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FRACP CLINICAL SS > OSCESTOP > Flashcards

OSCESTOP Flashcards

1
Q

Differentials for proximal weakness

A 
CMIND **normal sensation
Congenital - mitochonrial 
Metabolic - Cushings, hypothyroidism
Inflammatory - dermato/polymyositis, IBM
Neuromuscular - MG, LAMS
Dystrophies - Becker's, FSHD, limb girdle
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2
Q

Bilateral UMN / pyramidal weakness

A

3Ms

MS
MND (normal sensation)
Myelopathy (sensory level)

Others - brainstem stroke, hereditary spastic paraplegia

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3
Q

Unilateral UMN / pyramidal weakness

A

Intracranial - CVA, SOL, MS (hemisensory loss)
Brainstem - MS
Spinal cord - MS, trauma, SOL, abscess/haemhorage/AVM (sensory level)

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4
Q

Bilateral LMN distal weakness + loss of sensation

A

sensory motor polyneuropathy
DIM VIT

DM
Inherited - CMT
Metabolic - B1, B12 def.
Vasculitis - SLE, PAN, RA
Infection - herpes zoster, HIV, leprosy, syphilis
Toxins - EtOH, TB drugs, nitrofurantoin, vincritine, cisplatin, amiodarone

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5
Q

Bilateral LMN distal weakness with NORMAL sensation

A

distal motor neuropathy

GBS
CIDP
Myotonic dystrophy
Lead poisoning
Porphyria
IBM (distal arms, prox legs) 
Progressive muscular atrophy
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6
Q

Unilateral LMN - radiculopathy

A

Radiculopathy * dermatomal sensory loss

  • disc herniation
  • cervical spondyosis with osteophytes
  • spinal canal stenosis
  • nerve sheath tumours
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7
Q

Mononeuritis multiplex

A

Vasculitis - GPA, EGPA, PAN, microscopic polyangiitis

Autoimmune - SLE, Sjogrens, RA, Sarcoid,

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8
Q

UMN + LMN

A

MND
Dual pathology: eg. cervical myelopathy + peripheral neuropathy
Cervical radiculomyelopathy

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9
Q

Absent ankle jerks +/- KJs and up going plantars

A

Subacute combined degeneration of the cord
Syphilic tabo-paresis
Frederich’s ataxia
MND

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10
Q

Cerebellar disease

A

MAVIS P

MS
Alcohol
Vascular - thromboembolic, haemorrhage
Inherited - Freiderich's ataxia, SCA, ataxia telangectasia
SOL
Paraneoplastic
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11
Q

Complex ophthalmoplegia

A 
Graves
Mitochondrial myopathy 
Myesthenia gravis
Multiple CNs - cavernous sinus pathology, mononeuritis multiplex
Brainstem - Stroke, SOL, tumour
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12
Q

Optic atrophy

A 
MS
Ischaemia
Temporal arteritis
compression (SOL, raised ICP)
Glaucoma
DM
methanol
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13
Q

3rd nerve palsy

A

PCOM aneurysm
Cavernous sinus thrombosis
DM, mononeuritis multiplex, MS, SOL

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14
Q

6th nerve palsy

A

Raised intracranial pressure

DM, mononeuritis multiplex, MS, SOL

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15
Q

Unilateral facial nerve

A 
Bells palsy 
Ramsay Hunt 
Brainstem lesion (SOL, demyelination, stroke) 
TB
Nerve infiltration (lymphoma/sarcoid)
Parotid tumour/surgery
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16
Q

Bilateral facial nerve

A 
Bilateral Bells palsy 
Sarcoid
Autoimmune - MG, vasculitis
Inflammatory - GBS
Dystrophies
Amyloidosis
17
Q

Bulbar palsy

A 
MND
Brainstem infarct/SOL
MG
GBS
Polio
Syphilis 
Syringiobulbia
18
Q

Pseudobulbar palsy

A 
MND
Brainstem infarct/SOL
MS
internal capsule infarct/small vessel disease
neurodegenerative
brain tumour
high brainstem tumours
PSP
19
Q

CN 3-6

A

cavernous sinus thrombosis

20
Q

CN 5-8 + cerebellar

A

cerebellar pontine angle tumour

21
Q

CN 9-10

A

+11 = julgular foramen syndrome

+12 = pseudobulbar/bulbar palsy

22
Q

CN 9-10 + ipsilateral horners + cerebellar + sensory loss (ipsi face, contra body)

A

= lateral medullary syndrome

23
Q

Homonymous hemianopia

A

Stroke, cerebral SOL

24
Q

Bitemporal hemianopia

A

pituitary tumour
craniopharngioma
suprasellar meningioma
aneurysym

25
Q

Tunnel vision

A

Glaucoma

Retinitis pigmentosa

26
Q

Central scotoma

A

MS, ischaemic, temporal arteritis, compression, glaucoma, methanol

27
Q

Homonymous quadrantanopia

A

Parietal Inferior

Temporal Superior

28
Q

Monocular visual loss

A 
Central retinal artery occlusion
Vitreous haemorrhage 
Large retinal detachment 
Trauma 
Papillodema
29
Q

Ptosis - unilateral or bilateral

A

MG

Muscular dystrophy

30
Q

Ptosis - unilateral

A

Horners
3rd nerve
idiopathic

31
Q

Ptosis - bilateral

A

Congenital

Tabes dorsalis with Argyle Robertson pupils

32
Q

Differentials for Horners

A

1st - MS, spondylosis, SOL, syringiomyelia, stroke/lateral medullary syndrome

2nd - Pancoast tumour, cervical rib

3rd - Carotid artery dissection, malignant infiltration (thyroid, lymphoma or mets)

33
Q

Chorea

A 
Huntingtons
Sydenhams chorea
Drugs 
Stroke
HIV
34
Q

Hemibalism

A

Stroke
SOL
HIV
trauma

35
Q

Athetosis

A

asphyxia
neonatal jaundice
thalamic stroke

36
Q

Dystonia

A 
trauma
drugs
Wilson's disease
PD
Huntington's
Stroke
SOL
encephalitis
asphyxia
37
Q

Myoclonus

A 
epilepsy
metabolic
physiological 
toxins/drugs
SOL
MS
PD
CJD
38
Q

Unilateral LMN - plexopathy

A

Plexopathy *vast dermatomal sensory loss

- brachial neuronitis, trauma, congenital, thoracic outlet syndrome, neoplastic infiltration

39
Q

Unilateral LMN - peripheral nerve

A
  • Median / Carpal tunnel syndrome
    • pregnancy, obesity, local pressure, endo: hypothyroid, acromeg, diabetes
  • Ulnar
  • -Compression at elbow; bony, crutches, periop; fracture; idiopathic; DM
  • Radial
    • at elbow; fracture, compression, ganglion
    • humeral shaft fracture
    • axilla; crutches/ saturday night palsy
  • common peroneal
    • plaster cast compression, trauma, diabetes, leprosy

FRACP CLINICAL SS (6 decks)

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