Quiz 25 on Reflexes

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Information about Quiz 25 on Reflexes
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Published on August 18, 2009

Author: draswinikumars

Source: authorstream.com

Reflex Quiz - Theme : Reflex Quiz - Theme Dr. Aswini Kumar. MD Professor of Medicine Medical College Hospital Thiruvananthapuram 1. Normal : 1. Normal . Additional Points: Patient Conscious Higher Functions N Cranial Nerves Normal Tone Normal No Motor Deficits No Sensory Deficits No Cerebellar signs No Meningeal Signs 2. Right Hemiplegia Neuronal Shock : 2. Right Hemiplegia Neuronal Shock . Additional Points: Patient Conscious Motor Aphasia UMN Facial [Right] Hypotonia [Right] Grade 0 power [Right] No Sensory Deficits No Cerebellar signs No Meningeal Signs 3. Left HemiplegiaPost shock : 3. Left HemiplegiaPost shock . Additional Points: Patient Conscious Higher Functions N Left UMN Facial Clasp Knife [Left] Grade 2 [Left] No Sensory Deficits No Cerebellar signs No Meningeal Signs 4. Right Hemiplegia1 Year Old : 4. Right Hemiplegia1 Year Old . Additional Points: Patient Conscious Higher Functions N UMN Facial [Right] Tone  [Right] Contractures [Right] Power Grade 3 [Right] Patellar Clonus [Right] Ankle Clonus [Right] 5. Pseudo-bulbarPalsy : 5. Pseudo-bulbarPalsy . Additional Points: Patient Conscious Emotional Incontinence Exaggerated Gag reflex Hypertonia B/L Variable weakness Primitive Reflexes + No Cerebellar signs No Meningeal Signs 6. Parkinson’s Disease : 6. Parkinson’s Disease . Additional Points: Patient Conscious Expressionless face Cranial Nerves Normal Cog wheel rigidity Generalized Hypokinesia Glabellar Tap Resting tremor No Meningeal Signs 7. Lateral Medullary Syndrome [Left] : 7. Lateral Medullary Syndrome [Left] . Additional Points: Patient Conscious Vertigo and ataxia Vomiting and hiccups Horner’s Syndrome[Left] IX & X palsy [Left] Pain & Temp lost Lt face Pain & Temp lost Rt body Cerebellar signs [Left] 8. QuadriplegiaC3 Level : 8. QuadriplegiaC3 Level . Additional Points: Patient Conscious Respiratory distress Weakness all 4 limbs Hypertonia Bilateral Distal > proximal weakness Total sensory loss below C3 Pectoral&Trapezius Jerk+++ UMN Bladder 9. Right C5Radiculomyelopathy : 9. Right C5Radiculomyelopathy . Additional Points: Patient Conscious Higher Functions N Cranial Nerves Normal Hypertonia Lower limbs Shoulder abduction  Elbow flexion  Sensory loss along C5 C6 UMN Bladder 10. Cauda EquinaSyndrome : 10. Cauda EquinaSyndrome . Additional Points: Patient Conscious Higher Functions N Asymmetric Wasting of LL Hypotonia both LL Weakness below L3 Patchy sensory loss below L3 No Cerebellar signs Late Bladder involvement 11.SyringomyeliaC-8,T-1 Level : 11.SyringomyeliaC-8,T-1 Level . Additional Points: Patient Conscious Higher Functions N Cranial Nerves Normal Hypotonia distally both ULs Small muscle wasting ULs Handgrip weakness B/L Suspended sensory loss C8T1 Sensory Dissociation 12. ParaplegiaL-1 Level - Shock : 12. ParaplegiaL-1 Level - Shock . Additional Points: Patient Conscious Higher Functions N Cranial Nerves Normal Hypotonia LLs Power grade 0 both LL Total sensory loss below L1 No Cerebellar signs UMN Bladder 13. ParaplegiaT-10 Level : 13. ParaplegiaT-10 Level . Additional Points: Patient Conscious Higher Functions N Cranial Nerves Normal Hypertonia both LLs Grade 0 both LLs Beevor’s sign + Sensory level at Umbilicus UMN Bladder 14.Amyotrophic Lateral Sclerosis : 14.Amyotrophic Lateral Sclerosis . Additional Points: Patient Conscious Higher Functions N Wasting hands & calf Tone Increased B/L Variable Weakness No Sensory Deficits Fasciculations present No bladder involvement 15. Gullian BarreSyndrome : 15. Gullian BarreSyndrome . Additional Points: Patient Conscious Higher Functions N Acute Ascending paralysis Markedly reduced tone No Sensory Deficits Single Breath Count < 20 Bilateral LMN Facial No Bladder involvement 16.Peripheral Neuropathy : 16.Peripheral Neuropathy . Additional Points: Patient Conscious Higher Functions N Cranial Nerves Normal Tone Normal Distal weakness UL & LL Glove & Stocking sensory No Cerebellar signs No Meningeal Signs 17. MyastheniaGravis : 17. MyastheniaGravis . Additional Points: Patient Conscious Higher Functions N Bilateral Partial Ptosis Tone Normal Fatigability No Sensory Deficits No Cerebellar signs No Meningeal Signs 18.Right T11 Brown- Sequard : 18.Right T11 Brown- Sequard . Additional Points: Patient Conscious Higher Functions N Right lower limb grade 2 Tone reduced right LL Pain and temp lost left LL Vibration and joint position lost right LL Right T11 hyperaesthesia 19.Friedrichs ataxia : 19.Friedrichs ataxia . Additional Points: Symptomatic before 20 years Higher Functions N Pes cavus, kyphoscoliosis H/o ataxia in family Power grade 4 all limbs Ataxia Vibration, joint position impaired distally 20. Subacute combined degeneration of spinal cord : . Additional Points: Patient Conscious Higher Functions irritable Optic atrophy Grade 4 power all 4 limbs Loss of vibration and joint position sense Megaloblastic anemia in peripheral smear 20. Subacute combined degeneration of spinal cord 21.Facioscapulo humeral dystrophy : 21.Facioscapulo humeral dystrophy . Additional Points: Facial weakness, shoulder girdle weakness,winging of scapula,deltoid preserved, pseudohypertrophy present Tone reduced Wrist extensors grade 2, flexors grade 3 No Sensory Deficits No Cerebellar signs No Meningeal Signs 22. Cerebral palsy : 22. Cerebral palsy . Additional Points: H/O hypoxia at the time of birth Non progressive weakness of LL more than UL Tone Increased Scissoring gait No Sensory Deficits 23. CIDP : 23. CIDP . Additional Points: Chronic history Relapsing remitting Patient Conscious Higher Functions N Proximal and distal weakness Tone reduced Sensory loss distally 24. Anterior spinal artery occlusion : 24. Anterior spinal artery occlusion . Additional Points: Hyper acute onset Patient Conscious Higher Functions N Hypotonia both LL Grade 0 power LL Pain and temperature lost both LL Vibration and joint position preserved 25. Myotonic dystrophy : 25. Myotonic dystrophy . Additional Points: Patient Conscious Frontal balding Bilateral Partial Ptosis Hatchet facies Testicular atrophy Grade 4 power proximally and grade 2 distally Myotonia No Sensory Deficits

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