PACKRAT REVIEW QUESTIONS & ANSWERS
A 32 year-old carpenter complains of right eye irritation all day after driving a metal
stake into the ground with his hammer. He states that "something flew into my eye."
Visual acuity is 20/20. Pupils are equal, round, reactive to light and accommodation.
Extraocular movements are intact. There is minimal right corneal injection. No foreign
body is noted with lid eversion. Fluorescein stain reveals a tiny pinpoint uptake in the
area of the corneal injection. Which of the following is the most appropriate diagnostic
test at this stage? - Answers - X-ray orbits
A 45 year-old male complains of loss of hearing in his left ear. He also complains of
ringing in the ear, and has had occasional dizziness. On exam, there is unilateral
leftsided sensorineural hearing loss and a diminished corneal reflex. Neuro exam is
otherwise normal. TMs are normal, and canals are clear. Neck is supple, without
adenopathy. Oropharynx is normal. Of the following, the best diagnostic study to identify
the cause of this patient's complaints is... - Answers - Gadolinium-Enhanced MRI
looking for acoustic neuromas
A 64 year-old patient with known history of type 1 diabetes mellitus for 50 years has
developed pain radiating from the right buttock to the calf. Patient states that the pain is
made worse with walking and climbing stairs. Based upon this history which of the
following would be the most appropriate test to order? - Answers - Arterial Duplex
Scanning looking at arterial perfusion
A 73 year-old male presents to the clinic with his wife. His wife has noticed that he has
developed a resting tremor in his right hand and a shuffling gait over the last year. What
finding on physical examination would support your suspected diagnosis? - Answers -
Masked Facies (thinking Parkinson's)
Primary biliary cirrhosis will have which of the following laboratory results? - Answers -
Antimitochondiral antibodies
Which of the following historical factors differentiates post-traumatic stress disorder from
acute stress disorder? - Answers - A belief that their future has been foreshortened
because of the event
What test is the single most useful test in establishing the diagnosis of multiple
sclerosis? - Answers - MRI
On physical examination you note diminished breath sounds over the right lower lobe
with decreased tactile fremitus and dullness to percussion. Which of the following is the
most likely cause? - Answers - Pleural Effusion
A 38 year-old male sustained a fracture of the left distal tibia following a 25-foot fall and
is taken to the operating room for an open reduction internal fixation of the distal tibia.
Sixteen hours post-op, the patient develops sustained pain, which is not relieved with
