#june2020mccqe1
A 34-year-old woman is evaluated in the office for right-sided facial paralysis that she noticed on awakening 1 hour ago. She has a 10-pack-year smoking history. Personal and family medical history is noncontributory. Her only medication is a daily oral contraceptive. On physical examination, vital signs are normal. Limb strength, reflexes, and tone are normal bilaterally. Findings from a sensory examination, which included her face, are also normal. When asked to raise her eyebrows, the patient does not elevate the right side. When asked to shut her eyes, she cannot close the right one but the globe rotates upward, partially covering the iris. When asked to smile, the patient does not move the right side of her face. Which of the following is the most likely diagnosis?
(A) Graves ophthalmopathy
(B) Left cerebral infarction
(C) Right facial nerve (Bell) palsy
(D) Right trigeminal neuralgia
A 34-year-old woman is evaluated in the office for right-sided facial paralysis that she noticed on awakening 1 hour ago. She has a 10-pack-year smoking history. Personal and family medical history is noncontributory. Her only medication is a daily oral contraceptive. On physical examination, vital signs are normal. Limb strength, reflexes, and tone are normal bilaterally. Findings from a sensory examination, which included her face, are also normal. When asked to raise her eyebrows, the patient does not elevate the right side. When asked to shut her eyes, she cannot close the right one but the globe rotates upward, partially covering the iris. When asked to smile, the patient does not move the right side of her face. Which of the following is the most likely diagnosis?
(A) Graves ophthalmopathy
(B) Left cerebral infarction
(C) Right facial nerve (Bell) palsy
(D) Right trigeminal neuralgia
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