Neuro Abnormal Liza

Question 0

Lethargy

Answer 0

Sleepy but open eyes and respond before falling back to sleep

Question 1

Affect can be

Answer 1

Full/normal (congruent with mood)
Blunted restricted - moderately
Flat - absence of all or most affect
Labile - multiple abrupt changes in affect

Question 2

Obtunation

Answer 2

Harder to arouse with verbal stimulus, may need to shake

Slower responses and confused; low interest in envt

Question 3

stupor

Answer 3

Need painful stimuli to arouse

lapse into unresponsiveness when stop stimuli, min aware of self or envt

Question 4

Coma

Answer 4

no response

Question 5

Dysarthria

Answer 5

problem with motor speech or articulation

with bulbar or pseudobalbar palsy

Question 6

Dysphonia

Answer 6

weak breathy voice
vocal cords not well approximated
seen with presbyphonia (old sound), vocal cord nodules, CA, polyps paralysis

Question 7

Expressive (Broca’s) Aphasias

Answer 7

Comprehension intact, unable to speak

Question 8

Receptive Aphasia

Answer 8

Wernicke’s
Comprehension: fluent but nonsensical speech
Can’t understand but can write?

Question 9

Global Aphasia

Answer 9

Combo of receptive and expressive

Question 10

Aphasia are common with

Answer 10

strokes (MCA), trauma and mass lesions

Question 11

Apraxia

Answer 11

Unable to perform a learned motor act:
need to understand command, remember, have intact motof fx
- in parietal lobe lesions
-finger to nose test

Question 12

Agnosia

Answer 12

Unable to recognize sensory stimuli:olfactory, auditory, visual or tactile
With large parieto-occipital-posterior temporal lesion
CVA or dementia, trauma

Question 13

Coma

Answer 13

sustained loss of consciousness that does not reverse with internal or external stimulation. Total or near total unresponsiveness. Significant mortality. If awaken with 3 days - most survive

Question 14

Delirium

Answer 14

Hypervigilant with agitation and impaired attention. Tripped out on drugs

Question 15

stupor

Answer 15

severely impaired arousal - responds to pain

Question 16

Obtunation

Answer 16

reponds to light stimulus (verbal)

Question 17

Lethargy

Answer 17

Somnolence: arousal with verbal stimulus

Question 18

Fugue

Answer 18

abondon life and start new elsewhere, then start back - amnesia

Question 19

Catatonia

Answer 19

in schizophrenia with periods of muscular rigidity, excitement or stupor

Question 20

Coma localization

Answer 20

• impaired bilateral thalamus
• bilat hemispheric injury (RAS)
• Injury to midbrain or below

Question 21

Coma is due to

Answer 21

cardiac arrect
overdose
stroke
cerbral edema
metabolic (hepatic failure)
untreated status epilepticus (seizure over 30 min?)

Question 22

Coma exam

Answer 22

Glasgow coma scale
Neuro Exam:
-posturing
-Doll's eyes
-pupils and fundi
-vestibulocochlear reflex
-respiratory pattern

Apnea exam

Question 23

Glasgow coma scales

Answer 23

look at slides

Question 24

Coma Vigil and Alpha Coma

Answer 24

Pts act awake, us after deep coma: eyes open, cough, yawn, swallow and meaningless use of extremeties but still essentially brain dead

Question 25

Levels of coma

Answer 25

• persistent vegitative state (vigil or alpha coma)
• Decorticate posturing - flexion
• decerebrate posturing - extension (worse)

Question 26

Which level of coma is worse

Answer 26

decerebrate posturing - extention

Question 27

decorticate posturing is

Answer 27

flexion

Question 28

decerebrate posturing is

Answer 28

extension

Question 29

Glasgow coma scale 1

Answer 29

Eyes:
response of 4: opens eye spontaneously
3: opens in response to speech
2: to pain
1: no response

Question 30

Glasgow coma scale II

Answer 30

motor response
6: obeys
5:

Question 31

Stiff man gait is a sign of

Answer 31

Myelopathy