CLINICAL PRESENTATION VI

Question 1

toe extension/fanning upon plantar scrape

Answer 1

babinski sign (UMN lesion)

Question 2

hyperphagia, hypersexuality, hyperorality

Answer 2

kluver bucy syndrome (bilateral amygdala lesion)

Question 3

resting tremor, athetosis, chorea

Answer 3

basal ganglia lesion

Question 4

lucid interval after TBI

Answer 4

epidural hematoma (middle meningeal artery)

Question 5

worst headache of my life

Answer 5

subarachnoid hemorrhage

Question 6

resting tremor, rigidity, akinesia, postural instability, shuffling gait

Answer 6

parkinson disease (DA neurons in substantia nigra pars compacta)

Question 7

chorea, dementia, caudate degeneration

Answer 7

huntington disease (autosomal dominant CAG repeat)

Question 8

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

Answer 8

Multiple sclerosis

Question 9

Rapidly progressive limb weakness that ascends following

GI/upper respiratory infection

Answer 9

Guillain-Barré syndrome (acute inflammatory

demyelinating polyradiculopathy subtype)

Question 10

Café-au-lait spots, Lisch nodules (iris hamartoma),

cutaneous neurofibromas, pheochromocytomas, optic gliomas

Answer 10

Neurofibromatosis type I

Question 11

vascular birthmark (port wine stain) of the face

Answer 11

nevus flummeus

Question 12

renal cell carcinoma, hemangioblastoma, angiomatosis, pheochromocytoma

Answer 12

von hippel lindau disease (dominant tumor suppressor gene mutation)

Question 13

bilateral vestibular schwannomas

Answer 13

neurofibromatosis type II

Question 14

hyperreflexia, hypertonia, babinski sign present

Answer 14

UMN damage

Question 15

hyporeflexia, hypotonia, atrophy, fasciculations

Answer 15

LMN damage

Question 16

spastic weakness, sensory loss, bowel/bladder dysfunction

Answer 16

spinal cord lesion

Question 17

unilateral facial drooping involving forehead

Answer 17

LMN facial nerve (CN 7) palsy; UMN lesions spare the forehead

Question 18

episodic vertigo, tinnitus, hearing loss

Answer 18

meniere disease

Question 19

ptosis, miosis, anhidrosis

Answer 19

horner syndrome (sympthetic chain lesion)

Question 20

conjugate horizontal gaze palsy, horizontal diplopia

Answer 20

internuclear ophthalmopegia (damage to MLF; may unilateral or bilateral)

Question 21

polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets

Answer 21

fanconi syndrome

Question 22

athlete with polycythemia

Answer 22

2 degree to erythropoietin injection

Question 23

periorbital and or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia

Answer 23

nephrotic syndrome

Question 24

heriditary nephritis, sensorineural hearing loss, retinopathy, lens dislocation

Answer 24

alport syndrome (collagen IV)

Question 25

streak ovaries,congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema

Answer 25

turner syndrome (45,XO)

Question 26

red, itchy, swollem rash of nipple/areola

Answer 26

paget disease of the breast (sing of underlying neoplasm)

Question 27

fibrous plaques in tunica albuginea of penis with abnormal curvature

Answer 27

peyronic disease

Question 28

hypoxema, polycythemia, hypercapnia

Answer 28

chronic bronchitis (hyperplasia of mucous cells, blue bloater)

Question 29

pink complexion, dyspnea, hyperventilation

Answer 29

emphysema or panacinar

Question 30

bilateral hilar adenopathy, uveitis

Answer 30

sarcoidosis (noncaseating granuloma)