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16 Cards in this Set
- Front
- Back
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Key History -
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Distribution -
u/l, b/l, proximal, distal duration progression pain - esp. HA, neck or back constitutional Sxs other neuro Sxs h/o diabetes alcoholism atherosclerotic vascular dis |
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Key PE -
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VS
neurological exam musculoskeletal exam relevant vascular exam |
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68 y/o M
presents following a 20-min. episode of slurred speech, right facial drooping and numbness and right-hand weakness. His Sxs had totally resolved by the time he got to the ER. He has a h/o HTN, DM and heavy smoking. What is Differential? |
TIA
hypoglycemia seizure |
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68 y/o M
presents following a 20-min. episode of slurred speech, right facial drooping and numbness and right-hand weakness. His Sxs had totally resolved by the time he got to the ER. He has a h/o HTN, DM and heavy smoking. What is Workup? |
CBC
glucose electrolytes EKG CT - head MRI - brain doppler US - carotid echocardiography EEG |
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68 y/o M
presents with slurred speech, right facial drooping and numbness and right-hand weakness. Babinski's sign is present on the right. He has a h/o HTN, DM and heavy smoking. What is Differential? |
Stroke
TIA seizure intracranial tumor subdural or epidural hematoma |
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68 y/o M
presents with slurred speech, right facial drooping and numbness and right-hand weakness. Babinski's sign is present on the right. He has a h/o HTN, DM and heavy smoking. What is Workup? |
CBC, electrolytes
PT/PTT CT - head MRI - brain (preferred) doppler US - carotid echocardiography |
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33 y/o F
presents with ascending loss of strength in her lower legs over the past 2 wks. She had a recent URI. What is Differential? |
Guillain-Barre
MS polymyositis myasthenia gravis peripheral neuropathy tumor in the vertebral canal |
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33 y/o F
presents with ascending loss of strength in her lower legs over the past 2 wks. She had a recent URI. What is Workup? |
CBC, electrolytes
CPK LP - CSF analysis MRI - spine EMG/nerve conduction study serum B12 |
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30 y/o F
presents with weakness, loss of sensation and tingling in her left leg that started this morning. She is also experiencing right eye pain, decreased vision and double vision. She reports feeling "electric shocks" down her spine upon flexing her head. What is Differential? |
MS
stroke conversion d/o malingering CNS tumor neurosyphilis syringomyelia CNS vasculitis |
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30 y/o F
presents with weakness, loss of sensation and tingling in her left leg that started this morning. She is also experiencing right eye pain, decreased vision and double vision. She reports feeling "electric shocks" down her spine upon flexing her head. What is Workup? |
CBC, ESR
RPR/VDRL MRI - brain LP - CSF analysis retinal evoked potentials |
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55 y/o M
presents with tingling and numbness in the hands and feet (glove and stocking distribution) over the past two months. He has a h/o DM, HTN and alcoholism. There is decreased soft touch, vibratory and position sense in the feet. What is Differential? |
Diabetic peripheral neuropathy
alcoholic periph neuropathy B12 deficiency hypocalcemia hyperventilation paraproteinemia/myeloma |
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55 y/o M
presents with tingling and numbness in the hands and feet (glove and stocking distribution) over the past two months. He has a h/o DM, HTN and alcoholism. There is decreased soft touch, vibratory and position sense in the feet. What is Workup? |
ESR
calcium serum B12 glucose, HbA1c SPEP/UPEP |
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40 y/o F
presents with occasional double vision and droopy eyelids at night with normalization by morning. What is Differential? |
Myasthenia gravis
horner's syndrome MS intracranial tumor compressing CN3, 4 or 6 ALS |
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40 y/o F
presents with occasional double vision and droopy eyelids at night with normalization by morning. What is Workup? |
Tensilon test
Ach receptor Ab CXR CT - chest MRI - brain EMG |
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25 y/o M
presents with hemiparesis (ater a tonic-clonic seizure) that resolves over a few hours What is Differential? |
Todd's paralysis
TIA stroke complicated migraine malingering |
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25 y/o M
presents with hemiparesis (ater a tonic-clonic seizure) that resolves over a few hours What is Workup? |
CBC, electrolytes
EEG MRI - brain doppler US - carotid |
