Neuropathy Signs and Symptoms 2 — Questions and Answers
Question 1: A patient describes a sensation of walking on cushions or thick socks despite being barefoot. This altered perception is best classified as which neuropathy symptom?
- Allodynia
- Paresthesia (Correct answer)
- Hyperalgesia
- Anhidrosis
Correct answer: Paresthesia
Paresthesia is an abnormal sensation such as tingling, prickling, or the feeling of padding under the feet.
Question 2: In a 'stocking-glove' distribution of symptoms, where do sensory changes typically begin first?
- The proximal thighs and shoulders
- The trunk and chest
- The toes and feet (Correct answer)
- The fingertips before the toes
Correct answer: The toes and feet
Length-dependent neuropathy affects the longest nerves first, so symptoms usually start in the toes and feet.
Question 3: A patient with neuropathy reports severe pain when a bedsheet lightly touches their feet. This painful response to a normally non-painful stimulus is called:
- Allodynia (Correct answer)
- Paresthesia
- Hypoesthesia
- Dysarthria
Correct answer: Allodynia
Allodynia is pain produced by a stimulus that does not normally cause pain, such as light touch.
Question 4: Which symptom suggests autonomic involvement rather than purely sensory neuropathy?
- Numbness in the toes
- Burning foot pain
- Orthostatic dizziness on standing (Correct answer)
- Loss of vibration sense
Correct answer: Orthostatic dizziness on standing
Orthostatic dizziness reflects autonomic dysfunction affecting blood pressure regulation.
Question 5: A patient notices they cannot feel the temperature of bathwater accurately with their feet. Which fiber type is most likely affected?
- Large myelinated motor fibers
- Small unmyelinated/thinly myelinated fibers (Correct answer)
- Proprioceptive fibers only
- Cranial nerve fibers
Correct answer: Small unmyelinated/thinly myelinated fibers
Small fibers carry temperature and pain sensation, so their damage impairs thermal perception.
Question 6: Which of the following is an early motor sign of peripheral neuropathy affecting the feet?
- Increased muscle bulk in the calves
- Difficulty with fine toe movements and foot weakness (Correct answer)
- Resting tremor of the hands
- Exaggerated knee reflexes
Correct answer: Difficulty with fine toe movements and foot weakness
Motor neuropathy causes distal weakness, making fine foot and toe movements difficult.
Question 7: A diabetic patient is unaware of a blister forming on the sole of the foot. This 'silent' injury risk is most directly due to:
- Loss of protective sensation (Correct answer)
- Excessive sweating
- Muscle hypertrophy
- Improved reflexes
Correct answer: Loss of protective sensation
Loss of protective sensation means injuries go unnoticed, increasing ulcer risk.
Neuropathy Signs and Symptoms 2
A patient describes a sensation of walking on cushions or thick socks despite being barefoot.
This altered perception is best classified as which neuropathy symptom?