SENSATION Flashcards
A 55-year-old male presents with sudden-onset weakness and sensory loss in the right leg. On examination, there is ipsilateral weakness and loss of proprioception below the level of the lesion, as well as contralateral loss of pain and temperature sensation below the level of the lesion. The most likely diagnosis is:
A) Mononeuropathy
B) Radiculopathy
C) Brown-Sequard Syndrome
D) Central cord syndrome
C) Brown-Sequard Syndrome
Explanation: Brown-Sequard Syndrome is characterized by ipsilateral weakness and loss of proprioception below the level of the lesion, along with contralateral loss of pain and temperature sensation below the level of the lesion.
A 60-year-old female presents with symmetric weakness, sensory loss, and tingling in the hands and feet. On examination, there is reduced deep tendon reflexes and distal sensory impairment in a “stocking-glove” distribution. The most likely diagnosis is:
A) Polyneuropathy
B) Anterior myelopathy
C) Posterior cord disease
D) Complete transverse cord lesion
A) Polyneuropathy
Explanation: Polyneuropathy is characterized by symmetric weakness, sensory loss, and tingling in a distal pattern, often affecting the hands and feet. Reduced deep tendon reflexes and “stocking-glove” distribution of sensory impairment are typical findings.
A 45-year-old male presents with sudden-onset severe neck pain, radiating to the right arm, along with right arm weakness and sensory loss. On examination, there is decreased sensation in the right C5-C6 dermatomes, and weakness of the right biceps and brachioradialis muscles. The most likely diagnosis is:
A) Mononeuropathy
B) Radiculopathy
C) Central cord syndrome
D) Sacral sparing
B) Radiculopathy
Explanation: Radiculopathy refers to the compression or irritation of a nerve root, typically resulting in pain that radiates along the affected nerve’s distribution. The decreased sensation and weakness in specific dermatomes and muscles indicate involvement of the corresponding nerve roots.
A 35-year-old male presents with weakness and sensory loss in the right leg, sparing the saddle area. On examination, there is reduced sensation and motor function in the lower limbs, along with loss of bowel and bladder control. The most likely diagnosis is:
A) Complete hemi-sensory loss
B) Crossed Sensory Syndrome
C) Cauda Equina Syndrome
D) Sacral sparing
D) < C
due to sparing of the saddle area. However there is
A 50-year-old male presents with weakness and loss of pain and temperature sensation in the upper limbs, but preserved light touch and proprioception. On examination, there is intact strength, vibration sense, and position sense. The most likely diagnosis is:
A) Central cord syndrome
B) Complete hemi-sensory loss
C) Sacral sparing
D) Posterior cord disease
DA) Central cord syndrome.
Central cord syndrome is a type of spinal cord injury characterized by damage to the central portion of the spinal cord. It often occurs due to hyperextension injuries, such as those caused by falls or motor vehicle accidents. The syndrome typically presents with greater weakness and sensory loss in the upper limbs compared to the lower limbs.
A 70-year-old diabetic patient has developed painless burns and unnoticed trauma on his feet. What type of sensory symptom is associated with these consequences?
A) Negative symptom
B) Positive symptom
A) Negative symptom
Explanation: The patient’s symptoms of painless burns, unnoticed trauma, and associated consequences such as ulcers or trophic changes are examples of negative sensory symptoms. The lack of pain and sensation in the affected areas leads to these consequences.
A 45-year-old female experiences a band-like sensation around her chest, along with tingling and “pins and needles” in her hands and feet. She also reports Lhermitte’s sign, an electric shock-like sensation down her back with neck flexion. What type of sensory symptoms are described?
A) Negative symptoms
B) Positive symptoms
B) Positive symptoms
Explanation: The patient’s symptoms of a band-like sensation, tingling, “pins and needles,” and Lhermitte’s sign indicate positive sensory symptoms. These symptoms involve abnormal sensations such as pain, tingling, and altered perceptions of touch or temperature.
A 65-year-old male presents with loss of sensation on the left side of his body, including the face, arm, and leg. The most likely cause of this sensory deficit is:
A) Hemianaesthesia
B) Spinal sensory level
C) Peripheral neuropathy
D) Brown-Sequard Syndrome
A) Hemianaesthesia
Explanation: The patient’s loss of sensation on one side of the body, including the face, arm, and leg, is characteristic of hemianaesthesia, which is typically associated with stroke.
A 40-year-old female presents with loss of sensation below a specific level on her back. The most likely cause of this sensory deficit is:
A) Hemianaesthesia
B) Spinal sensory level
C) Peripheral neuropathy
D) Brown-Sequard Syndrome
B) Spinal sensory level
Explanation: The patient’s loss of sensation beneath a specific level on her back is consistent with a spinal sensory level, which is typically associated with spinal cord disease or injury.
A 55-year-old male presents with loss of sensation in his hands and feet, following a “glove and stocking” distribution. The most likely cause of this sensory deficit is:
A) Hemianaesthesia
B) Spinal sensory level
C) Peripheral neuropathy
D) Brown-Sequard Syndrome
C) Peripheral neuropathy
Explanation: The patient’s loss of sensation in the distal parts of both arms and legs, following a “glove and stocking” distribution, is characteristic of peripheral neuropathy, which is associated with disease of the peripheral nerves themselves.
A 60-year-old female presents with loss of sensation on the right side of her body, including the face, arm, and leg, and weakness on the left side. The most likely cause of these sensory and motor deficits is:
A) Hemianaesthesia
B) Spinal sensory level
C) Peripheral neuropathy
D) Brown-Sequard Syndrome
D) Brown-Sequard Syndrome
Explanation: The patient’s loss of sensation on one side of the body and weakness on the opposite side suggest a spinal cord injury or disease affecting one side, which is characteristic of Brown-Sequard Syndrome.
A 50-year-old male presents with loss of sensation in his hands and feet, following a “glove and stocking” distribution, as well as muscle weakness and atrophy. The most likely cause of these sensory and motor deficits is:
A) Hemianaesthesia
B) Spinal sensory level
C) Peripheral neuropathy
D) Brown-Sequard Syndrome
C) Peripheral neuropathy
Explanation: The patient’s loss of sensation in the distal parts of both arms and legs, following a “glove and stocking” distribution, along with muscle weakness and atrophy, is consistent with peripheral neuropathy, which is associated with disease of the peripheral nerves themselves.
A 35-year-old female presents with numbness and tingling in her left hand and forearm. On examination, you perform a graphaesthesia test by drawing numbers on her palm with a ballpoint pen. She is unable to identify the numbers correctly. Where is the possible point of damage in this case?
A) Ipsilateral dorsal columns
B) Contralateral parietal lobe
C) Ipsilateral parietal lobe
D) Contralateral dorsal columns
) Ipsilateral parietal lobe
Explanation: Loss of graphaesthesia suggests damage between the tested point (palm) and the ipsilateral dorsal columns, and the contralateral parietal lobe. In this case, the patient’s inability to correctly identify the numbers drawn on her palm indicates a possible damage in the ipsilateral parietal lobe.
A 55-year-old female presents with reduced sensation in her left hand. You perform a two-point discrimination test and find that she can distinguish between two points at a distance of 3 mm. What can be concluded from this finding?
A) Normal two-point discrimination threshold
B) Impaired two-point discrimination threshold
C) Increased two-point discrimination threshold
D) Inconsistent two-point discrimination threshold
A) Normal two-point discrimination threshold
Explanation: A normal two-point discrimination threshold varies depending on the area of the body tested but is generally around 2-8 mm. In this case, the patient’s ability to distinguish between two points at a distance of 3 mm suggests a normal two-point discrimination threshold, indicating no significant sensory deficit in the tested area.
A 50-year-old male presents with difficulty recognizing objects by touch. You perform a stereognosis test by placing a small object in his right hand and asking him to identify it. He is unable to correctly identify the object. Which area of the brain is likely affected?
A) Ipsilateral parietal lobe
B) Contralateral parietal lobe
C) Ipsilateral primary motor cortex
D) Contralateral primary motor cortex
B) Contralateral parietal lobe
Explanation: Stereognosis tests determine the integrity of the parietal lobe. In this case, the patient’s inability to recognize objects by touch suggests a possible damage in the contralateral parietal lobe.
