Neurology

Question 1

Femoral nerve injury

Answer 1

inability to extend the knee, loss of knee jerk reflex, and sensory loss over the anterior and medial aspects of the thigh, medial aspect of shin, and arch of the foot.

Question 2

Obturator nerve injury

Answer 2

pain, weakness in leg adduction, sensory loss over a small area in the medial thigh (2/2 to pelvic trauma or surgery)

Question 3

Common peroneal injury

Answer 3

acute foot drop, weakness in foot dorsiflexion and eversion. Parathesias and/or sensory loss over the dorsum of the foot and lateral shin (superficial peroneal nerve territory) (injury located at the knee, on the lateral aspect of the fibular head)

Question 4

Lesion of nondominant parietal lobe

Answer 4

construction apraxia, difficulty copying simple line drawings, difficulty wearing clothes, dressing apraxia, confusion

Question 5

Lesion of dominant parietal lobe

Answer 5

Gerstmann syndrome: acalculia (difficulty performing simple arithmetic tasks, finger agnosia (inability to name individual fingers), impaired writing (agraphia), and right/left confusion

Question 6

Lesion of nondominant temporal lobe

Answer 6

visual disorders (homonymous upper quadrantanopia) and impaired perception of complex sounds (auditory agnosia)

Question 7

Lesion of dominant temporal lobe

Answer 7

homonymous upper quadrantaopia, aphasia, Wernicke’s aphasia (impairment in comprehension of spoken or written language)

Question 8

Broca’s aphasia

Answer 8

inferior frontal gyrus

Question 9

Wernicke’s aphasia

Answer 9

superior temporal gyrus

Question 10

Normal CSF

Answer 10

WBC: 0-5
Glucose: 40-70
Protein: <40

Question 11

Bacterial meningitis CSF

Answer 11

WBC: >1000
Protein: 250
Glucose: <40

Question 12

TB meningitis

Answer 12

WBC: 5-1000
Protein: 250
Glucose: <10

Question 13

Viral meningitis

Answer 13

WBC: 100-1000
Glucose: 40-70
Protein: <100

Question 14

Guillan-Barre

Answer 14

WBC: 0-5
Glucose: 40-70
Protein: 45-1000

Question 15

L1-L2

Answer 15

cremasteric reflex
hip flexion
adduction

Question 16

L5-S2

Answer 16

dorsiflexion

plantar flexion

Question 17

S2-S4

Answer 17

anal spinhcter tone

Question 18

Patellofemoral pain syndrome

Answer 18

young adult women, reproduction of pain by extension of the knee with anterior pressure on the patella (patellofemoral compression test). Tx is stretching and strengthening exercises of the thigh muscles, NSAIDs but usually not that helpful

Question 19

Anserine bursitis

Answer 19

medial knee pain, pain at the medial aspect of the knee joint distal to the joint line

Question 20

Osgood-Schlatter syndrome

Answer 20

causes pain at the insertion of the patellar tendon at the anterior tibial tubercle. Occurs during growth spurts. Pts have localized tenderness at the tibial tubercle

Question 21

Patellar tendonitis (jumper’s knee)

Answer 21

pain at the inferior patella and patellar tendon. Tenderness at the inferior margin of the patella

Question 22

Prepatellar bursitis (housemaid’s knee)

Answer 22

visible swelling anterior to the patella. Frequently complicated by secondary infection of Staph aureus