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Flashcards in Problem solving - neurology Deck (27):
1

Recall problem based clinical reasoning

1. define problem
2, define system
3. define location
4. define lesion

2

How to define the problem with collapse?

seizures of syncope?

3

Define 'can't eat properly'?

inability to prehend or swallow food

4

Define 'vomits'

vomiting or regurgitation

5

Define 'wees a lot'

polyuric or pollakiuric

6

What is the 6 finger rule?

1. localisation
2. signalment
3. onset
4. progression
5. symmetry
6. pain

7

Localisation - hydrocephalus

brain

8

Localisation - cerebellar abiotropy

cerebleeulm

9

Localisation - atlanto-axial subluxation

upper cervical spinal cord

10

Localisation - caudal cervical spondylomyelopathy

caudal cervical spinal cor

11

Localisatio - spinal nephroblastoma (uncommon)

spinal cord (thoracic - lumbar?_

12

Localisation - myasthenia gravis (MG)

NMJ

13

Localisation -muscular dystrophy

mm bed

14

Localisation -vincristine neuropathy

peripheral nn

15

Outlien localisation -lesion distribution - 3

- FOCAL: neoplasia, IVDH, congenital malformation
- MULTIFOCAL: inflammatory, infection, multifocal neoplasia: lymphoma
- DIFFUSE: neurodegenerative, metabolic

16

What are the different onsets of (neuro) diseases

- per-acute
- acute
- sub-acute
- chronic
- acute on chronic

17

What are the different classifications of 'progression' of (neuro) diseases?

- improving
- static
- deteriorating
- waxing and waning
- episodic
- paroxysmal

18

Are there pain receptors in the spinal cord?

No

19

List the 8 parts to the neuro exam

1. mentation
2. posture
3. gait
4. postural reactions
5. spinal reflexes
6. cranial nerves
7. palpation
8. nociception

20

What should you do if you suspect a focal lesion?

imaging

21

What should you do if you suspect infection/ inflammation?

Minimum database- CBC, biochem, UA

22

What are teh most important aspects of patient hx in neuro cases? 3

- signalment
- onset
- progression

23

What are the most important things to determine on physical and neuro exam?

- localisation
- symmetry
- presence of pain

Then choose diagnostic tests based on remaining ddx (the true rule outs)

24

What is the ddx based on? 6

- localisation
- signalment
- onset
- progression
- symmetry
- pain

25

What is mucopolsaccharidosis (MPS)?

- rare disease
- affects young animals
- pure bred
- progressive
- multi-system involvement (can cause lameness)

26

Diagnosis - MPS

- urine MPS spot test: measures GAG
- enzyme activity of leukocytes (EDTA) and activity of arlysulfatase B activity

27

Outcome - MPS

- poor prognosis
- genetic counselling