PCP semester 2

Question 1

What are the 3 important features for quality of weakness?

Answer 1

Bilateral vs unilateral Symmetrical vs asymmetrical Proximal vs distal

Question 2

What does proximal muscle weakness suggest?

Answer 2

Primary muscle disorder affecting axial muscles

Question 3

What questions should you ask for associated features of weakness?

Answer 3

Pain in muscles Sensory symptoms Vision Cognition Balance Falls

Question 4

What associated features should you always ask about?

Answer 4

Weight loss Rigors Fever Loss of appetite

Question 5

What does unilateral weakness suggest about location of pathology?

Answer 5

Cerebral

Question 6

What does weakness of a myotome suggest about location of pathology?

Answer 6

Spinal root lesion

Question 7

If someone has severe +++ muscle weakness, what is a good question to ask on Hx?

Answer 7

Difficulty breathing

Question 8

What is the order of events for motor exam of lower limb? (hint: inspection first)

Answer 8

Gait. Inspection. Tone. Power. Reflexes. Co-ordination.

Question 9

When inspecting a limb for the motor exam, what are you looking for?

Answer 9

Scars, deformities, muscle bulk (atrophy), fasciculations.

Question 10

How many beats is abnormal when looking for clonus?

Answer 10

>5 beats is abnormal

Question 11

If someone has complete paralysis, what grade is their strength?

Answer 11

0

Question 12

If someone has flickers of movement, what grade is their strength?

Answer 12

1

Question 13

If someone has traces of contraction, what grade is their strength?

Answer 13

1

Question 14

If someone has active movement with gravity eliminated, what grade is their strength?

Answer 14

2

Question 15

If someone has active movement against gravity, what grade is their strength?

Answer 15

3

Question 16

If someone has active movement against gravity and resistance, what grade is their strength?

Answer 16

4

Question 17

If someone has normal power, what grade is their strength?

Answer 17

5

Question 18

What are the 3 reflexes to test during the lower limb neuro exam?

Answer 18

Knee, ankle and Babinski

Question 19

Which dermatomes does the knee jerk assess?

Answer 19

L2, 3 and 4

Question 20

Which dermatomes does the ankle jerk assess?

Answer 20

S1, 2

Question 21

Which dermatomes does plantar reflex assess?

Answer 21

L5, S1, S2

Question 22

If someone has absent reflexes, what is their grade?

Answer 22

0

Question 23

If someone has hypoactive reflexes, what is their grade?

Answer 23

1

Question 24

If someone has normal reflexes, what is their grade?

Answer 24

2

Question 25

If someone has hyperactive reflexes without clonus, what is their grade?

Answer 25

3

Question 26

If someone has hyperactive reflexes with clonus, what is their grade?

Answer 26

4

Question 27

Associated features for neurological symptoms?

Answer 27

Vision, hearing, pins and needles, weakness, facial droop,balance, falls, walking, memory, personality, speech

Question 28

Associated features for cancer?

Answer 28

Pain, loss of weight, loss of appetite, fatigue, fever.

Question 29

Associated features for cardiac issues?

Answer 29

Chest pain, SOB, palpitations, orthopnoea, cough

Question 30

Associated features for respiratory issues?

Answer 30

Haemoptysis, pain on inspiration, cough, sputum, chest pain, SOB

Question 31

Associated features for GI issues?

Answer 31

Nausea, vomiting, diarrhoea, constipation, bloating, flatus, stools, haematemesis

Question 32

Associated features for infection?

Answer 32

Loss of weight, loss of appetite, fatigue, fever, night sweats, chills, shivering