1.2 NEU I - Approach to Neurological Diseases

Question 1

Difficulties in comprehending neurology is overcome by ____

Answer 1

…adhering to basic principles of clinical medicine.

Question 2

Important in the study of neurologic disease.

Answer 2

The Clinical Method

Question 3

Step 1 of the Clinical Method.

Answer 3

Secure the symptoms and signs by history and physical examination.

Question 4

Step 2 of the Clinical Method.

Answer 4

Interpret the symptoms and signs considered relevant to the problem at hand in terms of physiology and anatomy

Note: Identify the disorders of function and the anatomic structures implicated.

Question 5

Step 3 of the Clinical Method.

Answer 5

Localize the disease process through analysis of data gathered from the previous steps.

Question 6

Step 4 of the Clinical Method.

Answer 6

Deduce the pathological diagnosis from the anatomic diagnosis and other medical data.

Question 7

Step 5 of the Clinical Method.

Answer 7

Assess the degree of disability and determine whether it is temporary or permanent.

Question 8

Topographic Diagnosis

Answer 8

Name the parts of the nervous system involved. (Step 3)

Question 9

Anatomic Diagnosis

Answer 9

Name the parts of the nervous system involved. (Step 3)

Question 10

Syndromic Diagnosis

Answer 10

Recognize a characteristic clustering of symptoms and signs, constituting a syndrome of anatomic, physiologic, or syndromic type. (Step 3)

Question 11

T/F: Syndromic diagnosis is often conducted in parallel with anatomic diagnosis.

Answer 11

TRUE

Question 12

Etiologic Diagnosis

Answer 12

The diagnosis reached when the mechanism and causation of the disease can be determined. (Step 4)

Question 13

T/F: In etiologic diagnosis, we should focus on the formulation and aggregation of symptoms and signs in cohesive terms

Answer 13

FALSE. Syndromic diagnosis.

Question 14

Pathologic Diagnosis

Answer 14

Diagnosis which involves the mode and speed of onset, evolution, course of illness, involvement of non-neurologic structures, relevant past and family histories, and the laboratory findings.

Question 15

Functional Diagnosis

Answer 15

Assessment of the degree of disability and whether it is temporary or permanent.

Question 16

T/F: The functional diagnosis is important in managing the illness and judging the potential for restoration of function.

Answer 16

TRUE

Question 17

If one is trying to find as much as possible, the exact location of the neurological disease, he/she is doing which type of diagnosis?

Answer 17

Anatomical diagnosis

Question 18

A doctor tries to check what daily activities the patient can still perform after the patient’s right arm was fractured during a basketball game. What type of diagnosis does the doctor make?

Answer 18

Functional diagnosis

Question 19

Step I in the diagnosis of neurologic disease.

Answer 19

Elicitation of clinical facts by history-taking and neurologic examination.

Question 20

Step II in the diagnosis of neurologic disease.

Answer 20

Interpretation of symptoms and signs in terms of physiology and anatomy.

Question 21

Step III in the diagnosis of neurologic disease.

Answer 21

Syndromic formulation and localization of the lesion. (Syndromic and Anatomic Diagnosis)

Question 22

Step IV in the diagnosis of neurologic disease.

Answer 22

Anatomic diagnosis, mode of onset and course, appropriate lab tests, and other medical data. (Pathologic or Etiologic Diagnosis)

Question 23

T/F: In the initial diagnosis of a neurologic disorder, etiologic diagnosis takes precedence over anatomic localization.

Answer 23

FALSE. Anatomic localization takes precedence in the INITIAL diagnosis.

Question 24

2 Questions answered in the process of diagnosing a neurologic disorder.

Answer 24

1) Where is the lesion? (Anatomic Diagnosis)
- (Most important in Neurology I)
2) What is the lesion? (Etiologic Diagnosis)

Question 25

T/F: anatomic localization takes place before etiologic diagnosis.

Answer 25

TRUE

Question 26

When taking a patient’s history, what must be done first?

Answer 26

Get the patient’s trust and cooperation.

Question 27

T/F: In etiologic diagnosis, focus is on the clinical details.

Answer 27

TRUE

Question 28

State examples of Neurologic Diseases: Infectious

Answer 28

CNS infections, meningitis, encephalitis, bacterial, fungal, viral.

Question 29

State examples of Neurologic Diseases: Genetic

Answer 29

Congenital malformation, spina bifida, Huntington’s disease.

Question 30

State examples of Neurologic Diseases: Traumatic

Answer 30

Concussion, contusion, fractures, epidural hematoma, subdural hematoma.

Question 31

State examples of Neurologic Diseases: Degenerative

Answer 31

Parkinson’s disease, Alzheimer’s disease, Lewy body dementia.

Question 32

State examples of Neurologic Diseases: Vascular

Answer 32

Stroke, aneurysms, subarachnoid hemorrhages, infarcts

Question 33

State examples of Neurologic Diseases: Toxic

Answer 33

Substance abuse, toxic effects of prescribed medications (toxic neuropathies).

Question 34

State examples of Neurologic Diseases: Metabolic (Inherited)

Answer 34

Lipid storage disease, other inborn errors of metabolism like G6PD

Question 35

State examples of Neurologic Diseases: Metabolic (Acquired)

Answer 35

Encephalopathies

Question 36

T/F: There can be overlap between Metabolic and Toxic categories.

Answer 36

TRUE. Especially in the Acquired Metabolic category.

Question 37

State examples of Neurologic Diseases: Neoplastic

Answer 37

Primary and secondary intracranial tumors

Question 38

State examples of Neurologic Diseases: Inflammatory

Answer 38

Demyelinating multiple sclerosis

Question 39

State examples of Neurologic Diseases: Psychogenic

Answer 39

Psychosis seen in degenerative diseases.

Question 40

State examples of Neurologic Diseases: Iatrogenic

Answer 40

Acquired neurologic diseases, caused by extrinsic activities.

Question 41

Spina bifida falls into which Neurologic Disease category?

Answer 41

Genetic/Congenital

Question 42

A 77 y.o. male was brought into the hospital due to his worsening Alzheimer’s disease. In order to make an etiologic diagnosis, what must the physician do?

Answer 42

Ask the guardian about the patient’s disease.

Question 43

The diagnosis reached when the mechanism and causation of the disease can be determined.

Answer 43

Etiologic diagnosis

Question 44

T/F: In taking a patient’s history, characteristics of the symptoms are asked prior to the location the symptoms are felt.

Answer 44

TRUE

Question 45

What must be done in order to assure maximal reliability of a patient’s history?

Answer 45

Immediate recording of the history.

Question 46

T/F: In history-taking, you should primarily utilize questions that are answerable by “Yes or No” in order to simplify the history-taking process.

Answer 46

FALSE. Avoid using close-ended questions.

Question 47

T/F: In patients suffering from memory-loss, it is desirable to verify the patient’s account through a knowledgeable and subjective informant.

Answer 47

FALSE. OBJECTIVE informant.

Question 48

Enumerate the necessary descriptions of symptoms when taking a patient’s history.

Answer 48

1) Character
2) Location
3) Intensity
4) Timing
5) Aggravating Factors
6) Associated Factors

Question 49

How can the competence of a particular patient to provide a history of the illness be checked?

Answer 49

Through a mental status exam.

Question 50

What does a brain do when it sees a friend across the street?

Answer 50

Gives a Brainwave. ;)