SAM I Neurology Practice Questions

Clinical signs develop slowly over days to weeks

FCE mostly occurs in large breed dogs and rarely in cats

The condition is usually non-painful

Diagnosis is by exclusion of other possible causes of clinical signs

Surgery is of no benefit and only supportive medical therapy is indicated

Paralysis

Hyporeflexia or areflexia

Normal or hyperreflexia

Normal to increased muscle tone

Minimal muscle atrophy

Potential paralysis/paresis

Increased muscle tone

Hyporeflexia or Areflexia

Potentially severe muscle atrophy

Markedly dilated bladder

Extensor carpi radialis flexor withdrawal reflex may be excluded due to the paralysis

Cranial tibial flexor withdrawal reflex may be excluded due to the paralysis

Perineal Reflex may be excluded due to the complete paralysis

Postural reactions may be excluded

None, all parts of the neurological exam must be performed for a full assessement

LMN signs in one or both of the forelimbs and UMN signs in the hindlimbs and bladder

Normal innervation signs of both the upper and lower limbs

Normal innervation of forelimbs with UMN signs seen caudal to T2

LMN signs of all four limbs

UMN signs of all four limbs

Upper signs in all four limbs

Normal forelimbs and UMN signs in hindlimbs

Normal forelimbs and LMN signs in hindlimbs

LMN signs in forelimbs and UMN signs in hindlimbs

No abnormal UMN or LMN signs in any limbs

Peripheral nerve injury of one limb quickly resolves with no signs of previous injury.

Decreased reflexes of the affected limb are seen with peripheral nerve injury.

Glucocorticoids can be given to decrease inflammation at sight of injury

Amputation of a limb affected by peripheral nerve damage may still be the end result even with diligent owners.

LMN signs of affected limb are seen with peripheral nerve injuries

Brachial plexus avulsion can occur spontaneously without any history indicating a potential cause

Brachial plexus avulsion can include any or all nerve roots between C6 and T2 and may also involve the dorsal roots

Damage to nerve roots C8 and T1 leads to denervation of the extensors and flexors of the elbow and carpus

C6 and C7 damage leads to denervation of the extensors and flexors of the shoulder

Brachial plexus avulsion can result in Horner's syndrome.

A full degeneration of nerves with remnants of the myelin sheath remaining

A condition due to a loss of blood supply, pressure from the weight of an animal during anesthesia or a tourniquet.

Degeneration of axons but endoneurium and Schwann cells remain intact which allows axon regeneration at 1mm/day and return to function

Complete severance of a nerve and degeneration of the distal portion of Schwann cells

A history of slowly progressive monoparesis with "root signs" is highly suggestive of neoplasia

Nerve sheath tumors can occur in any spinal or cranial nerve

Nerve sheath tumors only occur in the caudal cervical area and are associated with the brachial plexus

Advanced diagnostic techniques can be used to identify the site of the tumor but a definitive diagnosis is made using histopathology of samples collected during surgery.

Although surgical removal is the best available treatment for all tumors it can result in further loss of function.

There are a variety of possible emboli including fat, septic-type, thrombi in cats with HCM etc although fibrocartilaginous emboli are the most common cause of spinal cord injuries.

The condition is uncommon in large breed dogs with Miniature Schnauzers being the most affected breed

FCEs are only seen as a congenital defect in the very young

FCEs are extremely painful to the patient and sedation may be necessary

The condition is rare in cats where it occurs in the C6-T2 region and associated with exercise.

Observation of posture and gait, Palpation of muscular skeletal system, Evaluation of sensation, Evaluation of cranial nerves, Evaluation of spinal nerves, Evaluation of postural reactions

Observation of mental status, Palpation of muscular skeletal system, Evaluation of postural reactions, Evaluation of cranial nerves, Evaluation of spinal nerves, Evaluation of sensation

Observation of mental status, Palpation of muscular skeletal system, Evaluation of cranial nerves, Evaluation of postural reactions, Evaluation of spinal nerves, Evaluation of sensation

Observation of posture and gait, Palpation of muscular skeletal system, Evaluation of sensation, Evaluation of postural reactions, Evaluation of cranial nerves, Evaluation of spinal nerves

Patient/Client History

Patient Physical exam

Patient Neural exam

Research and experimental information

Perineal Reflex : Perineal nerve

Patellar Reflex : Femoral nerve

Cranial Tibial Reflex : Sciatic nerve

Flexor Withdrawal Reflex : Femoral and Sciatic nerves

Flexor Withdrawal Reflex : Musculocutaneous, Median, and Ulnar nerves

Brachialis reflex

Tricipital reflex

Gastrocnemius reflex

Extensor Carpi Radialis Reflex

Not enough information has been given

Brain

C1-C6

C7-T2

T3-L3

L4-S3

S3 and caudally

3 year old male Boxer

4 year old female GSD

7 year old male Irish Wolf Hound

10 year old male DSH

Digoxin + Mexilitene

Beta blockers + hypertonic fluid therapy

high long doses of bactericidal antibiotics

overdose of barbituates/euthanol

dead worms

released growth factors by damaged vessel walls

Wolbachia organisms

Melarsomine treatments

reduces lung pathology

strengthens reachback effect

decreases resistance

lowers the reduction rate in worms when combined with Melarsomine

all of the above

The concentration test gave a false negative because this could be an occult infection.

The antibody test gave a false positive and this could be allergies.

There are no microfilaria or worms but the antibody test came up positive because he could have received adulticide treatment less than 24 weeks ago.

All of the above are possibilities

Neuropraxia – nerve damage caused by a lack of blood supply, mild

Axonotmesis – nerve damage but the cell bodies are still active and can regrow

Neurotmesis – nerve damage that is permanent because the axon is completely severed and separated from the cell body and schwanns

All of the above are correct

Sciatic sign

Radial nerve paralysis

Diabetes insipidus

Root sign

Infection

Muscle Atrophy

Self Mutilation

EMG changes

Oculomotor Nerve

T1

Trigeminal Nerve

Both Oculomotor Nerve and T1

Both Oculomotor nerve and Trigeminal nerve

Surgical resection

Radiation

Chemotherapy

Cage rest

Right sympathetic innervation to the eye

Right parasympathetic innervation to the eye

Left oculomotor innervation to the eye

Right trigeminal innervation to the eye

Left vagal innervation to the eye