OSCE

Question 1

What is the disease correlation of a positive visual field finding on exam?

Answer 1

visual pathway defect or lesion

pituitary tumors can create bitemporal hemianopsia

Question 2

What is the disease correlate associated with diminished or absent pupillary light reflex?

Answer 2

CN III damage

Question 3

What is the disease correlate of abnormal consensual response when shining light in affected eye?

Answer 3

CN I damage

Question 4

What is the physical exam presentation of an oculomotor nerve lesion?

Answer 4

eye down and out, ptosis, decreased pupillary light reflex

Question 5

What is the presentation of a lesion to the trigeminal nerve?

Answer 5

can’t feel cotton swab, jaw deviates toward lesion

Question 6

What is the presentation of an UMN lesion to the facial nerve? What can cause it?

Answer 6

presentation: contralateral paralysis of lower facial muscles (forehead sparing)
could be caused by stroke

Question 7

What is the presentation of a LMN lesion to the facial nerve? What can cause it?

Answer 7

presentation: ipsilateral paralysis of upper and lower facial expression
could be caused by Bell’s palsy

Question 8

What is the presentation on physical exam of a lesion to the glossopharyngeal or vagus nerve?

Answer 8

deviation of uvula away from the lesion

Question 9

What is the presentation on physical exam of a lesion to the spinal accessory nerve?

Answer 9

ipsilateral pain of trapezius

contralateral pain of sternocleidomastoid

Question 10

What is the presentation on physical exam of a lesion to the hypoglossal nerve?

Answer 10

tongue deviates toward lesion

Question 11

What type of lesion is associated with rigidity when assessing tone?

Answer 11

upper motor neuron lesion

Question 12

What type of lesion is associated with flaccidity when assessing tone?

Answer 12

lower motor neuron lesion

Question 13

What lesion is associated with pronator drift?

Answer 13

lesion in contralateral corticospinal tract

Question 14

What lesion is associated with toes that go up when assessing Babinski?

Answer 14

lesion in contralateral corticospinal tract - upper motor neuron lesion

Question 15

What pathology is associated with pain on Spurling’s neck compression?

Answer 15

cervical radiculopathy on the side the head is turned towards

Question 16

What pathology is associated with pain on straight leg raise?

Answer 16

lumbar radiculopathy

Question 17

What pathology is associated with loss of light touch, vibration, or proprioception?

Answer 17

lesion in ipsilateral dorsal column

Question 18

What pathology is associated with loss of pain/temperature?

Answer 18

lesion in contralateral spinothalamic tract

Question 19

What pathology is associated with sterogenesis and graphestesia?

Answer 19

lesion in parietal lobe (failure of integration)

Question 20

What pathology is associated with positive findings on monofilament test?

Answer 20

peripheral neuropathy

Question 21

What pathology is associated with a positive Romberg test?

Answer 21

lesion in dorsal column (proprioception) or cerebellum (vestibular function)

Question 22

What pathology is associated with positive findings in gait, heel to shin, and finger to nose tests?

Answer 22

lesions in cerebellum

Question 23

What are the major components of the patient interview?

Answer 23

HPI, PMH, PSH, meds, allergies, family history, social history, ROS

Question 24

What do you palpate for on the shoulders?

Answer 24

acromion process, acromioclavicular joint, long head of biceps tendon, clavicle, sternoclavicular joint, spine of scapula

Question 25

What do you palpate for on the elbows?

Answer 25

medial and lateral humeral epicondyles, radial head, ulnar groove, anterior cubital fossa, distal biceps and triceps tendons, olecranon process, bursa