-Sam Neuro Flashcards
Below are findings made during a neurological examination of a 5 year-old Schnauzer spayed bitch that suddenly ‘collapsed’ after her evening walk:
- Mental status – bright and alert.
- Posture and gait – tetraplegia.
- Palpation of muscular and skeletal systems – normal, no pain, muscle tone maybe increased. Evaluation of postural reactions – tetraplegia.
- Evaluation of cranial nerves – normal.
- Evaluation of spinal nerves – all reflexes exaggerated.
- Evaluation of sensation – decreased on all 4 limbs.
Which ONE of the following conditions is the dog most likely to have?
a.) Fibrocartilagenous embolus
b. ) Bain stem tumor.
c. ) Cervical disc extrusion.
d.) Bilateral brachial plexus
avulsion.
e.) Granulomatous meningioencephalitis.
A.) FIbrocartilagenous embolus
Which one of the following is NOT tested in the flexor withdrawal reflex on a hind limb?
A.) Muscle strength.
B.) Sensory perception.
C.) Flexion of the hip via the femoral nerve.
D.) Flexion of the stifle and hock via the sciatic nerve.
E.) Continence.
E.) Continence
Which statement about thoracolumbar disc disease is INCORRECT?
a. ) Cage rest helps most dogs with spinal hyperesthesia and paresis.
b. ) Relapses are very rare in dogs that recover with cage rest.
c. ) Animals that do not improve with cage rest are candidates for surgery.
d. ) Surgery is the therapy of choice in dogs that are paralyzed.
e. ) Surgery usually consists of a hemilaminectomy and fenestration of the affected and surrounding discs.
b.) Relapses are very rare in dogs that recover with cage rest.
Below are findings made during a neurological examination of a 3 year-old Great Dane dog:
- Mental status – normal mentation.
- Palpation of muscular and skeletal systems - lack of muscle tone.
- Evaluation of postural reactions - dog has tetraplegia.
- Evaluation of cranial nerves - normal.
- Evaluation of spinal nerves - all reflexes markedly depressed or absent.
- Evaluation of sensation - normal.
Which ONE of the following conditions is the dog most likely to have?
a. ) Canine wobbler syndrome (cervical spondylopathy).
b. )Tetanus.
c. )Aute polyradiculoneuritis (coonhound’s Paralysis)
d. Myositis.
e. Brain stem neoplasia.
C.) Acute polyradiculoneuritis (coonhound’s Paralysis)
Below are findings made during a neurological examination of a 15 year-old dog:
- Mental status, posture and gait – depressed, seizures, pacing, circles to the left.
- Palpation of muscular and skeletal systems - normal.
- Evaluation of postural reactions – abnormal on the right fore and hind limbs.
- Evaluation of cranial nerves – no menace in the right eye; minimal response to stimulation of the nasal mucosa on the right.
- Evaluation of spinal nerves – hyperreflexia on the right fore and hind limbs.
- Evaluation of sensation – depressed on the right side.
Which ONE of the following conditions is the dog most likely to have?
a. ) A tumor in the left cerebral cortex.
b. ) A tumor in the right cerebral cortex.
c. ) A tumor in the cerebellum.
d. ) A tumor in the left brain stem.
e. ) A tumor in the right vestibular apparatus.
A.) A tumore in the Left cerebral cortex.
Which of the following are you LEAST LIKELY to see in a dog with lower motor neuron signs?
a. ) Lack of voluntary motor activity.
b. ) Decreased sensation.
c. ) Lack of muscle tone.
d. ) Areflexia.
e. ) Crossed extensor reflex.
E.) Crossed extensor reflex.
Below are findings made during a neurological examination of a 5 year-old intact male poodle:
- Mental status – bright and alert.
- Posture and gait – dragging back legs today, was normal last night. Palpation of muscular and skeletal systems – hind limbs a little atonic
- Evaluation of postural reactions – paraplegia
- Evaluation of cranial nerves – normal.
- Evaluation of spinal nerves – hyporeflexia on hind limbs
- Evaluation of sensation – superficial pain sensation absent on hind limbs.
Where is the neurological lesion MOST LIKELY to be in this dog?
a. ) T2 to L3
b. ) L3 caudally
c. ) in the muscles
d. ) C6 to T2
e. ) in the peripheral nerves
B.) L3 caudally
A dog with vestibular signs, facial nerve signs and conscious proprioceptive deficits on the same side must have a lesion in the:
a. ) brain stem on the same side
b. ) ear on the opposite side
c. ) brain stem on the opposite side
d. ) cerebral cortex on the opposite side
e. ) cerebellum on the same side.
A.) Brain stem on the same side
Which of the following is not consistent with a cerebellar problem?
a. ) dysmetria
b. ) ataxia
c. ) head bobbing
d. ) broad based stance
e. ) conscious proprioception deficits
E.) Conscious proprioception deficits.
Below are findings made during a neurological examination of a 5 year-old intact male GSD (police dog):
- Mental status – bright and alert.
- Posture and gait – difficulty with rising over the past 3 months – getting slowly worse; avoids stairs.
- Palpation of muscular and skeletal systems – pain over lumbosacral area
- Evaluation of postural reactions – mild paraparesis.
- Evaluation of cranial nerves – normal.
- Evaluation of spinal nerves – normal forelimbs; patellar reflex exaggerated; flexor withdrawal – poor flexion of hock and stifle; reduced cranial tibial and perineal reflexes.
- Evaluation of sensation – reduced superficial pain sensation in hind limbs.
Where is the neurological lesion MOST LIKELY to be in this dog?
a. Brain stem
b. C2/3
c. C7/T1
d. T2/T3
e. L7/S1
E.) L7/S1
Which of the following statements is INCORRECT?
a. ) Megaesophagus occurs commonly in dogs with myasthenia gravis.
b. ) Botulism, tick paralysis and coonhound paralysis all cause flaccid paralysis in the dog.
c.) Deafness is a common congenital problem in Dalmatians. It is generally recommended that
bilaterally deaf animals be euthanized.
d.) In dogs with masticatory myositis there is usually a good response to antibiotic therapy.
e.) Granulomatous meningioencephalomyelitis (GME) can cause focal or multifocal
neurological signs.
D.) In dogs with masticatory myositis there is usually a good response to antibiotic therapy.
(WE DIDNT DO BEHAVIOR PROBLEMS)
Which of the following would suggest that a given behavior was compulsive in nature?
A.) behavior appears similar to a normal behavior but is performed repeatedly and out of context
B.) behavior appears seizure-like, cannot be interrupted, and has a postictal phase
C.) behavior not seen until the animal reached old age (~11 yrs and older)
D.) both A and B would suggest a compulsive behavior
E.) both B and C would suggest a compulsive behavior
A.) behavior appears similar to a normal behavior but is performed repeatedly and out of context
Which of the following statements is TRUE about the treatment recommendations for Compulsive Disorders presented in lecture?
A.) restraint devices and positive punishment are recommended to reduce the frequency of these behaviors, thereby solving the problem
B.) serotonin-enhancing drugs such as SSRI’s and TCA’s are sometimes used to reduce compulsive behaviors
C.) stress-reduction techniques (such as NILIF, a predictable daily routine, and providing adequate physical and mental exercise) may be helpful in reducing compulsive behaviors
D.) all of the above are true about Compulsive Disorders
E.) only B and C are true about Compulsive Disorders
E.) only B and C are true about Compulsive Disorders
Which of the following statements is TRUE about cognitive dysfunction syndrome (CDS)?
A.) CDS can be completely cured in most cases, if correct treatment techniques are used
B.) CDS has behavioral symptoms and pathophysiology similar in many ways to Alzheimer’s in humans
C.) CDS is effectively treated with SSRI’s and TCA’s, such as fluoxetine and clomipramine
D.) CDS may be caused by acute stress and is seen in animals of all ages
E.) All of the above are true about CDS
B.) CDS has behavioral symptoms and pathophysiology similar in many ways to Alzheimer’s in humans
Which of the following is a management and/or treatment recommendation for Cognitive Dysfunction Syndrome (CDS)?
a.) increase access to appropriate areas for elimination
b.) provide the animal with regular opportunities for increased mental and physical activity
(use it or lose it!)
c. ) supplement the diet with antioxidants, or feed an antioxidant enriched ‘prescription’ diet
d. ) use learning theory – reinforce calm, quiet behaviors; ignore anxiety-based pacing and panting
e. ) all of the above are management and/or treatment recommendations for CDS
e. all of the above are management and/or treatment recommendations for CDS
Which of the following statements is INCORRECT?
a. ) Bethanecol can be used in dogs with a ‘lower motor neuron bladder’.
b. ) Phenoxybenzamine can be used in dogs with an ‘upper motor neuron bladder’.
c. ) Phenylpropanolamine can be used in dogs with a ‘lower motor neuron bladder’.
d. ) Prazosin can be used in dogs with an ‘upper motor neuron bladder’.
e. ) indwelling urinary catheters are better than the above drugs for the management of upper/lower motor neuron bladders
e.) indwelling urinary catheters are better than the above drugs for the management of upper/lower motor neuron bladders
Which statement comparing cervical (CDP) and thoracolumbar disc prolapses (TLDP) is CORRECT?
a. ) CDP are more likely to cause neurological deficits and less likely to cause pain.
b. ) CDP are most commonly Hansen type II in small dogs
c. ) CDP are less likely to respond to cage rest
d. ) Surgery for a CDP involves a ventral approach; a dorsal approach is made for TLDP
e. ) Prognosis following surgery for CDP is much poorer than for TLDP
D.) Surgery for a CDP involves a ventral approach, a dorsal approach is made for TLDP
Which statement about intervertebral disc disease is INCORRECT?
a. ) Calcification of discs occurs commonly in chondrodystrophic breeds.
b. ) Most thoracolumbar disc protrusions are between T11 and L2.
c. ) Clinical signs with a disc prolapse vary from spinal hyperesthesia with no neurological deficits to anesthesia with paralysis.
d. ) Myelography, CT or MRI are needed for the definitive diagnosis of a disc prolapse and to locate the site of the prolapse.
e. ) Onset of clinical signs is usually precipitated by exercise/ trauma.
e.) Onset of clinical signs is usually precipitated by exercise/ trauma.
Which of the following statements about vestibular disease is INCORRECT?
a. ) Signs include head tilt, falling to one side and nystagmus.
b. ) Head tilt and falling are usually toward the side of the lesion.
c. ) The fast phase of nystagmus is usually towards the side of the lesion.
d. ) Central vestibular disease is often associated with neoplasia or infections.
e. ) Peripheral vestibular disease is usually associated with otitis.
c.) The fast phase of nystagmus is usually towards the side of the lesion.
In animals with cranial trauma which of the following statements is INCORRECT?
a. ) Shock and life threatening injuries should be treated first.
b. ) Colloids are contraindicated and Lactate
c. ) Hypercapnia must be prevented as this raises intracranial pressure.
d. ) Brain edema is best treated with mannitol.
e. ) Irregular respiration and unresponsive bilateral mydriasis indicate a poor prognosis.
b.) Colloids are contraindicated and Lactated Ringer’s Solution (LRS) must be used to treat
shock.
Which of the following conditions is LEAST LIKELY to be painful?
a. ) fibrocartilaginous embolus.
b. )discospondylitis.
c. ) cervical disc protrusion.
d. ) lumbosacral instability.
e. ) malignant peripheral nerve sheath tumor.
a.) fibrocartilaginous embolus.
Which of the following statements about seizures is INCORRECT?
a. )Generalized tonic-clonic motor seizures are the most common form of seizures in dogs.
b. )In the preictal phase, there may be subtle behavior changes such as seeking out the owner, restlessness or anxiety.
c. ) During the ictal phase, animals usually fall unconscious and show tonic and then clonic muscle activity with autonomic signs (urination/ defecation/ salivation).
d. ) In the postictal phase, animals very rapidly regain consciousness and soon appear normal, behaviorally and neurologically.
e. )Idiopathic epilepsy is treated with anticonvulsant drugs; with secondary epilepsy the underlying cause should be treated.
d.) In the postictal phase, animals very rapidly regain consciousness and soon appear normal, behaviorally and neurologically.
Which of the following statements about the treatment of seizures is INCORRECT?
a.) Phenobarbital is contraindicated in dogs with existing liver disease.
b.) Blood levels of phenobarbital should be measured at regular intervals to enable the correct
dose of the drug to be given.
c. ) Dogs having seizures in clusters or more frequently than every 6-8 weeks should be placed on phenobarbital.
d. ) ALP and ALT must be measured regularly so that phenobarb induced hepatopathy can be detected early.
e. ) Potassium bromide can also be used for seizure control, but it should not be used if there are signs of renal insufficiency.
d.) ALP and ALT must be measured regularly so that phenobarb induced hepatopathy can be detected early.
Which of the following statements about seizures in cats is INCORRECT?
a. ) They are less likely to be idiopathic (primary) than in dogs.
b. ) They are more variable than those seen in dogs.
c. ) They are most commonly treated with phenobarbital.
d. ) Phenobarbital does not cause hepatotoxicity in cats.
e. ) Potassium bromide is the safest drug to treat seizures in cats.
e.) Potassium bromide is the safest drug to treat seizures in cats.
A dog with tetraplegia as a result of a severe lesion at C6-T2 is most likely to have which of the following?
a. ) Normal respiration
b. ) No respiration
c. ) Marked abdominal effort
d. ) Marked thoracic effort
e. ) Marked abdominal and thoracic effort.
c.) Marked abdominal effort
Which of the following definitions is INCORRECT?
a. ) Monoparesis - lack of voluntary muscle activity on one limb.
b. ) Hemiplegia – absence of voluntary motor activity on one side.
c. ) “Root signature” - hyperesthesia with limb palpation or manipulation.
d. ) Paraplegia – lack of voluntary motor activity on all four limbs.
e. ) Hypesthesia – decreased sensation.
d.) Paraplegia – lack of voluntary motor activity on all four limbs.
Which of the following statements is INCORRECT?
a. ) Dogs with hydrocephalus show signs as puppies and these may include seizures, tetraparesis, altered mental status and learning problems.
b. ) Hydrocephalus is best treated with shunts that drain CSF into the abdominal/ peritoneal cavity.
c. ) Gliomas and meningiomas are the commonest primary brain tumors in dogs.
d. ) Gliomas are easier to remove surgically and have a better prognosis.
e. ) Brain herniation is a possible complication of a CSF tap.
d.) Gliomas are easier to remove surgically and have a better prognosis.
Which of the following treatments is LEAST important in a neurological patient that is non-ambulatory?
a. ) Physiotherapy.
b. ) Regular turning.
c. ) Emptying the bladder regularly.
d. ) Prophylactic antibiotics.
e. ) Ensure dog can reach water and food.
d.) Prophylactic antibiotics.
Which of the following statements is INCORRECT?
a. ) Cerebellar hypoplasia in cats can be due to in utero infection with feline panleukopenia parvovirus.
b. ) Granulomatous meningoencephalomyelitis (GME) responds well to prednisolone therapy.
c.) Dogs in the early stages of degenerative myelopathy generally have normal sensation in the limbs
and are continent.
d.) Dysautonomia can be seen in dogs in the mid-western US and is associated with signs due to
autonomic nervous system dysfunction.
e.) There is no effective treatment for degenerative myelopathy in dogs.
b.) Granulomatous meningoencephalomyelitis (GME) responds well to prednisolone therapy.
Severe peripheral nerve injuries result in which ONE of the following?
a. ) Very little muscle atrophy.
b. ) Hypermetria.
c. ) Nerve root signs.
d. ) Anesthesia and areflexia.
e. ) Hyperesthesia and hyperreflexia.
d.) Anesthesia and areflexia.
Which statement about thoracolumbar disease is MOST CORRECT?
a. ) Disc prolapses are commonly precipitated by exercise
b. )Most animals will show lower motor neuron signs in the back legs.
c. )Disc prolapses occur most commonly in the mid lumbar vertebrae.
d. ) Most dachshunds with disc prolapses will have upper motor neuron bladders.
e. ) Chondrodystrophic breeds most commonly have Hansen Type II prolapses.
d.) Most dachshunds with disc prolapses will have upper motor neuron bladders.
#
Which statement about thoracolumbar disc disease is MOST CORRECT??
a. )Cage- rest seldom helps dogs with spinal hyperesthesia and paresis.
b. ) It is acceptable to use prednisilone instead of cage- rest in mildly affected dogs.
c. ) Animals that improve with cage rest quite commonly have relapses of clinical signs.
d. ) Cage rest is the therapy of choice in dogs that are paralyzed.
e. )Following surgery, dogs are usually fully recovered from their neurological signs in a few days.
c.) Animals that improve with cage rest quite commonly have relapses of clinical signs.
#
Which of the following is not usually associated with LMN lesion?
a. ) Muscle atrophy
b. ) Hyporeflexia/areflexia
c. ) Paralysis/paresis
d. ) Hyperesthesia
e. ) Hypotonia/atonia
d.) Hyperesthesia
#
Which statement about diskospondylitis is most correct?
a. )It is an infection of the cartilaginous endplates and intervertebral disk, especially in the caudal cervical mid thoracic and lumbosacral areas.
b. ) Infections are rapidly encapsulated and fever and systemic signs of infection are rare.
c. )Paresis usually develops before pain on palpation of the affected area.
d. ) Radiographic changes are obvious from the early stages of infection.
e. ) Short term antibiotic therapy is highly effective in treating the condition.
a.) It is an infection of the cartilaginous endplates and intervertebral disk, especially in the caudal cervical mid thoracic and lumbosacral areas.
#
Which statement about degenerative myelopathy is MOST correct?
a. ) there is rapidly progressive development of paresis and ataxia.
b. ) It occurs especially in German Shepherd dogs.
c. ) The condition is painful and urinary and fecal incontinece usually develop.
d. ) Diagnosis is based on the presence of inflammatory cells in the CSF.
e. )Cage rest and steroids are an effective therapy.
a.) there is rapidly progressive development of paresis and ataxia.
#
Which is incorrect?
a. ) Lesions in cerebral cortex cause ipsilateral UMN signs and postural reaction deficits
b. ) Lesions in C1-C6 cause UMN signs in both pelvic and thoracic limbs
c. ) Lesions in C6-T2 cause UMN signs in the pelvic limbs and LMN signs in the thoracic limbs
d. ) Lesions in T2-L6? cause UMN signs in the pelvic limbs
e. ) Lesions in L6-S2 cause LMN signs in the pelvic limbs
a.) Lesions in cerebral cortex cause ipsilateral UMN signs and postural reaction deficits
&
Which of the follow not usually ass with LMN lesion?
a.) Muscle atrophy
b. ) Hyporeflexia/areflexia
c. ) Paralysis/paresis
d. ) Hyperesthesia
e. ) Hypoton/atonia
d.) Hyperesthesia
&
Which is not cerebellar sign?
a.) Broad based stance
b. ) Ataxia
c. ) Dysmetria
d. ) Intention tremors
e. ) Conscious proprioceptive defitcits
e.) Conscious proprioceptive defitcits
&
Which of the following statements about Fibrocartilaginous emboli is INCORRECT?
a. ) It occurs in large breed dogs and rarely in the cat
b. ) Clinical signs develop slowly over day to weeks
c. ) The condition is usually non-painful
d. ) Diagnosis is by exclusion of other possible causes of clinical signs
e. ) Surgery is of no benefit and only supportive medical therapy is indicated
b.) Clinical signs develop slowly over day to weeks
&
- Which of the following statements about degenerative myelopathy is INCORRECT?
a. ) There is a slow progressive development of paresis and ataxia
b. ) It occurs especially in German Shepherd dogs
c. ) The condition is painful and urinary and fecal incontinence usually develop
d. ) Diagnosis is by exclusion of inflammatory and compressive conditions of the spinal cord
e. ) There is no effective therapy
c.) The condition is painful and urinary and fecal
&
- Which statement about cervical spondylomyelopathy (canine wobblers) is INCORRECT?
a. ) The condition occurs most in young great danes and old dobermans
b. ) The pelvic limbs are usually more affected than the thoracic limbs
c. ) Myelograms are not necessary for the diagnosis; vertebral changes are obvious on plain radiographs
d. ) Medical therapy is only palliative as the condition is progressive
e. ) surgical decompression and or surgical stabilization may provide short term benefits
c.) Myelograms are not necessary for the diagnosis; vertebral changes are obvious on plain radiographs
&
What is Not a LMN signs?
a. ) muscle atrophy
b. ) Hyporeflexia/areflexia
c. )Paralysis/paresis
d. ) Hypotonia/atonia
e. ) Hyperesthesia
E.) Hyperesthesia
&
Does Panting resemble a murmur?
NO
Great Dane with Atrial fibrillation- whats the rate to tx or not and whats the contractility?
- poor contractility
- poor heart rate
We treat with digoxin and top it up with dialtazem.
Where is the lesion ( what vertebrae) in brachial plexus avulsion?
How does avulsion occur?
C6-C7- shoulder
C7-T1 elbow and amp, carpus force while abducted cranial or caudal
Miosis, protruding nictitans, enophthalmos are systems of __________. Where is the lesion?
Horners Syndrome T1 (weird ass backwards innervation)
Peripher nerve root tumor(boxer tumors) lesions are seen in the area?
Caudal cervical area
T: chronic
F: is progressive
HYPERsthesia, MONOparesis
Fibrocartilage Emboli (FCE) are usually seen in what breeds? T/F: this is a disc disease it is chronic.
Irish Wolf hounds and amp; mini schnauzers
T: originates from nucleus pulpous–>ischemia
** TEST QUESTION*
Define Neuropraxia?
Cut off blood supply “leg fell asleep”
Basic neuropathy will recover with no permanent damage
Define Axonotmesis
Axon degeneration
* endonerium and schwann intact regenereation = 1mm/day
Define Neurotmesis
Severed nerve
*** NO REGENERATION- paralysis
Patient has paraparesis where is the lesion?
Caudal to T2
* TEST QUESTION
Degenerative Myelopathy is an immune mediated, non-painful, non-inflammatory disease seen classically in ____. Where is the lesion?
Old GSD (SOD1 gene) Thoracolumbar spinal chord is progressive knuckling/crossing over.
Where does IVDDD Hansens type II lesion form? What are the signs?
L7-S1
Cauda equina : Tail jack pain
What breed is mainly effected by Hansen Type I IVDD?
WEINERS!!!
