MBChB Clinical Exam: Cranial Nerves, Resp & OmpathStudy

MOUNT KENYA UNIVERSITY MEDICAL SCHOOL — DEPARTMENT OF INTERNAL MEDICINE BACHELOR OF MEDICINE AND BACHELOR OF SURGERY (MBChB) UNIT CODE: MBIM 3100 UNIT TITLE: CLINICAL TECHNIQUES MAIN EXAMINATION — 2021/2022 DATE: FRIDAY 28TH, 2022 TIME: 2 HOURS --- Compiled Past Papers — MBIM 3100: Clinical Techniques This compilation draws together Clinical Techniques exams and continuous assessment tests from Mount Kenya University's School of Medicine spanning the 2018/2019 through 2021/2022 academic years, including the 2021/2022 main exam, CAT I, CAT II, and a dedicated respiratory system assignment. Together they cover cranial nerve examination, respiratory and cardiovascular signs, abdominal and cerebellar/CNS assessment, and general examination findings — the full breadth of bedside clinical skills tested across Year 3. SECTION 1 — MAIN EXAM 2021/2022 Topic: General Examination, Cranial Nerves, Respiratory & Abdominal Examination Choose the single best answer --- 1. Which of the following statements is true regarding oral findings? a) Angular stomatitis is associated with liver disease b) Oral candidiasis is only seen in HIV/AIDS patients c) Trauma, vitamin B12 deficiency and folate deficiency are associated with aphthous ulceration d) All of the above ANSWER: C Trauma, vitamin B12 deficiency and folate deficiency are associated with aphthous ulceration --- 2. Which of the following is FALSE regarding essentials of a mental state exam? a) Recent and distant memory b) Walking/abnormal gait c) Poor dressing, dirty person d) Appropriate language and speech ANSWER: B Mental state examination assesses cognition, appearance, behaviour, speech, and memory — not gait. Gait is part of a neurological/physical exam. --- 3. Which cranial nerve conducts sensory touch from the forehead, cheeks and lower jaw AND motor signals to the muscles of mastication? a) Facial nerve b) Trigeminal c) Hypoglossal d) Abducens ANSWER: B CN V (Trigeminal) has three sensory divisions (ophthalmic, maxillary, mandibular) covering the face, plus a motor branch to the muscles of mastication. --- 4. A middle-aged man cannot taste anything on the POSTERIOR portion of his tongue. Which nerve innervates this area? a) Glossopharyngeal b) Hypoglossal c) Facial d) Trigeminal ANSWER: A CN IX (Glossopharyngeal) carries taste from the posterior 1/3 of the tongue. CN VII (Facial) carries taste from the anterior 2/3. --- 5. A patient has diplopia, poor accommodation, absent direct and consensual light reflexes, and ptosis. Which statement is true? a) Oculomotor supplies the superior levator palpebrae b) Horner's syndrome should be considered c) A cerebellar lesion is most likely d) Trigeminal nerve supplies motor fibres to the frontalis ANSWER: A CN III (Oculomotor) supplies the superior levator palpebrae (raising the eyelid), the pupillary constrictor, and most extraocular muscles. Lesion causes ptosis, mydriasis, and loss of light reflexes. --- 6. Which of the following indicates a PARTIAL obstruction of a focal bronchiole/bronchus? a) Diffuse rhonchi b) Stridor c) Pleural rub d) Monophonic wheeze ANSWER: D A monophonic (single-pitched) wheeze indicates partial obstruction of a single airway. Stridor indicates laryngeal/tracheal obstruction. Diffuse rhonchi suggest widespread airway disease. --- 7. On drooping of the eyelid (ptosis), which statement is FALSE? a) It can be congenital or acquired b) It can be due to injury or stretching of the eye muscles c) Has been associated with apical lung tumors d) It is not associated with Myasthenia gravis ANSWER: D Ptosis IS associated with Myasthenia gravis (neuromuscular junction disorder). Apical lung tumors cause Horner's syndrome which also features ptosis. --- 8. The BEST place to check for jaundice is: a) Conjunctiva b) Sclera c) Nail beds d) Frenulum ANSWER: B The sclera is the best site — bilirubin deposits in the scleral elastin earliest and is most visible there, especially in dark-skinned individuals where conjunctival pallor may be easier to detect for anaemia. --- 9. The following percussion notes are matched to conditions — which is TRUE? a) Resonance — pneumothorax b) Stony dullness — pneumonia c) Stony dullness — intestinal obstruction d) Fluid thrill — gross ascites ANSWER: D Fluid thrill is elicited in gross ascites. Stony dullness = pleural effusion. Resonance = normal lung. Hyperresonance = pneumothorax. Dullness = consolidation. --- 10. Which of the following statements on abdominal examination is TRUE? a) Symmetrically distended abdomen may be due to fluid b) Visible peristalsis may be due to peritonitis c) Cullens sign is associated with ectopic pregnancy d) Visible right hypochondrial scar may be due to appendicectomy ANSWER: A Symmetrical distension can result from ascites, obesity, gas, or organomegaly. Cullen sign (periumbilical bruising) is associated with haemoperitoneum, including ruptured ectopic pregnancy and acute pancreatitis — so C is partially true, but A is the most straightforwardly