Leik Neuro questions with correct answers

A 23-year-old woman is seen in the office by the nurse practitioner for complaints of weakness, poor balance, and problems with walking. She states, "I am so clumsy. Sometimes I fall when I walk." She reports new-onset vision loss and bladder incontinence. Each episode lasts a few days; she has had several in the past 6 months. When she bends her head forward to tie her shoes, she reports a sharp shooting sensation from the upper to lower back. She is anxious and crying at the office. What is th CORRECT ANSWER Solution: C Multiple sclerosis The women's symptoms are highly suggestive of multiple sclerosis, an autoimmune disease that affects the spine and brain. The peak incidence is from age 15 to 45 years. To confirm the diagnosis, an MRI of the spinal cord and brain is necessary. Lhermitte sign is the sharp shooting electric type of sensation from upper to lower spine with neck flexion. The nurse practitioner is instructing the patient to flex both wrists at 90 degrees for 1 minute. This test is associated with: Median nerve inflammation Navicular fracture Colle's fracture Scaphoid bone fracture CORRECT ANSWER Solution: A Median nerve inflammation The name of the test being performed is Phalen's test; it is positive when the patient reports that their fingers (including the thumb) feel numb or tingle. Inflammation of the median nerve is called carpal tunnel syndrome. This question is an example of how to guess using the pattern method. If you are guessing, pick the answer that does not fit the pattern. In this question, options B, C, and D are about fractures, and option A is not. Therefore, it does not fit the pattern, and it is the answer.