ADULT - NEUROLOGIC PROBLEMS (Primary Care, Dunphy,
Winland-Brown, Porter, & Thomas) Questions with 100% Correct
Answers Latest 2024 Version
MS: Degenerative Dis. - ✔✔PATHO: Unknown Etiology; Genetic susceptibility or Autoimmune;
Viral; Environmental; **Progressive, Stemming fr. axon demyelination; **SX's: Motor/Sensory,
Paralysis, Weakness,
Blindness (Sensory);
**DIFF DX's: Lyme Dis., HIV, Systemic Lupus; **DIAG's: Immunoglobulin; CSF- check Lymphocytes; No
spec. tests; LP; CT of Brain/MRI; **RX: Glucocort's, Depomedrol (IV), DMARDS
PARKINSON's: Degenerative - ✔✔**CAUSE: Unknown, Multifactorial - genetic,
exogenous and endogenous toxins (pesticides), Familial component, Normal aging;
**PATHO: Progressive, Chronic, Degenerative dis. of Basal Ganglia in CNS; Insidious onset;
**S/SX's: Motor tremor, Cogwheel rigidity, Akinesia /bradykinesia, Postural disturbance;
**DIFF DX's: Essential tremor, MS, ALS, Alzheimer's;
**DIAG's: Ser. Calc. level R/O Hypoparathyroidism,
Brain CT to differentiate PD & Essential Tremor; MRI of Brain to exclude structural brain lesions;
**TX: Control SX's, no drugs/surgical Tx. prevents progression; "Falls" Risk; Health maint. screenings;
*RX: Levodopa/Carbidopa; Requip; Bromocriptine
ALZHEIMER's: Degenerative - ✔✔**CAUSE: Not known; Genetic mutation changes sequence of
chemical pairs;
**PATHO: Progressive Irreversible cortical disconnection causes formation of neurologic plagues (cortex,
hippocampus, amygdala & neurofibrillary tangles) inside neurons that cause neuron cell death; Increase
of Tou protein;
**SX's: Motor, Sensory, Cognitive, Speech; Difficulty accomplishing tasks; Memory probs.; Lost
in familiar places; Word finding difficulty (anomia);
**DIFF. DX's: Delirium, Drug/alcohol abuse, Psychosis;
**LABS: CBC, CMP, Thyroid levels, LFT's,
CT/MRI Brain, MMSE (20-25 early, 10-19 middle, <10 late stage);
, **TX: Control SX's, Safety, Fam. support, Memory aids, environmental modification, provide info. re:
Legal financial issues R/T capacity to make decisions;
**RX: Donepezil, Memontine, Busprone,
Antidepressants, & Anxiolytics
ENCEPHALITIS: Infectious - ✔✔**CAUSE: Viral: HSV, Mosquitos; Infection of Brain
Parenchyma; **SX's: Fever;
**DIFF. DX: Meningitis, Seizures;
**DIAG's: LP, EEG, MRI, Ser. AB, Gram Stain CSF;
**TX: Avoid mosquito bites; Mosquito repellant agents; **RX: Antiviral: Acyclovir
MENINGITIS: Infectious - ✔✔**CAUSE: Bacteria - 1ST colonizes fr. Nasopharynx, then enters underlying
Bld. vessels; Acute purulent infection develops w/in Subarachnoid space; **SX's: Fever, Nuchal Rigidity;
**DIFF. DX's: Systemic Lupus, Encephalitis, Giant Cell arteritis;
**DIAG's: CSF, LP, CBC, Na, Brain CT/ MRI: meningeal hydrocephalus, focal lesions;
**TX: Eliminate infection; Isolation; Symptomatic care; Prevent complications; Rest; Fluids; Avoid close
contact with others; Vaccinations;
**RX: ABX x 10-14 days; Tylenol
HERPES ZOSTER: Infectious - ✔✔**CAUSE: Immunosuppression w/ age;
**SX's: Pain along dermatome for mos.;
**DIFF. DX's: Impetigo, HSV, CoxSackie;
**DIAG's: PCR (polymerase chain reaction),
AB titer;
**RX: Acyclovir, Valtrex; Pain med's; TCA, Neurontin, Capsaicin;
**F/U: Ophthalmology if rash near eye.
BOTULISM: Infectious - ✔✔**CAUSE: Foodborne illness, Inhalation, Iatrogenic;
**SX's: Diplopia, Pupil changes (Eye probs), N & V,
Xerostomia;
