Neurology: Neuro Exam Correlation

Question 1

What is asterixis?

Answer 1

Flapping tremor of the hand when the wrist is extended (stopping traffic position). Associated with metabolic encephalopathy.

Question 2

What is dystonia?

Answer 2

Abnormal sustained posture that often leads to twisting of the body.

Question 3

What is tardive dyskinesia?

Answer 3

Movement disorder with repetitive and involuntary movements that are slow onset.

Question 4

What is akathisia?

Answer 4

Syndrome of restlessness manifesting as an inability to sit still.

Question 5

Describe broca’s aphasia in terms of fluency, comprehension, and repitition.

Answer 5

Non-fluent, comprehension spared, repetition impaired

Question 6

Describe wernicke’s aphasia in terms of fluency, comprehension, and repitition.

Answer 6

Fluent, comprehension impaired, repetition impaired

Question 7

Describe global aphasia in terms of fluency, comprehension, and repitition.

Answer 7

All functions have deficits

Question 8

Conductive aphasia is damage to the peri-sylvian connections between broca’s and wernicke’s and usually results in paraphasic errors. Name and describe the two types of paraphasic errors.

Answer 8

1. Phonemic: substitution of similar sounding words in normal speech
   - ex. saying “pish” when you mean “fish”
2. Semantic: substituting a simlar word in normal speech
   - ex. saying “ink” when you mean to say “pen” or saying “taxi” when you mean to say “car”

Question 9

Describe transcortical motor aphasia in terms of fluency, comphrehension and repitition.

Answer 9

Non-fluent but comprehension and repetition are spared.

Question 10

Describe transcortical sensory aphasia in terms of fluency, comprehension and repitition.

Answer 10

Fluent, no comprehension, but repetition is spared.

Question 11

Describe transcortical mixed aphasia in terms of fluency, comprehension and repitition.

Answer 11

Everything is impaired except for repetition

Question 12

Describe anomic aphasia.

Answer 12

Inability to name the word for a particular item.

Question 13

What can cause unilateral vs. bilateral anosmia?

Answer 13

Unilateral: trauma, tumor
Bilateral: trauma, smoking, virus, allergy

Question 14

Describe the presentation of Foster-Kennedy Syndrome. (4 things)

Answer 14

Syndrome due to frontal lobe tumors

1. Anosmia: ipsilateral side
2. Optic Atrophy: ipsilateral eye
3. Central Scotoma: loss of middle visual field of ipsilateral eye
4. Papilledema: contralateral eye

Each result from optic nerve compression, olfactory tract compression, increased intra-cranial pressure

Question 15

What is anisocuria?

Answer 15

Unequal pupil size

Question 16

What is hippus?

Answer 16

Normal brief oscillations of pupil size in response to light changes

Question 17

What is a Marcus Gunn pupil?

Answer 17

Afferent pupillary defect.

One eye responds to the light reflex slower than the other. Can be due to optic nerve or retinal disease.

Question 18

What is an Adie’s Pupil?

Answer 18

Dilated pupil due to loss of parasympathetic innervation to the iris. Accommodation is spared.

Question 19

What is an Argyll Robertson Pupil and what commonly causes it?

Answer 19

Pupil that constricts for accommodation but doesn’t react to light stimuli.

Caused by Neurosyphilis (prostitutes carry syphilis)

Edinger Westphal lesion (MS or other demyelinating disease)

Question 20

What is one important condition that is associated with Horner Syndrome that a physician would want to rule out?

Answer 20

Carotid dissection

Question 21

Common CN IV palsy symptoms.

Answer 21

Vertical diplopia
Contralateral head TILT
Caused by trauma

Question 22

Common CN VI palsy symptoms.

Answer 22

Horizontal diplopia
Ipsilateral head TURN
Caused by increased intracranial pressure

Question 23

Pneumonic to remember the nystagmus direction with CN VIII caloric testing.

Answer 23

COWS
Cold water: opposite nystagmus
Warm water: same side nystagmus

Question 24

What is “-paresis”?

Answer 24

Weakness, diminished motor strength

ex. Hemiparesis

Question 25

What is “-plegia”?

Answer 25

Paralysis

ex. hemiplegia

Question 26

Which primitive reflex is NEVER normal in adults?

Answer 26

Grasp Reflex

Question 27

What lesion would be suspected in a patient that walks on their heals?

Answer 27

Ant. tibialis lesion

• L5 radiculopathy
• peripheral neuropathy

Question 28

What lesion would be suspected in a patient that walks on their toes?

Answer 28

Gastroc lesion

• S1 radiculopathy
• peripheral neuropathy