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CNS imp questions

The document presents three clinical cases involving different patients with distinct medical issues. The first case describes a 60-year-old male with symptoms suggestive of Parkinson's disease, including tremors and rigidity. The second case involves a 32-year-old male with a penetrating thorax injury leading to sensory and motor deficits, while the third case discusses an 8-year-old child with difficulty reading from a distance, indicating potential refractive error.

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2 views17 pages

CNS imp questions

The document presents three clinical cases involving different patients with distinct medical issues. The first case describes a 60-year-old male with symptoms suggestive of Parkinson's disease, including tremors and rigidity. The second case involves a 32-year-old male with a penetrating thorax injury leading to sensory and motor deficits, while the third case discusses an 8-year-old child with difficulty reading from a distance, indicating potential refractive error.

Uploaded by

mohitarya2141
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Case based/ Integrated questions: -.

a) History: Harish, A-60-year-old male, reported difficulty in initiating motor activity like walking,
brushing his teeth, etc. He also mentioned that, with advancing age his motor
activities had become slower.
Doctor also noted that while he was sitting, there were tremors
in his hand. On further questioning, Harish mentioned that these tremors stop while doing any activity. Doctor also noted that, along with the change in emotions, there was no
change in facial expressions.
On Examination: His vitals were normal with temperature 98.6°F, pulse 75/min,
BP = 130/80 mm Hg. He was conscious, calm and well oriented to time, place and person.
The general facial expressions of the patient were lost resuiting in a mask-like face.
Examination of CNS Revealed
Motor functions:
Топе: Hypertonia with cogwheel type rigidity in limbs.
Power of muscles is Grade +4/+5.
Reflexes: Deep tendon reflexes are normal and plantar response is flexor.
Pill rolling resting tremors of the hands.
Shuffling gait with narrow base and a tendency to fall forward and backwards. He walks with slight flexion at hip and knee joints.
Cerebellar function tests: Normal.
Sensory function: Normal.
Cortical sensations: Normal.
Higher functions: Normal.
Based on the above clinical scenario answer the following question:
i What is your probable diagnosis?
ii. What is the pathophysiology of the disease?
ii. What is the physiological basis of Hypokinetic symptoms in this patient (akinesia, Bradykinesia)?
A 32-year-old male was brought to the emergency following penetrating knife injury in the posterior part of the left
thorax. The patient complained of left lower extremity numbness and weakness, and right lower extremity burning
sensation.
On Examination: left lower extremity paresis as well as diminished proprioception touch, and pinprick sensation. The right
lower extremity demonstrated intact motor function, and intact proprioception, touch, and pinprick sensation.
Based on the above clinical scenario answer the following question: (1+4=5)
i What is your probable diagnosis?
i. Explain the sensory and motor loss at the site of the lesion and below the site of the lesion with the help of a diagram.
History: An 8 yr old brought to the Ophthalmologist with difficulty in reading the black board letters at school. He
has no difficulty in reading from the text book
On examination:
Visual Acuity for Distant vision: RE: VA 6/12 and LE: 6/9
Visual Acuity for near vision: N6
Based on the above clinical scenario answer the following question:
(1+2+2=5)

What is your probable diagnosis?


Enumerate the causes and Pathophysiology of the diagnosed condition
What treatment will you advise and why?

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