Page: 12-13 (Central Nervous System) Flashcards Preview

NBCE Part II/III. Neuromusculoskeletal Diagnosis (Irene Gold Associates) > Page: 12-13 (Central Nervous System) > Flashcards

Flashcards in Page: 12-13 (Central Nervous System) Deck (32)
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1
Q

_____: associated with two-point discrimination, vibration, and joint position sense?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

A

c.) Corticospinal (aka: “Pyramidal”)

2
Q

_____: associated with pain and temperature?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

A

a.) Lateral spinothalamic

3
Q

_____: associated with crude light touch?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

A

b.) Anterior spinothalmic

4
Q

_____: associated with UMNL?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Ventral corticospinal
d. ) Lateral corticospinal

A

c.) Ventral corticospinal

5
Q

_____: associated with Labyrinthitis and Benign Positional Vertigo?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

A

d.) Vestibulospinal

6
Q

_____: associated with Syringomyelia?

a. ) Lateral spinothalamic
b. ) Anterior spinothalmic
c. ) Corticospinal
d. ) Vestibulospinal

A

a.) Lateral spinothalamic

7
Q

_____: refers to a pathological longitudinal cyst of the central canal of the spinal cord causing a loss of pain and temperature over the shoulders and back in a cape like distribution?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

c.) Syringomyelia

8
Q

_____: refers to a non-progressive motor disorder of the cerebral cortex due to anoxia to the brain prenatally or during birth trauma causing Athetosis/Choreiform movements?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

d.) Cerebral palsy

MC symptom = Athetosis: a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue.

9
Q

_____: refers to a disease in Females 20-40 y/o, which causes demyelination of the CNS. Patient experiences periods of exacerbations and remissions, as well as Scanning speech, Intention tremors, and Nystagmus. Worse when moving from a cold to warm environment?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

b.) Multiple sclerosis

  • BOTH sensory and motor tracts are affected.
  • Oligodendrocytes, are responsible for myelination in CNS.
  • Ortho’s: (+) Lhermitte’s Test
  • Diagnosed: MRI, Proteins in CSF fluid
10
Q

_____: refers to an autoimmune disease in Females 20-40 y/o, in which the body makes antibodies against the acetylcholine receptors. Weakness in cranial nerves then proximal muscles affected. Early signs: Ptosis, Diplopia, Dysarthria, and Fatigue of muscles (especially following exercise)?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

a.) Myasthenia gravis

  • MC in Females, 20-40 y/o
  • Diagnosed via ACHr(+) and Tensilon Test and treated with Cholinesterase inhibiting drugs.
11
Q

_____: affects the corticospinal tract and anterior horn, usually begins in the hands/feet of Males over 40 y/o and life expectancy is short?

a. ) Tabes dorsalis
b. ) Gullain-Barre syndrome
c. ) Amyotrophic lateral sclerosis
d. ) Posterolateral sclerosis

A

c.) Amyotrophic lateral sclerosis (aka: “Lou Gehrig’s Disease”)

  • Fasciculations are present as well as spasticity and increased DTR’s. LMNL in the arms and UMNL in the legs.
  • DDX: Lateral canal stenosis
12
Q

_____: refers to inflammatory polyneuropathy of the PNS linked to recent immunizations or seen after recent FLU infection. Pt presents with ascending paralysis (Beginning in the Legs) and sensory symptoms?

a. ) Tabes dorsalis
b. ) Gullain-Barre syndrome
c. ) Amyotrophic lateral sclerosis
d. ) Posterolateral sclerosis

A

b.) Gullain-Barre syndrome

13
Q

_____: refers to degeneration of the posterior columns and the corticospinal tracts as a result of a B12 deficiency (pernicious anemia). Neurological symptoms are irreversible. Patient has a glove and stocking paresthesia?

a. ) Tabes dorsalis
b. ) Gullain-Barre syndrome
c. ) Amyotrophic lateral sclerosis
d. ) Posterolateral sclerosis

A

d. ) Posterolateral sclerosis (aka: “Combined Systems Disease”)
- Ortho’s:(+) Schilling test

14
Q

_____: refers to a chronic progressive condition associated with loss of dopamine in the substantial nigra causing basal ganglionic dysfunction. Extrapyramidal tract involvement. Gradual onset over age 50?

a. ) Muscular dystrophy
b. ) Charcot Marie Tooth disease
c. ) Parkinson’s disease
d. ) Brown sequard

A

c.) Parkinson’s disease (aka: “Paralysis Agitans”)

15
Q

_____: refers to a sex linked recessive disorder in boys ages 3-7 y/o. Pt has proximal muscle weakness causing a Waddling gait; Gower’s sign, Psuedohypertrophy of the calves, Toe walking, and HYPERlordosis?

a. ) Muscular dystrophy
b. ) Charcot Marie Tooth disease
c. ) Parkinson’s disease
d. ) Brown sequard

A

a. ) Muscular dystrophy (aka: “Erb Duchenne”)

- Large increase in CPK (CK-MM); decreased creatine

16
Q

_____: refers to a hereditary condition that affects both motor and sensory nerves. A typical feature includes weakness of the foot and lower leg muscles which may result in foot drop and a high-steppage gait with frequent tripping or falls?

a. ) Muscular dystrophy
b. ) Charcot Marie Tooth disease
c. ) Parkinson’s disease
d. ) Brown sequard

A

b.) Charcot Marie Tooth disease

17
Q

_____: refers to mental deterioration (cortical degeneration), amnesia?

a. ) Paralysis agitans
b. ) Parkinson’s disease
c. ) Alzheimer’s
d. ) Huntington’s chorea

A

c. ) Alzheimer’s

- Most definitive dx: Autopsy

18
Q

_____: refers to a neurodegenerative genetic disorder, which affects muscle coordination; cognitive decline and dementia. MC onset 35-44 y/o?

a. ) Paralysis agitans
b. ) Parkinson’s disease
c. ) Alzheimer’s
d. ) Huntington’s chorea

A

d.) Huntington’s chorea

19
Q

Diagnosed via Tensilon Test and treated with Cholinesterase inhibiting drugs?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

a.) Myasthenia gravis

20
Q

Which of the following orthopedic test are positive for Multiple Sclerosis?

a. ) Soto hall
b. ) Schilling test
c. ) Brudzinski
d. ) Lhermitte’s

A

d.) Lhermitte’s

21
Q

Which of the following orthopedic test are positive for Posterolateral Sclerosis?

a. ) Soto hall
b. ) Schilling test
c. ) Brudzinski
d. ) Lhermitte’s

A

b.) Schilling test

22
Q

Which of the following is associated with Charcot’s Triad: Scanning speech, Intention tremors, Nystagmus (SIN)?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

b.) Multiple sclerosis

23
Q

Which of the following tracks is associated with Parkinson’s Disease?

a. ) Corticospinal
b. ) Lateral spinothalmic
c. ) Reticulospinal
d. ) Extrapyramidal

A

d.) Extrapyramidal

24
Q

What condition causes a loss of pain and temperature over the shoulders and back in a cape like distribution?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

c.) Syringomyelia

25
Q

What condition is associated with Charcot’s triad?

a. ) Myasthenia gravis
b. ) Multiple sclerosis
c. ) Syringomyelia
d. ) Cerebral palsy

A

b.) Multiple sclerosis

Charcot’s triad: Scanning speech, Intention tremors, Nystagmus

26
Q

What is the most common symptom in a patient with Cerebral palsy?

a. ) Scissor gait
b. ) Spastic paralysis
c. ) Athetoid
d. ) Choreiform movements

A

c.) Athetoid

27
Q

What’s the best way to diagnose a patient with Alzheimer’s?

A

autopsy

28
Q

What is the average age for onset of Huntington’s Chorea?

A

35-44 years old

29
Q

Cerebral palsy is most commonly caused by what?

A

birth trauma

30
Q

This condition has a gradual onset over the age of 50. Causing a patient to present with Bradykinesia, Festinating gait, Cogwheel/lead pipe rigidity, Resting tremors, Mask like face, and a Forward stooped posture?

A

Parkinson’s disease (aka: Paralysis agitans)

31
Q

What is the case management for a patient with Parkinson’s disease?

A
  • GABA
  • Modify home to decrease falls
  • Encourage continuation of ADL
32
Q

This condition is commonly seen after a recent flu infection, which causes ascending paralysis and sensory symptoms. Can become a medical emergency if it reaches the diaphragm?

A

Gullian-Barre Syndrome