Imaging/Clinical

Imaging/Clinical US Medical PG Question 1: An otherwise healthy 62-year-old woman comes to the physician because of a 3-year history of hearing loss. To test her hearing, the physician performs two tests. First, a vibrating tuning fork is held against the mastoid bone of the patient and then near her ear, to which the patient responds she hears the sound better on both sides when the tuning fork is held near her ear. Next, the physician holds the tuning fork against the bridge of her forehead, to which the patient responds she hears the sound better on the right side than the left. The patient's examination findings are most consistent with which of the following conditions?

• A. Otosclerosis on the left
• B. Cerumen impaction on the right
• C. Cholesteatoma on the right
• D. Acoustic neuroma on the left (Correct Answer)
• E. Cochlear ischemia on the right

Imaging/Clinical Explanation: ***Acoustic neuroma on the left*** - The patient's **Weber test lateralizing to the right** means sound is heard better on the right, indicating either a **sensorineural hearing loss on the left** or a conductive hearing loss on the right. - Her **Rinne test being positive bilaterally** (air conduction > bone conduction) rules out a conductive loss on the right, thus confirming unilateral **sensorineural hearing loss on the left side**. An acoustic neuroma is a common cause of progressive unilateral sensorineural hearing loss. *Otosclerosis on the left* - Otosclerosis typically causes a **conductive hearing loss** due to abnormal bone growth in the middle ear. - A conductive hearing loss on the left would result in the **Weber test lateralizing to the left**, not the right. *Cerumen impaction on the right* - Cerumen impaction causes **conductive hearing loss** in the affected ear. - If the right ear had a conductive loss, the **Weber test would lateralize to the right**, but the Rinne test in the right ear would show bone conduction > air conduction (negative Rinne), which is not the case here. *Cholesteatoma on the right* - A cholesteatoma typically causes **conductive hearing loss** by eroding ossicles or filling the middle ear space. - Similar to cerumen impaction, a conductive loss on the right would lead to a **negative Rinne test on the right**, which is not seen here as the Rinne test is positive bilaterally. *Cochlear ischemia on the right* - Cochlear ischemia would cause **sensorineural hearing loss** in the right ear. - If the right ear had a sensorineural loss, the **Weber test would lateralize to the left**, as the better (left) ear would perceive the sound more clearly, not the right.

Imaging/Clinical US Medical PG Question 2: A 67-year-old man with type 2 diabetes mellitus comes to the emergency department because of lightheadedness over the past 2 hours. He reports that he has had similar episodes of lightheadedness and palpitations over the past 3 days. His only medication is metformin. His pulse is 110/min and irregularly irregular. An ECG shows a variable R-R interval and absence of P waves. The patient undergoes transesophageal echocardiography. During the procedure, the tip of the ultrasound probe is angled posteriorly within the esophagus. This view is most helpful for evaluating which of the following conditions?

• A. Myxoma in the left atrium
• B. Thrombus in the left pulmonary artery
• C. Thrombus in the left ventricular apex
• D. Tumor in the right main bronchus
• E. Aneurysm of the descending aorta (Correct Answer)

Imaging/Clinical Explanation: ***Aneurysm of the descending aorta*** - When the TEE probe is angled **posteriorly within the esophagus**, it optimally visualizes structures directly posterior to the esophagus, particularly the **descending thoracic aorta**. - The descending aorta runs parallel and immediately posterior to the esophagus, making this the ideal view for evaluating **aortic aneurysms, dissections, and atherosclerotic disease** of the descending aorta. - Note: This patient's symptoms (lightheadedness, palpitations) are due to **atrial fibrillation** (irregularly irregular rhythm, absent P waves). The TEE is likely being performed for stroke risk evaluation, but this question tests knowledge of TEE probe positioning and anatomical visualization. *Myxoma in the left atrium* - The left atrium is best visualized using **mid-esophageal views** (especially the 4-chamber view at 0-20 degrees), not a posteriorly angled view. - While TEE is excellent for detecting left atrial myxomas and is commonly performed in AFib patients to evaluate for left atrial appendage thrombus, the posterior angle is not optimal for this structure. *Thrombus in the left pulmonary artery* - The pulmonary arteries are located **anterior** to the esophagus, making them poorly visualized with a posteriorly angled probe. - Pulmonary artery evaluation requires **anterior or superior angulation** of the TEE probe, or CT pulmonary angiography is preferred for pulmonary embolism diagnosis. *Thrombus in the left ventricular apex* - The left ventricular apex is best visualized using **transgastric views** (probe in stomach looking upward), not posterior esophageal views. - LV apex thrombus evaluation requires short-axis and 2-chamber transgastric views at 0-90 degrees. *Tumor in the right main bronchus* - The bronchi are **anterior** to the esophagus and are not adequately visualized with TEE, regardless of probe angle. - TEE is designed for cardiac and great vessel evaluation, not airway pathology; bronchoscopy or CT chest would be appropriate for bronchial tumors.

Imaging/Clinical US Medical PG Question 3: A healthy 22-year-old male participates in a research study you are leading to compare the properties of skeletal and cardiac muscle. You conduct a 3-phased experiment with the participant. In the first phase, you get him to lift up a 2.3 kg (5 lb) weight off a table with his left hand. In the second phase, you get him to do 20 burpees, taking his heart rate to 150/min. In the third phase, you electrically stimulate his gastrocnemius with a frequency of 50 Hz. You are interested in the tension and electrical activity of specific muscles as follows: Biceps in phase 1, cardiac muscle in phase 2, and gastrocnemius in phase 3. What would you expect to be happening in the phases and the respective muscles of interest?

• A. Increase of tension in experiments 2 and 3, with the same underlying mechanism
• B. Increase of tension in all phases (Correct Answer)
• C. Recruitment of large motor units followed by small motor units in experiment 1
• D. Fused tetanic contraction at the end of all three experiments
• E. Recruitment of small motor units at the start of experiments 1 and 2

Imaging/Clinical Explanation: ***Increase of tension in all phases*** - In **phase 1**, lifting a 2.3 kg weight requires the **biceps** to contract, generating sufficient force (**tension**) to overcome gravity. - In **phase 2**, the **cardiac muscle** increases its contractile force (**tension**) to meet the metabolic demands of **exercise**, leading to a heart rate of 150/min. - In **phase 3**, electrical stimulation of the **gastrocnemius** at 50 Hz triggers muscle contraction, leading to an increase in **tension**. *Increase of tension in experiments 2 and 3, with the same underlying mechanism* - While tension increases in phases 2 and 3, the **underlying mechanisms differ**: cardiac muscle tension increases due to increased sympathetic stimulation and preload, while skeletal muscle tension increases due to unfused or fused tetanus from electrical stimulation. - Cardiac muscle contraction is regulated by **calcium-induced calcium release**, while skeletal muscle involves direct coupling of DHP receptor and ryanodine receptor. *Recruitment of large motor units followed by small motor units in experiment 1* - **Motor unit recruitment** follows the **size principle**, meaning smaller, more easily excitable motor units are activated first, followed by larger ones as more force is needed. - Therefore, in phase 1, **small motor units** would be recruited first, not large ones. *Fused tetanic contraction at the end of all three experiments* - **Fused tetanic contraction** occurs in **skeletal muscle** when stimulation frequency is high enough that individual twitches summate completely, leading to sustained contraction. - This phenomenon is **not possible in cardiac muscle** due to its long **refractory period**, which prevents sustained contraction and allows for adequate filling time. *Recruitment of small motor units at the start of experiments 1 and 2* - **Motor unit recruitment** applies to **skeletal muscle** (phase 1) and involves recruiting small motor units first for fine or gentle movements. - **Cardiac muscle** (phase 2) does not have motor units; instead, it relies on the **Frank-Starling mechanism** and hormonal/nervous regulation to adjust its contractile force as a syncytium.

Imaging/Clinical US Medical PG Question 4: A 27-year old primigravid woman at 37 weeks' gestation comes to the emergency department because of frequent contractions for 4 hours. Her pregnancy has been complicated by hyperemesis gravidarum which subsided in the second trimester. The contractions occur every 10–15 minutes and have been increasing in intensity and duration since onset. Her temperature is 37.1°C (98.8°F), pulse is 110/min, and blood pressure is 140/85 mm Hg. Uterine contractions are felt on palpation. Pelvic examination shows clear fluid in the vagina. The cervix is 50% effaced and 3 cm dilated. After 4 hours the cervix is 80% effaced and 6 cm dilated. Pelvic examination is inconclusive for the position of the fetal head. The fetal heart rate is reassuring. Which of the following is the most appropriate next step?

• A. Administer oxytocin
• B. Perform external cephalic version
• C. Administer misoprostol
• D. Perform Mauriceau-Smellie-Veit maneuver
• E. Perform ultrasonography (Correct Answer)

Imaging/Clinical Explanation: ***Perform ultrasonography*** - The examination notes that the **pelvic examination is inconclusive for the position of the fetal head**, which is a critical piece of information needed for safe delivery. **Ultrasonography** is the most appropriate next step to ascertain the fetal presentation and position, especially given the dilated cervix. - Determining fetal position is essential to rule out **malpresentation**, such as **breech** or **transverse lie**, which would significantly impact the delivery plan and potentially necessitate a **cesarean section**. *Administer oxytocin* - **Oxytocin** is used to induce or augment labor when contractions are insufficient or labor is prolonged, but in this case, the cervix is progressing well (from 3 cm to 6 cm dilation in 4 hours), indicating **active labor**. - Without knowing the fetal presentation, administering oxytocin could exacerbate issues if there's a **malpresentation**, potentially leading to **fetal distress** or **uterine rupture**. *Perform external cephalic version* - **External cephalic version (ECV)** is performed to change a **breech presentation** to a **cephalic presentation** by external manipulation, typically done before labor onset or early in labor at term. - This patient is already in **active labor** with significant cervical dilation (6 cm), making ECV less likely to be successful and potentially increasing risks like **placental abruption** or **umbilical cord compression**. *Administer misoprostol* - **Misoprostol** is a prostaglandin analog used for **cervical ripening** and **labor induction** in cases where the cervix is unfavorable or labor needs to be initiated. - This patient is already in **active labor** with progressive cervical dilation, making misoprostol unnecessary and potentially harmful due to the risk of **uterine hyperstimulation**. *Perform Mauriceau-Smellie-Veit maneuver* - The **Mauriceau-Smellie-Veit maneuver** is a technique used during a **vaginal breech delivery** to deliver the fetal head, specifically in cases of **frank or complete breech** that are being delivered vaginally. - This maneuver is only performed *during* delivery of a breech baby, and the fetal position is currently unknown. It would be premature and inappropriate to consider this maneuver without first confirming a **breech presentation** and the decision for vaginal delivery.

Imaging/Clinical US Medical PG Question 5: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

• A. "Does the diarrhea typically precede the constipation, or vice-versa?"
• B. "Is the diarrhea foul-smelling?"
• C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
• D. "Are the symptoms worse in the morning or at night?"
• E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)

Imaging/Clinical Explanation: ***Can you tell me more about the symptoms you have been experiencing?*** - This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis. - In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions. *Does the diarrhea typically precede the constipation, or vice-versa?* - While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience. - It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture. *Is the diarrhea foul-smelling?* - Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions. - However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed. *Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life* - Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time. - However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially. *Are the symptoms worse in the morning or at night?* - Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related. - This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.

Imaging/Clinical US Medical PG Question 6: A 22-year-old Caucasian male is stabbed in his left flank, injuring his left kidney. As the surgeon undertakes operative repair, she reviews relevant renal anatomy. All of the following are correct regarding the left kidney EXCEPT?

• A. The left kidney has a longer renal vein than the right kidney
• B. The left kidney underlies the left 12th rib
• C. The left kidney moves vertically during deep breathing
• D. The left kidney has a longer renal artery than the right kidney (Correct Answer)
• E. The left kidney lies between T12 and L3

Imaging/Clinical Explanation: ***The left kidney has a longer renal artery than the right kidney*** - The **aorta** lies to the left of the midline, so the **right renal artery** must traverse a greater distance to reach the right kidney. - Therefore, the right renal artery is longer than the left renal artery. *The left kidney has a longer renal vein than the right kidney* - The **inferior vena cava (IVC)** is positioned to the right of the midline, requiring the **left renal vein** to cross the aorta to drain. - This anatomical arrangement makes the left renal vein longer than the right renal vein. *The left kidney underlies the left 12th rib* - The kidneys are retroperitoneal organs, and the 12th rib provides significant posterior protection for **both kidneys**. - The superior pole of the left kidney typically extends to the level of the **11th and 12th ribs**. *The left kidney moves vertically during deep breathing* - The kidneys are surrounded by **perirenal fat** and are influenced by the diaphragm's movement. - During **deep inspiration**, the diaphragm descends, causing both kidneys to move vertically by 2-3 cm. *The left kidney lies between T12 and L3* - The kidneys are situated in the retroperitoneum, generally extending from the level of the **T12 vertebra** to the **L3 vertebra**. - The left kidney is typically positioned slightly higher than the right kidney.

Imaging/Clinical US Medical PG Question 7: A researcher is investigating the blood supply of the adrenal gland. While performing an autopsy on a patient who died from unrelated causes, he identifies a vessel that supplies oxygenated blood to the inferior aspect of the right adrenal gland. Which of the following vessels most likely gave rise to the vessel in question?

• A. Inferior phrenic artery
• B. Abdominal aorta
• C. Renal artery (Correct Answer)
• D. Superior mesenteric artery
• E. Common iliac artery

Imaging/Clinical Explanation: ***Renal artery*** - The **inferior suprarenal artery**, which supplies the inferior part of the adrenal gland, typically arises from the **renal artery**. - The adrenal glands receive a rich blood supply from three main arterial sources: superior, middle, and inferior suprarenal arteries. *Inferior phrenic artery* - The **superior suprarenal arteries** typically arise from the **inferior phrenic arteries** and supply the superior aspect of the adrenal glands. - While critical for adrenal blood supply, they do not typically contribute to the inferior aspect directly. *Abdominal aorta* - The **middle suprarenal artery** usually arises directly from the **abdominal aorta**. - This vessel supplies the central part of the adrenal gland, but not primarily the inferior aspect. *Superior mesenteric artery* - The **superior mesenteric artery** primarily supplies structures of the midgut (e.g., small intestine, ascending colon) and does not typically give rise to vessels supplying the adrenal glands. - It is located inferior to the origin of the renal arteries and the adrenal glands. *Common iliac artery* - The **common iliac arteries** supply the lower limbs and pelvic organs, originating from the abdominal aorta bifurcation. - These arteries are located much too far inferior to supply the adrenal glands, which are retroperitoneal structures in the upper abdomen.

Imaging/Clinical US Medical PG Question 8: A 72-year-old woman presents to the emergency department for vision loss. She was reading a magazine this afternoon when she started having trouble seeing out of her left eye. Her vision in that eye got progressively darker, eventually becoming completely black over the course of a few minutes. It then returned to normal after about 10 minutes; she reports she can see normally now. She had no pain and no other symptoms then or now. Past medical history is notable for hypertension and hyperlipidemia. A high-pitched sound is heard when the diaphragm of the stethoscope is placed on her left neck, but her physical exam is otherwise unremarkable; vision is currently 20/30 bilaterally. The etiology of her symptoms most likely localizes to which of the following anatomic locations?

• A. Left atrium
• B. Subclavian artery
• C. Temporal artery
• D. Carotid artery (Correct Answer)
• E. Vertebral artery

Imaging/Clinical Explanation: ***Carotid artery*** - The sudden, temporary vision loss (amaurosis fugax) in one eye, described as a "curtain coming down," is a classic symptom of an **embolus originating from the ipsilateral carotid artery**. - The **bruit** heard in the left neck further points to significant **carotid artery stenosis**, which can be a source of these emboli to the **ophthalmic artery**. *Left atrium* - An embolus from the left atrium (e.g., in atrial fibrillation) would typically cause symptoms of a **cerebral stroke** or vision loss in **both eyes** if it affects a major supplying vessel before the intracranial branches, or could affect the carotid artery system, but the neck bruit directly implicates the carotid. - While a source of emboli, the direct finding of a neck bruit makes the carotid the more immediate and specific localization. *Subclavian artery* - **Subclavian artery** stenosis can cause **subclavian steal syndrome**, leading to vertebrobasilar insufficiency and symptoms like **dizziness** or **syncope**, but generally does not cause unilateral amaurosis fugax. - Its territory primarily supplies the arm and posterior circulation, not the anterior cerebral circulation or ophthalmic artery directly as suggested by amaurosis fugax. *Temporal artery* - **Temporal arteritis** (Giant Cell Arteritis) can cause sudden vision loss, often irreversible, and is usually associated with **headaches**, **jaw claudication**, and a very high **ESR**, none of which are reported here. - While it affects the ophthalmic artery, the absence of pain and the transient nature of the vision loss (amaurosis fugax) make it less likely than an embolic event. *Vertebral artery* - The **vertebral arteries** supply the **posterior circulation** of the brain, leading to symptoms such as **diplopia**, **vertigo**, **ataxia**, or **hemiparesis**, but not isolated unilateral amaurosis fugax. - Problems in this artery typically manifest as **vertebrobasilar insufficiency**, which affects both eyes or causes other brainstem symptoms, not transient unilateral blindness.

Imaging/Clinical US Medical PG Question 9: A 24-year-old woman comes to the physician for an annual routine examination. Menses occur at regular 28-day intervals and last for 4 days with normal flow. Her last menstrual period was 3 weeks ago. She is sexually active with one male partner and they use condoms consistently. The patient is 160 cm (5 ft 3 in) tall and weighs 72 kg (150 lb); BMI is 28.1 kg/m2. She feels well. Pelvic examination shows a smooth, mobile right adnexal mass. A subsequent ultrasound of the pelvis shows a single, 2-cm large, round, hypoechoic mass with a thin, smooth wall in the right ovary. The mass has posterior wall enhancement, and there are no signs of blood flow or septae within the mass. Which of the following is the most appropriate next step in management?

• A. Diagnostic laparoscopy
• B. CT scan of the pelvis
• C. Oral contraceptive
• D. CA-125 level
• E. Follow-up examination (Correct Answer)

Imaging/Clinical Explanation: ***Follow-up examination*** - The ultrasound findings of a **small (2-cm)**, **simple (hypoechoic, thin-walled, no septations, no blood flow)** adnexal cyst in a **premenopausal woman** are characteristic of a functional ovarian cyst. - Functional cysts are typically benign and resolve spontaneously, making **expectant management with follow-up** the most appropriate initial step. *Diagnostic laparoscopy* - This is an **invasive surgical procedure** indicated for suspicious or persistent ovarian masses that require histological evaluation or removal. - It is **not warranted for a small, simple cyst** with benign features found incidentally in an asymptomatic, premenopausal woman. *CT scan of the pelvis* - A CT scan provides additional imaging but exposes the patient to **radiation** and is generally reserved for masses with **complex features** or when evaluating for metastasis. - It is **not necessary for a simple cyst** that has already been well-characterized by ultrasound. *Oral contraceptive* - While oral contraceptives can **suppress ovulation** and potentially prevent the formation of new functional cysts, they generally do **not hasten the resolution of existing cysts**. - They are sometimes used in cases of recurrent functional cysts but are not the primary management for an initial, asymptomatic simple cyst. *CA-125 level* - **CA-125** is a tumor marker primarily used for monitoring ovarian cancer, especially in **postmenopausal women** or those with highly suspicious masses. - Its levels can be elevated in various benign conditions, and it is **not indicated for a small, simple cyst** in a premenopausal woman, where the risk of malignancy is very low.

Imaging/Clinical US Medical PG Question 10: A 69-year-old man comes to the physician with a 2-year history of progressive hearing loss. His hearing is worse in crowded rooms, and he has noticed that he has more difficulty understanding women than men. He has no history of serious illness and does not take any medications. A Rinne test shows air conduction is greater than bone conduction bilaterally. This condition is most likely associated with damage closest to which of the following structures?

• A. Tympanic membrane
• B. Round window
• C. Base of the stapes
• D. External acoustic meatus
• E. Basal turn of the cochlea (Correct Answer)

Imaging/Clinical Explanation: ***Basal turn of the cochlea*** - The patient's presentation of progressive hearing loss, difficulty hearing in crowded rooms (**presbycusis**), and trouble understanding women's voices (higher frequencies) is characteristic of **sensorineural hearing loss**. - The **basal turn of the cochlea** is responsible for detecting high-frequency sounds, making it the most likely site of damage in presbycusis. *Tympanic membrane* - Damage to the **tympanic membrane** would typically result in a **conductive hearing loss**, characterized by bone conduction being greater than air conduction (abnormal Rinne test). - The patient's Rinne test shows air conduction greater than bone conduction, indicating a sensorineural or normal hearing pattern. *Round window* - The **round window** plays a role in relieving pressure in the cochlea, allowing fluid movement and sound transmission. - While damage here can affect hearing, it's not the primary site of progressive, age-related high-frequency sensorineural loss. *Base of the stapes* - Issues at the **base of the stapes**, particularly **otosclerosis**, cause **conductive hearing loss** due to the ossification of the oval window, hindering sound transmission. - This would present with an abnormal Rinne test (BC > AC), which is not observed in this patient. *External acoustic meatus* - Obstruction or damage to the **external acoustic meatus** (e.g., earwax impaction, otitis externa) would cause a **conductive hearing loss**. - The Rinne test would show bone conduction greater than air conduction, which is inconsistent with the patient's findings.

Imaging/Clinical Flashcard 1 of 10

Question: In portal hypertension, the _____ vein backs up into the esophageal vein, resulting in varices

Answer: left gastric

Imaging/Clinical Flashcard 2 of 10

Question: _____ is a congenital lung malformation that presents as discrete, round, sharply defined and air-filled densities on CXR

Answer: Bronchogenic cyst

Imaging/Clinical Flashcard 3 of 10

Question: Thrombosis most commonly occurs in the _____ of the leg below the knee

Answer: deep veins (DVT)

Imaging/Clinical Flashcard 4 of 10

Question: Enlargement of the heart can cause _____ due to compression of the left recurrent laryngeal nerve

Answer: hoarseness

Imaging/Clinical Flashcard 5 of 10

Question: Congenital adrenal hyperplasia affects the adrenal glands on _____ side(s) of the body (one or both)

Answer: both

Imaging/Clinical Flashcard 6 of 10

Question: Astigmatism is corrected with _____ lenses

Answer: cylindrical

Extra Information:   https://onlinemeded.org/spa/pediatrics/ophthalmology/acquire?ref=anki Atlas: 

Imaging/Clinical Flashcard 7 of 10

Question: What complication arises more often in the left testis than the right due to its venous drainage? _____

Answer: Varicocele

Extra Information:   Watch Testicular Disorders & Cancer [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-reproductive-gu/videos/medical-pathophysiology-reproductive-and-gu-male-gu-testicular-disorders-and-cancer?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/gross-anatomy/videos/perineum-and-external-genitalia?index=5] https://onlinemeded.org/spa/endocrinology?ref=anki 

Imaging/Clinical Flashcard 8 of 10

Question: The orbital floor is composed of a very thin layer of bone that separates the orbit from the air-filled _____

Answer: maxillary sinus

Extra Information: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/gross-anatomy/videos/external-examination-of-the-brain?index=18] https://onlinemeded.org?ref=anki 

Imaging/Clinical Flashcard 9 of 10

Question: Patients with basilar skull fractures may have _____ ("Battle's Sign")

Answer: retroauricular ecchymosis

Extra Information:  https://onlinemeded.org?ref=anki 

Imaging/Clinical Flashcard 10 of 10

Question: _____ is a process in which metaphase chromosomes are stained, ordered, and numbered according to morphology, size, arm-length ratio, and banding pattern

Answer: Karyotyping

Extra Information:  Watch associated Bootcamp video [https://app.bootcamp.com/med-school/genetics/videos/laboratory-techniques?index=5] https://onlinemeded.org?ref=anki