Problem Solving in Clinical Neurology

Question 1

What does DAMN ITV stand for?

Answer 1

D - Degeneration
A - Anomalous
M - Metabolic
N - Neoplasia, nutritional 
I - Infectious, inflammatory, idiopathic
T - Toxic, trauma
V - Vascular

Question 2

What is the six finger rule in neurology?

Answer 2

1. Localisation
2. Signalment
3. Onset
4. Progression
5. Symmetry
6. Pain

Question 3

Give 3 examples of focal lesions in neurology…

Answer 3

neoplasia
intervertebral disc herniation
congenital malformation

Question 4

Give 3 examples of multifocal lesions in neurology…

Answer 4

Inflammation
Infection
Multifocal neoplasia e.g. lymphoma

Question 5

Give 2 examples of diffuse lesions in neurology…

Answer 5

Neurodegenerative

Metabolic

Question 6

What are the most important signalments in narrowing DDx in neurology

Answer 6

Species
Breed
Age
Sex

Question 7

What can symmetry of a lesion tell you about the probable aetiology in neurology?

Answer 7

Possible location
Metabolic often symmetrical
Asymmetrical brain lesions tend to circle

Question 8

Which part of the spine has no pain receptors?

Answer 8

The cord. It only transmits pain but does not feel it as it has no free nerve endings. The vertebrae, meninges, IVD and articular joints may feel pain however.

Question 9

What would you expect if you find pain on a spinal exam?

Answer 9

A lesion affecting the bone/joints/discs/meninges

Question 10

What could cause diffuse pain along the spine?

Answer 10

Meningitis/polyarthritis