extra passmed conditions

Question 1

neoplastic spinal cord compression

Answer 1

mets compressing on spinal cord -most likely lung breast and prostate cancer
back pain, worse lying down and coughing, lower limb weakness, sensory changes, neuro signs depending on level of lesion
urgent MRI within 24h
high dose oral dexamethasone

Question 2

trigeminal neuralgia

Answer 2

pain syndrome-severe unilateral pain -pains like brief electric shocks. commonly evoked by light touch but also can be spontaneous. just on areas trigeminal nerve covers.
carbamazepine=1st line then referral

Question 3

bell’s palsy

Answer 3

acute, unilateral, idiopathic, facial nerve paralysis -if UMN lesion forehead is spared though. can also have altered taste, ear pain, dry eyes, hyperacusis.
peak incidence 20-40yo, more common in pregnant women
oral prednisolone within 72h. controversial whether to use antivirals with. have to do eye care too
if no improvement after 3w, refer urgently to ENT