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What should be ensured if a teratogenic medication is prescribed to a female of childbearing age?
What should be ensured if a teratogenic medication is prescribed to a female of childbearing age?
Muscle weakness and fatigability are common symptoms of muscle disorders.
Muscle weakness and fatigability are common symptoms of muscle disorders.
True
What condition is suggested by spontaneous, irregular, and brief contractions of a muscle?
What condition is suggested by spontaneous, irregular, and brief contractions of a muscle?
Lower Motor Neuron disease (LMN disease)
Dystrophia myotonica is characterized by weakness and __________, particularly in the face and neck.
Dystrophia myotonica is characterized by weakness and __________, particularly in the face and neck.
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Match the symptoms of muscle disorders with their descriptions:
Match the symptoms of muscle disorders with their descriptions:
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What is the role of the reflex arc in the reflex action?
What is the role of the reflex arc in the reflex action?
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Clonus is associated with lower motor neuron lesions.
Clonus is associated with lower motor neuron lesions.
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What does the presence of a brisk reflex indicate?
What does the presence of a brisk reflex indicate?
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A reflex that is absent could imply a breach in the reflex arc at the __________ nerve or root.
A reflex that is absent could imply a breach in the reflex arc at the __________ nerve or root.
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Match each type of reflex response with its implication:
Match each type of reflex response with its implication:
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Which method is used to accentuate a reflex that seems absent?
Which method is used to accentuate a reflex that seems absent?
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Reinforcement of reflexes lasts indefinitely until the reflex is observed.
Reinforcement of reflexes lasts indefinitely until the reflex is observed.
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What type of problems might an absent reflex indicate?
What type of problems might an absent reflex indicate?
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Which of the following cranial nerves is tested for the ability to differentiate smells?
Which of the following cranial nerves is tested for the ability to differentiate smells?
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Monocular blindness indicates a lesion in the optic chiasm.
Monocular blindness indicates a lesion in the optic chiasm.
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What is one potential cause of lesions affecting cranial nerves?
What is one potential cause of lesions affecting cranial nerves?
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The cranial nerve responsible for vision is the ______.
The cranial nerve responsible for vision is the ______.
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Match the cranial nerves with their clinical tests:
Match the cranial nerves with their clinical tests:
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Which of the following conditions can affect cranial nerves?
Which of the following conditions can affect cranial nerves?
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Bitemporal hemianopia is a result of a lesion beyond the optic chiasm.
Bitemporal hemianopia is a result of a lesion beyond the optic chiasm.
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Name one type of visual field loss that can occur due to lesions affecting cranial nerves.
Name one type of visual field loss that can occur due to lesions affecting cranial nerves.
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What is a common cause of diplopia when looking outwards?
What is a common cause of diplopia when looking outwards?
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A normal-sized pupil indicates a IIIrd nerve lesion.
A normal-sized pupil indicates a IIIrd nerve lesion.
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What are the symptoms of a VII nerve (facial nerve) lesion?
What are the symptoms of a VII nerve (facial nerve) lesion?
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The __________ nerve is responsible for hearing and balance.
The __________ nerve is responsible for hearing and balance.
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Match the cranial nerve with its associated symptoms:
Match the cranial nerve with its associated symptoms:
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Which of the following conditions is NOT related to facial nerve (VII) damage?
Which of the following conditions is NOT related to facial nerve (VII) damage?
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The function of cranial nerve VIII includes only auditory capabilities.
The function of cranial nerve VIII includes only auditory capabilities.
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What is the potential cause of a unilateral corneal reflex loss?
What is the potential cause of a unilateral corneal reflex loss?
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Which drug class is NOT commonly associated with exacerbating neurological symptoms according to the content?
Which drug class is NOT commonly associated with exacerbating neurological symptoms according to the content?
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Iron deficiency is associated with 50% of sufferers in the context provided.
Iron deficiency is associated with 50% of sufferers in the context provided.
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What is the recommended management for Wernicke's encephalopathy?
What is the recommended management for Wernicke's encephalopathy?
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The most common inherited ataxia is __________.
The most common inherited ataxia is __________.
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Match the neurological conditions with their associated symptoms or characteristics:
Match the neurological conditions with their associated symptoms or characteristics:
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Which of the following management strategies is prioritized before drug therapies?
Which of the following management strategies is prioritized before drug therapies?
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Korsakoff syndrome can occur without a history of alcohol misuse.
Korsakoff syndrome can occur without a history of alcohol misuse.
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What are two common symptoms of Huntington’s disease?
What are two common symptoms of Huntington’s disease?
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What percentage of patients is affected by relapsing-remitting MS (RRMS)?
What percentage of patients is affected by relapsing-remitting MS (RRMS)?
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Secondary progressive MS (SPMS) develops in 65% of patients after 15 years of relapsing-remitting MS.
Secondary progressive MS (SPMS) develops in 65% of patients after 15 years of relapsing-remitting MS.
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What is the first-line treatment for acute relapses of MS?
What is the first-line treatment for acute relapses of MS?
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Primary progressive MS (PPMS) affects ___% of patients.
Primary progressive MS (PPMS) affects ___% of patients.
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Match the following types of MS with their characteristics:
Match the following types of MS with their characteristics:
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Which of the following is NOT a disease-modifying drug for MS?
Which of the following is NOT a disease-modifying drug for MS?
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All disease-modifying drugs for MS are prescribed without monitoring.
All disease-modifying drugs for MS are prescribed without monitoring.
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What is the Expanded Disability Status Scale (EDSS) threshold for starting treatment immediately?
What is the Expanded Disability Status Scale (EDSS) threshold for starting treatment immediately?
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Study Notes
Chapter 15: Neurology
- Reflexes and muscle power: Reflexes are automatic responses; the reflex arc goes from stimulus to spinal cord and back to motor nerve. Key reflexes are recorded as absent, present with reinforcement, normal, or brisk ± clonus.
- Cranial nerve lesions: Cranial nerves can be disrupted anywhere from the brainstem to the point of innervation. Sites of lesions include muscles, neuromuscular junctions, and locations outside/within the brainstem. Multiple nerves can be affected by certain conditions.
- Neuropathy: Dermatomes and peripheral nerve distribution are included; mononeuropathy is a lesion of individual peripheral nerves (including cranial nerves). Common causes include trauma, compression, diabetes, leprosy, and cancer.
- Mononeuropathies: Bell's palsy is sudden facial palsy of unknown cause. Ramsay Hunt syndrome is a viral infection causing pain in the ear, facial nerve palsy, and vesicles. Morton's metatarsalgia is a pain in the forefoot. Autonomic neuropathy can present as symptoms including postural hypotension, urinary problems, sweating issues, and vomiting issues.
- Polyneuropathy: Generalized disorder affecting peripheral nerves including cranial and autonomic nerves. Sensory neuropathy causes numbness, tingling, and burning sensations; motor neuropathy causes weakness in the hands, stumbling, and difficulty in breathing.
- Speech problems: Hoarseness, stammering, dysarthria, and dysphasia are discussed. Myasthenia gravis is an autoimmune disease causing muscle weakness, often affecting orbital and bulbar muscles. Lambert-Eaton syndrome is similar to myasthenia gravis.
- Walking problems: Causes of walking difficulties include musculoskeletal issues (osteoarthritis, fractures), psychological issues (depression, fear of falling), neurological issues (stroke, Parkinson's disease), spinal cord compression, and systemic issues (pneumonia, infections).
- Other movement problems: Cramps are painful muscle spasms, often at night or after exercise. Dystonia is a prolonged muscle contraction resulting in abnormal postures and movements. Myoclonus is sudden involuntary jerks, and may be associated with several conditions. Tremors, athetosis, chorea, and ballism/hemiballism are classified in this chapter.
- Transient loss of consciousness: Funny turns in young children and causes of transient loss of consciousness in general are discussed.
- Assessment of headache: History, including specific issues, symptoms, triggers, characteristics and response to medication. Examination should include blood pressure, neurologic examination, and head circumference in children.
- Raised intracranial pressure (↑ ICP): Symptoms—including headache, drowsiness, vomiting, focal neurology, or seizures—are associated with ↑ ICP. Common causes include tumor, head injury, intracranial hemorrhage, hydrocephalus, meningitis, and cerebral edema.
- Acute stroke and intracranial bleeds: Causes of acute stroke are cerebral infarction (atherothrombotic/embolic occlusion) and intracranial/subarachnoid hemorrhage. Risk factors include age, hypertension, diabetes, and prior stroke/TIA.
- Prevention of stroke: Lifestyle measures (diet, exercise, alcohol reduction), primary prevention (treating hyperlipidemia, hypertension), and anticoagulation (for atrial fibrillation, valve disease)
- Parkinsonism and Parkinson’s disease: Symptoms of Parkinsonism—tremor, rigidity, difficulty initiating movement, and slow movement—are discussed. Parkinson's disease is a neurodegenerative disorder of unknown cause; causes of Parkinsonism include other neurological conditions, drugs (e.g., haloperidol), toxins, trauma, or normal pressure hydrocephalus.
- Multiple sclerosis (MS): Chronic disabling autoimmune disease. Symptoms depend on the area of the central nervous system affected. Common symptoms include visual symptoms, sensory/motor problems, balance issues, speech difficulties, pain, bladder/bowel problems, fatigue, and cognitive changes.
- Motor neurone disease and CJD: MND is a progressive neurodegenerative disorder affecting motor neurons. CJD is a rapidly progressive prion disease.
- Spinal cord conditions: Conditions affecting the spinal cord include quadriplegia, paraplegia, anterior cord syndrome, Brown-Séquard syndrome, and Cauda equina syndrome. Causes - trauma, tumours, abscesses, compression.
- Muscle Disorders: Causes and symptoms are classified. Toxic myopathies (e.g. due to drugs) and acquired myopathies are presented.
- Other neurological syndromes: Von Recklinghausen's disease (NF1) is an autosomal dominant trait neurofibromatosis. Neurofibromatosis 2 is much rarer, also autosomal, presenting predominantly with unilateral vestibular schwannoma; causes include drug use, toxins, and infections.
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Description
Test your knowledge on muscle disorders, teratogenic medications, and the reflex arc. This quiz covers symptoms, conditions, and types of reflex responses relevant to muscle-related issues. Ensure you understand the implications of absent and brisk reflexes as well.
