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MBChB Year 4 OSCE > OSCE Prep > Flashcards

OSCE Prep Flashcards

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1
Q

Gastrointestinal System Exam: Inspection

Causes of abdominal distension

A 
Fat
Fluid (ascites)
Flatus
Faeces 
Fetus
Filthy big mass
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2
Q

Gastrointestinal System Exam: Palpation

DDx for Hepatomegaly (INCHIB)

A

Infection (Hepatitis, EBV, Malaria, Abscess)
Neoplastic (Myeloproliferative disease, HCC, metastasis)
Congestion (Venous) (RHF, TR, Budd-Chari Syndrome)
Haematological (Lymphoma/leukemia, Sickle cell or haemolytic anaemia)
Infiltrate (Sarcoidosis, Amyloidosis, fatty liver)
Biliary (PBC, PSC)

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3
Q

Gastrointestinal System Exam: Palpation

DDx for Splenomegaly

A

Massive (Malaria, Myeloproliferative disease [myelofibrosis or CML]
Moderate (Lymphoma, leukemia, Portal hypertension, haemolytic anaemia)
Mild (Glandular fever, Rheumatoid arthritis [Felty Syndrome], Infective endocarditis, Pernicious anaemia)

SLE

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4
Q

Gastrointestinal System Exam: Palpation

DDx for Hepato-splenomegaly

A

Hepatitis, EBV, Malaria, Lymphoma, Leukemia, Myelofibrosis, Sickle cell, haemolytic anaemia, sarcoidosis, amyloidosis

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5
Q

Gastrointestinal System Exam: Hands

DDx for clubbing (gastro causes)

A

Cirrhosis
IBD
GI lymphoma
Coeliac Disease

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6
Q

Cardiovascular System Exam: Hands

DDx of peripheral cyanosis

A

Peripheral vascular disease
Raynaud’s Syndrome
Heart failure
Shock

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7
Q

Cardiovascular System Exam: Mouth

DDx of central cyanosis

A

Hypoxic lung disease
Right-to-left shunt
Methaemoglobinaemia (drug or toxin induced)

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8
Q

Cardiovascular System Exam: Peripheral

DDx of irregular irregular pulse

A

Atrial Fibrillation
Atrial Flutter
Ventricular ectopic beats
Complete heart block with ventricular escape

To differentiate between AF and VEB without an ECG, exercise the patient, this will abolish VEBs but AF will remain.

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9
Q

Cardiovascular System Exam: Irregular Irregular Pulse

Causes of AF

A 
Ischemic Heart disease
Rheumatic Heart disease
Thyrotoxicosis
Pneumonia/PE/
Alcohol
Idiopathic
Fever
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10
Q

Cardiovascular System Exam: Heart Failure

Causes of Heart Failure

A

Pump Failure: IHD, Cardiomyopathy, Constrictive pericarditis, arrythmia or negative inotropes/chronotropes)
Excessive preload: MR or AR, Fluid excess (renal failure or IV fluids))
Excessive afterload (AS or hypertension)
Isolated RHF (Cor Pulmonale secondary to chronic lung disease or pulmonary hypertension (primary/due to MS))
High output cardiac failure (anaemia, pregnancy, metabolic)

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11
Q

Cardiovascular System Exam: Infective Endocarditis

List the stigmata of infective endocarditis

A 
Changing heart murmur
Clubbing
Splinter haemorrhages
Mild Splenomegaly
Microscopic haematuria
Oslers nodes
Janeway lesions
Roths spots (retina)
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12
Q

Peripheral Vascular Exam: Critical Limb Ischemia

6 signs of critical limb ischemia

A 
Pain 
Pallor
Pulseless
Paraesthesia
Perishingly cold
Paralysed
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13
Q

Peripheral Vascular Exam: Venous

Causes of chronic venous insufficiency

A

Valvular incompetance of deep veins (90%)

Obstruction of deep veins (10%)

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14
Q

Peripheral Vascular Exam

Causes of acute limb ischaemia

A

Thrombosis
Emboli (80% cardiac source eg AF, 10% non-cardiac source eg AAA or peripheral aneurysm, and 10 % unknown source)
Graft rejection/occlusion
Trauma

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15
Q

Peripheral Vascular Exam: ABPI

How is a ABPI done and what do the results show?

A

Performed using a pencil doppler machine and a standard blood pressure cuff. Bilateral brachial systolic pressures are recorded and then the highest reading is taken as the denominator for both legs.
In legs, take highest systolic reading from DP and PT to use as the numerator
>1.3 = Unreliable - vessels are calcified, commonly seen in diabetics
0.9-1.8 = Normal range
<0.8 = Evidence of peripheral arterial disease (claudication)
<0.5 = significant peripheral arterial disease - gangrene and ulceration

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16
Q

Cardiovascular System Exam: Murmur

Etiology of Aortic Stenosis

A

Rheumatic Heart disease
Calcified bicuspid aortic valve (50-60)
Calcified tricuspid aortic valve (70+)
Supravalvular stenosis

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17
Q

Cardiovascular System Exam: Murmur

Presentation of Symptomatic Aortic Stenosis

A

Dyspnoea/Decreased exercise tolerance
Syncope/dizziness
Angina pectoris

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18
Q

Cardiovascular System Exam: Murmur
Physical exam findings associated with Aortic Stenosis
What may you see on an ECG?

A

Low volume, slow rising pulse
Narrow pulse pressure
Ejection systolic murmur heard loudest over right 2nd intercostal space, radiating to carotids.
LVH with strain pattern, p mitralle, Left axis deviation

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19
Q

Cardiovascular System Exam: Murmur

DDx of Aortic Stenosis

A

Aortic Sclerosis
HOCM
Pulmonary stenosis (usually congenital)
Mitral regurgitation

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20
Q

Cardiovascular System Exam: Murmur

Etiology of Aortic Regurgitation

A

Acute: Endocarditis, Aortic dissection, Cusp rupture (congenital, traumatic), Iatrogenic

Chronic: Rheumatic heart disease, aortic root dilatation, congenital bicuspid aortic valve and calcific valve disease

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21
Q

Cardiovascular System Exam: Murmur

Presentation of Aortic Regurgitation

A

Often asymptomatic
May develop exertional dysnpnoea, angina and symptoms of Heart failure
Palpitations

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22
Q

Cardiovascular System Exam: Murmur
Physical exam findings associated with Aortic Regurgitation
What might you see on CXR

A

Quincke’s Sign: Pulsatile nailbeds
Corrigan’s Sign: Exaggerated carotid pulse
Wide pulse pressure.
Early diastolic murmur heard loudest over left sternal edge, increased on leaning forward and expiration
CXR: Cardiomegaly, CHF (ABCD)

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23
Q

Cardiovascular System Exam: Murmur

DDx of Aortic Regurgitation

A 
Pulmonary regurgitation
Graham Steel (PR secondary to pulmonary hypertension)
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24
Q

Cardiovascular System Exam: Murmur

Etiology of mitral regurgitation

A

IE, RHD, Calcification, mitral valve prolapse, ruptured chordae tendinae, papillary muscle rupture, connective tissue disorders (marfan’s)
Functional: LV dilation

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25
Cardiovascular System Exam: Murmur | Presentation of Mitral Regurgitation
``` SOB/Fatigue Other LVF (orthopnea/PND) ```
26
Cardiovascular System Exam: Murmur | Physical exam findings associated with Mitral Regurgitation
Pansystolic murmur hear loudest in the mitral area. | AF common
27
Cardiovascular System Exam: Murmur | DDx of Mitral Regurgitation
Ventricular septal defect Tricuspid regurgitation AS
28
Cardiovascular System Exam: Murmur | For Mitral Regurgitation, what may you see on ECG and CXR
ECG: AF common, VEB's CXR: Cardiomegaly or CHF
29
Cardiovascular System Exam: Murmur | Etiology of mitral stenosis
RHD (99%)
30
Cardiovascular System Exam: Murmur | Presentation of Mitral stenosis
``` Dyspnoea Pulmonary oedema/haemoptysis AF RHF (late) Really enlarged atria can compress recurrent laryngeal nerve - hoarseness ```
31
Cardiovascular System Exam: Murmur | Physical exam findings associated with Mitral stenosis
Mitral facies Signs of RHF AF Mid-diastolic murmur loudest on LHS with expiration
32
Cardiovascular System Exam: Murmur | For Mitral stenosis, what may you see on ECG and CXR
ECG: AF or P mitrale (bifid P waves)
33
Cardiovascular System Exam: Murmur | DDx of Mitral stenosis
``` Austin Flint (2ndary AR) Carey Coombs (Rheumatic Fever) Tricuspid Stenosis (RHD) ```
34
Gastrointestinal System Exam: Inspection 1. Causes of Leukonychia 2. Causes of Koilonychia 3. Causes of xanthomata
1. Hypoalbumininaemia 2. Iron-deficiency anaemia 3. Hyperlipidaemai
35
Gastrointestinal System Exam: Inspection | Causes of depuytren's contracture
CLD, diabetes, heavy labour, phenytoin, trauma, familial
36
Gastrointestinal System Exam: Inspection | Causes of Palmar erythema
CLD, pregnancy, hyperthyroidism, rheumatoid arthritis
37
Gastrointestinal System Exam: Inspection | Why would someone have increased bruising?
CLD: THrombocytopenia , decreased clotting factors and falls Jaundice: Biliary obstruction > reduced fat absorption > reduced absorption of fat soluble vitakne (A D E K) - reduced vitamin K means less synthesis of factors 10, 2 7 and 9.
38
Gastrointestinal System Exam: Inspection | Why would someone have a cushingnoid appearance of the face?
Alcoholic pseudocushings - hypercortisolaemia secondary to stress of repeated alcohol withdrawal
39
Respiratory Exam: Causes of wheeze
Asthma, COPD, Bronchiectasis, Fixed bronchial obstruction
40
Respiratory Exam: Causes of atelectasis
Intraluminal: Mucus, Foreign body, aspiration Mural: Bronchial carcinoma Extramural: ....
41
Respiratory Exam: DDx of haemoptysis
``` Malingering Pseudo-haemoptysis: GI source Infection: TB, Pneumonia. Infective bronchitis, bronchiectasis Infarction: PE Pulmonary odema: LVH, MS Vasculitis: SLE, Goodpastures ```
42
Respiratory Exam: DDx of pleural effusion
Transudate: HF, hypoalbuminuria, cirrhosis, nephrotic syndrome, hypothyroidism Exudate: Infection, inflammation, neoplastic, pancreatitis Empyema: Pus Haemothorax: Blood Chylothorax: Lymph
43
``` Respiratory Exam: How does Consolidation present? Mediastinal shift: Chest wall movement: Percussion: Breath sounds: Added sounds: ```
``` Mediastinal shift: None Chest wall movement: Decreased over affected area Percussion: Dull Breath sounds: Reduced (bronchial) Added sounds: Crackles ```
44
``` Respiratory Exam: How does Atelectasis present? Mediastinal shift: Chest wall movement: Percussion: Breath sounds: Added sounds: ```
Mediastinal shift: Towards side of collapse Chest wall movement: Decreased over affected area Percussion: Dull Breath sounds: Absent/reduced Added sounds: None
45
``` Respiratory Exam: How does Pleural effusion present? Mediastinal shift: Chest wall movement: Percussion: Breath sounds: Added sounds: ```
Mediastinal shift: Away from side of effusion in large effusions Chest wall movement: Decreased over area affected Percussion: Stony dull Breath sounds: Absent over fluid, bronchial over upper border Added sounds: nil
46
``` Respiratory Exam: How does Pneumothorax present? Mediastinal shift: Chest wall movement: Percussion: Breath sounds: Added sounds: ```
``` Mediastinal shift: Away from side fo Ptx Chest wall movement: Decreased over affected area Percussion: Hyperresonant Breath sounds: Absent/reduced Added sounds: nil ```
47
``` Respiratory Exam: How does ILD present? Mediastinal shift: Chest wall movement: Percussion: Breath sounds: Added sounds: ```
``` Mediastinal shift: Nil Chest wall movement:Decreased Symmetrically Percussion: Normal Breath sounds: Normal Added sounds: Crackles ```
48
Respiratory Exam: What is type one respiratory faiure and what are the commonest causes?
Low PaO2 but normal/low PaCO2 V/Q mismatch, hypoventilation, abnormal diffusion, right to left cardiac shunts. V/Q mismatch: Pneumonia, PE, pulmonary oedema, asthma, emphysema, pulmonary fibrosis, ARDS
49
Respiratory Exam: What is type two respiratory failure and what are the commonest causes?
Low PaO2 and High PaCO2 Pulmonary problme: COPD, Pulmonary oedema, pneumonia Mechanicl Problem: Chest wall trauma, muscular dystrophy, MND, Myasthenia gravis Central: Opiate overdose, acute CNS disease
50
Respiratory Exam: List causes of dullness on percussion
``` Consolidation Effusion Atelectasis (presents same as lobectomy) Lobectomy/Pneumonectomy Raised hemidiaphragm Pleural thickening ```
51
Cranial Nerve Exam: Causes of opthalmoplegia
``` Myasthenia gravis Cranial Nerve Palsy Graves Disease Wernicke's Encephalopathy Progressive supranuclear palsy (vertical gaze) ```
52
Cranial Nerve Exam: Where does the lesion occur in internuclear opthalmoplegia?
Medial longitudinal fasciculus
53
Cranial Nerve Exam: What are the causes of Internuclear opthalmoplegia?
MS | Stroke
54
Cranial Nerve Exam: General causes of any cranial nerve palsy
``` Diabetes (microangiopathy of the vasa nervorum) Stroke MS Tumours Sarcoid SLE Vasculitis ```
55
Cranial Nerve Exam: Specific Causes of Cranial Nerve 1 (olfactory) palsies
Trauma (shearing of olfactory bulbs through cribriform plate) Alzheimer's and Parkison's Frontal lobe tumour (meningioma) Meningitis
56
Cranial Nerve Exam: Specific Causes of Cranial Nerve 2 (optic) palsies 1. Monocular 2. Bitemporal hemianopia 3. Homonymous hemianopia
1. MS, GCA 2. Lesion at optic chiasm: pituitary adenoma, suprasellar meningioma, craniopharyngioma 3. Anything behind optic chiasm (stroke, tumour or abscess)
57
Cranial Nerve Exam: Causes of Relative Afferent Pupilllary defect
Optic Nerve disorder: Optic ischaemic neuropathy, optic neuritis, Optic nerve compression, unilateral glaucoma Retinal Disorders: Central retinal artery/veins occlusion, severe diabetic retinopathy, retinal detachment, Infection (CMV/HSV), tumours (retinoblastoma/melanoma)
58
Cranial Nerve Exam: What would you see in a cranial nerve 3 palsy
Eye down and out position (unapposed lateral rectus and superior oblique) Ptosis (levator palpebrae dysfunction) Fixed Dilated pupil (parasympathetic nerve fibres from ciliary ganglion affected) Do not always get all three signs. Often not all branches of the nerve affected
59
Cranial Nerve Exam: Causes of unilateral ptosis?
Cranial nerve III palsy Horners syndrome Congenital
60
Cranial Nerve Exam: Causes of bilateral ptosis?
``` Myasthenia gravis Myotonic dystrophy Bilateral Horners Neurosyphilus Congenital ```
61
Cranial Nerve Exam: Causes of cranial nerve 3 palsy
Location dependent! Diabetes - vascular neuropathy Demyelination Midbrain: Infarction, haemorhage, tumour Subarachnoid space: PCA aneurysm (will be painful!) Superior orbital fissure (tumour, ICA artery [would also affect nerves in cavernous sinus] Orbit: Tumour/trauma
62
Cranial Nerve Exam: Causes of cranial nerve 4 (trochlear) palsy
microvascular disease | Orbit trauma
63
Cranial Nerve Exam: CN5 | What are the afferent and efferent branches of the corneal reflex?
Afferent: Opthalmic branch of the trigeminal Efferent: Facial Nerve
64
Cranial Nerve Exam: CN7 | What is the difference between an UMN and LMN 7th nerve lesion?
UMN: Sparing of the forehead due to bilateral facial representation at the level of the 7th nerve nuclei LMN: All muscles of the face affect
65
Cranial Nerve Exam: Causes of LMN CN7 palsy?
Pons: Infarction, tumour, MS Cerebellopontine angle (CN 6, 7 and 8 affected): Tumour (meningioma or acoustic neuroma) Base of skull/parotid: Bells Palsy, Maligannt parotid tumour/parotid pathology, Herpes Zoster (Ramsay Hunt)
66
Cranial Nerve Exam: Causes of UMN CN7 palsy?
Stroke | Tumours
67
Cranial Nerve Exam: Causes of Bilateral facial nerve LMN weakness
Guillain Barre syndrome. Sarcoidosis, Myasthenia gravis, myotinic dystrophy
68
Cranial Nerve Exam: Features of bulbar palsy
Absent gag reflex Wasted tongue + Fasciculations Absent/normal Jaw Jerk Nasal Speech
69
Cranial Nerve Exam: Features of pseudobulbar palsy
Increased/normal gag reflex Spastic tongue Jaw jerk increased Spastic dysarthria
70
Cranial Nerve exam: Which way does the tongue deviate in a CNXII nerve lesion?
Toward the side of the lesion
71
Cranial Nerve exam: Which way does the uvula deviate in a CNX nerve
Away from side of lesion
72
Cranial Nerve Exam: Afferent and Efferent pathways of the gag reflex?
Afferent: Glossopharyngeal Efferent: Vagus
73
Median Nerve Palsy 1. Inspection 2. Power 3. Sensation 4. Special Tests
1. Inspection: Thenar wasting, carpel tunnel decompression scar 2. Power: Thumb abduction 3. Sensation: Lateral side of index finger 4. Special Tests: Phalen's, Allens
74
Radial Nerve Palsy 1. Inspection 2. Power 3. Sensation
1. Inspection: Forearm extensors and wrist drop 2. Power: Wrist/MCP extension 3. Sensation: Dorsal 1st interosseus space
75
Ulna Nerve Palsy 1. Inspection 2. Power 3. Sensation 4. Special Tests
1. Inspection: Hypothenar wasting, interosseus wasting, elbow trauma 2. Power: Index finger abduction 3. Sensation: Medial side of little finger 4. Special Tests: Fromonth's
76
Rheum Hand: DDx of symmetrical polyarthritis
Rheumatoid arthritis Osteoarthritis Systemic conditions: SLE, Sarcoidosis etc
77
Rheum Hand: DDx of asymmetrical polyarthritis
Reactive arthritis Psoriatic Arthritis Systemic SLE, Sarcoid etc
78
Rheum Hand: DDx of oligoarthritis
``` Gout CPPD Psoriatic arthritis Reactive arthritis Ankylosing spondylitis OA ```
79
Rheuma Hand: DDx of monoarthritis
``` Septic arthritis Gout CPPD OA Trauma ```
80
XRay features of OA
Loss of joint space Osteophytes Subchrondral cysts Subarticular sclerosis
81
Stoma: Features of iliostomy stoma and types/indications for one?
Site: RIF Contents: Soft faeces Opening: Spout to protect skin from enzymes End Iliostomy: UC, FAP or Hirsprungs Loop: De-function distal bowel (obstruction due to malignancy, anus (Crohn's) or new distal anastamoses
82
Stoma: Features of colostomy stoma and types/indications for one?
Site: LIF Contents: Hard faeces Opening: Flush with skin End: AP resection or hartmann's Loop: De-function distal bowel (obstruction due to malignancy, anus (Crohn's) or new distal anastamoses
83
Stoma: Early complications?
``` High output ( dehydration, hypokalaemia) Peristomal inflammation Retraction Obstruction Ischaemia/Necrosis ```
84
Stoma: Late Complications?
Parastomal hernia Prolapse Fistula formation Dermatitis
85
Cranial Nerve Exam: Presentation of a cranial nerve 4 lesion
Trochlear nerve palsies present
86
Cranial Nerve Exam: Presentation of a cranial nerve 6 lesion
Abducens Nerve palsies present with inability to abduct affected eye
87
Respiratory Exam: Causes of ILD
Idiopathic Systemic disease: Rheumatoid arthritis, SLE, Sarcoidosis Occupational exposure to asbestos Drug toxicity: Amiodarone, methotrexate or radiotherapy
88
Lower Limb Neurology: Approach to foot drop? ?location of lesion ?What lesion is
Think anterior horn, L5 nerve root, lumbosacral plexus, sciatic nerve palsy, Common peroneal nerve palsy, Muscle. Common peroneal nerve palsy: Ankle reflex intact, sensory loss between 1st and 2nd toes. Sciatic nerve lesions: weak knee flexion, no ankle jerk, widespread sensory loss L5 lesion: skdjdbadkjl
89
Neurological Exam: Signs of UMN lesion
``` Increased tone: Spasticity Decreased power Impaired coordination Increased reflexes (clonus present) Up-going plantars ```
90
Neurological Exam: Signs of LMN lesion
``` Muscle atropy, fasciculations Decreased tone Decreased power Coordination not impaired unless weakness Reduced or absent reflexes ```
91
Neurological Exam: What Hz tuning fork is used for webers and rinnes?
256Hz or 512Hz
92
Neurological Exam: What Hx tuning fork is used for vibration sensation
128Hz
93
Head and Neck: Describe the features of a neck lump you would comment on?
``` Sizze Shape Symmetry Surface Consistency Edges Fluctuance Pulsation Translumination ```
94
Head and Neck: DDx for mid-line neck mass
``` Thyroid THyroglossal cyst Lymph node Lipoma Sebaceous cyst Abscess ```
95
Head and Neck: DDx for anterior triangle neck mass
``` Thyroid, salivary gland, carotid artery aneurysm Carotid body tumour Branchial tumour Lymph node Lipoma Sebaceous cyst Abscess ```
96
Head and Neck: DDx for posterior triangle mass
cystic hygroma, lymph node, subclavian artery aneurysm , lipoma, abscess, sebaceous cyst
97
Head and Neck: DDx for a goitre
``` Multinodular goitre Hashimoto's thyroiditis Grave's Disease Iodine deficiency Acute thyroiditis (de Quer) Tumours Amyloid/sarcoid ```
98
Head and Neck: What are the classes of thyroid cancers and what markers are useful in these malignancies?
Differentiated: Papillary (85%) Follicular (12%) Thyroglobulin proportional to amount of thyroid tissues so helpful in monitoring cancer burden and recurrence Undifferentiated: ANaplastic Medullary: Parafollicular (C) cells - CALCITONIN
99
``` Lower Limb Neuro: Causes of Bilateral leg weakness (paraparesis)? Acute: Spastic: Flaccid: Mixed UMN/LMN: ```
Acute: Acute cord compression, Cauda equina, Guillain-barre syndrome Spastic: Sagital sinus lesion (meningioma), bilateral strokes, cord trauma, cord compression (epidural abscess, disc prolapse, spondylosis), intrinsic cord disease (tumour, Vascular myelopathy, MS, transverse myelitis) Flaccid: Polio, Guillain-barre, lead poisening Mixed: CMT
100
Lower Limb Neuro: Causes of Unilateral leg weakness? | Upper vs Lower motor neuron
UMN: Stroke, tumour, MS LMN: Root lesion, Nerve lesion
101
Lower Limb Neuro: If on exam you find a spastic paraparesis, what should be included in the exam?
Assess for a sensory level on the thorax
102
Lower Limb Neuro, If on exam you find a flaccid paraparesis, what should you include on exam?
PR assessing for peri-anal sensation and sphincter tone
103
Peripheral Neurological exam: Causes of glove/stocking distribution sensory loss
``` Diabetes Mellitus Alcohol B12/folate deficiency Paraneoplastic syndrome Medications e.g. isoniazid ```
104
Neuro: What does a positive romberg's test tell you?
Person has sensory ataxia | Can be due to dorsal column loss (B12/folate deficiency or MS) or sensory peripheral neuropathy
105
Diabetic Foot Exam: What are the key exam findings in assessing a diabetic foot? hat complications arise in diabetic feet?
``` Peripheral arterial disease Diabetic neuropathy (fine touch, vibration, joint-position sensation) + autonomic neuropathy ``` Ulcers and infections!
106
Cerebellar exam: Causes of cerebellar disease
``` Stroke Tumour MS Friedreich's Ataxia Alcohol abuse Thiamine deficiency (Wernicke's Encephalopathy) Anti-epileptic medication ```
107
Cerebellar exam: Classic signs of cerebellar lesion (DANISH)
``` Dysdiodochokinesis Ataxia (limb/trunk) Nystagmus Intention tremor Speech (slurred, staccato) Hypotonia ```
108
Cerebellar exam: Causes of cerebellar lesions
``` Stroke Tumour MS Congenital Friedreich's ataxia ALcohol abuse Thiamine deficiency Anti-epileptic medication ```
109
Extrapyramidal Exam: Causes of Parkinsonism
``` Idiopathic Parkinsons Disease Drug induced (Metacloperamide, lithium) Parkinsons plus syndromes (Progressive supranuclear palsy, corticobasilar degeneration, Multiple System atrophy) Vascular Parkinsons Lewy Body Dementia ```
110
Neuro Examination: Differential diagnosis of dysarthria, plus what features would you look for to confirm each?
Facial nerve palsy (facial muscle weakness) Bulbar palsy (flaccid, wasted fasciculating tongue) Pseudobulbar palsy (spastic, contracted tongue) Myasthenia gravis Cerebellar disease

MBChB Year 4 OSCE (1 decks)

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