In VHL, whats more common, renal cell carcinoma or pheochromocytoma?
renal carcinoma is much more common.
macrocytic anemia in alcoholic.
if it doesnt say megaloblastic, could just be a macrocytic anemia from the toxic damage alcohol has on the bone marrow.
-so dont disregard a thiamine deficiency just because you see alcoholic w/macrocytic anemia.
Would you ever use lumbar puncture on a pt w/inc. ICP?
No, never.
-could lead to herniation.
MCA stroke
-Sxs:
- language deficit or hemineglect.
- contra motor/sensory deficit in face/upper limbs.
ACA stroke
-Sxs:
-contra motor/sensory deficit in lower limb.
ASA stroke
-Sxs:
anterior spinal artery
- contra hemiparesis upper & lower limbs.
- dec. contra proprioception (DC/ML).
- Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).
ASA stroke
-Sxs:
anterior spinal artery
- contra hemiparesis upper & lower limbs.
- dec. contra proprioception (DC/ML).
- ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).
PICA stroke
-Sxs:
dec. pain and temperature sensation from ipsilateral face and contralateral body.
PICA stroke
- what tissue is affected?
- Sxs:
- lateral medulla.
- dec. pain and temperature sensation from ipsilateral face and contralateral body.
ASA stroke
-Sxs:
anterior spinal artery
- contra hemiparesis upper & lower limbs.
- dec. contra proprioception (DC/ML).
- ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).
*caudal medulla = hypoglossal n.
PICA stroke
- what tissue is affected?
- Sxs:
- lateral medulla.
- dec. pain and temperature sensation from ipsilateral face and contralateral body.
- dysphagia, hoarseness.
- ipsi Horners.
- Vomiting, vertigo, nystagmus.
Lateral medullary (Wallenberg) syndrome.
- wheres the stroke? which art & what region?
- Sxs:
- mnemonic:
- Nucleus ambiguus effects are specific to PICA lesions.
- “Don’t pick a (PICA) horse (hoarseness) that can’t eat
(dysphagia) .”
nucleus ambiguus
-function?
Motor innervation of pharynx, larynx, and upper esophagus (e.g., swallowing, palate elevation).
-its a vagal nuclei.
Lateral medullary (Wallenberg) syndrome.
- wheres the stroke? which art & what region?
- Sxs:
- mnemonic:
- Nucleus ambiguus effects are specific to PICA lesions.
- “Don’t pick a (PICA) horse (hoarseness) that can’t eat
(dysphagia) .”
Which affects are specific to PICA lesion?
- Nucleus ambiguus effects are specific to PICA lesions.
- “Don’t pick a (PICA) horse (hoarseness) that can’t eat
(dysphagia) .”
Which affects are specific to PICA lesions?
- Nucleus ambiguus effects are specific to PICA lesions.
- “Don’t pick a (PICA) horse (hoarseness) that can’t eat
(dysphagia) .”
Which affects are specific to AICA lesions?
Facial nucleus effects are specific to AICA lesions.
“Facial droop means AICA’s pooped.”
Which affects are specific to AICA lesions?
Facial nucleus effects are specific to AICA lesions.
“Facial droop means AICA’s pooped.”
*dont confuse w/loss of pain/temp from face like you can see in others. This is loss of motor function of facial nerve so you get dropping.
PICA stroke
-what tissue is affected?
-lateral medulla.
AICA stroke
-what tissue affected?
lateral pons.
Basilar artery stroke
-Sxs:
“Locked-in syndrome.”
-pontine branches come from basilar art.
Basilar artery stroke
-Sxs:
“Locked-in syndrome.”
- pontine branches come from basilar art.
- same Sxs as Central pontine myelinolysis.
ACom stroke
-Sxs:
visual defects.
PCom stroke
-Sxs:
CN 3 palsy.
