Neuro

Question 1

What are the Dx for Neuro?

Answer 1

Multiple sclerosis 
Parkinsons 
ALS 
Bells palsy 
Stroke/TIA
Gullian barre

Question 2

What are the unique findings of Multiple sclerosis?

Answer 2

Typically middle aged,
European woman
Sensations, pain, & movement are all affected
Worse in heat (Uhthoff)
Electric shock from bending neck (Lhermitte)
Double vision, or complete loss of vision in one eye
Bowel/bladder issues

Question 3

What are the associated symptoms of Multiple sclerosis?

Answer 3

(+) bladder problems 
(+) fatigue 
(+) diplopia
(+) vision loss
(+) vertigo
(+) difficulty with balance 
(+) trouble thinking clearly

Question 4

What are the unique findings of parkinsons?

Answer 4

T (tremor), R (rigidity), A (bradykinesia), P (flexed/slumped posture)
Masked face
Diminished arm swing
Slurred speech

Question 5

What are the associated symptoms of parkinsons?

Answer 5

TRAP

Question 6

What are the unique findings of ALS?

Answer 6

Muscle cramps
Muscle atrophy
Spasticity
Foot drop
Positive Babinski
Only affect MSK – nothing with sensation, loss of bowel/bladder, no numbness
Difficulty with simple tasks e.g. buttoning a shirt, turning a key

Question 7

What are the associated symptoms of ALS?

Answer 7

(+) pseudobulbar 
(+) Sialorrhea (drooling)
(+) Dyspnea
(+) Dysphagia- swallowing
(+) Pseudobulbar affect: involuntary laughing or crying
(-) Loss of bowel and bladder
(-) Numbness
(-) Loss of Sensation

Question 8

What are the unique findings of bells palsy?

Answer 8

Recent viral infection
One-sided facial hemiparalysis, altered taste
Hyperacusis
Dry eyes, rash

Question 9

What are the associated symptoms of bells palsy?

Answer 9

(+) drooling, dryness of eye or mouth
impairment of taste
Excessive tearing in one eye
Discomfort around jaw and behind ear, ringing in one or both ears, impaired speech

Question 10

What are the unique findings of Stroke?TIA?

Answer 10

Paresthesia
Facial hemiparalysis
Limb muscle weakness/paralysis
Loss of consciousness
Aphasia
Visual deficits
Numbness

Question 11

What are the associated symptoms of stroke/TIA?

Answer 11

(+) pseudobulbar ? 
(+) dizziness vertigo spinning 
(+) diplopia 
(-) fever
(-) seizure

Question 12

What are the unique findings of Guillian barre?

Answer 12

Ascending paralysis, usually associated with viral infection

DTR’s are absent/reduced

Question 13

What are the associated symptoms of Guillian barre?

Answer 13

(+) b/l leg weakness
(+) to recent URI/being sick
(-)UE muscle weakness, (-) recent trauma to LE B/L,