirrhosis is (a) Acetazolamide (b) Amiloride (c) Furosemide (d) Hydrochlorothiazide (e) Spironolactone

Last Answer : Ans: A

How is the skin involved in the regulation of body temperature?

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Last Answer : The skin is one of several organ systems participating in maintaining a core temperature, meaning the temperature near the center of someone's body. Temperature sensors in the skin and internal organs monitor ... sweat evaporates off the skin surface it carries a large amount of body heat with it. 

Nursing management of the patient with acute symptoms of benign paroxysmal positional vertigo includes which of the following? a) Bed rest Bed rest is recommended for patients with acute symptoms. Canalith repositioning procedures (CRP) may be used to provide resolution of vertigo, and patients with acute vertigo may be medicated with meclizine for 1-2 weeks.

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Are there differences between the male and female skeletons?

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Which of the following regarding the anatomy of the heart is true? A. The aortic valve is tricuspid. B. The ascending aorta is entirely outside the pericardial sac. C. The left atrial appendage is identified readily by transthoracic echocardiography. D. The pulmonary trunk lies anterior to the ascending aorta. E. The right atrium is posterior to the left atrium.

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Last Answer : Ans: A

What are some of the initial symptoms in about 70% of people infected with HIV within the first few weeks? a. A migrating rash covering the whole body b. Flu-like symptoms, of fever, chills c. Sneezing and symptoms of a head cold d. No one develops symptoms until several years later

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Last Answer : b. Flu-like symptoms, of fever, chills

A diabetic develops a severe perineal infection with skin necrosis, subcutaneous crepitance, and drainage of a thin, watery, grayish and foul-smelling fluid. Management should consist of: a. Gram stain of the fluid, which will likely demonstrate multiple bacteria including predominantly gram-positive rods b. A CT scan is indicated in a stable patient to define the extent of the disease c. Broad spectrum antibiotics followed with prompt extensive debridement is indicated d. A safe guideline is to resect infected necrotic tissue so that a several centimeter margin of grossly normal, healthy tissue can be achieved e. A colostomy is of little benefit in this situation

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Last Answer : Answer: a, b, c, d The presence of severe perineal infection (referred to as Fournier gangrene when this process involves the perineum and scrotum in males) is associated with a ... often provides improved wound care and patient management, although it is not invariably a positive outcome

A 47-year-old patient undergoing a complicated laparotomy for bowel obstruction develops a postoperative enterocutaneous fistula. Which of the following statement(s) is/are true concerning parenteral nutritional support in the postoperative period? a. Oral intake can result in severe dehydration, electrolyte abnormalities, and perifistula skin injury b. Total parenteral nutrition increases the spontaneous closure rate of intestinal fistula c. Total parenteral nutrition decreases mortality rate in patients with intestinal fistulas d. The use of TPN better prepares the patient for surgery if surgical intervention proves necessary

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Last Answer : Answer: a, b, d Patients with gastrointestinal-cutaneous fistulas represent the classical indication for TPN. In such patients, oral intake of food almost invariably results in increased ... treated more aggressively surgically after a defined period of nutritional support (unless closure occurs)

A 45-year-old solicitor had an onset of severe, crushing, substernal chest pain while attending a football match. He collapsed on his way to the car. Bystander Cardiorespiratory Resuscitation was begun immediately and continued until arrival in Casualty where an endotracheal tube was inserted and ventilation was maintained on 100% oxygen. Investigations revealed: pH 7.13 PaO2 560 mmHg PaCO2 18 mmHg Bicarbonate 5.8 SaO2 98% Based on these laboratory values, which of the following statements best describes his current pathophysiology? 1) He is demonstrating a primary respiratory alkalosis 2) He probably developed a large right to left intracardiac shunt 3) His anion gap is probably normal 4) His oxyhemoglobin curve is shifted to the left 5) His pulmonary artery pressure is probably elevated

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Last Answer : Answers-5 This young patient with severe central chest pain has probably arrested due to myocardial infarction and arrhythmia. His gases reveal high PO2 following 100% O2 but severe acidosis ... no left to right shunting and high pulmonary pressures would be expected after this arrest scenario.

How to tell right or left bones of appendicular skeleton?

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Last Answer : Ever hear of anatomical position? If you visualize the bones in that position, you can’t go wrong. The Radial bone is also on your thumb side.

Which of the following statements is true with regard to the erratic behaviour of Indian monsoons? (a) Uniform duration but varying amounts of rain from one year to another, as well as at different places (b) Uncertain date of onset and withdrawal, as well as unequal distribution of rain (c) Uncertain date of onset and withdrawal as well as varying amounts of rainfall during different years (d) Uniform duration but varying amounts of rain from place to place

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Last Answer : Ans: (c)

The following is true of anti-H.pylori therapy except: A. It is indicated in all patients of peptic ulcer B. Resistance to any single antimicrobial drug develops rapidly C. Concurrent suppression of gastric acid enhances efficacy of the regimen D. Colloidal bismuth directly inhibits H.pylori but has poor patient acceptability

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Last Answer : A. It is indicated in all patients of peptic ulcer

Which of the following conditions indicates that a lead-acid battery is being charged too rapidly? A. Sparks occurring at the positive terminal. B. Unusually high electrolyte specific gravity. C. Low plate potentials being developed. D. Excessively high temperatures and gassing rates.

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Last Answer : Answer: D

Destruction of the anterior horn cells of the spinal cord would result in loss of (a) commissural impulses (b) integrating impulses (c) sensory impulses (d) voluntary motor impulses

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Last Answer : (d) voluntary motor impulses.

A 60-year-old patient presented with anorexia, weakness, paresthesia and mental changes. His tongue was red, tendon reflexes were diminished, haemoglobin was 6 g% with large red cells and neutrophils had hypersegmented nuclei. Endoscopy revealed atrophic gastritis. Deficiency of which factor is likely to be responsible for his condition: A. Folic acid B. Vitamin B12 C. Pyridoxine D. Riboflavin

Description : A 60-year-old patient presented with anorexia, weakness, paresthesia and mental changes. His tongue was red, tendon reflexes were diminished, haemoglobin was 6 g% with large red cells and neutrophils had ... be responsible for his condition: A. Folic acid B. Vitamin B12 C. Pyridoxine D. Riboflavin

Last Answer : B. Vitamin B12

Which of the following statements reflects the nursing management of the patient with West Nile Virus infection? There is no treatment for West Nile Virus infection. Patients are supported by fluid replacement, airway management, and standard nursing care support during the time that the patient has meningitis symptoms. a) The incubation period is three to five days. The incubation period (from mosquito bite until onset of symptoms) is between 5–15 days.

Description : Which of the following statements reflects the nursing management of the patient with West Nile Virus infection? There is no treatment for West Nile Virus infection. Patients are supported by fluid replacement ... the virus to animals and humans. There is no human-to-human transmission of virus.

Last Answer : a) The incubation period is three to five days. The incubation period (from mosquito bite until onset of symptoms) is between 5–15 days.

How can I learn to whistle loudly and shrilly using my thumb/index finger and middle finger?

Description : How can I learn to whistle loudly and shrilly using my thumb/index finger and middle finger?

Last Answer : Oops. I meant this to be “social.”

Which of the following manifestations is often the earliest sign of malignant hyperthermia? a) Tachycardia (heart rate above 150 beats per minute) Tachycardia is often the earliest sign of malignant hyperthermia. b) Hypotension Hypotension is a later sign of malignant hyperthermia. c) Elevated temperature The rise in temperature is actually a late sign that develops rapidly. d) Oliguria Scant urinary output is a later sign of malignant hyperthermia.

Description : Which of the following manifestations is often the earliest sign of malignant hyperthermia? a) Tachycardia (heart rate above 150 beats per minute) Tachycardia is often the earliest sign of malignant ... develops rapidly. d) Oliguria Scant urinary output is a later sign of malignant hyperthermia.

Last Answer : a) Tachycardia (heart rate above 150 beats per minute) Tachycardia is often the earliest sign of malignant hyperthermia.