Exam 1: Anatomy

A 50-year-old man presented to the office complaining of left hip pain for the past week. The pain is exacerbated with movement and with crossing the left leg over the right leg. BMI is 32 kg/m2. Physical examination shows point tenderness on the lateral side of the thigh. Additionally, the pain is exacerbated with left hip abduction and internal rotation against resistance when the hip is flexed. The pain is expected to be caused by tendinopathy. Which of the following muscles' tendons is involved in the presentation?

A 35-year-old man presented to the office complaining of double vision. The patient had a motorcycle accident last month, which led to an orbital fracture. The patient's vision has been well until after the fracture when he started having problems with vision focus that has been progressing over the last month. The patient has no previous medical history. On examination, has lost corneal reflex on the right side, and loss of right eye abduction. The patient's presentation is caused most likely by an injury in which of the following anatomical structures?

A 15-year-old boy presents to the clinic due to left side lumbar pain that persisted for two years. He has no history of trauma or sexually related diseases. Physical examination reveals normal bowel sounds without tenderness. Urinalysis showed hematuria. A contrast-enhanced CT scan reveals the left renal vein to be compressed between the aorta and the vertebrae. Which of the following will complicate this condition?

A 72-year-old woman presented to the office complaining of vulvar itchiness. The patient has vulvar discoloration that has increased in size in the last 6 months. The patient has 40 years smoking history, she had menopause at 50 years. Physical examination shows a 2-cm white plaque on the left labia majora. A biopsy has been taken from the plaque that confirmed the diagnosis of squamous cell carcinoma. Sentinel lymph node biopsy is planned, what is the targeted lymph node for the procedure?

A 50-year-old woman is evaluated in the office due to pain in the left shoulder. The pain is exacerbated by movement and wakes the patient up during her sleep. There is no history of trauma, but the pain started after she did heavy house chores last week. She does not have medical or surgical history. On examination, there is tenderness below the acromion. When the patient is asked to abduct her arm 90 degrees to the side, flexing them 30 degrees forward with the thumbs pointing downward. A force is then applied downward to the arms. This technique induced the pain and showed left side weakness. Which of the following muscles' tendons is affected in this patient?

A 4th-year medical student is examining a comatose patient in the ICU. During examining the reflexes, stimulating the posterior pharyngeal wall did not induce soft palate movement or gagging. This would indicate dysfunction in which of the following structures?

A 23-year-old basketball player arrives at the office complaining of right knee discomfort. A coronal MRI of his knee, seen from the back, is presented below. The asterisk marks the attachment site of which of the following ligaments?

A 20-year-old woman is evaluated for gross hematuria. Cystoscopy reveals blood oozing from the 2 slit-like openings in the bladder. The internal urethral orifice was visualized and does not have any abnormality. Which of the following is the most likely cause of this patient's hematuria?

A 47-year-old lady arrives at the clinic with a fever, dysuria, and abdominal discomfort. She has experienced multiple urinary tract infections throughout her adolescence, but no other medical issues. A physical examination indicates that the patient is experiencing minor suprapubic pain. Urinalysis reveals pyuria as well as many microorganisms. A CT scan of the abdomen is performed, as seen in the figure below. Which of the following most likely prevented the proper ascent of the anomalous organ seen on the CT scan?

A 65-year-old man comes to the office complaining of visual abnormalities. One day before the presentation, he started having double vision associated with left eyelid drooping. On examination, the patient has a left dilated pupil with no response to light or accommodation. Additionally, the left eye deviates inferolateral when the patient is asked to start straight. Magnetic resonance angiography shows a basilar artery aneurysm on the left side. Which of the following muscles would not be affected by this lesion?

A 17-year-old man is evaluated in the office due to right shoulder pain. He suffered an injury in a basketball game last week. He fell strongly on the posterior side of his right shoulder. He started having severe pain in the right shoulder. The pain has persisted and did not respond to any medication. Physical examination shows bruising on the posterior side of the right shoulder. External rotation of the right arm with resistance induces severe pain. Which of the following muscles is most likely injured?

A 45-year-old woman is evaluated due to left-hand weakness. 2 weeks ago, she started complaining of numbness and tingling in the left hand, which is exacerbated at night. The patient does not report neck pain or previous trauma. She has been working as a secretary for the last 15 years. Physical examination shows loss of sensation in the fourth and fifth digits. There are no abnormalities detected in the left-hand examination. The options most likely have weakness in which of the following functions?

A 21-year-old previously healthy man comes to the clinic due to left hemi-scrotal swelling. The patient noticed the sweeling while he was preparing to go for work. He denies any trauma, fever, or dysuria.  Examination shows a dsicrete mass over the left testice. An ultrasound showed solid mass in the left testicle. During the procedure of left sided inguinal radical orchiectomy, the left testicular artery was ligated. Which of the following is the likely origin of the artery iligated?

A 52-year-old alcoholic man presented to the office complaining of recurrent diarrhea. The patient describes his stool to be in large amount, with bad smell and difficult to flush. The patient has no past medical or surgical history. The patient drinks 5cans of beer daily. Examinaiton shows mild epigastric tenderness. The CT shown below, would show abnormalities in which of the following structures?

A 7-year-old man is brought to the emergency department due to left arm pain after a fall. He was playing outside when he fell on his outstretched left arm. On examination, there is swelling of the left elbow with tenderness on the distal side of the humerus. The radial pulse is felt full bilaterally. Radiological imaging shows supracondylar fracture of the humerus, along with anterolateral displacement of the proximal part of the humerus. Which of the following structures is most likely injured in this patient?

A 20-year-old presented to the emergency department due to acute left-sided pelvic pain. The pain has a sudden onset character, started while she was preparing her breakfast. It is associated with nausea and vomiting. The pain is exacerbated by movement, and not relieved with analgesics. THer last menstrual period was 2 weeks ago. Her Temperature is 37.8 C (100 F), her blood pressure is 95/60 mm Hg, and her pulse is 101/min. Pelvic ultrasound reveals enlarged left ovary, with a 7-cm mass. Doppler scan reveals absent blood flow to the left ovary. The patient's presentation is caused by a block of blood flow in which of the following structures?

A 36-year-old construction worker arrives at the emergency room after falling three meters (ten feet) off a ladder. The patient braced his fall with outstretched hands and instantly felt significant pain in his left wrist upon striking the ground. The left wrist is swollen, but there are no lacerations. There is a robust radial pulse and the fingers are fully perfused. A palpable lump is located directly proximal to the left palm. As seen in the exhibit, an X-ray of the left wrist demonstrates a lunate dislocation with no sign of a distal radius fracture.  The patient is at greatest risk for impairment of which of the following hand functions?

A 20-year-old woman fractured her left foot after she fell from the stairs. Her left foot is stabilized with a cast and uses underarm crutches for moving around. One week later, she presented to the office complaining of left upper extremity numbness. She does not complain of pain. Physical examination shows a decreased extension of the left wrist, with loss of the triceps reflex. Which of the following nerves is injured in this patient?

A 39-year-old woman, who is a known case of hyperthyroidism, presented to the office complaining of palpitations over the last month. On examination, the patient has an irregularly irregular heart rate measuring around 150 beats per minute, her blood pressure is 120/80 mm Hg. Her ECG reveals atrial fibrillation. A trans-esophageal echocardiogram shows a thrombus in the left atrium. If this thrombus embolized to the systematic circulation, which of the following organs would be the least vulnerable to ischemia?

During the preparation for a catheter-based radiofrequency ablation of the atrioventricular node, one of your medical students asked where we should place the catheter tip to ablate the AV-node, your answer should be?