1. Chapter 3 Diseases of the Neurological System
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2. Instructions
The following unit contains individual case studies which are based on the information learned in the pathophysiology review.
Evaluate each case, review the signs and symptoms and determine the diagnosis of the disease from the provided options.
Once you have determined the diagnosis, proceed to the next slide to receive the answer with the rationale.
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3. Question 1 of 5
17 year old black / male suddenly began smacking his lips, walking aimlessly, picking at his clothes and not responding to his name for ten minutes at school. At the present time is he is sleepy, confused and disoriented to person, place and time. His skin is pink, warm and dry.
He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. He moves all extremities with equal range of motion and strength.
The patient has no medical history. His Blood pressure was 122/72 pulse 76 and regular, respirations 20. His blood sugar is 134 mg/dl. Oxygen saturation by pulse oximeter is 99%.
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
Answer

4. Question 1 of 5
17 year old black / male suddenly began smacking his lips, walking aimlessly, picking at his clothes and not responding to his name for ten minutes at school. At the present time is he is sleepy, confused and disoriented to person, place and time. His skin is pink, warm and dry.
He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. He moves all extremities with equal range of motion and strength.
The patient has no medical history. His Blood pressure was 122/72 pulse 76 and regular, respirations 20. His blood sugar is 134 mg/dl. Oxygen saturation by pulse oximeter is 99%.
Smacking his lips
Walking aimlessly
Picking at his clothes
Not responding to his name
Sleepy and confused
Disoriented to person, place and time (post ictal)
Key Indicators
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
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5. Question 2 of 5
63 year old black / female had a sudden onset of right sided weakness, slurred speech and loss of balance which started one hour ago. At the present time she states that her symptoms are gone and she feels fine. She is oriented to person, place and time.
Her skin is pink, warm and dry. He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She moves all extremities with equal range of motion and strength. The patient has a history of Hypertension.
Her Blood pressure was 166/94, pulse 78 and regular, respirations 20. Her blood sugar is 103 mg/dl. Oxygen saturation by pulse oximeter is 97%.
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
Answer

6. Question 2 of 5
63 year old black / female had a sudden onset of right sided weakness, slurred speech and loss of balance which started one hour ago. At the present time she states that her symptoms are gone and she feels fine. She is oriented to person, place and time.
Her skin is pink, warm and dry. He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She moves all extremities with equal range of motion and strength. The patient has a history of Hypertension.
Her Blood pressure was 166/94, pulse 78 and regular, respirations 20. Her blood sugar is 103 mg/dl. Oxygen saturation by pulse oximeter is 97%.
Right sided weakness
Slurred speech
Loss of balance
Symptoms are now gone (less than 24 hours)
Key Indicators
a. Transient Ischemic Attack h. Partial of Focal Seizure
b. Cerebral Vascular Accident i. Primary or Generalized Seizure c. Vasovagal Syncope
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7. Question 3 of 5
38 year old black / male had a sudden onset of unconsciousness and convulsions with sever muscle rigidity. During the episode he was noted to have repetitive, jerking movements. The patient was incontinent of both urine and feces.
At the present time is he is sleepy, confused and disoriented to person, place and time. His skin is pink, warm and dry. He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender.
He moves all extremities with equal range of motion and strength. You are unable to determine the patients’ medical history. His Blood pressure was 104/62 pulse 86 and regular, respirations 24. His blood sugar is 100 mg/dl. Oxygen saturation by pulse oximeter is 95%.
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
Answer

8. Question 3 of 5
38 year old black / male had a sudden onset of unconsciousness and convulsions with sever muscle rigidity. During the episode he was noted to have repetitive, jerking movements. The patient was incontinent of both urine and feces.
At the present time is he is sleepy, confused and disoriented to person, place and time. His skin is pink, warm and dry. He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender.
He moves all extremities with equal range of motion and strength. You are unable to determine the patients’ medical history. His Blood pressure was 104/62 pulse 86 and regular, respirations 24. His blood sugar is 100 mg/dl. Oxygen saturation by pulse oximeter is 95%.
Unconsciousness and convulsions with severe muscle rigidity
Repetitive, jerking movements
Incontinent of both urine and feces
Sleepy and confused
Disoriented to person, place and time (post ictal)
Key Indicators
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
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9. Question 4 of 5
22 year old white / male had a sudden onset of feeling weak, lightheaded, dizzy and losing consciousness while standing in line to get food at a concession stand. He remembers seeing spots and having tunnel vision before the event. Pt. states he awoke on the floor and did not remember falling. At the present time he is lying down and feels fine.
The patient is alert and oriented to person, place and time. His skin is pink, warm and dry. He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. He moves all extremities with equal range of motion and strength.
The patient has no medical history. His Blood pressure was 116/64, pulse 78 and regular, respirations 20. His blood sugar is 98 mg/dl. Oxygen saturation by pulse oximeter is 99%.
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
Answer

10. Question 4 of 5
22 year old white / male had a sudden onset of feeling weak, lightheaded, dizzy and losing consciousness while standing in line to get food at a concession stand. He remembers seeing spots and having tunnel vision before the event. Pt. states he awoke on the floor and did not remember falling. At the present time he is lying down and feels fine.
The patient is alert and oriented to person, place and time. His skin is pink, warm and dry. He pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. He moves all extremities with equal range of motion and strength.
The patient has no medical history. His Blood pressure was 116/64, pulse 78 and regular, respirations 20. His blood sugar is 98 mg/dl. Oxygen saturation by pulse oximeter is 99%.
Weak, lightheaded and dizzy
Losing consciousness while standing
Seeing spots and having tunnel vision
He is lying down and feels fine
Key Indicators
a. Transient Ischemic Attack h. Partial of Focal Seizure
b. Cerebral Vascular Accident i. Primary or Generalized Seizure c. Vasovagal Syncope
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11. Question 5 of 5
44 year old white/female had a sudden onset of headache, left sided weakness, sudden confusion, slurred speech and dizziness which started one several hours ago. She is confused to person, place and time. Her skin is pink, warm and dry. Pupils are equal and reactive to light.
Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She has significant decrease extremity movement, range of motion and strength on the left side.
The patient has a history of Hypertension. Her Blood pressure was 199/110, pulse 88 and regular, respirations 20. Her blood sugar is 114 mg/dl. Oxygen saturation by pulse oximeter is 95%.
a. Transient Ischemic Attack d. Partial of Focal Seizure
b. Cerebral Vascular Accident e. Primary or Generalized Seizure c. Vasovagal Syncope
Answer

12. Question 5 of 5
44 year old white/female had a sudden onset of headache, left sided weakness, sudden confusion, slurred speech and dizziness which started one several hours ago. She is confused to person, place and time. Her skin is pink, warm and dry. Pupils are equal and reactive to light.
Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She has significant decrease extremity movement, range of motion and strength on the left side.
The patient has a history of Hypertension. Her Blood pressure was 199/110, pulse 88 and regular, respirations 20. Her blood sugar is 114 mg/dl. Oxygen saturation by pulse oximeter is 95%.
Sudden onset of headache
Left sided weakness
Confusion
Slurred speech and dizziness
Decrease extremity movement, range of motion and strength on the left side
Key Indicators
a. Transient Ischemic Attack h. Partial of Focal Seizure
b. Cerebral Vascular Accident i. Primary or Generalized Seizure c. Vasovagal Syncope
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13. Proceed to the next unit
COMPLETE UNIT 3
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