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153 Cards in this Set
- Front
- Back
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Fever in acute confusional state
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Meningitis, anticholinergic intox, alcohol/sedative withdrawal, sepsis
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Headache in acute confusional state
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Head trauma, meningitis, subarachnoid hemorrhage
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Hypothermia in acute confusional state
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Ethanol/sedative intox, hepatic encephalopathy, hypoglycemia, hypothyroidism, sepsis
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Hypertension in acute confusional state
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Anticholinergic intox, ethanol/sedative withdrawal, HTN encephalopathy, subarachnoid hemorrhage, sympathomimetic intox
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Tachycardia in acute confusional state
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Anticholinergic intox, ethanol/sedative withdrawal, thyrotoxicosis, sepsis
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Bradycardia in acute confusional state
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Hypothyroidism
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Hyperventilation in acute confusional state
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Hepatic encephalopathy, hyperglycemia, stress
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Meningismus in acute confusional state
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Meningitis, subarachnoid hemorrhage
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Skin rash in acute confusional state
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Meningococcal meningitis
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Tetany in acute confusional state
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Hypocalcemia
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Papilledema in acute confusional state
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HTN encephalopathy, intracranial mass
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Dilated pupils in acute confusional state
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Head trauma, anticholinergic intox, ethanol/sedative withdrawal, sympathomimetic intox
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Constricted pupils in acute confusional state
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Opioid intoxication
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Nystagmus in acute confusional state
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Ethanol/sedative/phencyclidine intox, vertebrobasilar ischemia, Wernicke encephalopathy
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Tremor in acute confusional state
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Ethanol/sedative withdrawal, sympathomimetic intox, thyrotoxicosis
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Asterixis in acute confusional state
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Metabolic encephalopathy
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Hemiparesis in acute confusional state
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Cerebral infarction, head trauma, hyperglycemia, hypoglycemia
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Seizures in acute confusional state
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Ethanol/sedative withdrawal, head trauma, hyperglycemia, hypoglycemia
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Ataxia in acute confusional state
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Ethanol/sedative intox, Wernicke encephalopathy
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Argyll Robertson pupills
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Neurosyphilis
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Kayser-Fleischer rings
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Wilson disease
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Gait apraxia
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Normal pressure hydrocephalus
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Chorea
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Huntington disease, Wilson disease
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Myoclonus
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Creutzfeldt-Jakob disease, HIV-associated dementia
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Lemon yellow coloration of skin
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Vitamin B12 deficiency
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"Worst headache of life" w/vomiting, seizures
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Subarachnoid hemorrhage
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Amyloid plaques
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Senility, Alzheimer's
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Pill rolling
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Parkinson's
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Locus ceruleus
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Norepinephrine
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Raphe nuclei
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Serotonin
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Stroke symptoms on one side, with other symptoms on other side
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Brainstem stroke
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Hemiparesis & sensory loss in leg greater than arm
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ACA stroke
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Hemiparesis & sensory loss in arm greater than leg
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MCA stroke
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Stroke symptoms w/nausea, vomiting, hiccups
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Brainstem stroke
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Stroke symptoms w/oropharyngeal weakness, eye mvt abnormal
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Brainstem stroke
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Stroke symptoms w/ataxia, gait instability
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Cerebellar stroke
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Meaningless unintentional unexpected movements (chorea)
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Basal ganglia lesion
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Ataxia
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Cerebellar disorder
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Inability to perform rapid alternating movements
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Cerebellar disorder
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Overshooting the goal in reaching towards an object
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Cerebellar disorder
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Asthenia
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Cerebellar disorder
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Nystagmus
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Cerebellar disorder
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Parkinsonism
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Basal ganglia & substantia nigra disorder
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Positive Romberg (swaying with eyes closed but not with open)
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Proprioceptive or vestibular defect
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Inability to say "Kuh Kuh Kuh"
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CN 10 defect (soft palate)
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Inability to say "La La La"
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CN 12 defect (tongue)
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Inability to say "Mi Mi Mi"
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CN 7 defect (lips)
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Expressive aphasia
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Lesion in anterior Broca's area
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Receptive aphasia
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Lesion near Wernicke's area
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Alexia (inability to read)
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Lesion near the visual association cortex
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Agnosia or apraxia
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Cerebral cortex lesion
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Wrist drop
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Radial nerve injury (C5-C8)
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Atrophy of thenar eminence
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Median nerve injury (C6-T1)
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Claw hand
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Ulnar nerve injury (C8-T1)
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Atrophy of hypothenar eminence
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Ulnar nerve injury (C8-T1)
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Impaired supination of foremarm
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Musculocutaneous nerve injury (C5-C6)
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Deltoid atrophy
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Axillary nerve injury (C5-C6)
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Winging of scapula
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Long thoracic nerve injury (C5-C7)
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Foot drop
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Common peroneal nerve injury (L4-S2)
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Hyperreflexia
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Upper motor neuron injury
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Hyporeflexia
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Lower motor neuron injury
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Whole body muscle atrophy, fasciculations, hyperreflexia
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ALS
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Weakness, decreased sensory, hyporeflexia of distal extremities bilaterally
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Peripheral neuropathy
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Decreased proprioception, + Romberg, sharp pains lower distal extremities
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Tertiary syphilis
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Lower Spastic paralysis, decreased proprioception & hyperreflexia one side, decreased pain/temp on other side
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Brown-Sequard syndrome (hemisection of spinal cord) at T11
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Radicular pain upper extremity
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Cervical roots C5-C6 injury
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Upper extremity decreased pain/temp, light touch/proprioception intact
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Sphingomyelia
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Lower extremity spastic paralysis, loss all sensory modalities, hyperreflexia
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Total transection of T11
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Decreased triceps reflex
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Radial nerve injury (C5-C8)
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Weakness of elbow & wrist extension
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Radial nerve injury (C5-C8)
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Decreased sensory of buttocks/back of thighs, atrophy, impotence
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Cauda equina lesion (S2-S4)
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Decreased vision, + Babinski, ataxia, nystagmus, facial weakness
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Multiple sclerosis
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Absent knee jerk
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Femoral nerve lesion
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Legs swing outward when walking
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Obturator nerve lesion
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Upgoing toes (Babinksi)
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Upper motor neuron injury
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Clonus
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Upper motor neuron injury
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Fasciculations
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Lower motor neuron injury
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Gower's sign
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Duchenne's muscular dystrophy
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Calf pseudohypertrophy
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Duchenne's muscular dystrophy
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Dystrophin gene
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Duchenne's muscular dystrophy
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Gottron's sign
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Dermatomyositis
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Acetylcholine receptor antibodies
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Myasthenia gravis
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High protein on LP but no white cells
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Guillain-Barre
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Palpable purpura
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Neisseria meningitidis
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Only responsive to pain
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Stupor
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Inappropriate reactions to stimuli
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Delirium
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Decerebrate posturing to painful stimuli
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Coma
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Lesions of tongue/palate causing speech difficulty
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Dysarthria
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Difficulty with speech because of cerebral dysfunction
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Dysphasia
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Alteration of tone or volume of voice due to lesions of vocal cords/tongue
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Dysphonia
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Malformed words
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Paraphasia
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Phrases substituted for words that patient cannot remember
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Circumlocutions
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Inability to perform voluntary movements
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Apraxia
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Decreased ability to perform voluntary movements
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Dyspraxia (deep frontal lobe lesion)
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Inability to construct or draw simple designs
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Lesion in posterior parietal lobe (Constructive apraxia)
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Unilateral vibration sense loss
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Peripheral neuropathy
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Diffuse bilateral vibration sense loss
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Peripheral polyneuropathy - diabetes, B12 deficiency
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Lack of discriminative sensation (number in hand, object in hand)
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Contralateral cerebral cortex - parietal lobe lesion (posterior columns)
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Tactile localization more proximal than actual test site
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Contralateral parietal lobe dysfunction
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Two point discrimination impaired
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Contralateral parietal lobe dysfunction
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Superficial reflexes diminished
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Upper motor neuron injury
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Hyperactive DTRs
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Upper motor neuron injury
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Clumsiness in movement
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Dysmetria
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Drags leg, elbow flexed across abdomen
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Hemiplegia
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Shuffles w/short hurried steps, head down, back bent
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Parkinson's
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Wide based gait with staggering from side to side
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Cerebellar ataxia
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Foot drop
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Weakness of dorsiflexors of ankle
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High stepping gait with firm slap, patient looks down, positive Romberg
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Sensory ataxia
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Spastic diplegia (scissoring)
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Injury to pyramidal system
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Legs far apart, high then brought down forcibly, heel stamps on ground
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Tabetic gait
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Positive pronator drift
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Mild hemiparesis or contralateral corticospinal tract lesion
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Brief flexon of hands/wrist after holding in flexion
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Asterixis - metabolic encephalopathy
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Decorticate rigidity
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Lesion of corticospinal tract near or within cerebral hemispheres
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Unilateral decorticate rigidity
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Chronic spastic hemiplegia
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Decerebrate Rigidity
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Lesion in diencephalon, pons, midbrain, or metabolic disorder like hypoglycemia or hypoxia
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Hemiplegia
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Unilateral corticospinal tract causes one sided paralysis with initial flaccidity
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Eyes turned towards normal side
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Hemiplegia
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Doll's eye reflex present
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Comatose patient with lesion in brainstem
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Eyes do not drift toward irrigated ear in caloric stimulation
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Brainstem injury
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Resting tremor
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Parkinson's
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Intention tremor
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Multiple sclerosis
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Postural tremor
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Benign, anxiety, hyperthyroidism
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Chorea at rest or with movement
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Huntington disease
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Athetosis (slow twisting, spasticity)
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Cerebral palsy
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Pseudohypertrophy of calf muscles
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Duchenne & Becker muscular dystrophy
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Rubber band like resistance that snaps back to position when released
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Dystonia
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Unilateral headache
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Migraine or cluster headache
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Headache arising in temporal area
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Tension headache
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Retro-orbital headache
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Cluster headache
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Horizontal diplopia
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CN III or VI palsy
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Vertical diplopia
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CN III or IV palsy
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Noisy environment helps hearing loss
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Conductive hearing loss
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Trouble understanding words and noisy environment worsens hearing loss
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Sensorineural hearing loss
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Tinnitus, hearing loss, vertigo
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Meniere's disease
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Leg pain that resolves with rest and/or lumbar forward flexion
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Spinal stenosis
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Severe pain of rapid onset in a red, swollen joint
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Septic arthritis or gout
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Positive Lhermitte sign
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MS or cervical cord compression
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Ophthalmoplegia, ataxia, global confusion
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Wernicke's encephalopathy (treat w/thiamine - B1)
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Atrophy of hippocampus
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Schizophrenia, Alzheimer's, severe unipolar depression
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Excess activity in amygdala
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unipolar depression
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Increased frontal lobe & caudate nucleus activity
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OCD
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Drooping eyelids, double vision, oropharyngeal/appendicular weakness, SOB
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Myasthenia gravis
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Nasal speech, flattened smile
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Myasthenia gravis
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Torticollis (Shortening of neck muscles, head to one side, chin to other)
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Osteomyelitis of vertebrae, secondary to soft tissue infection of neck
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Rapid onset proximal weakness w/o pain
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Polymyositis
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Rapid onset proximal weakness w/heliotrope rash & Gottron's sign
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Dermatomyositis
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Very slow onset proximal/distal weakness, dysphagia
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Inclusion body myositis
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Thymoma
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Myasthenia gravis
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Slowly progressive atrophy of distal muscles innervated by peroneal nerve
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Charcot Marie Tooth disease
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Stroke victim neglects side of body
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Right brain stroke
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Stroke with aphasia
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Left brain stroke
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Crossfindings in stroke (face affected one way, other side of body another)
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Brainstem stroke
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"Down & out" pupils
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CN III palsy
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