Neuro exam

Question 1

What signs would you see in Cerebellar disease? (6*)

Answer 1

Dysdiakenesis
Ataxia
Nystagmus
Intention tremor
Slurred/staccato speech
Hypotonia

Question 2

What are the causes of Cerebellar disease? (5*)

Answer 2

MS
Alcohol
Vascular
Inherited
Space occupying lesion

Question 3

What phrases can you use to assess speech? (3)

Answer 3

West register street
Baby hippoptamus
British constitution

Question 4

When examining for cerebellar disease, what would you look for in the arms? (5)

Answer 4

Pronator drift (upward =cerebellar)
Rebound test
Hypotonia
Coordination
- Finger nose
- Hand slapping

Question 5

When examining for cerebellar disease, what would you test in the face? (4)

Answer 5

H test - nystagmus, occular muscle function
Saccades
Speech
Tongue side to side

Question 6

When examining for cerebellar disease, what would you look for when the patient is standing up? (3)

Answer 6

Standing up with arms folded (truncal ataxia)
Gait and heel-toe (ataxic gait)
Rombergs test (sensory ataxia)

Question 7

What are the primary symptoms in Parkinsons disease? (4*)

Answer 7

Tremor
Rigidity
Akinesia
Postural instability

Question 8

When examining for cerebellar disease, what would you look for on general inspection? (4)

Answer 8

Wheelchair
Neuro signs
Posture
Signs of neglect (e.g. alcohol)

Question 9

When examining a patient with an UMN lesion, what would you find? (4)

Answer 9

Increased tone
Brisk reflexes
Spasticity
Weakness (pyramidal)

Question 10

When examining a patient with an LMN lesion, what would you find? (4)

Answer 10

Decreased tone
Reduced reflexes
Wasting and fasiculations
Weakness

Question 11

What are the causes of bilateral UMN lesions? (3*)

Answer 11

MS
MND
Myelopathy (spinal cord injury)

Question 12

What are the causes of unilateral UMN lesions? (3 sections)

Answer 12

Intracranial:
- CVA, SOL, MS
Brain stem:
- MS
Spinal cord: 
- Trauma, SOL, Abscess, haemorrhage

Question 13

What are the causes of bilateral LMN lesions, with abnormal sensation? (6*)

Answer 13

Vasculitis (SLE, RA)
Infection (herpes zoster, HIV, leprosy, syphillis)
Toxins (alocohol, TB drugs)
Diabetes
Inherited (Charcot-Marie-Tooth)
Metabolic (B12/B1 deficiency)

Question 14

What are the causes of bilateral LMN lesions, with normal sensation? (3)

Answer 14

Guillain Barre syndrome
Lead poisoning
Myotonic dystrophy

Question 15

What are the causes of unilateral LMN lesions, with abnormal sensation? (3)

Answer 15

Radiculopathy
Plexopathy
Nerve palsy

Question 16

What causes a homonymous hemianopia? (2)

Answer 16

Stroke, cerebral SOL

Question 17

Where is the problem in a homonymous hemianopia? (1)

Answer 17

Optic tract

Question 18

What causes a bi-temporal hemianopia? (4)

Answer 18

Pituitary tumour, cranipharyngioma, suprasellar meningioma, anurysm

Question 19

Where is the problem in a bi-temporal hemianopia?

Answer 19

Optic chiasm

Question 20

What is CN1 and how do you test for it?

Answer 20

Olfactory

Ask patient if they have noticed any change in smell

Question 21

What is CN2 and how do you test for it?

Answer 21

Optic

Acuity
Fields
Reflexes
Optic disc

Question 22

What is CN3 and how do you test for it?

Answer 22

Oculomotor

Inspect
H-test
Saccades