ILA: WEAKNESS/STROKE Flashcards
You are clerking an elderly gentleman. The patient keeps trying to take his gown off and some of his responses are inappropriate and occasionally rude. Where is the likely lesion?
Frontal lobe (personality)
Whilst examining an elderly lady who arrives on the stroke pathway, it becomes apparent that she can only see one half of your face. Where is the likely lesion?
Occipital lobe (vision)
The patient is difficult to understand as her speech is broken. She appears to understand your questions but cannot produce the words. Where is the likely lesion?
Broca’s area in frontal lobe (Wernicke’s area in temporal lobe is still functioning)
53 year old hypertensive man with sudden collapse, unable to move any part of the body except for eye movements, appears to understand your questions but is unable to answer. Where is the likely lesion?
Brainstem (no movement so no cranial nerves are functioning)
89 year old, right handed man presents with acute onset of weakness and numbness of his left foot, as well as an aggressive mood. Which artery is likely to have been affected?
Anterior cerebral artery (supplies frontal lobe)
42 year old female with violent headache followed by sudden collapse. She is unconscious but her left pupil is fixed and dilated with her left eye deviated laterally. Which artery is likely to have been affected?
Posterior communicating artery (not basilar or would have greater consequences)
A 40 year old removal man felt immediate back pain and a popping sensation after lifting a heavy box. The next day he noticed he was tripping over his right foot as it was dragging along the floor. Where is the cause most likely to be located?
Nerve root (clue from heavy lifting –> spinal disc compressing nerve root)
An elderly patient with a stiff flexed arm, and a stiff extended left (both on the left) which the patient finds difficult to bend. Where is the cause most likely to be located?
Upper motor neuron (spastic paralysis)
A 30 year old pregnant lady complains to the GP of progressive hand weakness. She is completely unable to open jars and even grip her tea cup. The GP notices that the muscles around her thumb are wasting. Where is the causes most likely to be located?
Peripheral nerve (carpel tunnel syndrome)
A 69 year old lady was slurring her words at a church coffee morning. At the same time her right arm began to feel heavy and weak. 24 hours later all her symptoms had resolved. What is the likely cause?
Stroke/TIA
A 51 year old man has a 2 month history of weakness in both his hands - he is now unable to open jars. His hands show wasting of the thenar eminence. He has recently developed slurred speech and difficulty swallowing. His tongue appears spastic and he is unable to protrude it. What is the likely cause?
Motor neurone disease
A 30 year old woman noticed both her eye lids becoming progressively more droopy with time. Weeks later she began to experience double vision, and found it progressively more tiring and difficult to chew all the food in her mouth when eating. What is the likely cause?
Myasthenia gravis
