We've found 5 Neurology tests

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12. A 23 y/o PA student with no significant PMH presents to your clinic complaining of a lingering cough, weakness that worsens at the end of the day, and “seeing double” while studying her numerous neurology class notes. Physical exam reveals mild tachycardia, tongue with three furrows, use of accessory muscles on respiration, mild ptosis bilaterally, and fatigability to 3/5 in deltoids bilaterally with 8 reps that recovers to 5/5 after rest. She denies muscle atrophy and paralysis. Based on your diagnosis, what is the most likely first line of treatment for this patient?
Pyridostigmine plus corticosteroids
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ClinicalTherapeutics/Neurology What is the appropriate initial intravenous drug therapy for a patient in status epilepticus? A. Midazolam (Versed) B. Lorazepam (Ativan) C. Fosphenytoin (Mesantoin) D. Phenobarbital
(u) A. See B for explanation. (c) B. A benzodiazepine (lorazepam) is first line in the treatment of status epilepticus, followed by phenytoin or fosphenytoin. (h) C. See B for explanation. (h) D. This answer is potentially harmful because the patient is currently seizing and lorazepam is indicated.
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Diagnosis/Neurology A 51 year-old female presents to the clinic complaining of intermittent sharp pain that originates at the corner of her mouth and radiates toward her ipsilateral eye. She notes “everything makes it worse” including touching the area, talking and eating. What is the most likely diagnosis? A. Bell’s palsy B. Cluster headache C. Post-herpetic neuralgia D. Trigeminal neuralgia
(u) A. See D for explanation. (u) B. See D for explanation. (u) C. See D for explanation. (c) D. This is the classic presentation for trigeminal neuralgia (tic douloureux).
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Diagnostic Studies/Neurology A 22 year-old male presents to the clinic complaining of excessive daytime somnolence and strong desires to sleep at inappropriate times. He came in today because he had an episode of “feeling paralyzed” as he was falling asleep yesterday. What is the most appropriate diagnostic test to confirm this patient’s diagnosis? A. MRI of the brain B. Electroencephalogram C. Multiple sleep latency test D. Overnight polysomnography
(u) A. See C for explanation. (u) B. See C for explanation. (c) C. Multiple sleep latency test is required to observe the abrupt transition to REM sleep and establish the diagnosis of narcolepsy. (u) D. See C for explanation.
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The nurse cares for clients on the neurology unit. What is the MOST appropriate action for the nurse to take after noting that a client suddenly develops a fixed and dilated pupil? 1. Reassess in 5 minutes. 2. Check the client’s visual acuity. 3. Lower the head of the client’s bed. 4. Contact the physician.
Strategy: Answers are a mix of assessments and implementations. Is this a situation that requires assessment or validation? No. Determine the outcome of the implementations. (1) assessment; situation does not require validation (2) assessment; has symptoms of increased intracranial pressure (ICP) (3) implementation; would increase the ICP (4) correct—implementation; fixed and dilated pupil represents a neurological emergency
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History&Physical/Neurology A patient with an upper motor neuron lesion would exhibit which of the following findings? A. Fasciculations B. Areflexia C. Muscular atrophy D. Spasticity
(u) A. Fasciculations, areflexia and muscle atrophy are consistent with lower motor neuron lesions. (u) B. See A for explanations. (u) C. See A for explanation. (c) D. Spasticity is an upper motor neuron lesion finding.
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What are clinical sign of neurology in horses?
Ataxia – often due to CP deficits Spasticity (hypometria) – increased ton, stiff awkward movement due to UMN or vestibular dz Hypermetria – uncontrolled rapid forceful movements due to cerebellar dz Weakness
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ClinicalTherapeutics/Neurology A 37 year-old female presents to the clinic for follow-up regarding her recently diagnosed tonic-clonic epilepsy. She reports no seizures or side effects since starting valproate (Depakote) at her last visit one month ago. What diagnostic study would you order to monitor this patient’s treatment? A. Serum amylase B. Serum creatinine C. Liver function tests D. Electroencephalogram
(u) A. See C for explanation. (u) B. See C for explanation. (c) C. Valproate may be toxic to the liver as well as cause thrombocytopenia. (u) D. See C for explanation.
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An 18-year-old client is admitted to the neurology unit following a car accident 2 days ago. During an initial abdominal assessment, which abnormal finding does the nurse find that is consistent with a motor vehicle accident? A: Cullen’s sign B: Soft, non-tender abdomen C: High-pitched bowel sounds D: Tympany
A: Cullen’s sign Cullen’s sign is a superficial abdominal bruising around the umbilicus. It is usually caused by severe pancreatic symptoms or blunt force abdominal trauma. All other findings are normal abdominal assessments.
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dermatomes are useful in neurology for
finding the site of damage to nerve/spine or cause of lesion
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