MBChB Clinical Exam: Cranial Nerves, Resp & Abdominal Skills

30 clinical MCQs in Introduction to Clinical Techniques. Which of the following statements is true regarding oral findings? —. Free notes for medical st...

Questions, Answers & Explanations

1. Q1. Which of the following statements is true regarding oral findings? ---

   • Angular stomatitis is associated with liver disease
   • Oral candidiasis is only seen in HIV/AIDS patients
   • Trauma, vitamin B12 deficiency and folate deficiency are associated with aphthous ulceration
   • All of the above

   Answer: Trauma, vitamin B12 deficiency and folate deficiency are associated with aphthous ulceration

2. Q2. Which of the following is FALSE regarding essentials of a mental state exam? ---

   • Recent and distant memory
   • Walking/abnormal gait
   • Poor dressing, dirty person
   • Appropriate language and speech

   Answer: Walking/abnormal gait

3. Q3. Which cranial nerve conducts sensory touch from the forehead, cheeks and lower jaw AND motor signals to the muscles of mastication? ---

   • Facial nerve
   • Trigeminal
   • Hypoglossal
   • Abducens

   Answer: Trigeminal

4. Q4. A middle-aged man cannot taste anything on the POSTERIOR portion of his tongue. Which nerve innervates this area? ---

   • Glossopharyngeal
   • Hypoglossal
   • Facial
   • Trigeminal

   Answer: Glossopharyngeal

5. Q5. A patient has diplopia, poor accommodation, absent direct and consensual light reflexes, and ptosis. Which statement is true? ---

   • Oculomotor supplies the superior levator palpebrae
   • Horner's syndrome should be considered
   • A cerebellar lesion is most likely
   • Trigeminal nerve supplies motor fibres to the frontalis

   Answer: Oculomotor supplies the superior levator palpebrae

6. Q6. Which of the following indicates a PARTIAL obstruction of a focal bronchiole/bronchus? ---

   • Diffuse rhonchi
   • Stridor
   • Pleural rub
   • Monophonic wheeze

   Answer: Monophonic wheeze

7. Q7. On drooping of the eyelid (ptosis), which statement is FALSE? ---

   • It can be congenital or acquired
   • It can be due to injury or stretching of the eye muscles
   • Has been associated with apical lung tumors
   • It is not associated with Myasthenia gravis

   Answer: It is not associated with Myasthenia gravis

8. Q8. The BEST place to check for jaundice is: ---

   • Conjunctiva
   • Sclera
   • Nail beds
   • Frenulum

   Answer: Sclera

9. Q9. The following percussion notes are matched to conditions — which is TRUE? ---

   • Resonance — pneumothorax
   • Stony dullness — pneumonia
   • Stony dullness — intestinal obstruction
   • Fluid thrill — gross ascites

   Answer: Fluid thrill — gross ascites

10. Q10. Which of the following statements on abdominal examination is TRUE? ---

    • Symmetrically distended abdomen may be due to fluid
    • Visible peristalsis may be due to peritonitis
    • Cullens sign is associated with ectopic pregnancy
    • Visible right hypochondrial scar may be due to appendicectomy

    Answer: Symmetrically distended abdomen may be due to fluid

11. Q11. Which of the following statements is TRUE? ---

    • Bleeding of gums is due to lack of vitamin B12
    • Koplik spots are found on mucous membrane of the mouth
    • Pharyngitis is inflammation of the tongue
    • Smooth tongue is usually due to angular stomatitis

    Answer: Koplik spots are found on mucous membrane of the mouth

12. Q12. All the following are associated with HIGH OUTPUT heart failure EXCEPT: ---

    • Iron overload
    • Hyperthyroidism
    • Systemic arteriovenous fistula
    • Paget disease

    Answer: Iron overload

13. Q13. What is the preferred order for abdominal examination? ---

    • Inspection, auscultation, percussion, palpation
    • Percussion, auscultation, palpation, inspection
    • Auscultation, inspection, palpation, percussion
    • Inspection, auscultation, palpation, percussion

    Answer: Inspection, auscultation, percussion, palpation

14. Q14. A 15-year-old with RLQ pain: palpating the LEFT lower quadrant causes pain in the RIGHT lower quadrant. What is this sign? ---

    • Psoas sign
    • Obturator sign
    • Rovsing's sign
    • Cutaneous hyperesthesia

    Answer: Rovsing's sign

15. Q15. Which is TRUE regarding Virchow's node? ---

    • It is a right supraclavicular lymph node
    • Associated with lung malignancies
    • The right Virchow's node is associated with lung malignancies
    • GIT malignancies have been linked to it

    Answer: GIT malignancies have been linked to it

16. Q16. A patient with SOB and productive cough — consolidation is present if you find: ---

    • Dullness to percussion over the affected base
    • Bronchial breath sounds throughout
    • Increased tactile fremitus throughout
    • Inspiratory and expiratory wheezes

    Answer: Dullness to percussion over the affected base

17. Q17. On ocular movement, which statement is NOT TRUE? ---

    • Nystagmus is repeated involuntary eye movement
    • Nystagmus can be idiopathic
    • Oculomotor serves all extraocular muscles except superior oblique and lateral rectus
    • The lateral rectus muscle is supplied by cranial nerve IV

    Answer: The lateral rectus muscle is supplied by cranial nerve IV

18. Q18. Teenage boy: sharp pain, SOB, cyanosis, tachypnea, tracheal deviation to RIGHT, decreased TF on LEFT, hyperresonance LEFT, decreased breath sounds LEFT. Diagnosis? ---

    • Acute GERD
    • Asthmatic attack
    • Acute tension pneumothorax
    • Spontaneous pneumothorax

    Answer: Acute tension pneumothorax

19. Q19. Of the female reproductive system, which statement is FALSE? ---

    • The vagina is 5 cm long
    • Labia majora are fat pads covered with hair
    • The vulva consists of the labia majora and minora
    • The uterus is a muscular pear-shaped midline structure

    Answer: The vagina is 5 cm long

20. Q20. On abnormal vaginal bleeding, which statement is TRUE? ---

    • Anaemia is always a finding
    • It is not usually associated with iron deficiency anaemia
    • In longstanding cases the patient may present with a bounding pulse
    • Oligomenorrhoea is not a feature of polycystic ovarian disease

    Answer: In longstanding cases the patient may present with a bounding pulse

21. Q21. Causes of BILATERAL reduction in chest wall expansion include all EXCEPT: ---

    • Bilateral symmetrical pleural effusions
    • End-stage idiopathic pulmonary fibrosis
    • COPD
    • Pneumothorax

    Answer: Pneumothorax

22. Q22. On pupillary light reflexes, all are true EXCEPT: ---

    • Direct pupillary reflex is constriction of the pupil light is shown into
    • Constriction of the contralateral pupil is known as the consensual light reflex
    • Snellen charts are used to assess for colour blindness
    • On accommodation, pupils constrict and converge bilaterally

    Answer: Snellen charts are used to assess for colour blindness

23. Q23. In bronchial breathing, which statement is FALSE? ---

    • Associated with a clear distinct pause between inspiratory and expiratory phases
    • Louder than vesicular sounds
    • Quiet low-pitched rustling
    • Can be likened to auscultation of the trachea

    Answer: Quiet low-pitched rustling

24. Q24. Which is FALSE on vocal resonance? ---

    • Pleural effusion is associated with reduced or absent vocal resonance
    • Consolidation is associated with increased vocal resonance
    • Increased vocal fremitus is seen in consolidation
    • In vocal fremitus, decreased vibration suggests presence of fluid or air

    Answer: In vocal fremitus, decreased vibration suggests presence of fluid or air

25. Q25. On examination of the hands, which is TRUE? ---

    • Leuconychia — most common cause is trauma to the hands
    • Liver disease is the most common cause of leuconychia
    • Uraemia is associated with flapping tremors (asterixis)
    • Finger clubbing is only seen in chronic respiratory and cardiovascular conditions

    Answer: Uraemia is associated with flapping tremors (asterixis)

26. Q26. On spider naevi, which statement is TRUE? ---

    • Can be a normal finding in pregnancy
    • Finger clubbing can be a sign of chronic cardiovascular, respiratory and GIT disease
    • Janeway lesions are found on the face
    • Aortic dissection is associated with radio-femoral delay

    Answer: Can be a normal finding in pregnancy

27. Q27. On blood pressure reading, which statement is TRUE? ---

    • Narrow pulse pressure is considered normal
    • Aortic stenosis and cardiac tamponade have been associated with narrow pulse pressure
    • Wide pulse pressure is associated with aortic stenosis
    • All of the above are true

    Answer: Aortic stenosis and cardiac tamponade have been associated with narrow pulse pressure

28. Q28. On hepatojugular reflux, which statement is FALSE? ---

    • Can be elevated in constrictive pericarditis
    • Is associated with LEFT ventricular failure
    • Rise should not last more than 5 cycles
    • Restrictive cardiomyopathy is a known cause

    Answer: Is associated with LEFT ventricular failure

29. Q29. Which statement is TRUE on the apex beat? ---

    • Lateral and inferior apex beat is diagnostic of constrictive cardiomyopathy
    • If displaced to the right, suggests possible dextrocardia
    • The apex beat is at the mid-axillary 6th intercostal space
    • Normal position is the 6th intercostal space mid-clavicular line

    Answer: If displaced to the right, suggests possible dextrocardia

30. Q30. Left supraclavicular lymph node — which is the FALSE statement?

    • Also called Virchow's node
    • Is associated with CNS malignancies
    • Can be associated with gastric tumors
    • The right supraclavicular node points more towards a GIT malignancy

    Answer: Is associated with CNS malignancies