#january2020mccqe1
A 65-year-old man attends his local doctor for a repeat prescription for an antihypertensive medication. The doctor notices that the patient's left pupil is smaller than the right and is associated with a drooping of the eyelid as illustrated. The patient comments that he has noticed recently that even when he is hot, there is no sweating on the left side of his face. Physical examination shows no abnormality of cranial nerves. These physical signs are most likely to be associated with which one of the following causal conditions?
(A) A long-standing brachial plexus injury
(B) A tumour at the apex of the lung
(C) A dissecting carotid aneurysm
(D) Cluster migraine
(E) A neoplasm in the middle cranial fossa
A 65-year-old man attends his local doctor for a repeat prescription for an antihypertensive medication. The doctor notices that the patient's left pupil is smaller than the right and is associated with a drooping of the eyelid as illustrated. The patient comments that he has noticed recently that even when he is hot, there is no sweating on the left side of his face. Physical examination shows no abnormality of cranial nerves. These physical signs are most likely to be associated with which one of the following causal conditions?
(A) A long-standing brachial plexus injury
(B) A tumour at the apex of the lung
(C) A dissecting carotid aneurysm
(D) Cluster migraine
(E) A neoplasm in the middle cranial fossa
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