Lecture 7.3 Neuro (14% of final)

Question 1

List 6 red flags/ concerning symptoms for neuro

Answer 1

1) Dizziness / Vertigo
2) Weakness
3) Numbness or absent sensation
4) Fainting
5) Seizures
6) Tremors / involuntary movements

Question 2

1) What should you ask about regarding weakness? What should you then ask?
2) What condition starts with peripheral weakness that moves centrally?
3) What condition occurs with proximal limb weakness?

Answer 2

1) Should ask if it is generalized or local. If local, is it proximal or distal.
2) Guillain-Barre
3) Polymyositis

Question 3

1) Acute, unilateral loss of sensation should be concerning first and foremost for what?
2) What 3 symptoms can occur with some focal seizures or with atypical migraine?
3) What is correlated heavily with advanced and uncontrolled diabetes?

Answer 3

1) Stroke
2) Numbness, tingling, and paresthesia
3) Distal, chronic, and bilateral sensation loss

Question 4

1) What should you consider as the most ominous possibility with vertigo/ dizziness?
2) What are two other causes?

Answer 4

1) Cerebellar stroke
2) Vestibular nerve dysfunction and “benign positional paroxysmal vertigo” (BPPV)

Question 5

1) What can cause syncope? What is key?
2) Give examples of potential causes

Answer 5

1) Can be varied; details are key.
2) Vasovagal response, orthostatic hypotension, mechanical cardiac failure, arrhythmia, the (rare) central nervous cause, sudden PE, electrolyte imbalance, blood sugar imbalance, psychogenic cause

Question 6

What type of nystagmus is most likely benign?

Answer 6

Horizontal

Question 7

List 8 potential causes of syncope

Answer 7

1) Vasovagal response
2) Orthostatic hypotension
3) Mechanical cardiac failure
4) Arrhythmia, the (rare) central nervous cause
5) Sudden PE
6) Electrolyte imbalance
7) Blood sugar imbalance
8) Psychogenic cause

Question 8

1) What should you consider when evaluating a seizure?
2) What question is important to answer?
3) How should you get accurate info about a seizure?

Answer 8

1) Whether consciousness was lost
2) Is the patient confused now? (post-ictal)
3) Have bystander describe what happened if you can

Question 9

What is the mnemonic to remember the warning signs/ symptoms of a stroke? (according to AHA/ ASA)

Answer 9

FACE
1) Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
2) Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
3) Speech Difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
4) Time to call 9-1-: if someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately.
-Check the time so you’ll know when the first symptoms appeared

Question 10

Risk factors for CVA are modifiable; what are they?

Answer 10

1) HTN
2) Smoking
3) Dyslipidemia
4) Diabetes
5) Weight and nutrition
-Obesity increases risk by 64%
6) Physical inactivity
7) Alcohol use

Question 11

Obesity increases risk of CVA by ____%

Answer 11

65%

Question 12

List 3 diseases that are risk factors for CVA

Answer 12

1) Atrial fibrillation
2) Carotid artery disease
3) Obstructive Sleep Apnea