racuHy OTMe,,'Jlcme ana ~urge

Department of Medicine
;: ~
Medicine 1- lit Shifting Exam
,..;. 110008-1000 I'riday, 12 August 2005
",.",

('{\Nllllle:
, :.: ;~:~
•. .
~ Yr. ~ Sub.Sect.. 0_
·::;::::·<CI100SETHE Q.EST ANSWER:
. ~ ":./' //"" . '.

.-Kt~L.~.~<v~gth
. "~':'~<!' .K 40% ofof upper
inflatable bla.dd~r of-w1dfh
anlliength' th~ bl~od press~re cuff should be about
.
.:~.~:).. D. 6Q% ofupp~r arm circumference" .
. . :.~~~/' C .. (ZO% of upper ann length

,
... ..
- <·.if·,' . D." 80~<o.f.upp~r
~ ann circ.umference t .
I I 1r;X;;': }~~ accurately measure the blood pr~~sur~, .. t

.<.'1..'~ ~ A Center the inflatable bladder over the radial artery ~'G\C1;1'\~\\.,Jllfi.
'1 'j
,'
<·~tX· .... i{ Rest the seatei~£.atient's arm on a table .atheart level./ ' .. ', " ".

} ,')
'."~..:~::
:: .:~:::<."
".',-

::<:' A
C. Secure the u_p_p_er,,-b_o_rde(
/.
k1<~r(llkolr :mllnds arc iUlludiblo (hw to
-
of the cuff 2. 5 Inches above the antecubJtal foss~~.
D. Use t~~d-i1lphragm of a stethoscope over the artery, )?('}..\"

'.
,. :>:" .. ""-- K Erroneous placement of stethoscope '
:: ;ii' B. Full skin contact with the bell
,'::-;.~. C. Raised jugular venous pulse
.: ::~<..,
.t :I~:"~',)"
D. Very.•...__t~b-blood
---
pressure , .

.'~'i4~:~~f~;~
;:\iit:;;
V 4"~ess
K Co~nt the heart rate, ,." ' ~\(.1WY1()." ' '.
after compression of the r~dial artery to a mimmiU pulsation:
it
: , '

.':~~~i-'> . B.'·Count it for 15 seconds and multiply by 4 ifit is too slow R,((IlH.(;I('
.. :.,y /_ C .. Count it forGO seconds wtien it becomes unusually fast. . I.~ ).-

, ,: ;,>~I.;':: D. Count it/b§cardiac auscultation when the rhythm remains regular., '
::':/t\ ' / __
'_/, . "
.;·'''·:.:A
.:..:\,~ ~
.-5:"When using a glass thermometer to measure oral temperatures, '
,~;~:\:'::
.X Insert it und~r the tongue" .,
,. ,:):f,::;: . B. Place it inside the.m()uth with pursed lips. ·;I05C fti~~, !if)
: J~I.:
..:'·' ·C. Shake it down to at least 37°C. l?CjbC.) .
,<,"-:,;'j"';'
\., ' ... D Wait~.atmost 60 seconds before reading ('J._r.'J "'" Y"'ll1v!-fCc,.
I' t:./\ !
i'
· ....
/ ,\,' ,/" l' (,,,,'1, ", . "1
· ,\",.) /, .••.1, . '.

•'~<,
',,',..'~.' A. 12
r../'18·- .'/4" ~!J,() ~. 24 , \11.1))) f.j , ,,~,
" <'/:';
:')~::.:: t,': })
" /6:How
O. lllan~breathsper
"/t,t'] ~~Ij.'l •. minute
, docs" 0'
an 30
adult
.' take
': nci~rmall
. ,1_,
rJo j)(J'
r .. ~\\\\J~t
,'.~ (,G(\~\
, '.:
4 ~<·,K:.,,~~d
.;_":_'
_. '.,e., •.. ;: D ~
zjvi~r~l 'I
temperature of 37°C, the tympanic,membr~ne tf~fJ..)J, 'is '
tempereturc '! t"

. ./\--.t,_\:;';(::;
':· .''+:\'\:.
I:••.· •
'~stimatedtobe
,
372••• -to. rOc.. C 376, '• ':0. - &~
~1~M "V
~<. c..

.':.\\::1,:,
.,'1 . D. 37.4 D. 37.8 . recl1ll-,8'f-r v
.. ;.' ' .

.::;};>;.:;.~ ' 8. When ~ pa,tient can.on~y read the 40 line. ofSnell~~'s chart at' a'distance ~f20' , ~,\-e'\1
~',~::;" feet, hiS Visual aCUItyIS reported as .. ,r--t O\SlU\\\~~ ft.'tlV Lli
.:::..::~:::.,. A. ,,20/20 . C. 40/20 ~, ' !),"f., @ ~(I~. '.

;'//:.','.
': ;'!(,: ., Y20/40. ) ~D.40/40
~ 40 AfO\SllAV\t.'\;.
. " (~\ \l(o.~,
.

':<::i~:r:'~':'G 9. Visual field of an ind~vidual can be tested by this method:

: ::::;:,:,
",-,--. A. Accommodation e .e: Confrontation ' .,'
>:'~:(
. :a. Blinking' D. Divergence
'I' /I(IIf.
,I"

~L.-ltll-INI-1H1---1I
"

.. ,'"
"t'"
:rr.-· " . ,7
1
"
 : i. _JJ_ to. The normal blintl spot ca ' -
..... K ..
159lemporallo
0
the
'
line of gaze
... D. 30 nasal to the l/lle of gaze
C. 60olcmporal to the line of gaze
..... " D. 90° from the Jine of gaz~

:..';'?.;i
....
J.:.;. ~ II.
A. A1 pupillary
mOl open~ng is normal whene-:it4 measures
mm !~.-.,..£)
. ~. .
:';:::.'
">" ..
B. 2 mm I D. 6 mOl :1-5 InY)']' ..I '"1
' ~
.c
it

-1,;:.~~ 12. With intacG~cranial ne~e individual canpeiform th"fOliowiD88=:: I i::J~:j~

.i~!J

....:~,'
:.,'.;
.:;'.
, ,.'},.,~ .'
A. to the extreme
B. left
left and downward ~down
D. to the on
leftthe
andlenupward t\'JV~:' f ,'):II::fh;lt
. "'.", q"\.fv~'V(\J,etl; /i;':iJlli!l

", ,.' ·.h I J. \Vhc.~ll a patiellt is askcdh} liJllow the tinger of al1cxamincr, his~ycs cOllverge I

, n_ .uon-ually within
." .
... ' .
, .• :1

::1

.. ' ;(:..-A em .. C. 10 em.

/).j:1o' 8' CIll .. 0 1'/ ( ..
~ em.

'::':
.iL
.:'.'.
14, ~1ydriatic drops are used to dilate the pupils
A(evaluatc the'macula well ' ...
ill order to, .

. l.l.cxamine the fund~is ora con;atcisc,patient Y. PO \1vi bI\..&11 v

C illvestigalt: visual hISS follo\Villgltc'ild illjury j. (Ie hr,! l>\\.cnr~/
D, see peripheral structures in Ilarrow-migle glaucoma
"
~ I.

~v :~,::'fL
'~':<:;
15, Norma!l);, the optic disc is
A. somewhat bluned in the nasal portion'lC~,\'nC',.·~ (ctHCfl

~.··.r';'·:. B. usually red orange 111color V\(\}Jv \ !~YC.~·,

','.1:•... \' ...• i; i
I,
0,;

":'~,:'::'; ~(('slllalJerthanthephysiologiccup fh::". ;~.:~::: ,"'r '.j,,,.~

':\ ····D. located atthe temporal side NC\sm' ..
. . ~';' , .' i
I
iI
..·t:}A~
:' J~;>":: X
16, How many times docs tl~e ophthalmoscope
6. C, 12 magnify
, the.norn~~1 ~~tin~.?
IYI S";:; .~
"hr);.~ 4
:';,'j..: B.
~ ' .,; ,j ••
'.< 9 . D, 15 . I
# ••~.:~:.:. •• : • ,

</~ ;{t·:~0,
b: ,·i";.·.
.. '":.
: \~~",'
"
L
] 7' The elevation of the optic disc can be measured by this es~hnat.on:
The difference in dioptcrs of the two lenses used to focus on the disc
. involved retina ... '
.
., and the. .
I
I
I
:'~',~:;::::
.·D. Thc,diIferencein diopters of the two lenses used to rocuson the'dlscand the 1
!
.·'·;f':;; ;
~' ••.
uninvolyw retina
··",'X:'-':·':·,
. '. , . I
:;;<t.:i.[',:
...
~.:;':;C.
:,.•..
The sUrrlr()Tdiopters of the two lenses used ~o focus on the disc and the involved
.''-' "... retina.
:>;;.~.:,: D. The s~lm ofdiopters of the two lenses used to focus clearly on the disc and the.
, ...~:;i::
•• J.,." .... uninvolved retina'

~'.:~~:t-~.·;::.0
:.'.:.\!,.;';', 18,
A. Absent light reflex TIl~i~;Ca~~ri;;J1re
distinguished
prt<O,\l tfom vei~s
.«Smaller ~ased on the following
III ~lze features:
" :';;\.; i.:i. B. Dark red color - L\la~n rtl) " ~D.Visible pulsations' , .
, : II".' :.: :\"\,~ \ ..•

"'~~~~~·:~:·~A
]9. In Webertest for Iaterali~t~on, tile examinee should normally hear the so~nd
:::;';tr:~·:, . jY'in ~he midline C. on the right side ":, .
:~;,:)}'')
~
:. \.:. , ...'
B. on the left side .
D. over the occiput '

_.)/.~·:.t,:~::C,.-. 20. The rise of the soft palat~ is a test of this cranial nerve:
f'!:,·'1~"",'-- . A. VI[ lG\. C",AiI'.\.- f)' ~/
C. X \v··1\,.)
..:....
, }l/'' 1X
, !':e ,.'.,),I': IJI~" \ I.1J'{1,:
I ...(
J II ...
;1'.) . I.'\'0'UI'
J) ,Xl I \:' iJ .){( .;.'
f\'
 __
Jt._ 21, Tll.tcst chest cxpans'
- the Ic\d ~lrlhis lib:
A. 9lh

. ~:'·>~.1,:' ?lOlJ'
.
':.

··'·r::
,:,,:':n·,'··
~ ....
~ ,r"

',:,

:L '.
22. Fremitus is .' ~
A. absent in the supraclavicular fossa .pre<,e..\'\l diuf~
' ..

;.);~:.:: B .. more intense in the left side 1\~r\1 rift

I
.... ·::.d.: , rz: more prominent in the interscapular area I •
i;: :::r;{,' . D. palpable below the diaphragm 'I, \))1 i :,\t:i~I.i~'II"

1':;0:: . D 23. Which of the following percussion notes is distinguished ~:~ihl'yhy i~s:~~~i~;aj:' ': '.'::\:~~:~~~h,
'.
I; --:'•..
n·
~~~:.: , ... I ;.\ ,I' ~
~:,:",;<, A..timbre?
Dullness C, ,Hyperresonanc~ . . ".: . :1·~.~~L:~~~11
. ,:,:' ,: '~:: H ~i\:l.1~
If.' Tympany

L
~,~~{f;',:;: B .. Flatness ,; i :;\,}.j;
• " -:-~
;,.\'," . 'I" .'! .•• ' j i\,~l!\~:~l!\

<t){y 24. The extent of diaphragmatic ~x~ursion is estimated riorn~l1~'~b~ut' .' , 1 \J::\~1f.{11:'\
r.' "I, A 4 rY" 8 ' .. ; .'"'·'lJ' ,.
$r- Yf. ';:':;, .. ~1l1. ~. em,' , .... !~ t; : i,' ::;':'~ :"lif
~ .' '. ".1 'II

:'~lJ.
,..~\\' A n. BrOl1Ch~vesiculaf
25. {} CIll, D. 10best
breath sound is heard em. over ..' ". ,'. i:m~~~
; ;-'1' ':1': ;:il

. :··rr'· .K second mterspace anlenody' .. '" i.~':"\'!:"11

-~ .
.' .':~:'i..' ..B. manubrium, if heard at all BIOno':
- ·:iU ..... 'I :..·•/T
.~~. ..'

. ;::::.':'('~ Co most of both lungs '(£'i;C·\\·!i1'i l.qt\i}i

:",:.~.:;'::;: D. trachea in the neck 1\ (\(0C/\l '. ,·:••~\"q\I:1
'\0.
>I ."<:':>::
),: .•.... ~ ~ • ~ ' ';".'.:::';
I·
. ;~;{.r· ;~26. Wluclt adventitiOus sOllnd IS~~llchcd and musIcal? 'y\.(C\Ht .(.\,
:: ,~>', A. Crackle'i- ... C. Rhonchus V'J \~ .... ").:';':
fa ." I .. ".
. :t,.:
.. ' •. , ..... ,.. J
)"""1 . B: Rale . rD. Wheeze

1.~{f:.L.f_
.': ~":., J"') .. 27. Thethora~ in the no~al adult is" " .; .',:' ;, i· :1:'-::\"" ::'
.;.;·i:;:.~>
· '., ." •••. A. deeper than it i's wide C. depressed in the lower sternum. ':.j ..
" .-: •• -f'~ .' ';"
! I ",::),.! •.
.~. ·:·.:.'iW:!: B. deep as iris wide . LYwider than it is deep .. :, '. 1" . , . \ '.\

, :.:':'.;~'::;:
;.;
',,',. V
,:.?~\': .(\
.
28. In norma 1 alr-
.'
. fi1II e d Iung, t,'
"
.. .' "
:. I

:::;[.;'/~ A. breath sounds are predominantly bronchovesicular . ~'(,;.\CV\(" .; I

~:':::,;~i,"
::/~~\. ..t;. "ee" is transmitted
~ spoken as &lay".
words are muffled ecOY\I?\
and \~J
IndIstinct· ., ',I·
·<:it'·; D .. tactile fremitus is increased YlDt\\ 'fo.l..- '. ".'

'. :'li·:1, :;
;:::.:';~;::::.:.A .' sound~ ~r~ called
29. Louder,<Cl~arer voice .' ' . :; :
...
··~;tf.'. j{ Bronchophony C. Pectoriloquy lOI/.Del' \lrl'::.lrt(·I·L~.
;:~:.~~:fr B. Egophony . D, Stereophony

:..,:~Yi'~'
...':_~ '30. Which of the foliowing features helps to distingui f;~om carot~d artery
': ~.;:/::.. pulsations? .,,:vn,:~\)\LX Il)r. I 1''1','. ')" , ' .
.•.. '..
.':.\~ A. A more vigorous thrust with a singleI component
.[(,1\11\' :;.\1 f.1"\ \ ,) ..

. ' ·':'~,:;i" B. Level ofthe pulsations unchanged by position C\\(\V\({{'V·.

, ,\' .. .fC. Level of the pulsatio.ns descends with inspiration .

.;i':': -: D D. Pulsat ions not eliminated by light pressure ~\ II',.,\\ \" lC 'lJ
. ~:}\':.'.__. __ 31. In all positions, the sternal angle usually, remains above the right atrium by
· :I~ '.:. A. 2 em.· C. 4 enl.
",
. .'.....
n. 3 (Ill. . r{ 5 ern .
,.; ..
.......
.....'
, "

' ....•
 "
.J~'
.. _.__
t·· ..
3~. "Yhlch heart soulld IS heard ~est at the ape~ .,!L.lnr.~?:
~ ~ ••..
A First rY\nVUL' \...:..e':' fhird '
....

L
"
B. Second ' D. Fourth)

1. ..',\; 33. Heart sounds are differentiated from murmurs by their

,::";~'
: A. Early tiI11ing.• C. Louder intensity . v
i
.;:-":~;::'
... n. Higher pitch 1Y.'Shorter duration

4 : .~?~:,.:
_f') 34. Loud murmur with a palp~ble tJ~iIl is graded
i
:
ii .:,
" ..
,',
,.>.'i ..~~:·:.
•. ' ¥4
A.3 . '.' . 0.6
G· 5
.' . ", lilll
, ii"'i
i.l.i::d"!1
I
r
\

i
i "W~:;
...
~,:~~I-:,. D' 35. Which
using. heart
the bell of sound is heard•
a stethoscope? bes~a'i1be~iRhoidlnd
. : in. the supras~ema'l
I • ; , ":' Ii. ·J·'i
; ~,.;,/: 'notch :1"
i ':! !':i1i I:

'l
• '.'"",--'. A First . -- e:'Thlrd " I ""'. ,,;: 'I~
i. '1111
· ,,\l
;.:y .. .'
• .,:, •••
"
B. Second ..
'"
·D. Fourth Ii
" '"
,~.' ,,', :~I'
.... '; j;!1',1 ':",. I'~·:',Ji,·;~.
I • '1 ~!
'::ll' 'II' I, :It
'I: I" ,l

.. :,,:' ....
" ..
JL 36/Which oftl!dollo~in~
,..r.
~tep'enhanee~ ~xa.mi~aliL,n
Pl. Approach and examIne the patient very qUick! y. '. q i" ;I! . L:. rl;
.J . '"
?f the abdomen?
: 't "i
",
'I ' '.:. : . ;: .1; I <
.. I, , .. , I 'I' .
. "J. ! I
. ;,;: /~',.>\ .. : B:' Don't talk to the patient during abdo~inal palpation: ,re~(.\r·; II,.j:' ;.,",::, J1!:; :;·1 ;.:-\', :' ,;:' ,Iii,
';" :I.ii,. ::'~.::.)::."~; . C. Have'the patient keep arms over t'ho head. COV\l(u\Cl·. r((1~\~'lli,:';::
I :1,';:;:.,1' dJ, .. ": "'::'" : ..:i:t ~

.:~::::.'.'
.::.', : : D. .' Use.. a pillow
11 .: for. the patienfs ,;,':';h~ad 'and .,: ano'Lhe~'un'd'edhe
lUl:'\.Ih .'. kh~es~I!!li;
': "!'.!"!I:' Ili/,f/;lli';; . 11'{:i!.i!
i1·';I'I:~!::!·t:i!':~';""H·'1 I:' :11il/"'-
'f)'
i'l' ,

~~t
1,
l' II I. I,,! ""'\.1\.1'lr'l~t'.I~1:IJII:!""ll~! :f'l' I f'Jl"I,.' :1 ·',IFI.<I! I':
i·". ""
'" ...
,..l!...
_~7.
A . at, '
r'l
when dll~rontollf Qf t!1(;abdqmcn 'is markedly holloJ,e~i" it: i/re~'pA~d'
. ) 'otu H:ruut· I I • I :'. ",'
/.V!: !•.; I:,::
"':
1'!'\lt,~:r : :ll
' I 'II '
11

-'\ . 'j;
;~ ....:...•.
.':.'/r: B' ., 1'10 b'uar"
Gl 1 ...... , :' : .. ! " fI,".-. h. Ii iiL L; I i .l:1.
i~S!'I caplol
G . 1;l '.ld· i ::i".i;/II'il:l11jlll'!1
I, :."''',''.j
, , i"'I;I:61!:II/!f!ildl
I, j j:;:'i:!::!
i' ,·,·,t",·;,·,
II'" II'I','
"I !IIIIU\lff'II!':~
'!~> ~ /. I", ,

. ~;,~;~:(j:
.' ..":~~\:i:;
l3.8.. W11~nthe v~rtjcalspan ~eas~rcs 14cm in right midcla~~~:I~di~~~'lr6~
A. Absent. C. Normal'
Iive~is'
N" W - I~ (U I l' (",t,+-
'.1

I
;~!:(~
'T r-

'.:-~.C:.
. ~'''.'
YLarge.· D. Small . _-t. (J
n'!'0d~"
!:-~~al
1'.,
~;Ildr~r,.,~~ .,I : ".
II ... \ ..
(:;' . ..JLA- 39. An enlarged spleen is detected by this technique;' i .. " i:;.>Q '1 > if,.
'f
,1, .
,,, t'
):·>i !hl;i~;i;:lj,l;I!iijr
..
·'1
.. :.L:~:.:.:
\.::.. . )~ costal l.he .lon IO,wer nnterior
P~rCUS8m~glll .... chest wull hetween the I~n~
r~~lo~ance
': . , ~.~~v~
•.Ii' . an~.~!!I;:!!i.I.;.ir;rlllli
"/il 'hA'''!i If,I'
·1
,
i ". ..~.:.',,:
I·~.-'
. :,:·,:t~·:-- B. bPercuss
rea: tl 1 the
.' lowest interspace in the lea midaxillary line_befor~j I"~
','. ~~ ~~er'
I'"
' .,. a. 1 , '"
".J" .' , "'.'
d.: eep •... ,.:.1 ,I,·/:"('!I',,,.I·,,·
.'I .r.iit;!f'
I. 'i ':'.', .! '1"'lrq!l;
i/' li!:itl!,
1""1'

<'il:!::" c. Percuss' from th~ 9th to 11th'int~rspaces along the mida~iIlarY i~nJ.·". .':~··it'11;,(l!Y ;,'! :::/:1 ;H~I!:llll!:; ,.
:.,;::~,.·D. Percuss the. lowest interspace frc'm the midaxillary to the poste';or ~illary line;'''!;1 Jli!;"iii{i

,.t ! '-.' 't:, , t - ,

. ~'.\:'j~(~!.
:',.
t
D' ••
~ ,-
'
0
'
I I'
, ,.,
:', ~~"u
ip
I' '.
:;,;;1 j JL":~ ·b.i:d i :,:!;jl~: t!~;
,. ,;:-~,:~,)'
__ 40. N~rm(ll.l. I Trnube'sspnccls .. '., :,!,·Ut/::'riiflij;,;ij;'.:'i;'~:~i!nhh
'~""".I.", .. :. "',"". ' ','/1,. I,.. , 1'-"\""1J11,

,;.';5.;: A. Dull, - 4, vl'. tu-",&td; i- fl(/. .•., x( Resonant ' ';:! r !:,,! oil ,J"!fl;;"I!i' +1,1! ,ll!,IJ j
·.:).Y.,:'/,
"""n 'I B. HyperreSbnaut ' , •.~ D.Tympunitic· .'.:' I',i' I 'I. I . I: .' , 'I :]\;:il'II~:
I '" ~

1¥:~\:~
L 41.
..

The width of a normal aorta is not more than ' ".;'.', '"i' (,:: ; I.·I! ';, \:'i':.!~
«:.,~ J.-. ~cn, ~ 4 em ~(~ C£n A~:·(lc'q-t·I:·· ;: fr::

B_ ~ em n. :1l'AW : :;, ;;!. :i-: 'i 't:,

h 42. Which technique helps to confirm an o,-gatl tl1 au a~~ ~~tI. .'.. ' . ) i:t
. A. Dallotement ' .• 12': Puddle sign .' .
. B. Fluid wave ': D. Shifting dullness ':

.., ..,:;:;\,: f?J 43. Which sign is a test for referreJ reb~und tenderness of the abdomen?
..., ....
- '.::::\
,.: .,---- A' Markle's C. Psoas . "

,;;,},:~).,!: 13~ Rovsing' s D. Obturator

:.:?;/:)....~ 44. When a patientstr~ins down, tlw abdominal mass r~mains palpable and is locat,~& .
r.-
~, 1,
i ".:", ;' , in the' .
~~
I .' :\.n I\~Abdominal wall C. Pelvic ar~
I. i · ;~.~:'-:..': B. Abdominal cavily D, Relropenloneal s
., .
,l·r.;· .
 ". "'=

.' ~j
, ...:~.
. '~ ..
:
t. ·t5. PlIIe glCII.LlI_I.UJ\I.~~~JUPLiull iScJ.Lcj~~d by duing this ~chrUque: ,~~~.,.(':~t'
t ,e

'.:':- A. Pla~ bothJ~~d~_ behindthe neck, with elbows out Lothe side r ~;Ll'''('\\" . I '1,
. '.:/'.;
',:'):.;' ~ Placeboth hanas behlnc.tthe-smaJl of th~ back - ~L·c~\nl
'C. Rnisethe arms to shoulder level with palms facing down ... ~ 1~.>r.
..
{ !'1 i~.
' ~ j. hI ..(1••..• ~

",:..'.',,/::
.~", D. Raise the arms
. to a vertical position above the head .. ~tYl
'0 'A\) \"'H'\ \ 'k--·~""L,d
C.:t :","l,r1' '.I ,
"\)'V'.:w J

::::;.~
, ~:.: L46/Test1(. porsull1
median nerv~
of the handfunction by ~hecking
. sensation on the: ' . F ·~1·I, .: ..
,,::')~}' ' ...- B. Dorsa! web space of the thumbnlld index finger
'P\ \" •

::."1\'" C Pulp of the fifth finger'

.';,"~21", D. 'Pulp of the index finger

:')-J}.::;:' ~ 47. To test extension of tile neck, ask the patient to perform th~ following maneuver: .
:-',\:;! :: '.Jv( Look up the cf':i1ing, ' '.' .'
:'~;;:i> B, Tilt the head, touching each ear to the corresponding shoulder; 9'd€lk>e.\ ~'Jll)i.i
· -:';,:' C .. Touch the chin to the .chest. 'n..:.\~..)
\1\

· ,:\((1.' D, Turn the head tocach side, looking directly over the shoulder. :

:· .;...
:i~;,
..:'
,,'.~,
..
L 48,
A. Agait
2 Inchesis wide-based when the heel to heetC.dist~nce
.i(' 4 inches'
exceeos atlea~..
6 Inches,
'D, 8 inches
'I
.!

,:'j\~:':',; ~ 49, Awareness that disturbed behaviors are normal or not is used to evaluate
:7.1\'.;:, A. Insight C. Orientation
;':';~::~':~
l.,:t • D. Judgmcllt .IJ Perception
'. :' :.,

'.~';;~~~~~{
:::",:,':".~50,' ' ~eventh
ry cranial nerVe is .'tested by askingt.he. patiew·
0 .. 1;o~i.C~:~:,·:~S::·\}'i?~'
';j 0l v;, -(, '. ,.
:<:!~.;;
, ,'o, ..
.. ~ Frown. .. ~ C· N
. D, d 1\
Sleep~. ,\!'
'''I''''\S, t,!'l.
.D ( '., , ,.
:·· ...1:··/·· -,\-' ••.. ,," '.

,j{: ~ 51. Muscle strength ~~aded 4 wheu the individual can move
A. ...Against 0:) some
0 ~.IlC I\\o\'e\\.; •
~',:.f·:· :,"
·;'Y?>::' '~ Against gravity
gravity and ,J.:.. resislanc,e '.',. l'\<\Ci\\\CW:-~ "·:--"1"
:.'- ~C\I'(Ci\)'~'1~
'::,'n~(~:: ·c, A~ainst f~1I rc~.ist~nc~without evidence of fatib'Ue-E) 1_ C!C1\V'f., mOi-:.'. .;\ \1 '. ~
..,:.\'y....
, ' ..,

:~:d::'~;":
:.:-',('\
::;:;:>:.
.. ..
..
\
L D, With gravity ehnuilaled . -(~)

It, Brmg both legs together

\.'..

52~re.st adduction anhe hips by asking the patient'.to do this: ..

.' ..
B. P~shtheposteriorthjghdown..:-t:Z-\{.f~,t\jD.
.

5.-.~~\tV' rC1IS-::
C. Raise the leg - iltw,.H \ ..
Spread both legs -~(~\}~\C1l0"1
4 -,jrC\.l q,.\.(
• c;.•.•, ,:_. ~1,?"\1r:
- h:h'\(,~

1i::/;:: ": ~ 53. The Romberg test is mainly a test of .

',::',\'::.:'
.' K Cerebellar J1.Ulction . C: Position sense ,-.J
: ::,r:'.~>
I ~i" ~'\ ..
B. Hearing acuity ~
,,'
D. Vestibular
.\ .," ~"
apparatlls /v"

·:·:7Y~~:;
',:,~"i·.·
'A
.
54. Which r~t1~x
.x: Ankle .' tests primarily
.' th<f.rs~~~~i~_~~~;}
. C. Clonus ~),
: '.t::::·i D, Babinski ....L~)J '1'\ D, Plantar l~l4, \ i'

·f "'::J~~:('
~ 55. What level of consciousness is determined by shaking the patientgelltly as if .
. '» l: . awakening n sleeper? .. ..
/;J.\~<.~l
/;1. . ¢-' A.,
Lethargy i}l,~' .••:rv~{}J; 1'1 bet .. e· Stupor
: ii,qI0
" ", .... : B. OblllllOll1 inn T:I\\ \'7~ ,\,1,' • r;.', •.. i\ "
D, «lIllll
, ,,~ I ' . ' ' •• 'L
A:~:':\:~,: C/56. DoWs eye movements are ob~~~ed in response to .
';~:",' A. COl1leal reflex ' '.c.
Oculocephalic reue
:':::::;::
.. D. Gaze preference . D, S.•••:nging Oashl:g::, 'te.s·
~:2.~. ·. ,!:'
. :.• j'