Neuro Differential

Question 1

Alzheimer’s

Answer 1

progressive disease of cerebral cortex
development of amyloid plaques and neurofibrillary tangles

initial- mild memory changes and concentration, new learning
progression - loss of orientation, word finding difficulty, depression, poor judgment, rigidity, slow movement, shuffling gait
end stage - severe intellectual and physical destruction, incontinence

Question 2

Average age of onset/demographic for Alzheimers

Answer 2

65+
Women>men

Question 3

Describe tremors with Parkinson’s

Answer 3

resting tremors that decrease ith activity and movement

Question 4

Delerium vs Dementia

Answer 4

delerium is short term confusion and memory loss and is typically reversible

Question 5

Pathological findings with Alzheimers

Answer 5

enlarged ventricles
brain atrophy
amyloid plaques and neurofibrillary tangles
elevated Tau levels with spinal tap

Question 6

ALS

Answer 6

loss of anterior horn cells, cortocispinal tracts, and corticobulbar tracts

significant weakness and atrophy

UMN/LMN mixed disorder

sensation and cognition is typically normal - if they have pain it is likely due to immobility

mixed hypo/hyperreflexia

Question 7

ALS patient population

Answer 7

40-70 yrs
men>women

Question 8

Bulbar ALS

Answer 8

instead of limbs being first muscles affected, breathing, speaking muscles are affected first

worse prognosis

Question 9

Findings for ALS

Answer 9

mixture of hyper/hypotonia, reflexes, etc secondary to UMN/LMN involvement
usually no sensory changes, bowel and bladder, cognition changes (presents like locked in syndrome)

Question 10

Anterior cord syndrome

Answer 10

Bilateral loss of lateral corticospinal tracts (motor) and spinothalamic tract (pain and temp)

Proprioception and vibration intact (DCML)

typically caused by hyperflexion

Question 11

Arthrogryposis Multiplex Congenita

Answer 11

skeletal and soft tissue congenital deformity causing joint contractures and sausage-like appearance of limbs

Question 12

Findings for MCA stroke

Answer 12

UE>LE
contralateral motor and sensory loss of face and extremity
Wernickes/Brocas/global aphasia
Homonymous hemianopsia

Question 13

MCA stroke is most likely affected by an embolus from the … artery

Answer 13

internal carotid

Question 14

ACA stroke

Answer 14

LE>UE
Contralateral LE motor and sensory loss
Apraxia agraphia aphasia
Bowel/bladder/Behavior

Question 15

PCA stroke

Answer 15

contralateral sensory loss
Hemionopdua
Prospogsnoia

Question 16

Lacunar stroke

Answer 16

purely motor

Question 17

Global aphasia

Answer 17

Both Wernickes and Brocas

Question 18

Left sided CVA

Answer 18

Apraxia
impaired processing, sequencing, comprehension
aware of condition, frustrated
slow cautious hesitant

Question 19

R sided CVA

Answer 19

poor attention, decreased awareness and judgement
impulsive, quick
spatial/perceptual deficits
pushers, neglect

Question 20

CN nuclei located in pons

Answer 20

5,6,7,8

Question 21

CN nuclei located in midbrain

Answer 21

3,4

Question 22

CN nuclei located in medulla

Answer 22

9,10,11,12

Question 23

Medial medullary syndrome is occlusion of what artery

Answer 23

vertebral artery

Question 24

Medial medullary syndrome is occlusion of what artery

Answer 24

PICA

Question 25

Temporalis and masseter muscles are innervated by

Answer 25

Trigeminal nerve (CN 5)

Question 26

Muscles of facial expression (motor) are innervated by

Answer 26

Facial nerve (CN 7)

Question 27

ACA stroke symptoms

Answer 27

contralateral hemiplegia and sensory loss urinary incontinence LE > UE

Question 28

MS patient population

Answer 28

20-50 females>males

Question 29

Relapsing remitting MS

Answer 29

periods of exacerbation followed by periods of complete or partial recovery (remission)

Question 30

Which progression of MS is most common

Answer 30

relapsing remitting (85% cases)

Question 31

Primary progressive MS

Answer 31

steady worsening from the onset; without remissions or attacks

Question 32

Secondary progressive MS

Answer 32

Initially relapsing remitting course, followed by progressive decline in function

Question 33

Progressive relapsing MS

Answer 33

progressive from the onset with intermittent attacks, but even in "remission" there is progression

Question 34

Diabetic polyneuropathy

Answer 34

stocking glove distribution of burning pain and muscle weakness foot>>>legs fingers>>hands

Question 35

Transverse myelitis

Answer 35

inflammation of one section of the spinal cord caused by viral or bacterial infection

Question 36

Optic neuritis

Answer 36

inflammation of the optic nerve - common with MS more common in one eye progressive vision loss/worsening over a few days

Question 37

Optic neuritis vs oculomotor lesion differential

Answer 37

optic nerve is only sensory - pain oculomotor which is only motor - would display signs of ptosis (eyelid drooping) dilated pupil (lack of PS) and lateral strabismus (lateral rectus/superior oblique is unopposed)

Question 38

Afferent portion of corneal reflex

Answer 38

trigeminal nerve (sensation of cotton swab)

Question 39

Efferent portion of corneal reflex

Answer 39

facial nerve (blinking)

Question 40

GB symptoms occur

Answer 40

distal to proximal

Question 41

MG symptoms occur

Answer 41

proximal to distal

Question 42

Sulfamylon vs silver nitrate

Answer 42

both antibacterial but sulfa penetrates eschar and silver nitrate does not

Question 43

Panafil

Answer 43

enzymatic debridement

Question 44

Loss of peripheral vision followed by central vision

Answer 44

glacoma

Question 45

Loss of central followed by peripheral is

Answer 45

Central=cataracts

Question 46

Diffuse Lewy Body Disease vs PD

Answer 46

DLBD - major neurocognitive disorder - dementia basically can present with bradykinesia, rigidity, tremors, but secondary to cogitive impairments PD - may or may not show cognitive signs but will be in later stages if do

Question 47

Initial learning is best mediated with knowledge of results of performance

Answer 47

results _ visual input - learners benefit from seeing the task and whole task performed correctly

Question 48

If you see red streaking near a wound - think what

Answer 48

lymphangitis radiate from infection site proximal to lymph nodes + fever chills malaise etc

Question 49

Cellulitis vs lymphangitis

Answer 49

Both present with fever chills malaise but Cellulitis typically only sees redness surrounding wound where as lymphangitis produces streaking

Question 50

How to best dissolve LE synergy

Answer 50

bridging