MEQ

1. Woman with RA signs.

Pt1
1. Give dx: RA
2. name four pathological features seen in joints- synovial inflammation, pannus formation, swan neck z
deformity they all (counts as ONE I think), degeneration of cartilage, etc. ORDER MATTERS (pannus can’t
come before synovial inflammation or some shit like that) If you write swan neck + z thumb +
boutainnere + ulnar deviation not sure whether they’ll give 4 marks or just 1.
3. name one muscle that adduct wrist (flexor carpi ulnaris) and muscle that flexes wrist (FCU/FCR/PL)

Pt 2
The woman has tingling and numbness in lateral 3 fingers. Cannot hold cups and plates.
1. What test will you do? –nerve conduction test
2. Dx, give reasons – carpal tunnel syndrome, because the findings correlate (tingling etc). Common
sense answer.
3. She was treated conservatively. Give examples of conservative management? (We don’t know
whether they’re talking about the RA or Carpal tunnel here, question poorly designed) – immobilization,
NSAID

Pt 3
???

2. Man didn’t come down for breakfast, found unconscious in bed.

Pt 1
1. Name 4 causes of unconsciousness. – coma, stroke, drug abuse etc
2. Define consciousness.
3. Briefly state how you check for consciousness – GCS eye, speech, movement

Pt 2
1. State the posture in decebrate humans. Head turned to left- left arm extended, right arm flexed, legs
extended; Neck extended – all four limbs extended
2. Explain why decerebrate = extension (or something like that) –In humans there is extensor dominance
to keep us upright. Higher inhibitions inhibit extensor reflex. In decerebrate, loss of higher inhibitions -->
constant extension (something like that)
3. ??

3. Man playing golf, suddenly back pain after taking a swing, falls to the ground. Can’t remember rest of
the history.
Pt 1
1. Artery affected? – middle cerebral artery (or is it anterior…can’t remember)
2. Site? Internal capsule
3. 2 signs of increased ICP – papilloedema, bradycardia, etc
Pt 2
Doctor noticed left half of vertebrae more pressure. Suspected Brown Sequard syndrome.
1. Give 2 functions if intervertebral disc – shock absorber, allow movement, flexibility
2. Name the ligament that stabilizes the IVD in this case – posterior longitudinal ligament
3. [KILLER] Fill in the chart on whether pain, touch (they didn’t say but it’s LIGHT touch) and vibration will
be normal/reduced/absent on which side. Like wtf.

Pt3
Something about NSAIDs.
1. Example of a COX2 inhibitor – any one also can (coxib/oxicams)
2. Why use COX2 not COX 1 on old man? – less gastric side effects
3. What happens at a neuromuscular junction.

EMQ
1. Types of nerve injury – upper brachial plexus (Erb’s palsy), tarsal tunnel syndrome, median nerve,
ulnar nerve, axillary nerve

2. CNS – mental disorders and what hormones lacked/excess

Alzheimer’s – lack of Ach
Parkinson –lack of dopamine
Schizophrenia – too much dopamine
Huntington’s – too much GABA
Depression – lack of serotonin

3. Cranial nerves – quite easy.

Trigeminal – 2 nuclei in pons
Abdcens – comes from behind pons
Oculomotor – lesion results in ptosis
Glossopharyngeal – supply carotid body baroreceptors
Optic