56-80 LT Quiz Flashcards
What treatment approach should be chosen for acute inflammatory demyelinating polyneuropathy?
Intravenous immunoglobulin or plasmapheresis
Which pathogens most commonly cause bacterial meningitis in people aged 18-50?
Streptococcus pneumoniae, Neisseria meningitidis
The strength of the patient’s legs in all muscle groups is 1-2 points. What exercises will
you use first to strengthen your muscles ?:
isometric
Which of the following are neuropathic pain syndromes?
postherpetic neuralgia, painful diabetic neuropathy, trigeminal neuralgia
Medications can be used for epilepsy treatment
Oxcarbazepine, levetiracetam, valproate
55-year old male complains of bilateral leg weakness that makes him look at the ground and use a cane while walking. Also his sleep is disturbed because of a burning sensation in his feet. Examination reveals bilaterally absent Achilles reflexes and impairment of sensation of all modalities in the legs. What condition would you suspect?
Polyneuropathy
62a)Signs and symptoms characteristic of meningitis caused by enterovirus:
Summer-autumn seasonality, possible route of transmission is air-borne and fecal-oral.
62b)Signs and symptoms characteristic of tuberculous meningitis:
Subacute course, normal or subfebrile temperature, low glucose in CSF.
62c)Signs and symptoms characteristic of early disseminated neuroborreliosis:
Subacute course, normal or subfebrile temperature, lymphocytic pleocytosis in CSF.
62d)Signs and symptoms characteristic of tick-borne encephalitis:
Two-wave course of the disease, long recovery time, long-term sequelae in 1/3 of the patients.
The auditory nerve neurinoma clinic starts with:
Ipsilateral non-pulsating murmur
The slit in one of the patient’s eyes is narrower, the upper eyelid does not rise upwards, the pupil is wide, the eyes are directed outwards and downwards, limited movements inwards and upwards. What violation?
III cranial nerve
Which of the neuromuscular diseases features the following course: constant progression, spasticity, development of amyotrophy and contractures, followed by dysarthria, dysphagia and respiratory failure?
ALS - Amyotrophic lateral sclerosis
44 m. an old man living in a village, abusing alcohol. Infectious Diseases Clinic, he complained of headaches in the occipital area lasting about two weeks, with a fever of up to 37.7 ° C. sleepy, aggressive at intervals. Neck muscle rigidity (±), Kernig s. (-), scalp nerves – nothing significant., reflexes (+), pathological reflexes - . cytosis 132 x106 / l, 95% lymphocytes, protein 5.18 g / l, glucose 0.8 mmol / l, lactates 2.8 mmol /l
Which disease is most likely? What tests will you do to confirm the most likely disease? What will you do for treatment if your suspected disease is confirmed?
TBE
Clinical and biochemical CSF test + detection of specic antibodies in blood
Symptomatic treatment
Differential diagnosis of Parkinson’s disease includes:
Multiple system atrophy, Corticobasal degeneration,
Progressive supranuclear palsy
19-year-old male had a retrobulbar neuritis; then, 2 years later, he developed a urination disorder that lasted for a month. After extensive investigation the diagnosis of multiple sclerosis was made. What changes in cerebrospinal fluid are characteristic to multiple sclerosis?
Constant increase in IgG
68-year-old male presents to a stroke treatment centre with symptoms of acute cerebrovascular accident that have started 2.5 hours ago. Head CT is showing no abnormalities. BP is 198/115 mmHg. What approach would you choose?
Labetolol 10 mg i/v and recheck BP in 10 min.
The C5 / 6 intervertebral disc hernia is operated on:
Anterior discectomy, spondylodesis
38-year-old male has had fever and diarrhea one week ago, started feeling numbness in his toes, numbness got worse, did not see medics. next morning couldn’t get out of the bed, legs weak and his hands and legs numb. On examination: Cranial nerves intact are intact, dffuse limb muscle weakness present (hands – 4 points, feet – 2 points). Biceps reflex is present, other deep tendon reflexes absent bilaterally. Pathological reflexes are absent. There is hypoesthesia in hands and in legs below the knees. What is your preliminary diagnosis?
Guillain – Barre syndrome
65-year-old man reports a 6-month history of progressive weakness in the arms, recently he has also developed weakness in his legs. On neurological examination: fasciculations in the shoulder girdle muscles, atrophic thenar muscles, hand muscle strength MRC 3/5 bilaterally; brisk symmetrical deep tendon reflexes, normal muscle tone, Babinski reflex bilaterally; no sensory or coordination impairment. What preliminary diagnosis is the most likely?
Amyotrophic lateral sclerosis
Nociceptive pain is:
A physiological response to tissue damage
35-year-old male diagnosed MS 4 years ago with retrobulbar neuritis; no corticosteroids given. 2 years later sensory changes in hands, decrease in strength, impaired ability to write. Then treated with corticosteroids. Interferon β-1A was commenced 4 years ago. 1 year ago weakness in his right leg, constipation and urination urgency, treated with corticosteroids. Now progressive numbness in his right palm and right side of the waist. Neurological examination reveals tactile hypoesthesia in Th8 – Th10 dermatomes on the right. What treatment would you prescribe for the patient at this time?
Corticosteroids
What is the most effective treatment for focal dystonias?
BTX-A injections
mononeuropathies is characterized by a “hawk’s hand”
n.ulnaris
