Module 6 Part 1 Neurology

A 80 year old female is brought into the ED by her husband because she is talking strange. This has been occurring for the past 30 minutes, and she has never acted like this before. When asked how she is feeling, she responded with “Meatballs! Because Jimmy crashed the party.” When the patient speaks, the left side of her mouth doesn’t move and has a downward slant. The upper part of the right face has no deficit. What type of aphasia does the patient have?

• Wernicke's aphasia
• Global aphasia
• Broca's aphasia
• Conduction aphasia

How are stroke symptoms different than Bell's Palsy?

• Stroke symptoms are sometimes accompanied by severe headache, while Bell's Palsy does not cause headaches.

• Stroke symptoms are usually accompanied by difficulty walking, while Bell's Palsy does not affect mobility.
• Stroke symptoms are usually accompanied by other signs like difficulty speaking, numbness on one side of the body, and sudden onset, while Bell's Palsy is typically characterized by a sudden onset of facial weakness or paralysis on one side without other neurological symptoms.
• Stroke symptoms are typically characterized by gradual onset, while Bell's Palsy has a sudden onset.

John is a right-handed, 45-year-old male with no prior history of language disorders or neurological issues. His family reported that he was involved in a car accident, sustaining a traumatic brain injury that resulted in language impairments. Following the accident, John presented with a sudden onset of speech difficulties. His primary symptoms included hesitant, telegraphic speech with significant effort required to produce words and grammatical structures. Despite these expressive difficulties, he maintained good comprehension skills. What is your diagnosis?

• Wernicke's aphasia
• Global aphasia
• Conduction aphasia
• Broca's aphasia

Mr. Anderson had a history of hypertension, hyperlipidemia, and type 2 diabetes. He presented to the emergency department with a sudden onset of transient neurological symptoms, which included slurred speech, right-sided weakness, and difficulty walking. These symptoms resolved within an hour, prompting his visit to the hospital. Clinical Assessment: Upon admission, Mr. Anderson underwent a thorough clinical assessment:

1. Neurological Examination: His neurological examination revealed residual right-sided weakness and slurred speech. Vital Signs: Blood pressure was elevated at 160/95 mm Hg. Imaging Studies: A non-contrast head CT scan showed no evidence of hemorrhage, while a diffusion-weighted MRI revealed small ischemic lesions. Laboratory Tests: Blood tests revealed elevated levels of low-density lipoprotein (LDL) cholesterol and glycosylated hemoglobin (HbA1c).

• Transient ischemic attack (TIA)
• Bell's palsy
• Migraine with aura
• Hemorrhagic stroke

Sarah had a history of hypertension and was prescribed anticoagulants for atrial fibrillation. She presented to the emergency department with a sudden and severe headache, confusion, and left-sided weakness. Her family reported that she had also experienced vomiting. Upon arrival, she appeared lethargic and was unable to follow commands.

Clinical Assessment: Sarah underwent a thorough clinical assessment: Neurological Examination: She exhibited left-sided hemiparesis and facial droop, along with altered consciousness. Vital Signs: Blood pressure was elevated at 190/110 mm Hg. Imaging Studies: A non-contrast head CT scan revealed the presence of intracerebral hemorrhage in the right basal ganglia, causing mass effect and midline shift. What is your diagnosis?

• Ischemic stroke
• Migraine headache
• Hemorrhagic stroke
• Sinusitis

What is one of the major risk factors for a hemorrhagic stroke? Select all that apply:

• Low cholesterol
• High HDLs

• High blood pressure
• Arteriovenous Malformation

• Exercise

What is the most common artery involved in stroke?

• carotid artery
• vertebral artery
• basilar artery
• middle cerebral artery

Richard had a medical history that included hypertension, hyperlipidemia, and type 2 diabetes. He presented to the emergency department with sudden-onset right-sided weakness, facial droop, and difficulty speaking. His family reported that he was unable to lift his right arm and that his speech was slurred. These symptoms had begun approximately 90 minutes prior to presentation. Clinical Assessment: Richard underwent a thorough clinical assessment: Neurological Examination: He displayed right-sided hemiplegia, facial droop, and expressive aphasia. Vital Signs: Blood pressure was elevated at 180/100 mm Hg. Imaging Studies: A non-contrast head CT scan revealed no hemorrhage but showed early signs of ischemia in the left middle cerebral artery territory. Laboratory Tests: Blood tests confirmed hyperglycemia and hyperlipidemia. What should be the first step in treating this patient?

• Stabilization and avoidance of tPA for fear of worsening stroke symptoms

• Administer aspirin
• Administer tissue plasminogen activator (tPA)
• Initiate insulin therapy

Pronator Drift could be indicative of:

• Bell's Palsy

• damage to upper motor neurons

• viral meningitis

• damage to Broca's or Wernicke's area

What is arachibutyrophobia?

• Fear of spiders.
• Fear of clowns.

• Fear of peanut butter sticking to the roof of the mouth.
• Fear of super scary GCU students.