REVIEWs Flashcards
(53 cards)
Epistaxis that has failed all emergency management may require
sphenopalatine ligation in theatre
primary care for MS flare
methylprednisolone
beta interferon is preventative
thumb opposition
median nerve
armpit impaired sensation
Intercostobrachial
An 8-year-old boy falls onto an outstretched hand and sustains a supracondylar fracture. In addition to a weak radial pulse the child is noted to have loss of pronation of the affected hand.
median nerve
AICA strokes can be differentiated from PICA (lat medullary) strokes as AICA causes
ipsilateral facial paralysis and deafness, but PICA does not.
A 68-year-old woman presents to the acute medical unit after experiencing an episode of right-sided weakness and speech disturbances that resolved within 2 minutes. She has a history of hypertension and peripheral vascular disease. Her current assessment shows no neurological deficits, with normal ECG and capillary blood glucose levels. Diffusion-weighted MRI reveals no abnormalities.
What is the most appropriate next step in imaging for this patient?
urgent carotid doppler
A 33-year-old man presents to the optician with left vision loss. He noted central blurring and reduced colour vision 48 hours ago. This has now progressed to total vision loss. He also has pain behind the left eye that worsens with eye movements. Vision is unchanged in his right eye.
The patient has no ophthalmic history. He has a diagnosis of ankylosing spondylitis that is managed with ibuprofen.
On examination, he has 20/20 vision in his right eye and 20/6 vision in his left eye. There is a left relative afferent pupillary defect. Fundoscopy is unremarkable.
What is the likely diagnosis?
optic neuritis
pemphigoid gestationalis
A 5-year-old boy is brought to the GP by his mother, complaining of a rash over the past week. His mother is worried as he has not been attending school.
On examination, there are multiple clusters of well-demarcated papules, around 0.5cm in diameter, with an umbilicated centre over the trunk and face. The child seems settled and his mother reports no recent change in behaviour.
What organism leads to this presentation?
poxvirus
if you don’t correct childhood squint, this can lead to
Amblyopia
A non-healing painless ulcer associated with a chronic scar is indicative of
squamous cell carcinoma (SCC)
Pyoderma gangrenosum typically starts as a blister or papule at a site of minor injury and rapidly becomes painful, dusky-purple and purulent.
A 25-year-old woman is reviewed in clinic after experiencing 3 unprovoked episodes of sudden bilateral upper and lower limb limpness and falling. Each episode lasts for 10 seconds and she does not lose consciousness. She denies any incontinence and is able to carry on her activity after a few minutes.
She has no past medical history and denies any head trauma. Her mother had similar problems in the past.
Given the likely diagnosis, what is this patient most likely to be started on?
Lamotrigine is correct. This patient is likely to have atonic seizures due to experiencing 3 unprovoked episodes of muscle limpness (atony) and falling
Levetiracetam is incorrect. The NICE guidelines do not recommend the use of levetiracetam in the management of atonic seizures. It may be used first-line for women of childbearing potential experiencing generalised tonic-clonic seizures, but this would instead present with muscle stiffening (increased tonus), and jerking (myoclonus), which are not seen here.
A 32-year-old lady is admitted with weakness, visual disturbance and periorbital pain. On examination she is noted to have mydriasis and diminished direct response to light shone into the affected eye. The consensual response in the affected eye is preserved.
RAPD = optic nerve
A 63-year-old man is admitted with a severe headache, nausea and a recent epileptic fit. Fundoscopy shows papilloedema. He is also noted to have diplopia when asked to look laterally.
abducens nerve - raised ICP
A 56-year-old gentleman presents with lower limb stiffness and imbalance. His only past medical history of note is carpal tunnel syndrome that was diagnosed a year ago on clinical grounds and has been refractory to treatment with splints and steroid injections. Which of the following is most likely?
degenerative cervical myelopathy
scabies mx
permethrin 1st line, malathion aqueous
stopped anti epileptics
Can be considered if seizure free for > 2 years, with AEDs being stopped over 2-3 months
CN motor or sensory pneumonic
CN 1-5 functions/clinical/pathway
CN 6-9 functions/clinical/pathway
CN 10-12 functions/clinical/pathway
tuberous sclerosis
optic neuritis features
Features
unilateral decrease in visual acuity over hours or days
poor discrimination of colours, ‘red desaturation’
pain worse on eye movement
relative afferent pupillary defect
central scotoma
