1. Approach to the patient with neurologic disease Flashcards
The formulation & aggregation of symptoms & signs in cohesive terms is particularly helpful in ascertaining the locus & nature of the disease. This step is called __________
Syndromic diagnosis
This analysis permits the physician to localize the disease process, i.e., to name the part or parts of the nervous system involved
Anatomic/ topographic diagnosis
From the anatomic diagnosis & other medical data - particularly the mode & speed of onset, evolution, & course of illness, the involvement of nonneurologic organ systems, the relevant past & family histories, the laboratory findings - one deduces the __________
Pathologic diagnosis
When the mechanism & causation of the disease can be determined, one deduces the __________
Etiologic diagnosis
The physician should assess the degree of disability & determine whether it is temporary or permanent
Functional diagnosis
This is the most helpful diagnostic test in a difficult neurologic case
A second examination
The first step in the clinical encounter is to __________
Enlist the patient’s trust & cooperation & make him realize the importance of the history & examination procedure
What are the 2 main components of the mental status examination?
Psychiatric aspects
Neurologic aspects
The component of the MSE which incorporate affect, mood, and normality of thought process & content
Psychiatric aspect
The component of MSE which include level of consciousness, awareness (attention), language, memory, & visuospatial abilities
Neurologic aspect
These are the only tests of coordination that need be carried out in bed
Running the heel down the front of the shin
Alternately touching the examiner’s finger with the toe & the opposite knee w/ the heel
Rhythmically tapping the heel on the shin
Different reflex responses besides the Babinski response that can be evoked by stimulating the sole of the foot along its outer border from heel to toes:
The normal quick, high-level avoidance response that causes the foot & leg to withdraw
Spinal flexor nocifensive (protective) reflex/ triple flexion
Plantar grasp reflex
Support reactions in infants
T/F: It is better to ask whether stimuli on opposite sides of the body feel the same than to ask if they feel different
True
T/F: Moving the stimulus from an area of normal area into an area of diminished sensation is recommended because it enhances the perception of a difference
False
