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22 Cards in this Set
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Stepwise approach to solving problem:
1. Localize the lesion 2. Hypothesize 3. Confirm w/ Dx test 4. Outline Rx |
Fasciculations- have no movement of the joint
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Sx vs Sign:
1. Complaints by Hx 2. Pattern and distribution by EXAM 3. Disease affecting the ventral horn cells? 4. pain in distribution of a n.? 5. Pain is a sx of upper or lower nerve issue? |
1. Sx
2. Sign - typically more specific 3. polio 4. Radiculopathy 5. nerve root or lower |
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Potential causes for anything think:
CITTEN DVM |
CITTEN:
Congenital; Infection & inflammation; Toxic; Trauma; Endocrine; Neoplasm DVM: Degenerative & drugs; Vascular; Metabolic |
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1. What is an acute neuropathy that is peripheral, affects myelin, axons and nerves, effects respiratory m, loss of reflex, typ. ascending weakness, no ptosis
2. What about ptosis, limb weakness, no sensory loss, normal mentation, DTR are present in UE & LE, weak respiratory m. |
1. Guillan Barre
2. Myasthenia gravis |
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1. UE: Adducted shoulder; flexed elbow, flexed wrist; flexed fingers LE: Hip extended, knee extended, ankle plantar flexed are what signs?
2. What side of the cerebrum is the language center located? |
1. Pyramidal - basically half of decorticate rigidity
2. on the lt usu. |
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Say if the following have a focal deficity, severe headache or altered consciousness
1. Infarct 2. Subarachnoid hemorrhage 3. Parenchymal hemorrhage |
1. Focal deficit
2. Severe headache, altered consciousness 3. Focal deficit, mb headache, and altered consciousness |
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1. Why would a hemorrhage cause pain?
2. What is primary treatment for ischemic stroke? (secondary prevention?) 3. If both UMN and LMN abnormalities are present, what is the Dx? |
1. Causes traction on meninges
2. TPa (antiplatelet therapy: aspirin/plavix 3. ALS |
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1. Distal m. weakness bilaterally is due to what?
2. Eyelids drooping and nasal speech? 3. Proximal M. weakness? |
1. peripheral nerve, possibly toxin, kills long nerves first so appears in the extremities & ascends
2. Myasthenia Gravis 3. neuromuscular junction/muscle possibly myasthenia gravis is eyelids are drooping |
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1. Most common cause of peripheral neuropathy?
2. What might cause a mononeuropathy? 3. Cheiralgia Paresthetica is due to what? |
1. Diabetes
2. Autoimmune disorder like Lupus 3. Compression of the ulnar nerve, often due to hand cuffs |
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1. What are 3 neurological things that come and go?
2. What might cause benign positional vertigo? 3. Term for slurred speech? 4. Term for speaking clearly but not making sense |
1. TIA, Seizure, Migraine
2. Change in position, occurs b/c of a little stone (cupolith) in semicircular canal, very common in elderly 3. Dysarthria - alcohol or dilantin 4. Aphasia - comes and goes - TIA, migraine etc |
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1. Binocular vision is due to what/
2. Monocular vision is due to what? |
1. brainstem or MLF issue, eyes just are not focusing right
2. Problem of the globe, eyeball, - close one eye and still see double |
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1. What is the difference between complex partial and and partial seizures?
2. Is a generalized or partial seizure have an aura? 3. True writers cramp can be described as what? |
1. Complex has altered consciousness and partial has normal consciousness
2. Partial 3. Focal dystonia |
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1. Does an absence or complex partial seizure have a post ictal state? (what about aura?)
2. What is the main mechanism for staying awake? 3. How many cerebral hemispheres have to be intact to stay awake? 4. Where could you put a 2cm lesion to make a person comatose? |
1. Complex partial (complex partial)
2. Brainstem reticular activating system 3. Just 1 4. Brain stem |
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1. If a person presents w/ severe ataxia, and crossed sensory disturbances (i.e. pain on rt face but lt body) what should you think?
2. What is the hallmark of nerve root compression? 3. What 2 things would be considered a neurologic emergency? 4. What presents w/ ascending weakness on both sides, sensory and motor, is progressive over a few days, typically not painful; absent reflexes? |
1. Brain stem -
2. Pain (cauda equina is made up of roots) 3. If it is life threatening or might increase damage 4. Guillane Barre Syndrome |
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1. Why is Guillan Barre Syndrome (GBS) an emergency?
2. Are tremor, migraine, stable seizure disorders an emergency? 3. Term for not being able to see in a certain area? |
1. Stops respiratory muscles - can also happen in myasthenia gravis
2. No 3. Schitoma |
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1. Movement disorder w/ a shuffling gate & resting tremor that starts unilaterally w/ a recent onset?
2. Cogwheel rigidity is due to what? 3. What is the most common tremor type & is symmetric throughout the movement, does not get worse either initiating or ending? (present at rest?) |
1. PD
2. Tremors 3. Postural essential tremor (no) |
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1. Tremor type that has high amplitude, irratic, worse at the end point; alcohol helps?
2. Causes focal neurologic syndromes attributed to the CNS due to demyelination of CNS, have optic neuritis? |
1. Intention tremor or classic cerebellar tremor
2. MS - if you hurt all over then it is not MS |
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1. What has short term loss of memory, has no residual effects, Asked same question over and over, but recovered!?
2. New onset stuttering is due to what? 3. What begins w/ word finding difficulty that worsens over time; it is progressive and degenerative; antegrade and retrograde w/ additional cognitive loss? |
1. Antegrade amnesia (transient global amnesia)
2. Psychiatric 3. Alzheimers |
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1. What presents w/ a problem of the Neuromuscular junction; nasal speech, improves with AChEi?
2. Why can 1 be an emergency? 3. What is the most common headache type? |
1. Myasthenia Gravis - an autoimmune disorder
2. Leads to respiratory depression 3. MA - can be w/ or w/o pain, can have numbness or weakness on 1 side, can;t see in a certain area |
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1. A headache type that occurs at certain times of the yr, seems to occur on a schedule, very severe, and lasts about 30-60 min
2. Is a peripheral n. problem often painful? Saturday night palsy - overdrink, anesthetize your arm, sleep funny & damage your radial n. Radiculopathy can be infectious or compressive |
1. Cluster headaches
2. Not typically |
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1. What presents w/ sharp jabbing shootin pain, can be triggered, is intermittent, has no loss of sensation but just pain, occurs in the V2,V3 distribution
2. Dumbell shaped anesthesia over the perineal area w/ loss of urination & BM 3. How can you distinguish a peripheral nerve problem from one further up? |
1. Tic Douleraux or trigeminal neuralgia
2. Saddle anesthesia - lesion of cauda equina 3. numbness, weakness, pain, diminished reflex |
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1. Lt side numbness of arm and leg?
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1. Lacunar stroke in the thalamus (looked like a little lake on autopsy)
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