2011 oral exam

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Question 25

What additional information would you ask for in a focused musculoskeletal history (12)?

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Question 28

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•Following your assessment, this patient leaves your office and is treated by his primary care physician. He receives analgesics and a course of physiotherapy. He presents to your emergency room at your hospital 8 weeks later with worsening thoracic pain and a two week history of progressive leg weakness. He describes normal bowel/bladder function. He is having difficulty walking. Neurologic examination demonstrates 3/5 motor power in both legs, increased lower extremity tone, +ve Babinski, and 9 beats of clonus. There is a thoracic sensory level. Digital rectal tone is present and there is diminished peri-anal sensation.

Question 29

•Please describe the MRI scan shown (4)?

Answer 29

•Pathologic lesion mid-thoracic spine

•Pathologic fracture

•Cord Compression (anterior and circumferential)

•Signal Change in the spinal cord

•Absence of other obvious skip spinal lesions

•Deformity (acquired kyphosis)

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