morepm Flashcards
(8 cards)
Which of the following statements is most accurate regarding the usefulness of cervical spine radiographs (X-rays) in the assessment of degenerative cervical myelopathy (DCM)?
cannot diagnose
ischeamic stroke within 4 hrs management
A combination of thrombolysis AND thrombectomy is recommend for patients with an acute ischaemic stroke who present within 4.5 hours
You are examining a patient who complains of double vision. Whilst looking forward the patient’s right eye turns downwards and outwards. On attempting to look to the patient’s left the patient is unable to adduct the right eye and double vision worsens. On looking right the angle of the squint is less. What is the most likely underlying problem?
right third nerve palsy
syringomyelia
spinothalamic
Syringomyelia classically presents with cape-like loss of pain and temperature sensation due to compression of the spinothalamic tract fibres decussating in the anterior white commissure of the spine
An 81-year-old man presents to the emergency department with sudden onset nausea and vomiting. He was walking in the park when he suddenly felt like the ‘world around him was spinning’ and he started vomiting.
On examination, he look unwell and disorientated. A cranial nerve examination reveals that he is unable to raise his eyebrows, smile or raise his eyelid on the right side. The sensation is also lost on the right side of his face. He also cannot hear from the right ear, which is a new symptom for him. An ataxic gate is noted.
Given the most likely diagnosis, where is the lesion?
Right
Sudden onset vertigo and vomiting, ipsilateral facial paralysis and deafness - anterior inferior cerebellar artery
facial motor loss = must be anterior
A 50-year-old woman presents to the GP with her husband, reporting 5 weeks of daily headaches. They are worsening in severity and she has no previous history of headache.
During the consultation, she leaves the room to use the bathroom and her husband expresses concerns about her behaviour. Recently, she has made inappropriate remarks to her friends and her mood has been labile, which is uncharacteristic for her.
Which option is the best next step for the GP to take?
urgent secondary care for imaging
A 27-year-old woman attends the neurology clinic after a referral from her GP. She has been having one-minute episodes of repeatedly grabbing the air in front of her. She is not aware of these episodes, but her girlfriend has videoed one of the episodes. The patient can tell when she’s going to have one of these episodes as she feels a strong sense of feeling that she has lived through the present situation before.
What is the likely diagnosis?
Temporal lobe seizures typically feature epigastric aura and automatisms
