NeuroFinal2001

NeuroFinal2001 - Neurological Diagnosis End of Year Exam...

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Total Test = 100 marks Question 1 (16-Marks) A 56-year-old woman presents to your office with her husband. She is complaining of pins and needles in her toes and feet and also in her fingers and hands. Further questioning reveals that there has been a long-term use of alcohol, however in the last year she has dramatically reduced the amount she drinks since a scare from her doctor regarding her "fatty liver". On examination, you find that there is a stocking paraesthesia. There is some weakness of the lower extremities with absent knee and ankle jerk reflexes (1) What is your current list of differential diagnosis from the above information? 2-Marks A few weeks later the patient returns to your clinic with her husband. She now has excessive tiredness, fatigability and is breathless on exertion. Her husband mentions that she has had some slight personality changes. Examination at this time reveals a loss of position sense, positive Rhomberg's test (eyes closed only). There is some broadening of the base while walking and loss of vibratory sense. You notice that there is now voluntary muscle weakness, increased lower limb DTK's, some spasticity of the extremities and a Babinski sign (2) Discuss her current symptoms. Also discuss the neurological symptoms in regards to the areas and/or tracts of the nervous system now affected. 4-Marks You find out from a further consultant that they were very pleased with your quick referral. It seems that the above neurological findings were all reversed given the quick intervention. (3) How does this new information change your diagnosis? Discuss the diagnosis and how this occurs. 3-Marks (4) What was the likely form of treatment that they administered to this patient? 2-Marks Questions unrelated to above case. (5) What are the presenting symptoms of Delirium Tremens? 3-Marks
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NeuroFinal2001 - Neurological Diagnosis End of Year Exam...

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