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Lectures final revision > Zul's Revision lecture > Flashcards

Zul's Revision lecture Flashcards

1
Q

eye is down and out, ptosis and DILATED pupil

A

Compression of 3rd nerve.

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2
Q

Causes of 3rd nerve palsy

A

Pupil sparing and non pupil sparing

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3
Q

Does pupil dilate early or late in surgical 3rd nerve palsy and why?

A

Early because parasympathetic fibre are on the outside so compress first.

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4
Q

Why look at eyes in emergencies?

A

LOOK THIS UP

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5
Q

Easy things to also measure

A

BM and BP

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6
Q

how can the causes of ptosis be seperated?

A

Unilateral and Bilateral

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7
Q

Unilateral ptosis - causes

A

Horners
3rd nerve palsy
MG

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8
Q

Bilateral ptosis - causes

A

Myasthenia
Dystrophia Myotonica
Bilateral horner

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9
Q

Ptosis and small pupil

A

Horners

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10
Q

Ptosis and large pupil

A

3rd nerve palsy

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11
Q

Ptosis and normal pupil

A

MG

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12
Q

Causes of 6th nerve palsy

A

DM
HTN
MS
Raised ICP

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13
Q

When would someone with 4th nerve palsy complain of double vision

A

Looking down stairs

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14
Q

in double vision which is the ‘bad eye’

A

one that projects the outer image

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15
Q

Early signs of raised ICP

A

Loss of retinal vein pulsation

Late - papilloedema

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16
Q

What is cushings triad?

A

Bradycardia,
increased blood pressure,
irregular breathing (pressure on resp centre)

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17
Q

Why is the 6th nerve affected first in raised ICP

A

Has the longest intra-cranial course. Compression over the Petras Temple

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18
Q

What is spastic paraperesis

A

Increased tone and reflexes
Decreased power bilaterally
ankle clonus

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19
Q

Causes of spastic parapersis

A 
Cerebral Palsy
Stroke
Cord compression
Cervical spondylosis
MS
MND
CVA
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20
Q

How is spasticity described

A

Clasp knife

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21
Q

Rigidity

A

Same tension throughout

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22
Q

When a patient has spastic paraperesis in neuro exam what else might you think to do?

A

Sensory levels
Upper limb reflexes
cranial nerves

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23
Q

Recall the sites of the dermatones

A

The dance

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24
Q

If a patient has back pain what questions should you ask

A 
anal numbness
urinary symptoms
faecal incontinence
change in sensation when passing urine
sexual dysfunction
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25
Causes of wasting of the small muscles of the hands
bilateral and unilateral
26
Bilateral wasting of small muscles of hands - causes
RA Cervical Spondylitis MND
27
Unilateral wasting of small muscles of hands - causes
Pancosts tumour Brachial plexus trauma Cervical rib
28
What is Neurofibromatosis
Neurofibromatosis is a genetic disorder that causes tumors to form on nerve tissue. Auto Dom Chrom 17
29
What will you see on the patient with NF
freckling in axilla | dermal and neuronal fibroma
30
How many and what size of cafe au laits spots
>5 and >15mm in size
31
Complications of T1 NF
Renal Artery Stenosis - HTN Thoracic Kyphosis Malignant change in 10%
32
What triad is seen in NF T1
Lisch nodules Neurofibromas Cafe au lait spots
33
Crowe's signs
Axilla freckling in NF T1
34
In facial palsy what are the ddx
Bells Stroke Ramsay Hunt Lymes disease
35
What is Ramsay Hunt Syndrome
reactivation of herpes zoster in the geniculate ganglion. It is sometimes called herpes zoster oticus, and has variable presentation which may include a lower motor neuron lesion of the facial nerve, deafness, vertigo, and pain
36
Where to look for Ramsay hunt
around the ear - herpes Zoster
37
What questions may be needed in facial palsy?
Change in taste sensation | Any loud exaggerated sounds (Horners)
38
What is the earliest sign of a cerebellar pontine angle lesion?
Loss of corneal reflex | cornea is over the iris and is not the sclera
39
What is charcot marie tooth
hereditary motor and sensory neuropathies, a group of varied inherited disorders of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. Starts in small muscles of the hands
40
What shape does a sub dural make on CT
Crescent shape
41
What shape does an extra dural make
Lens shape
42
What do you want to know about a rash on an elbow
Itch Do you have eczema? Lichenification Associated with hayfever and asthma
43
How to describe psoriasis?
Salmon pink discoid patches with silver discoloration on extensor surfaces
44
What else to examine in Psoriasis?
Joints Nails for pitting, oncholyisis, subungal hyperkeratosis Scalp
45
Koebner Phenomenon is seen in which conditions
Vitiligo Psoriasis Lichen Planus Warts
46
What is Acanthosis Nigricans?
dark, velvety discoloration in body folds and creases
47
What is aconthosis nigricans associated with
Cushings and Diabetes
48
What are the cardiac causes of Syncope?
AS Arrythmias both fast and slow Fast - VF and VT Slow - Bradycardia
49
What type of MI might cause bradycardia
Inferior MI as the same vessel (RCA) as SAN
50
Triad seen in Parkinson
Bradykinesia, tremor and rigidity
51
Describe the cog wheel rigidity
it is a tremor superimposed upon lead pipe rigidity
52
What is Shy-Drager Syndrome
Multi System Atrophy. Get Parkinsonism and more pronounced autonomic dysfunction.
53
Supra Nuclear Palsy
slurring of speech, difficulty swallowing, and difficulty moving the eyes, particularly in the vertical direction. Can't look up
54
How would you examine the hands of someone with RA
Any pain ``` I see - bilateral deforming arthropathy wasting of the small muscles of the hands swan neck deformity of fingers Z shape deformity of the thumb ``` Are they warm to touch - active disease any rheumatoid nodules Examine eyes, neck, heart, lungs, abdo (splenomegaly) and peripheries for peripheral neuropathy
55
What nerve is affected in Pagets
8th nerve compression | Small bones of the ears fuse
56
What to patients with pagets disease die of?
High output heart failure from capillary expansion in bone.
57
Causes of bowed legs
Vit D deficiency Osteogenesis Imperfecta Pagets
58
What is Myotonic Dystrophy
Long term genetic disorder with gradual worsening muscle loss and weakness of muscles. ``` Heart conduction problems Early balding Long face Muscle contraction with poor relaxation Cataracts ``` No cure. Pain with TCAs and NSAIDS Pacing and Ventilation
59
Causes of hypoglycaemia
SAILSQ ``` Sulphonylureas Alcohol Insulin overdose Liver disease Sepsis Q - IV Quinine ```
60
What is the classic history of Addisons?
Weight loss Abdo pain Ill fitting clothes Postural hypotension - IMPORTANT TO DO THIS TEST Pigmentation - hands and points of pressure, lips, mouth, nipples and scars.
61
What are the causes of addisonian crisis?
``` Autoimmune Stopping steroids TB (in adrenals) HIV - CMV associated infeciton Mets to adrenals Amyloidosis ```
62
For Addisonian crisis what tests are important?
ABG acutely Short SYNACTHEN test Na - goes down K goes up Glucose goes down Urea increases as dehydrated
63
Rx of addisonian crisis
Iv 200mg hydrocortisone fluids Rx cause
64
Advice should be given to someone with addisons
Double steroids when unwell Medic alert bracelet Don't suddenly stop steroids lifelong Rx
65
What are the complications of Mitral Stenosis>
P Hypertension | RHF
66
What will you find on examination of P hypertension
Loud P2 Left Parasternal heave Grey Steele Murmur - back flow to pulmonary valve pulm regurg murmur.

Lectures final revision (10 decks)

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