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YR6 Images + Instruments > UL and LL Vivas > Flashcards

UL and LL Vivas Flashcards

1
Q

Differentials for proximal myopathy

A

Endo: Hypothyroidism, Cushings, Osteomalacia

Inflammatory: Dermatomyositis, polymyositis

Drugs: Statins, Steroids

Becker muscular dystrophy

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2
Q

Define proximal myopathy

A

symmetrical weakness of proximal upper +/or lower limbs

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3
Q

Ix for proximal myopathy

A

TFT: hypothyroidism
Vit D/ bone profile: osteomalacia
CK: poly-/ dermatomyositis

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4
Q

Differentials causing weakness (not proximal myopathy)

A

MS
MND
Myasthenia gravis
Lambert Eaton myasthenic syndrome

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5
Q

Peripheral neuropathies with predominantly motor loss

A

GBS
Porphyria
Lead poisoning
Hereditary sensorimotor neuropathies: Charcot-Marie-Tooth
Chronic inflammatory demyelinating polyneuropathy
Diptheria

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6
Q

Peripheral neuropathies with predominantly sensory loss

A

Diabetes
Alcoholism
B12 deficiency
HIV
Syphilis
Uraemia
Leprosy
Amyloidosis

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7
Q

What causes subacute combined degeneration of the spinal cord? What does this result in?

A

B12 deficiency
Results in impairment of dorsal columns, lateral corticospinal tract + spinocerebellar tracts

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8
Q

Give 2 features of dorsal column involvement in subacute combined degeneration of the spinal cord

A

Symmetrical dstal tingling/ burning/ sensory loss, tends to affect legs > arms
Impaired proprioception + vibration sense

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9
Q

Give 5 features of lateral corticospinal tract involvement in subacute combined degeneration of the spinal cord

A

Muscle weakness, hyper-reflexia, spasticity
UMN signs (legs 1st)
Brisk knee reflexes
Absent ankle jerks
Extensor plantars

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10
Q

2 features of spinocerebellar tract involvement in subacute combined degeneration of the spinal cord

A

Sensory ataxia: gait abnormalities
+ve Romberg’s sign

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11
Q

Define peripheral neuropathy

A

Damage to peripheral nerves (not brain/ spinal cord)
Symmetrical glove + stocking loss to all modalities

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12
Q

Define mononeuropathy. Give 2 examples

A

Damage to a single peripheral nerve
Carpal tunnel syndrome (median nerve at wrist)
Cubital tunnel syndrome (ulnar nerve in elbow)

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13
Q

Ix for peripheral neuropathy

A

FBC
ESR, CRP
LFTs, GGT: alcoholism
Glucose: DM
Creatinine: end stage renal disease
B12 + folate: B12 deficiency
Nerve conduction studies + EMG

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14
Q

What is polio?

A

Viral disease, largely affects <5s
Faeco-oral transmission

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15
Q

How does polio manifest?

A

Majority asymptomatic/ mild Sx + disease usually goes unrecognized.
Sx: fever, fatigue, headache, vomiting, stiffness in neck + pain in limbs.
Sx usually last 2–10 days + recovery is complete in almost all cases.
Rarely: can cause paralysis, usually of legs, which is most often permanent. Paralysis can occur rapidly (within hours of infection)

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16
Q

Mx of polio

A

No cure
Vaccination to prevent
Mx: limiting + alleviating Sx. Heat + physical therapy to stimulate muscles + antispasmodic drugs to relax effected muscles. Can improve mobility but does not reverse permanent polio paralysis.

17
Q

UMN defects

A
18
Q

LMN defects

A
19
Q

Rigidity ddx

A

PD
Multiple system atrophy
Lewy body dementia
NMS

20
Q

Tremor ddx

A

Resting tremor: PD

Action tremor: idiopathic, anxiety, thyrotoxicosis
Postural: Essential (most common action tremor)
Intention tremor: cerebellar disease

21
Q

Charcot marie tooth

A

Hereditary peripheral neuropathy
Predominant motor loss
No cure
Mx: PT + OT

22
Q

Features of Charcot Marie tooth

A

Foot drop
High-arched feet (pes cavus)
Hammer toes
Hx of frequently sprained ankles
Distal muscle weakness
Distal muscle atrophy
Hyporeflexia
Stork leg deformity

23
Q

Charcot joint

A

neuropathic joint
joint disrupted + damaged secondary to a loss of sensation
S/S: swollen, red, warm
Causes: DM, Syphilis

24
Q

McDonald’s criteria

A

diagnostic criteria for MS

25
Q

Foot drop ddx

A

Common peroneal nerve damage

Trauma: fibula fracture

26
Q

Why examine eyes in PD?

A

Impaired vertical gaze in progressive supranuclear palsy (Parkinson’s plus syndrome)

27
Q

Progressive supranuclear palsy

A

Postural instability + falls
Impairment of vertical gaze
Parkinsonism: bradykinesia

28
Q

Multiple system atrophy

A

Parkinsonism
Autonomic disturbance: ED, postural hypotension, atonic bladder

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