Clinical differentials

Question 1

Causes of a continuous heart murmur?

Answer 1

patent ductus arteriosus

Question 2

What murmur does a VSD make?

Answer 2

Pan systolic murmur

Question 3

What murmur does a ASD make?

Answer 3

Diastolic mumur

Question 4

What is a pyramidal distribution of weekness?

Answer 4

upper limb flexion, lower limb extension

Question 5

What is spasticity?

Answer 5

Velocity dependent hypertonia

Question 6

What is rigidity?

Answer 6

Consistent hypertonia

Question 7

What senses do the anterior and lateral spinal columns and where does it decussate?

Answer 7

pain and temp

decussates at the level of the spine

Question 8

What senses do the dorsal column and where does it decussate?

Answer 8

vibration and proprioception

Decussates at the medullar

Question 9

Are spinothalamic tracts lesions on the ipsilateral or contralateral side?

Answer 9

contralateral

Question 10

Are dorsal column lesions on the ipsilateral or contralaterlyal side?

Answer 10

ipsilateral

Question 11

Does the cerebellar innervate contralaterally or ipsilateral?

Answer 11

Ipsilateral

Question 12

What symptoms indicate extrapyramidal signs?

Answer 12

Parkinsonism

Question 13

What is the acronym for cerebellar signs?

Answer 13

DANISH

Dysdiadochokinesia 
Ataxia 
Nystagmus 
Intention tremor
Stuccarto/slured speech 
Hypotonia

Question 14

DD for bilateral distal sensory-motor lesions?

Answer 14

ABCDE
Alcohol 
B12 deficiency 
Carcinoma, charlcot marie tooth
DM 
Every vasculitis

Question 15

DD for pyramidal weakness

Answer 15

endocrine

muscular dystrophies

Question 16

DD for extra-pyramidal week

Answer 16

Parkinsons

Anti-psychotic overdose

Question 17

DD for cerebellar lesions?

Answer 17

MAVIS

MS
Alcohol
PLEASE COMPLETE

Question 18

What is the mnemonic for Life threatening Asthma/ COPD?

Answer 18

92 33 Chest

<92 O2
<33 PEFR

Cyanosis 
Hypotension 
Exaustion
Silent chest
Tachycardia

Question 19

DD for small bowel obstruction

Answer 19

adhesions adhesion adhesions…. hernia

Question 20

DD for large bowel obstruction

Answer 20

malignancy, diverticular disease, volvulus

Also think intra/mural/ extra mural causes

Question 21

MLD?

Acidosis <7.3
Ketones in urine
Glucose >11mmol

Answer 21

DKA

Question 22

Causes of mitral regurgitation?

Answer 22

Rheumatic heart disease
Ischaemia - papillary rupture
Infective endocarditis - vegetation
Enlarged left atria

Question 23

What areas of the brain is responsible for an expressive dysphasia?

Answer 23

Bracos area (frontal temporal gyrus)

Question 24

What symptoms are in an expressive dysphasia?

Answer 24

• loss of fluency
• difficulty word finding
  BUT good repetition and comprehension

Question 25

What areas of the brain is responsible for an receptive dysphasia?

Answer 25

Wernickies area (superior temporal gyrus)

Question 26

What symptoms are in an receptive dysphasia?

Answer 26

Fluent speech with good repetition of words, Difficulty with comprehension of speech

Question 27

Medical treatment for PE?

Answer 27

DOAC or warfarin. LMWH used for prevention not cure.

Question 28

Difference between presbyacausis and otosclerosis?

Answer 28

Otosclerosis is conductive whereas presbyacausis is sensorineural