10/22/24, 1:27 NR 509 w eek 6 quiz neuro and
PM musculo
A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his
palms and notice that every few seconds his palms suddenly move toward the floor. What does
this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
D) Severe fatigue and weakness
Ans: B
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the
muscles. It is usually due to various metabolic diseases. A variant of this is called “milkmaid's
grip” in which the patient is asked to grasp two fingers. A positive occurs if the patient is unable
to sustain the grip and it feels as if the patient is trying to milk a cow. Most would consider
checking an ammonia level in this patient. A stroke is less likely to produce bilateral symptom
Which of the following is a “red flag” regarding patients presenting with headache?
A) Unilateral headache
B) Pain over the sinuses
C) Age over 50
D) Phonophobia and photophobia
Ans: C
Feedback:
A unilateral headache is often seen with migraines and may commonly be
accompanied by phonophobia and photophobia. Pain over the sinuses from sinus
congestion may also be unilateral and produce pain. Migraine and sinus headaches
are common and generally benign. A new severe headache in someone over 50 can
be associated with more serious etiologies for headache. Other red flags include:
acute onset, “the worst headache of my life”; very high blood pressure; rash or signs
of infection; known presence of cancer, HIV, or pregnancy; vomiting; recent head
trauma; and persistent neurologic problems.
A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his
palms and notice that every few seconds his palms suddenly move toward the floor. What does
this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
D) Severe fatigue and weakness
Ans: B
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the
muscles. It is usually due to various metabolic diseases. A variant of this is called “milkmaid's
grip” in which the patient is asked to grasp two fingers. A positive occurs if the patient is unable
to sustain the grip and it feels as if the patient is trying to milk a cow. would consider checking
an ammonia level in this patient. A stroke is less likely to produce bilateral symptoms. Carpal
tunnel represents a sensory loss in the median nerve distribution.
about:blan 1/
k 4
PM musculo
A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his
palms and notice that every few seconds his palms suddenly move toward the floor. What does
this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
D) Severe fatigue and weakness
Ans: B
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the
muscles. It is usually due to various metabolic diseases. A variant of this is called “milkmaid's
grip” in which the patient is asked to grasp two fingers. A positive occurs if the patient is unable
to sustain the grip and it feels as if the patient is trying to milk a cow. Most would consider
checking an ammonia level in this patient. A stroke is less likely to produce bilateral symptom
Which of the following is a “red flag” regarding patients presenting with headache?
A) Unilateral headache
B) Pain over the sinuses
C) Age over 50
D) Phonophobia and photophobia
Ans: C
Feedback:
A unilateral headache is often seen with migraines and may commonly be
accompanied by phonophobia and photophobia. Pain over the sinuses from sinus
congestion may also be unilateral and produce pain. Migraine and sinus headaches
are common and generally benign. A new severe headache in someone over 50 can
be associated with more serious etiologies for headache. Other red flags include:
acute onset, “the worst headache of my life”; very high blood pressure; rash or signs
of infection; known presence of cancer, HIV, or pregnancy; vomiting; recent head
trauma; and persistent neurologic problems.
A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his
palms and notice that every few seconds his palms suddenly move toward the floor. What does
this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
D) Severe fatigue and weakness
Ans: B
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the
muscles. It is usually due to various metabolic diseases. A variant of this is called “milkmaid's
grip” in which the patient is asked to grasp two fingers. A positive occurs if the patient is unable
to sustain the grip and it feels as if the patient is trying to milk a cow. would consider checking
an ammonia level in this patient. A stroke is less likely to produce bilateral symptoms. Carpal
tunnel represents a sensory loss in the median nerve distribution.
about:blan 1/
k 4
