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    Chir20001 Practical Assessment - Steven James Chang

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    This document discusses alcoholism and its associated pathophysiology and neurological effects. It notes that alcoholism is a chronic condition and risk factor for many diseases. It causes more than 95,000 deaths annually in the US. Symptoms of Wernicke's encephalopathy include altered mental status, eye movement abnormalities, impaired coordination, and delirium. Differential diagnoses include amnestic-confabulatory syndrome and peripheral neuropathy. Prognosis includes conditions like cirrhosis, various cancers, and cardiovascular disease. The document provides steps for a neurological examination with cerebellar testing including assessing speech, eye movements, posture, finger-nose coordination, gait, and muscle tone.

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    Chir20001 Practical Assessment - Steven James Chang

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    This document discusses alcoholism and its associated pathophysiology and neurological effects. It notes that alcoholism is a chronic condition and risk factor for many diseases. It causes more than 95,000 deaths annually in the US. Symptoms of Wernicke's encephalopathy include altered mental status, eye movement abnormalities, impaired coordination, and delirium. Differential diagnoses include amnestic-confabulatory syndrome and peripheral neuropathy. Prognosis includes conditions like cirrhosis, various cancers, and cardiovascular disease. The document provides steps for a neurological examination with cerebellar testing including assessing speech, eye movements, posture, finger-nose coordination, gait, and muscle tone.

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    chir20001 practical assessment- steven james chang

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    This document discusses alcoholism and its associated pathophysiology and neurological effects. It notes that alcoholism is a chronic condition and risk factor for many diseases. It causes more than 95,000 deaths annually in the US. Symptoms of Wernicke's encephalopathy include altered mental status, eye movement abnormalities, impaired coordination, and delirium. Differential diagnoses include amnestic-confabulatory syndrome and peripheral neuropathy. Prognosis includes conditions like cirrhosis, various cancers, and cardiovascular disease. The document provides steps for a neurological examination with cerebellar testing including assessing speech, eye movements, posture, finger-nose coordination, gait, and muscle tone.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    81 views7 pages

    Chir20001 Practical Assessment - Steven James Chang

    Uploaded by

    api-455408952
    This document discusses alcoholism and its associated pathophysiology and neurological effects. It notes that alcoholism is a chronic condition and risk factor for many diseases. It causes more than 95,000 deaths annually in the US. Symptoms of Wernicke's encephalopathy include altered mental status, eye movement abnormalities, impaired coordination, and delirium. Differential diagnoses include amnestic-confabulatory syndrome and peripheral neuropathy. Prognosis includes conditions like cirrhosis, various cancers, and cardiovascular disease. The document provides steps for a neurological examination with cerebellar testing including assessing speech, eye movements, posture, finger-nose coordination, gait, and muscle tone.

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    CHIR20001 Practical Assessment

    Steven Chang s0288064

    Pathophysiology:

    Alcoholism is a chronic condition and is a risk factor for many chronic diseases.4
    Alcohol addiction is a multifactorial issue where personality structure, individual state
    of mind and social influences are in constant interaction with brain neurobiology and
    pathophysiology.3 It is associated with factors like environmental influences and peer
    interaction, genetic factor, the level of cognitive functioning, and certain existing
    personality disorders.2
    It is among the most common psychiatric disorders in the general population, and even
    though the incidence of alcoholism is still more common in men, but it has been
    increasing in women.2 And excessive alcohol use is responsible for more
    than 95,000 deaths in the United States each year.1

    Working Diagnosis:

    For patients who diagnosed with Wernicke’s encephalopathy, they might have
    shown acute altered mental status, ophthalmoplegia with 3rd and 6th nerve palsy,
    impaired coordination such as truncal ataxic gait abnormalities, delirium, and
    hypotension. As the result, physical examination may include a complete neurological
    exam with cerebellar testing.

    Differential Diagnosis:

    Twenty-five chronic disease and condition codes in the international Classification of


    Disease (iCD)-10 are entirely attributable to alcohol.5 Alcohol also plays a risk factor
    in certain cancers, other tumours, neuropsychiatric conditions, and numerous
    cardiovascular and digestive diseases.5 Furthermore, alcohol has both beneficial and
    detrimental impacts on diabetes, ischemic stroke, and ischemic heart disease.5

    Differential Diagnosis include:

    • Amnestic-confabulatory syndrome
    • peripheral neuropathy
    • cerebellar degeneration
    • Wernicke-Korsakorff syndrome,
    • Delirium tremens
    • Hallucinations
    • Tremulousness.

    Prognosis:

    • Cirrhosis
    • Oral cancer
    • Esophageal, liver and breast cancer
    • Cardiovascular disease such as Hemorrhagic stroke or heart attack
    • Koraskoff’s syndrome

    1
    CHIR20001 Practical Assessment
    Steven Chang s0288064

    • Wernicke’s encephalopathy (WE)

    Neurological Assessment (Neurologic exam with Cerebellar Examination)

    Step 1- Wash your hands.

    Step 2- Introduce yourself and confirm patient’ detail. Explain the examination.

    Step 3- Explain the examination

    Step 4- Assess Speech

    (https://news.ucsc.edu/2019/03/speech-therapy-game.html)

    2
    CHIR20001 Practical Assessment
    Steven Chang s0288064

    Step 5- Assess for Nystagmus

    (https://www.flintrehab.com/dizziness-after-head-injury/)

    Step 6- Inspect Patient’s Posture (Sitting down Position)

    (https://geekymedics.com/cerebellar-examination-osce-guide/)

    3
    CHIR20001 Practical Assessment
    Steven Chang s0288064

    Step 7- Finger-To-Nose Test (Intention tremor)

    (https://neupsykey.com/gait-coordination-and-abnormal-movements//)

    Step 8- Assess for Rebound Phenomenon

    (https://www.youtube.com/watch?v=mawBzDjbzfo)

    4
    CHIR20001 Practical Assessment
    Steven Chang s0288064

    Step 9- Dysdiadochokinesia

    (https://geekymedics.com/cerebellar-examination-osce-guide/)

    Step 10- Knee Reflex

    (https://www.huffpost.com/entry/your-doctors-kneejerk-ref_b_5695290)

    5
    CHIR20001 Practical Assessment
    Steven Chang s0288064

    Step 11- Gait Assessment

    (https://masnad.com.au/treatment-options/gait-analysis/)

    Step 12- Assess Tone

    (https://www.youtube.com/watch?v=AuNgCHgfDag)

    6
    CHIR20001 Practical Assessment
    Steven Chang s0288064

    Reference

    1. Fama R, Le Berre AP, Hardcastle C, Sassoon SA, Pfefferbaum A, Sullivan


    EV, et al. Neurological, nutritional and alcohol consumption factors underlie
    cognitive and motor deficits in chronic alcoholism. Addict Biol.
    2019;24(2):290-302.

    2. Mary-Anne Enoch DG. Problem Drinking and Alcoholism: Diagnosis and


    Treatment. National Institute on Alcohol Abuse and Alcoholism.
    2002;1(65):411-49.

    3. Nehring SM, Freeman AM. Alcohol Use Disorder. [Updated 2020 Nov 18].
    In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021
    Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436003/

    4. Shield KD, Parry C, Rehm J. Chronic diseases and conditions related to


    alcohol use. Alcohol Res. 2013;35(2):155-73.

    5. Shield KD, Parry C, Rehm J. Chronic diseases and conditions related to


    alcohol use. Alcohol Res. 2013;35(2):155-71.

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