Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LMCC > Neurology > Flashcards

Neurology Flashcards

1
Q

Neuro exam

A 
Mental status 
Cranial nerves
Deep Tendon Reflexes 
Tone
Power
Sensation
Cerebellar 
Gait
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Seizure investigations

A 
EEG
CT head 
CBC, lytes 
Medications- eg phenytoin levels 
LP (if new onset, fever, clinical signs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Seizure history

A
  • onset, chronology
  • frequency- increasing, decreasing
  • duration
  • describe seizures: sequence of events, movements, salivation, tongue biting, incontinence, incontinence, aura (visual, smell)
  • new symptoms: headache, vomiting, neuro deficits
  • post itcal: headache, limb pain, todd’s paralysis
  • medications: which ones, dose, how long, compliance
  • Basic info: PMHx, PSHx, Meds, Allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Focused physical exam for a 60 year old female with acute confusion

A 
vitals 
GCS
Cranial nerve exam
CNII- visual fields, fund
CNIII- EOM
CN II, III pupillary reflex, accommodation 
CN V facial sensation, clench teeth
CN VII facial movements 
CN IX, X: gag, movement of palate 
CN VIII: hearing, 
CXI: sternocleidomastoid power, trapezius 
CXII: tongue 
Power: arms, legs, hands 
Sensory: light touch, pin prick
Reflexes
Babinski
Cerebellar: finger to nose, heel to shin
Tone: cog wheeling 
Gait
Balance (rhomberg)

Resp
Cardio
Abdomen
Infectious signs?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

GCS
E
V
M

A 
Eyes
4- spontaneous open
3- open to speech 
2- open to pain 
1- never 
Verbal 
5-oriented and converses
4- confused conversation 
3- inappropriate words 
2- incomprehensible sounds 
1- none

Motor
6- obeys commands
5- localizes pain
4- withdraws to pain
3- decorticate position (abnormal flexion- arms adducted, flexed at elbows, wrist, feet in plantar flexion)
2- decerebrate position (abnormal extension- arms adducted, pronated, extended at elbow, flexed at wrist, plantar flexion)
1-none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ddx neck pain and left arm weakness

A
  • Musculoskeletal/muscular strain
  • Disc degeneration, disk herniation
  • Spondylosis (degenerative, osteoarthritis)
  • cervical spondylytic myelopathy (degenerative changes narrowing the spinal canal)
  • cervical radiculopathy (dysfunction of the spinal nerve root that may manifest with pain, weakness, reflex changes, or sensory changes)
  • Malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Red flags for neck pain/those who need imaging

A 
History of recent significant fall or major trauma
Unexplained weight loss
Fever or chills
History of cancer
Immunosuppression
Intravenous drug use
Chronic steroid use
Neurological signs or symptoms (arm clumsiness, gait difficulty, bowel or bladder dysfunction, Babinski's sign)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neck Pain exam

A

Inspection: symmetry, erythema/bruising, atrophy (sternocleidomastoids), deformity,
Palpation: notes, masses, dorsal vertebral spines
Neck range of motion: flex, extension, rotation, lateral flexion

Shoulders/arms/hands

  • inspection: symmetry, atrophy, deformity, skin lesions
  • strength:
  • Bicep flex: C5, C6
  • Tricep ext: C6,7,8
  • wrist extension: C6,7,8
  • Grip: C7,8,T1
  • Finger abduction: C8,T1, ulnar
  • Opposition of thumb: C8,T1, median
  • Sensation
  • Deep tendon reflexes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Investigations

Indications for neck xray

A
  • Age >50 years with new symptoms
  • Constitutional symptoms (fevers, chills, unexplained weight loss)
  • Moderate to severe neck pain lasting more than six weeks
  • Progressive neurological findings
  • Infectious risk (eg, injection drug use, immunosuppression)
  • History of malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sensation of the hand

  • median
  • ulnar
  • radial
A

Median: palmar surface of thumb, index, middle, thenar side of ring finger
Ulnar: 4th and 5th finger (dorsal and palmar)
Radial: dorsal surface of thumb, index, middle to PIP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cervical radiculopathy management

A
  • conservative therapy: soft collar, NSAIDS and acetaminophen
  • if persistent symptoms then refer to neurosurgery, may ask for CT neck, may require surgery (decompressive laminectomy, anterior disectomy/graft fusion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

History for Carpel tunnel syndrome

A

age, occupation
-work done with hands
-onset, duration, chronology, time of day,
aggravating/relieving factors
-previous episodes, previous investigations

  • associated symptoms: pain at night, diff opening jars, previous injuries
  • functional limitations/work limitations
  • neuro symptoms: pain, numbness, weakness in other areas, vision, headache, neck pain, nausea

Basic info: PMHx-diabetes, hypothyroid, rheumatoid artheritis, pregnancy, PSHx, meds, allergies,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differential for carpal tunnel syndrome

A

carpal tunnel syndrome
cervical radiculopathy
brachial plexus injury
diabetic peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Investigations for carpal tunnel syndrome

A

Nerve conduction studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment for carpal tunnel syndrome

A
  • wrist splint
  • modified work
  • local corticosteroid injection
  • surgical decompression via flexor retinaculum release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Physical exam for carpal tunnel syndrome

A

Arm/wrist/hand

  • strength: wrist extension (radial), finger abduction (ulnar), thumb opposition (median)
  • reflexes
  • sensation median, ulnar, radial distribution
17
Q

Differential for 42 yo M found unconscious in street with GCS 11 and unilateral body weakness

A 
Seizure, post itcal 
Stroke 
Intracranial hemorrhage 
Brain contusion 
Spinal cord injury
18
Q

History of unconscious person

A
  • sequence of events leading to collapse
  • trauma?
  • seizure?
  • syncope?
  • LOC?
  • Injuries from fall

SAMPLE

19
Q

To clear Cspine

A

Negative imaging
No distracting injuries
No tenderness on palpation of dorsal spinous processes
rotation to left and right not painful

20
Q

Treatment of trauma patient who had loss of consciousness/unilateral weakness

A
  1. Vitals
  2. ABC’s (intubation if reps compromise, bolus is low BP), immobilize C-spine
  3. Trauma bloods: CBC, blood gas, lytes, liver enzymes, Cr
  4. Disability: GCS, pupils. If increased ICP- dilantin load, manitol, consult neurosurgery
  5. CT neck, CT head
21
Q

Parkinson’s Disease

-features on exam

A

TRAP
Tremor: resting, pill rolling, suppressible with voluntary movement
Ridgitidy- cog-wheeling
Akinesia/bradykinesia
Postural instability: shuffling gait, retropulsion, falls

Other features:
mask like face
loss of arm swing

22
Q

Parkinson’s disease

-features on history

A 
drooling
hypophonia
micrographia
dementia
r/o depression
23
Q

Physical exam for parkinson’s

A

Inspection: tremor, posture, face, decreased blinking
MMSE- short term memory, concentration, abstraction, micrographia

Neuro exam: 
CN
Power
DTR
Sensation 
Tone
Cerebellar 
Gait
24
Q

Mini-mental status exam

A
  1. Orientation:
    - year/season/month/date/ day of week
    - place: country/province/city/hospital/floor
  2. memory: 3 words -immediate and delayed recall
  3. Concentration: spell world backwards
  4. Language:
    - comprehension: 3 step command
    - reading: close our eyes
    - writing: has to write 1 sentence
    - repetition: no ifs, and, or buts
    - naming: watch, pen
    - spatial ability: 2 intersecting pentagons
25
Q

Allen test

A
  • compress ulnar and radial arteries at wrist
  • have patient open and close hand to remove blood
  • then release one side
  • hand should pink up due to blood supply
  • to demonstrate ulnar artery function
26
Q

Head injury neuro exam

A 
ABC-DE
GCS, pupils 
SAMPLE history 
2nd survey 
-log roll 
-spine

Neuro exam

  • CN
  • blood from ears and nose
  • power upper and lower extremity
  • reflexes
  • sensation
27
Q

Differential diagnosis for head injury

A
  • concussion
  • bleeds: subarachnoid, subdural, epidural, brain contusion
  • seizure
  • spinal cord injury
28
Q

Management of head injury

A

CT head/neck
Neurosurgery consult
May need MRI to delineate injuries further

LMCC (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions