Cox & Roper: Clinical Skills - Extended Matching Questions

Table of Contents

1. Chapter 04 - Cardiovascular System
2. Chapter 05 - Respiratory system
3. Chapter 06 - Adominal system
4. Chapter 07 - Rectal examination
5. Chapter 08 - Arms
6. Chapter 09 - Hands
7. Chapter 10 - Legs
8. Chapter 11 - Cranial Nerves
9. Chapter 12 - Necks
10. Chapter 13 - Joints
11. Chapter 14 - Spot Diagnosis
12. Chapter 15 - The electrocardiogram
13. Chapter 16 - The chest X-ray

Chapter 09 - Hands

Instructions: Each group of extended matching questions consists of lettered options followed by a list of numbered problems/questions. For each numbered problem/question select the one lettered option that most closely answers the question. You can use the lettered options once, more than once, or not at all.

Options:

1. Anxiety
2. Beta 2 agonist
3. Hyperthyroidism
4. Parkinson's disease
5. Drug induced Parkinsonism
6. Cerebellar Syndrome
7. Flapping tremor secondary to type 2 respiratory failure
8. Flapping tremor liver disease
9. Hypoglycaemia
10. Benign essential tremor
11. Alcoholism

Choose from the list of causes of tremor, the one that matches the clinical scenarios below

1

Scenario 1 a) A 36 year old woman visits her GP. She has is an asthmatic and has a ventolin and a becotide inhalers. She is concerned because she has developed a coarse shaking of her hands. Choose... Anxiety Beta 2 agonist Hyperthyroidism Parkinson's disease Drug induced Parkinsonism Cerebellar Syndrome Flapping tremor secondary to type 2 respiratory failure Flapping tremor liver disease Hypoglycaemia Benign essential tremor Alcoholism Correct. See page 228.Incorrect. See page 228.Your answer has been saved.

2

Scenario 2 a) A 43 year old man is referred to the neurology clinic because he has slowed down.and has developed a tremor of his right hand. The tremor is pill-rolling in nature and the neurologist notes that there is poverty of facial expression. Choose... Anxiety Beta 2 agonist Hyperthyroidism Parkinson's disease Drug induced Parkinsonism Cerebellar Syndrome Flapping tremor secondary to type 2 respiratory failure Flapping tremor liver disease Hypoglycaemia Benign essential tremor Alcoholism Anxiety Beta 2 agonist Correct. See pages 219, 400-401.Incorrect. See page 219, 400-401.Your answer has been saved.

3

Scenario 3 a) A 81 year old man is on a medical ward. He has been falling recently and the physicians suspect a stroke. The consultant decides to test his coordination. He demonstrates an intention tremor and frequently misses the target finger and his nose with his left finger. Choose... Anxiety Beta 2 agonist Hyperthyroidism Parkinson's disease Drug induced Parkinsonism Cerebellar Syndrome Flapping tremor secondary to type 2 respiratory failure Flapping tremor liver disease Hypoglycaemia Benign essential tremor Alcoholism Anxiety Beta 2 agonist Correct. See pages 228, 296-298.Incorrect. See pages 228, 296-298.Your answer has been saved.

4

Scenario 4 a) A 72 year old woman with chronic obstructive pulmonary disease (COPD) continues to smoke. Her breathing has become steadily worse and no longer responds to her nebuliser. She was sent by ambulance to A&E and on the way she was given high flow rates of oxygen. On arrival at A&E she is semi-conscious. The doctor in attendance gets her to cock her wrists back and her hands start to jerk downwards in a flapping manner. Choose... Anxiety Beta 2 agonist Hyperthyroidism Parkinson's disease Drug induced Parkinsonism Cerebellar Syndrome Flapping tremor secondary to type 2 respiratory failure Flapping tremor liver disease Hypoglycaemia Benign essential tremor Alcoholism Anxiety Beta 2 agonist Correct. The patient is demonstrating a flapping tremor and it is likely that the high flow rates of oxygen has led to respiratory depression and hypercapnia. See pages 88, 228.Incorrect. See pages 88, 228.Your answer has been saved.

5

Scenario 5 a) A 17 year old man is a diabetic. He took his normal insulin at breakfast time but skipped lunch so he could play football with his friends. In the afternoon, he complained of a headache, was sweaty and belligerent. In fact some of his friends thought he had been drinking. He exhibited a coarse tremor of his hands. Choose... Anxiety Beta 2 agonist Hyperthyroidism Parkinson's disease Drug induced Parkinsonism Cerebellar Syndrome Flapping tremor secondary to type 2 respiratory failure Flapping tremor liver disease Hypoglycaemia Benign essential tremor Alcoholism Anxiety Beta 2 agonist Correct. Knowing the patient is diabetic gives a clue. His lifestyle choices that day have led to him becoming hypoglycaemic. The headache, sweating and tremor are typical. Personality change can be seen with aggression often featuring. If sugar is not administered the patient will become unconscious and can die. See page 228.Incorrect. See page 228.Your answer has been saved.