OBA

1. RA is a chronic systemic inflammatory disease which involve several inflammatory

cytokines. What is an important interleukin involved? Ans. IL-1
2. 14 year old, African male diagnosed with sickle cell disease came with signs of
osteomyelitis, what organism is most commonly involved? Ans. Salmonella T.
3. In an intra-articular injury, which phase during healing will be most affected? Ans.
Hematoma phase.
4. A woman with post-surgical hypo-parathyroidism and hypothyroidism was given
calcium/vit. D and ergocalciferol. Why? Ans. Enhance the mineral absorption of the
bone.
5. Vertebral triangle in relation to the lateral neck muscles? Ans. Anterion scalene forms
the lateral border of the vertebral triangle.
6. Which objective is the least likely achieved in the treatment of RA? Ans. To induce
remission.
7. A patient with multiple schwannoma and NF2 would most commonly also have what?
Ans. Acoustic neuroma.
8. A obese woman, pain on weight bearing joints affecting both hip joints. What is the
most probable diagnosis? Ans. OA.
9. Women who exercise excessively have a series of medical conditions known as? Ans.
Female athlete triad.
10. During a lumbar puncture, which statement about this procedure is correct? Ans. The
iliac crest is used as a landmark to determine the level at which a lumbar puncture is
done.
11. A patient with malignant parotid tumor, during surgical removal which the main trunk of
the facial nerve was damaged. Which muscle would be affected? Ans. Buccinator
12. What is the midbrain embryologic origin known as? Ans. Mesencephalon
13. Which is associated with NREM sleep? Ans. Logical dreams.
14. Which statement concerning the anticonvulsant Phenytoin is true? Ans. Used to treat
partial and grand mal epilepsy.
15. Which reflex will be absent in a midbrain lesion? Labyrinth righting reflex.
16. A child is given plus lens (biconvex lens), which situation would require the use of these
glasses? Ans. When the patient is squinting. (long sighted-ness? Not sure, check it
out.)
17. Patient with Parkinson’s disease. Most common clinical manifestations? Bradykinesia
and resting tremor.
18. Which drug is TDM taken into account for? (something along those lines). Ans.
Valproate.
19. Which statement is least likely in a patient that is in a vegetative state?
20. A patient wandering aimlessly (possibly schizophrenic negative). Which statement is
true? Ans. 10% chance the children of that patient will get the same disorder.
21. Left leg injury, road traffic accident, foot drop, fracture at the neck of fibula. Which
muscle would you test to confirm the foot drop? Anterior tibial
22. Weakness in lower limb, difficulty in flexing knee and extending hip? Which muscle?
Adductor Longus
23. 5y/o, flaccid paralysis right lower limb. Poliomyelitis. Pathophysiology
24. Massater muscle. Anatomy. Inserted ramus
25. Night sweat, ESR increase, bony mass, thoracic tuberculosis. Least likely occurrence.
Reactive new bone formation
26. Which LA inhibits the uptake of catecholamines? Cocaine
27. Tear medial meniscus. Which structure would be vulnerable? Tibial collateral ligament
28. Wrist laceration. Which muscle would retain its functions? Lumbericals
29. Accident. Doctor asked the patient to raise his arm up to 90 degrees. Which structure is
the doctor testing? Axillary Nerve
30. Pregnant woman. Was prescribed diclofenac sodium for tooth ache. What would be
possible effect on the foetus? Closure of ductus arteriosus in foetus
31. Which tract does not cross the spinal cord? Fibers of posterior column
32. Occlusion of artery in the brain, causes temporary blindness. Which vessel is occluded?
Central artery of retina
33. Mechanism of pain endogenous modulator. Adrenergic neurons sending impulses to
(something)
34. Jerky, random, uncontrollable movements. CT scan was done. What structure would
atrophy which would show in CT scan? Putamen
35. Unable to adduct the right eye. Affected part of the brain? Pons
36. Disrupt vestibular pathways. Lead to? Absence of nystagmus
37. Sudden development of ataxia, dementia. Diagnosis of syphilis was made. What
diagnostic test would you do? Fluorescents treponema antibody
38. High mitotic rate, palisading necrosis. Glioblastoma
39. 15 y/o, suspected drug abuse, up late at night, sleep in class. Drastic changing of
behavior. Amphetamines

EMQ
1. Bone disorders and nerve injuries.
Choose from the possible answers below:

Claw hand deformity

 Rickets
Avascular necrosis
Osteoporosis
Osteopetrosis
Paget’s disease
Axillary nerve
Recurrent dislocation

Chronic back pain, old lady with decreased DEXA scan results.
a.
b. Middle aged woman with wrist injury. Lunate dislocation. Ans. Carpal Tunnel
Syndrome
c. 8 y/o repeated dislocation. Suspected nerve injury? Ans. Axillary Nerve
d. 79 y/o pain in the right groin. Inability to carry weight and a history of a fall 2 months
ago. Ans. Avascular necrosis
2. CNS tumours
a. 5 year old boy with walking/vomiting and an enlarging cystic lesion.
b. Sudden epilepsy, tumor of the temporal lobe with fried egg lesions on pathological
interpretations. Ans. Oligodendroglioma.
c. Cerebellar lesion, patient has ataxia and personality changes with diagnosed RCC.
Ans. Hemangioblastoma.

3. Cranial nerve injuries

a. Neck is drooping down on one side and cannot lift shoulder. Ans. Accessory nerve.
b. Cavernous venous thrombophlebitis, diplopia when walking downstairs. Ans. SO4
c. Lymph node, neck, right eye sunken, droopy. Ans. Sympathetic nerve of Carotid
plexus
d. Tumour at submandibular. Blocking nearby artery and vein. Difficulty in speech and
tongue shifted to the right. Ans. Hypoglossal Nerve
e. Severe pain right cheek. NSAID does not work. Ans. Trigeminal Nerve.

OSPE
1. Picture: Anterior and posterior aspect of the elbow joint.
● Biceps brachii (musculocutaneous nerve)
● Radial tuberosity
● Superior radio-ulnar joint
● Olecrenon
● Triceps brachii (radial nerve)
 Picture: Subcutaneous nodules on the elbow.
Picture: Hand is shown with swollen PIP on 3rd and 4th digits.
Picture: X-ray of the hand. (Identify erosion, cyst, reduced articular space)
Dx: RA
2. Picture: A case hx (a patient with photophobia, neck rigidity, fever 38 degrees Celsius
and had previous history of cough.
Picture: CSF findings: Physical – clear, colourless; Chemical – Protein raised, glucose
decreased; Microscopic – lymphocyte counts raised.
Dx: TB meningitis
Interpret the results. (Don’t over think this, it’s just as simple as recopying the trigger
given. NO JOKE. The model answers stated so. All those explanations in your head at
this point should go under the next question)
Explain why you think so from clinical features and lab investigations.
Give 2 drugs. Ans. RIPE
3. Picture: Ventricular System of the brain
Ans. Body, Anterior, Posterior part of lateral horn
Interventricular foramen
3rd ventricle
4th ventricle
What is on the lateral wall of the 3rd ventricle? Ans. Thalamus and hypothalamus.
Name the 2 foramens of the 4th ventricle. Ans. Foramen Magendie and Foramen
Luschka. (however you spell those 2 words, check it up)

MEQ 1

5 y/o pain in the knee. Refuses to allow anyone to touch it. Pain in the lower left limb.
Test shows increase C-reactive and leucocyte count.

1. 2 other specific tests. Ans. X-ray, Ultrasounography, Blood culture… More..

2. Nerve supply of knee and pathophysio of pain in this case. Ans. Tibial Nerve,
Common Peroneal Nerve, Obturator Nerve, Femoral Nerve. Hilton Law’s.
3. Diagnosis: Osteomyelitis
4. Pathology of diagnosis (mentioned boy developed sinus lateral aspect of left leg).
Ans. Chronic inflammation causing metaphysis of the bone to erode. Due to the
nature of avascularity, metaphysis region fail to heal creating sinus.
Staining shows Gram positive cocci organism in clusters
1. What is most likely organism? Ans. Staphylococcus Aureus.
2. Treatment. (Ans. Cloxacillin)
3. IM injection, JUSTIFICATIONS. Explain Gluteus maximus fx .and how it resulted in fix
hip flexion.
MEQ2
Patient presents with transient blindness for an hour at night. She went to the hospital
and was scanned for retinal pathology. None found. History of thrombosis and
undergone surgery for it.
1. What is the medical term for the transient blindness? Ans. Amaurosis fugax
2. Probable diagnosis. Ans. Transient Ischeamic Attack. Atherosclerosis.
Contrast angiogram done. Atherosclerosis of the internal carotid artery. Diagnosis of
T.I.A. reached.
1. Define T.I.A. Ans. Less than 24 hours. Neurologic deficit.
2. Clinical Significance. Ans. Increase risk of stroke.
Patient had a stroke. Decerebrate state.
1. What postural reflexes was unmasked? Ans. Tonic Neck Reflex, Tonic Labyrinth reflex.
2. Describe the posture of this patient. Ans. 4 limbs, extended.
MEQ3
Parkinson’s
1. Which part of history shows signs of your diagnosis?
2. Which areas of the brain and involving nucleus is involved? Ans. Basal Ganglia and its
nucleus (es) (look up yourself)
Pain in the patient wrist. Fracture. Diagnosis of Colles Fracture reached.
1. Definition. Ans. Fracture of Distal radius, dislocation of wrist. Fork-like wrist. Loss of
function.
Pain bothering patient. Patient rubs Tiger Balm. Short lived relief.
1. Explain how rubbing the tiger balm gives transient relief. Ans. The SG is the gate
keeper which modulates pain signals going to the brain. Small fibers (pain) inhibit
this gate keeper, thus gate remains open and pain signals go to our brain. Large
fibers (touch) stimulate the SG cells to close and thus stop pain signals.
2. Drugs recommended and its principle actions. Ans. NSAIDS and COX-2 inhibitors.