Miscellaneous

Question 1

Amyotrophic lateral sclerosis

Answer 1

Combination of upper motor neuron sign (hyperreflexia, spasticity, and
extensor plantar response) with lower motor neuron signs (atrophy and
fasciculation), sensory deficit are absent

Can be associated with difficulty speaking and swallowing
Very poor prognosis

Question 2

Glasgow coma scale
Mild 13-15
Moderate 9-12
Severe 3-8

Answer 2

Eye opening
-Spontaneous = 4
- To sound = 3
-To pressure = 2
-None =1

verbal score
-Orientated= 5
-confused= 4
-words= 3
-sounds= 2
-none=1

Motor response
-Obey commands = 6
-Localizing= 5
-normal flexion= 4
-abnormal flexion=3
-extension= 2
-none=1

Question 3

A 45-year-old patient present to the clinic with
a three months history of stumbling weak grip,
dysphagia, generalized and lower limb
weakness, fatigability and tiredness and also
had 2 episodes aspiration pneumonia, has brisk
refex and fasciculation, what is the most likely
diagnosis?

Answer 3

Amyotrophic lateral sclerosis

Question 4

Old patient with history of recent travel, came
with difculty getting aroused/awaken, he
report multiple falls, examination showed no
head wounds and skull is intact, what is the
most likely diagnosis?

Answer 4

Chronic subdural hematoma

Question 5

In pituitary adenoma, what is the vision affection?

Answer 5

Bitemporal hemianopia= optic chiasma compression

Question 6

Patient can localize the pain, open eye to pain,
say only sounds, what is the GCS level?

Answer 6

9

Question 7

Patient with head injury, eye is opening to pain,
inappropriate words, abnormal fexion, how can
you consider this GCS level?

Answer 7

Severe

Question 8

RTA patient eye respond to painful stimuli,
localize the pain, groaning sounds, calculate
GCS?

Answer 8

9