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l. Your young female patient has repeated episodes of viral and fungal infections, and her blood serum exam reveals hypocalcemia. Which of the following will be also be seen in this patient?

(A) Fewer thyroid follicles

(B) No palatine tonsil

(C) A smaller than normal paracortex in many lymph nodes

(D) Mandibular hypoplasia

(E) A cleft palate

Your patient has been diagnosed with multiple sclerosis. Which of the following neural structures will most likely be affected by this disease?

(A) Dorsal root ganglia

(B) Optic nerves

(C) Ulnar nerves

(D) Superior cervical ganglia

(E) Facial nerves

A CT cross-sectional image of the thorax reveals an absence of an shadow in a patient diagnosed with the DiGeorge sequence. What the patient?

(A) Thyroid gland

(B) Palatine tonsil

(C) Malleus and incus

(D) Parathyroid gland

(E) Adrenal medulla

An infection develops in a dural sinus lateral to the body of the sphenoid bone in the floor of the middle cranial fossa. Which neurological observation might you expect the patient to exhibit initially on the affected side?

(A) Ptosis

(B) Dilated pupil

(C) Medial strabismus

(D) Altered sensation in skin of the forehead

(E) Hemianopsia

An apical lung tumor has compressed structures that pass through the scalene interval and cross the first rib. This patient would most likely exhibit

(A) weakness in abduction at the shoulder

(B) Horner syndrome

(C) weakness in protracting the scapula

(D) hemidiaphragmatic weakness

(E) a Babinski sign

A 25-year-old man was stuck in the face during a fight. He is brought to the emergency room where he can no longer close his mouth. Pain is intense in the right side of his jaw, and bloodstained saliva drips from his mouth. The patient indicates that he cannot feel the skin of his chin or lower Hp on the side of the fracture. Radiology reveals a mandibular fracture. The posterior part of the mandible may be displaced superiorly by contractions of which muscle?

(A)

Digastric

(B)

Buccinator

(C)

Masseter

(D)

Lateral pterygoid

(E)

Orbicularis oris

anterior mediastinum else will be missing in

The altered sensation in the above patient is due to laceration of branches of the

(B) cervical nerves 1

(C) maxillary nerve !

(D) mandibular nerve

(E) great auricular nerve

A 15-year-old boy falls from his bicycle and lilts his head. His initial examination in the emergency room is normal, but later in the day, he becomes noticeably lethargic. He is brought back to the ER where he is too drowsy to answer the examiner's questions. His right pupil is 7 mm, and his left pupil is 4 mm. Patellar tendons reflexes are brisker on the left, and a Babinski sign can be elicited on the left CT imaging reveals that a pool of blood has displaced the right temporal lobe to the left The hematoma is evacuated, and a blood vessel is cauterized. Through which opening did the lacerated blood vessel enter the cranial cavity? — j

(A) Foramen spinosum

(B) Stylomastoid foramen i

(C) Foramen lacerum

(D) Carotid canal

(E) Jugular foramen

A tumor in the superior mediastinum impinges upon the arch of the aorta and com- : presses a nerve. Which of the following is most likely to be observed in the patient?

(B) Weakness in the ability to tense the vocal cord

(C) Altered sensation in the larynx above the vocal cord

(D) Weakness in the ability to elevate the hyoid bone

(E) Weakness in the ability to abduct the vocal cord

An infant has a bilateral cleft lip. Which processes failed to fuse?

(A) Lateral nasal prominences with the maxillary prominences

(B) Maxillary prominences with the intermaxillary segment

(C) Palatine shelves from each maxillary prominence j

(D) Medial nasal prominences from each side

(E) Frontonasal prominence with each maxillary prominence

An infant has mandibular hypoplasia and a conductive hearing loss. The defect is in the development of the !

(A) first pharyngeal arch

(B) second pharyngeal arch

(C) first pharyngeal pouch

(D) ectoderm of the head

(E) first somite

12. An infant has a small lump on the anterior aspect of the thyroid cartilage near the midline. You describe this as the pyramidal lobe of the thyroid gland. The pyramidal lobe is a remnant of the

(A) thyrocervical cyst

(B) first pharyngeal pouch

(C) second pharyngeal pouch

(D) thyroglossal duct

(E) sulcus terminalis

13. Which of the following is derived from the third aortic arch?

(A) Maxillary artery

(B) Leftsubclavianartery

(C) Right common carotid artery

(D) Left pulmonary artery

(E) Ductus arteriosus

14. Your patient has been diagnosed with jugular foramen syndrome, which is caused by a tumor compressing nerves passing through the jugular foramen. Which of the following autonomic deficits is the patient most likely to present with?

(A) Loss of sweating on the side of the face

(B) Reduction in parotid gland secretions

(C) A dilated pupil

(D) An eye that is dry and red

15. If the jugular foramen syndrome were severe enough to cause a destructive lesion to all of the nerve fibers passing through the jugular foramen, where would you expect to see retrograde chromato lysis?

(A) Superior salivatory nucleus

(B) Solitary nucleus

(C) Spinal nucleus of V

(D) Nucleus of Edinger Westphal

(E) Nucleus ambiguus

16. A tumor has compressed structures traversing the superior orbital foramen. Where is the patient most likely to experience pain and altered sensation?

(A) Mucosa of the nasal cavity

(B) Mucosa of the nasopharynx

(C) Skin over the maxilla

(D) Skin of the anterior scalp and dorsum of the nose

(E) Mucosa of the oral cavity

17. A tumor in the superior orbital foramen erodes through the floor of the orbit. Where will the surgeon find the tumor?

(A) Sphenoid sinus

(B) Nasal cavity

(C) Oral cavity

(D) Maxillary sinus

(E) Ethmoid sinus

Questions 18 and 19 are based on the figure below.

18. In the figure below, which of the letters indicates a location of tonsillar lymphatic tissue?

(A)

A

(B)

B

(C)

C

(D)

D

(E)

E

(F)

F

(G)

G

(H)

H

(I)

I

19. In the figure above, which of the following roman numerals indicates a structure that gives rise to the stapes and the styloid process?

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