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Final OSCEs > Neuro Histories > Flashcards

Neuro Histories Flashcards

1
Q

What red flags should you ask about in a collapse/seizure history? (6)

A 
Chest pain/SOB/palpitations
Collapse when exercising
FH of sudden cardiac death
Weight loss, headaches
Neuro symptoms
Head injury
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2
Q

What are the red flags for a head injury? (4)

A

Loss of consciousness
>1 episode vomiting
Amnesia
Anti-coagulants

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3
Q

What questions should you ask about what happened before a collapse/seizure? (3)

A

What were you doing?
Preceding symptoms
Witness

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4
Q

What questions should you ask about what happened during a collapse/seizure? (6)

A 
How did you fall?
Seizure: describe
Loss of consciousness
Tongue biting: side/front
Incontinence
Hit head?
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5
Q

What questions should you ask about what happened after a collapse/seizure? (3)

A

Post ictal state
- how did you feel, confusion, drowsy, aching muscles
Todds paralysis: weakness
Previous episodes

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6
Q

What differentials would you think about for a collapse/seizure? (6)

A 
Vasovagal syncope
Cardiogenic syncope
Seizure
Situational syncope
Carotid sinus syncope
Postural hypotension
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7
Q

What should you ask in a systems review in a patient with a headache? (8)

A 
Trauma
Constitutional 
Meningism
NS - weakness, vision, sensory disturbance
Aura
Previous seizures/blackouts
Sentinel headache - recent less severe headache
Pain on combing/chewing
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8
Q

What red flags should you ask about in a headache history? (7)

A 
Meningism
Non-blanching rash
Systemically unwell
Weight loss
Neuro symptoms 
Seizures
>65y + unilateral
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9
Q

What differentials would you think about for a first headache? (10)

A 
Meningitis
Extradural headache
Subdural headache
Subarachnoid headache
Raised ICP
Temporal arteritis
Acute sinusitis
Angle closure glaucoma
Medications 
Trigeminal neuralgia
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10
Q

What differentials would you think about for recurrent headaches? (3)

A

Migraines
Cluster
Tension

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11
Q

What red flags should you ask about in a weakness history? (5)

A 
Progression of Sx
New onset incontinence
Weight loss
Headaches
Seizures
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12
Q

What should you ask in a systems review in a patient with weakness? (9)

A 
Numbness/tingling
Muscle wasting 
Balance, Speech
Headaches, Seizures/blackouts
Pain
Incontinence
Constitutional
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13
Q

What differentials would you think about for weakness? (muscles) (3)

A

Muscular dystrophy
- Duchennes/Beckers
Polymyositis/dermatomyositis
Muscle wasting from disuse

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14
Q

What differentials would you think about for weakness? (neuromuscular junction) (2)

A

Myaesthenia gravis

Lambert-eaton myasthenic syndrome

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15
Q

What differentials would you think about for weakness? (peripheral nerves) (3)

A

Peripheral neuropahy
Mononeuropathy
Mononeuritis multiplex

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16
Q

What differentials would you think about for weakness? (Spinal cord) (4)

A

Radiculopathy/plexopathy
Cervical spondylosis
Syringomyelia
Spinal stenosis

17
Q

What differentials would you think about for weakness? (central) (4)

A

Stroke/TIA
MS
Tumour/abscess
Motor neuron disease

18
Q

What red flags should you ask about in an altered sensation history? (7)

A 
Progression of symptoms
Motor symptoms
Other sensory symptoms
New onset incontinence
Weight loss
Headaches
Seizures
19
Q

What should you ask in a systems review in a patient with altered sensation? (11)

A 
Changes in vision/hearing/taste/smell
Weakness, Balance, Speech
Headaches
Seizures/blackouts
Pain
Incontinence
Constitutional
Anxiety
Vascular
20
Q

What differentials would you think about for altered sensation? (central)

A

MS
Stroke/TIA
Tumour/abscess

21
Q

What differentials would you think about for altered sensation? (spinal cord)

A

Radiculopathy/plexopathy
Cervical spondylosis
Spinal stenosis
Syringomyelia

22
Q

What differentials would you think about for altered sensation? (peripheral neuropathy)

A

Mononeuropathy
Mononeuritis multiplex
Polyneuropathy

23
Q

What differentials would you think about for altered sensation? (Non-neurological)

A

Anxiety +/- hyperventilation

Raynaud’s

24
Q

What are the causes of mononeuropathy? (3)

A

Trauma
Carpal tunnel syndrome
Infection

25
Q

What are the causes of mononeuritis multiplex? (3)

A

Diabetes
Autoimmune infections
Amyloidosis

26
Q

What are the causes of polyneuropathy? (5*)

A 
Alcohol
B12 deficiency
Chronic renal failure
Diabetes
Everything else: MS, cancer, amyloidosis

Final OSCEs (18 decks)

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