Neuro - OSCE booklet

Question 1

Dermatomes Of arm and leg

Answer 1

Leg starts with L1 - L5

Neck starts with C2 - C8 (cervical)

Question 2

Wasting and fasciculations?

Answer 2

LMN

Question 3

Cerebellar lesion

-VANISHED

Answer 3

Vertigo
Ataxia
Nystagmis
Intention tremor
Slurred speech 
Hypotonia
Exaggerated broad gate
Dysdiadochokinesia (cannot do rapidly alternating movements)

Question 4

Syringomyelia

Answer 4

• CSF blockage (chiari malformation) causing expansion of spinal cord central canal
• spinothalamic fibers mainly affected - loss of pain and temp sensation over arms, shoulders and upper body
• LMN signs in upper limbs, spastic paraparesis of lower limbs

Question 5

Erbs palsy

Answer 5

• Upper brachial plexus
• Sensory loss down lateral arm
• waters tip position

Question 6

Differential for Bilateral leg weakness (paraparesis)

Answer 6

Spastic paralysis (UMN)

• Bilateral strokes
• syringomyelia
• cord trauma
• cord compression (tumour, disc prolapse, spondylosis)
• cord disease (tumour, vacular myelopathy, MS)

Flacid paralysis (LMN) 
-polio
-guillian bare
-lead posioning 
-MND 
SCDC

Question 7

Differential for peripheral neuropathy

Answer 7

Sensory - diabetes, uraemia
Motor - guillian barre, lead poisoning
Mixed - charcot-mrie-tooth, B12, folate, thiamine deficicent, alcohol, vasculitis, SLE, paraneoplastic, amyloid

Question 8

Foot drop differential

Answer 8

• stroke
• common peroneal nerve palsy
• l4/l5 root lesion
• MND
• charcot-marie-tooth syndrome