1St Aid Usmle Step 1 Neurology And Psychiatry High Yield Clinical Vignettes

Front 1

Patient presents with decreased pain and temperature sensation over the lateral aspects of both arms

What is the lesion?

Back 1

Syringomyelia`

Front 2

Penlight in patient's right eye produces bilateral pupillary constriction. When moved to the left eye there is paradoxical dilation

What is the defect

Back 2

atrophy of left optic nerve

Front 3

patint describes decreased prick sensation on the lateral aspect of her leg and foot

deficit of what muscular action is expected?

Back 3

dorsiflection and eversion of foot (common peroneal nerve)

Front 4

elderly woman presents with arthritis and tingling over the lateral digits of her right hand

what is the diagnosis?

Back 4

carpal tunnel syndrome, median nerve compression

Front 5

decreased reports decreased plantar flexion and decreased sensation over the back of thigh, calf, and lateral half of foot

what spinal nerve is involved

Back 5

tibial (L4-S3)

Front 6

patient cannot turn her head to the left and has right shoulder droop?

what structure is damaged?

Back 6

Right CNXI (runs thru jugular foramen with IX and X) innervating sternocleidomastoid and trapezius muscles

Front 7

man presents with one wild, flailing arm

where is the lesion

Back 7

contralateral subthalamic nucleus (hemiballismus)

Front 8

patient with cortical lesion does not know that he has a disease

where is the lesion

Back 8

right parietal lobe

Front 9

patient cannot protruede tongue toward left side and has a right sided spastic paralysis

wehre is the lesion?

Back 9

left medulla

Front 10

after fall that injures elbow, pt can't feel medial palm

which nerve and what injury?

Back 10

ulnar nerve due to broken medial condyle

Front 11

midshaft break of the humerus

what nerve and artery likely to be damaged

Back 11

radial nerve and deep brachial artery, which run together

Front 12

patient cannot blink right eye or seal lips and has mild ptosis on right side

what is diagnosis, what nerve affected?

Back 12

Bell's palsy, cn vii

Front 13

patient complains of pain, numbness, and tingling. on exam, wasting of thenar eminence

what diagnosis, what nerve?

Back 13

carpal tunnel, median nerve

Front 14

during a particular stage of sleep, man has variable blood pressure, penile tumescence, and variable eeg

what stage?

Back 14

rem

Front 15

episodes of hypoglycemia; blood analysis reveals no elevation in c protein

what diagnosis?

Back 15

factitious disorder; self scripted insulin

Front 16

headache, visual disturbance, galactorrhea, amenorrhea

what dx?

Back 16

prolactinoma

Front 17

middle aged pt with dizziness and tinnitus. ct shows enlarged internal acoustic meatus

what dx?

Back 17

schwannoma

Front 18

25 year old female with uniocular vision loss, slurred speech. history of weakness and paresthesias that have resolved

dx?

Back 18

MS

Front 19

child "paces out". quivering lips during spells.

dx?

Back 19

absence seizure

Front 20

man on antidepressants has mydriasis and becomes constipated

what is cause of sx?

Back 20

tricyclic antidepressants

Front 21

woman on MAO inhibitor has hypertensive crisis after a meal

what did she ingest?

Back 21

tyramine (wine or cheese)