26. Limb Weakness

Question 1

Answer 1

Question 2

Answer 2

Question 3

What are the possible anatomical locations for the lesion causing Mr Walker’s limb weakness?

Answer 3

Question 4

What are your differential diagnoses for limb weakness?

Answer 4

Question 5

Answer 5

Question 6

How to distinguish between upper and lower motor neuron lesions?

Answer 6

Question 7

Other than upper vs. lower motor neuron distinguishing features, what else will you look for on physical examination to help you locate the likely anatomical site of this patients lesion?
- Language defects?
- Attention defects?
- Eye signs?
- Sensory symptoms?

Answer 7

Question 8

Answer 8

Question 9

What is the differential for this type of lesion? Are there any clues to the aetiology from the examination above?

Answer 9

1. Stroke (infarct or haemorrhage)
2. Cerebral mass (eg. tumour, abscess - potentially with a bleed into it)
3. Hemiplegic migraine
4. Hypoglycaemia (can present with localised signs although it is unclear how)

Question 10

5 Investigations to diagnose a suspected right-sided MCA stroke?

Answer 10

Question 11

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Question 12

Answer 12

Question 13

Which 2 second-line investigations should Mr Walker have on the stroke unit?

Answer 13

Question 14

= 3

Answer 14

Question 15

= 5 things

Answer 15

Question 16

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Question 17

Provide an algorithm for acute management of stroke.

Answer 17

Question 18

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Question 19

Assessment and diagnosis?

Answer 19

Question 20

Management of TIAs?

Answer 20

Question 21

Which modifiable risk factors will be addressed? (6)

Answer 21

Question 22

What medications is Mr Browne likely to be recommended following his TIA?

Answer 22

Question 23

Answer 23

Question 24

Diagnosis?

Answer 24

Question 25

3 Investigations to confirm diagnosis?

Answer 25

Question 26

Why don’t all patients with ischaemic strokes receive thrombolysis treatment? What is the evidence to support thrombolysis?
- 15 Contraindications to thrombolysis?

Answer 26

Question 27

Answer 27

Question 28

Answer 28

Question 29

What scale is used to grade limb weakness?

Answer 29

Question 30

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Question 31

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Question 32

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Question 33

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Question 34

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Question 35

Answer 35