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1
Q

Differentials for short stature

A

Down Syndrome
Turner Syndrome
Achondroplasia
Hypothyroidism prior to growth plate fusion
Hypopituitism
Systemic illness prior to growth plate fusion

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2
Q

Complications of Down Syndrome

A 
Cognitive impairment 
Congenital heart disease - ASD, VSD, MR, Tetralogy, PDA 
Gastro - duodenal atresia, hirschprung, Meckels, imperforate anus, coeliac disease 
Hypothyroidism 
T1DM 
AML/ALL 
Atlanto-axial instability 
Male infertility 
Alzheimers
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3
Q

Complications of Marfans

A

Heart disease - aortic root aneurysm, AR, dissection, MV prolapse
Ocular - lens dislocation, myopia, retinal detachment
Musculoskeletal - hypermobility, dural ectasia
Restrictive lung disease
Hernia

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4
Q

Causes of webbed neck

A 
Turner Syndrome 
Noonan syndrome 
Klippel-Fleil syndrome 
Diamond-Blackfan anaemia 
Watson syndrome
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5
Q

What are the causes of a widely split S2

A 
ASD (fixed) 
VSD 
Mitral regurgitation 
Pulmonary stenosis 
RBBB
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6
Q

When is the click of a prosthetic mitral valve heard?

A

In the place of the first heart sound

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7
Q

When is the click of a prosthetic aortic valve heard?

A

In the place of the second heart sound

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8
Q

What are the types of ASD?

A

Ostium secundum - site of foramen ovale
Ostium primum - ant/inferior aspect, involve MV and TV
Ostium venosus
Coronary sinus ASD

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9
Q

What are the features of a cavernous sinus lesion?

A 
Unilateral III, IV, VI nerve palsies 
Sensory loss in Va/b distribution 
Loss of corneal reflex 
Painful opthalmoplegia 
Visual loss 
Conjunctival congestion 
Papilloedema 
Retinal haemorrhage
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10
Q

What are the causes of a 3rd nerve palsy?

A

Central - vascular, tumour, demyelination, trauma, idiopathic
Peripheral - compressive (aneurysm, tumour, nasopharyngeal carcinoma, orbital lesions, basal meningitis). Infarction, trauma, cavernous sinus lesion

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11
Q

What are the indications for lobectomy/pneumonectomy?

A 
Malignancy 
Localised bronchiectasis 
Lung reduction surgery for COPD 
Cystic fibrosis 
TB 
Lung abscess
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12
Q

Causes of upper lobe fibrosis

A 
Berylliosis 
Radiation 
Hypersensitivity pneumonitis 
ABPA 
Sarcoidosis 
TB 
Silicosis 
Coal workers pneumoconiosis 
Langerhans cell histiocytocisis 
Ankylosing spondylitis 
Psoriasis
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13
Q

What are the causes of a cavitating lung lesion?

A

Infectious - S aureua, klebsiella, anaerobic infections, pseudomonas, TB, aspergilloma, histoplasmosis
Non-infectious - malignancy, GPA, rheumatoid nodule, caplan syndrome

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14
Q

What are the ECG features of PE?

A 
Sinus tachycardia 
Tall R wave in V1 
Right ventricular strain 
RBBB 
T wave invesion V1-3 
S1Q3T3
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15
Q

Extra-articular features of ankylosing spondylitis

A 
Uveitis 
Aortic regurgitation 
Mitral valve prolapse 
Reduced chest expansion 
Apical fibrosis 
Inflammatory bowel disease 
Plantar fasciitis 
Achilles tenditis
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16
Q

What are the classic deformities of RA?

A 
Ulnar deviation 
MCP subluxation 
Boutonnieres 
Swan neck 
Z deformity of the thumb
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17
Q

What are the RA deformities seen in the foot?

A

Hallux valgus
Subluxation of MTP
Hammer toe

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18
Q

What is the anatomy of a swan neck deformity?

A

Hyperextension at the PIP joint and then flexion at the DIP joint

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19
Q

What is the anatomy of a boutonniere deformity?

A

Flexion at the PIP with hyperextension at DIP

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20
Q

What is the anatomy of a z deformity?

A

Flexion at the IP joint and hyperextension at MCP

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21
Q

What is the difference between episcleritis and scleritis?

A

Episcleritis is painless while scleritis is painful

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22
Q

XR changes psoriatic arthritis?

A 
Enthesitis and marginal bone loss 
'Pencil in cup' 
Bone proliferation 
Joint subluxation 
Interphalenx ankylosis 
Soft tissue swelling
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23
Q

Psoriasis arthropathy patterns of involvement

A 
Asymmetric oligoarthropathy primarily affecting DIP 
Symmetric polyarthritis (RA pattern) 
DIP arthritis 
Arthritis mutilans 
Spondylitis +/- sacroilitis
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24
Q

XR findings in OA

A

Asymmetric joint space loss
Osteophyte formation
Subchondral sclerosis
Subchondral cyst formation

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25
Q

Why is the ptosis only partial in a Horners Syndrome?

A

Upper eyelid is controlled by levator palpebrae superioris (III nerve) and muller muscle (sympathetic fibres). A Horners syndrome affects the sympathetic fibres leading to a partial ptosis and alight elevation of the lower eye lid

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26
Q

What is the pathway of the sympathetic innervation of the eye?

A

Hypothalamus to brainstem to cord to T1 exiting to the cervical sympathetic chain ascending to superior cervical ganglion to the carotid plexus to the eye (muller muscle, pupil and sweat glands)

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27
Q

What is the pattern of anhidrosis in Horners Syndrome?

A

If central (1st order neuron) then affects ipsilateral face, arm and upper trunk. If 2nd order then ipsilateral face and there is no anhidrosis if affecting a 3rd order neuron

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28
Q

Causes of a unilateral ptosis?

A

3rd Nerve palsy
Horner Syndrome
Myasthenia gravis
Congenital

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29
Q

What are the causes of ptosis?

A 
Normal pupils: 
Senile 
myotonic dystrophy 
Fascioscapulohumeral dystrophy 
Ocular myopathy eg mitochondrial 
Thyrotoxic myopathy 
Myasthenia Gravis
Botulism, snake bite 
Congenital 
Fatigue 
With constricted pupils: 
Tabes dorsalis 
Horner Syndrome 
Dilated pupils 
3rd nerve palsy
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30
Q

Causes of bilateral anosmia

A 
Upper respiratory tract infections 
Meningioma of the olfactory nerve 
Ethmoid tumours 
Head trauma 
Meningitis 
Hydrocephalus 
Congenital eg Kellmann syndrome
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31
Q

How to differentiate between an essential tremor and a parkinsons tremor?

A

Essential tremors are symmetrical, postural and can affect the head. When writing essential tremor will become larger and tremor is seen, with parkinsons the tremor stops and there is micrographia

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32
Q

What is the clinical pattern of charcot-marie-tooth?

A

Symmetrical distal motor and sensory neuropathy

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33
Q

What are the causes of pes cavus?

A

Local - burns, malunion, compartment syndrome,
Spinal - polio, trauma, tumours, syringomyelia,
Other - fredreichs ataxia, muscular dystrophy, spinal muscular atrophy, cerebral palsy, hereditary spasic paraparesis

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34
Q

Causes of thickened nerves

A 
Hereditary motor and sensory neuropathy 
Acromegaly 
CIDP 
Amyloidosis 
Leprosy 
Others - sarcoidosis, neurofibromatosis
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35
Q

What are small fibre sensory modalities?

A

Pain and temperature

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36
Q

What are large fibre sensory modalities?

A

Position and vibration

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37
Q

What are the causes of pulsatile liver?

A

Tricuspid regurgitation/pulmonary HTN
Hepatocellular carcinoma
Vascular abnormalities

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38
Q

What are the causes of tender hepatomegaly?

A

Hepatitis
Rapid enlargement eg right heart failure, budd-chiari syndrome
Hepatocellular carcinoma

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39
Q

What are the causes of a firm and irregular liver?

A 
Cirrhosis 
Metastatic disease 
Polycystic liver disease 
Hydatid disease 
Granuloma 
amyloid 
Cysts 
Lipoidoses
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40
Q

What are the causes of massive hepatomegaly?

A 
Metastases 
Alcoholic liver disease 
Myeloproliferative disease 
Right heart failure 
Hepatocellular carcinoma
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41
Q

What are the causes of moderate hepatomegaly?

A

All the causes of massive hepatomegaly
Haemochromatosis
Haematological disorders - lymphoma, CML
Fatty liver disease

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42
Q

What are the causes of massive splenomegaly?

A

CML
Myelofibrosis
Primary lymphoma of spleen, hairy cell leukaemia, malaria

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43
Q

What are the causes of moderate splenomegaly?

A 
Causes of massive splenomegaly 
Portal HTN 
Lymphoma 
Leukaemia 
Thalassaemia 
Storage disease eg gauchers disease
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44
Q

What are the causes of hepatosplenomegaly?

A 
Chronic liver disease with portal HTN 
Haematological disease eg MPN, lymphoma, leukaemia, sickle cell anaemia, 
Infection - hepatitis, EBV, CMV 
Infiltrative - amyloidosis, sarcoidosis 
Connective tissues - SLE 
Acromegaly
Thyrotoxicosis
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45
Q

Which eye movement directions are affected in 3rd nerve palsy?

A

Eye is down and out

Cannot adduct or completely elevate

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46
Q

What nerve roots supply each reflex?

A 
Biceps - C5-6 
Brachioradialis - C5-6 
Triceps - C6-7 
Knee - L3-4  
Ankle jerk - S1-2
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47
Q

What are the features of an ulnar nerve palsy?

A

Claw hand (extension deformity lateral 2 fingers)
Wasting of intrinsic muscles of hands expect LOAF
Weakness of finger abduction and adduction
Sensory loss of 5th and medial 1/2 4th fingers
Froments sign

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48
Q

What are the causes of an ulnar nerve palsy?

A

At elbow - fractures, arthritis, compression
At wrist - tumours, ganglion, fracture, aberrant artery
Mononeuritis multiplex

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49
Q

What is Froments sign?

A

Hold a piece of paper between the thumb and the lateral aspect of the 2nd finger. Normally thumb is flat, in ulnar nerve palsy it bends due to weakness of thumb adduction

50
Q

What are the causes of a predominately sensory peripheral neuropathy?

A 
Diabetes 
ETOH 
Metabolic - Hypothyroidism, uraemia 
Nutritional - B12, B6 
Malignancy - paraneoplastic, paraprotein 
Drugs - chemotherapy, TB medications  
Autoimmune - sjogrens, vasculitis 
Idiopathic
51
Q

Causes of predominately motor peripheral neuropathy?

A 
Guilllain-Barre, Chronic inflammatory demeylinating polyradiculopathy 
Charcot Marie Tooth 
Acute intermittent porphyria 
Diabetes 
Lead poisoning 
Multifocal motor neuropathy
52
Q

What are heberdon and bouchards nodes?

A

Bony swelling associated with osteoarthritis. Heberdons nodes are at the DIP joint and bouchards nodes are at the PIP joint

53
Q

How can you differentiate the cause of facial sensory loss?

A

Corneal reflex. In cortical sensory loss the corneal reflex is intact, in trigeminal pathology it is lost

54
Q

Where is the lesion in upper quadrant homonyous hemianopia?

A

Temporal lobe - think stroke, mass, trauma and surgery

55
Q

Where is the lesion in lower quadrant homonyous hemianopia?

A

Parietal lobe - think stroke, mass, trauma and surgery

56
Q

What is the pattern of subacute degeneration of the cord?

A

Upper motor neuron signs in the lower limbs with absent ankle reflexes and extensor plantar response and peripheral neuropathy causing loss of ankle +/- knee jerks

57
Q

Causes of extensor plantar response with absent ankle reflexes?

A 
Subacute degeneration of the cord 
Conus medullaris lesion 
Combination of UMN lesion with cauda equina or peripheral neuropathy 
Syphilis (taboparesis) 
Friedreichs ataxia 
Diabetes 
Leukodystrophy
58
Q

Signs of severity MR

A 
LV enlargement/displaced apex beat 
Pulmonary HTN 
S3 
Early diastolic rumble 
Soft S1 
Early A2 
Small volume pulse 
LV failure
59
Q

Indications for surgery in MR

A

Acute MR with heamodynamic compromise
Class III and IV symptoms
LV dysfunction

60
Q

Causes of MR

A

Chronic - degeneration, MV prolapse, rheumatic heart disease, papillary muscle dysfunction, connective tissue disease
Acute - IE, MI, Surgery, trauma

61
Q

Murmur of AR

A

Crescendo - decrescendo murmur over the left sternal edge loudest on expiration and sitting forward. May have associated diastolic rumble at apex and ejection systolic murmur

62
Q

What are the signs of severe AR?

A 
Collapsing pulse 
Wide pulse pressure 
LV failure 
S3 
Soft A2 
Long murmur 
Austin flint murmur
63
Q

What are the causes of AR?

A

Acute - IE, dissection, HTN
Valvular - rheumatic, congenital, seronegative arthropathy
Aortic root - marfans, aortitis, dissecting aneurysm, age

64
Q

What is the murmur of MS?

A

Opening snap, Mid-diastolic murmur at the apex louder on expiration, left lateral position and exercise

65
Q

What are the signs of severity of MS?

A 
Small pulse pressure 
Early opening snap 
Length of murmur 
Diastolic thill at apex 
Pulmonary HTN
66
Q

What are the causes of cerebellar dysfunction

A 
Drugs and toxins esp ETOH 
Structural - trauma, masses, CVA, Arnold-Chiari, 
Genetic - Friedrichs ataxia 
Inflammatory - MS, paraneoplastic 
Metabolic - hypothyroidism
67
Q

What are the causes of unilateral cerebellar signs?

A 
MS
Masses 
Trauma 
CVA 
Paraneoplastic
68
Q

Cerebellar signs

A 
Staccato speech 
Nystagmus 
Broken eye pursuit 
Truncal ataxia 
Intention tremor 
Hypotonia 
Dysmetria - pass pointing 
Dysdodichokinesia 
Rebound 
Abnormal heal shin 
Abnormal foot tapping 
Pendular reflexes 
Ataxic gait
69
Q

Investigations for MND

A

NCS/EMG - fasiculations, acute and chronic deinervation
CT/MRI if unclear diagnosis
Spirometry
Early morning ABG
Barium swallow and speech path assessment
Cognitive screening

70
Q

Features to distinguish a spleen from a kidney

A 
No palpable upper edge 
Spleen has a notch 
Moves inferolateral with inspiration 
Dull to percussion 
Not ballotable
71
Q

What is a brown sequard syndrome?

A

Unliateral disease of the spinal cord. Causes UMN weakness and dorsal column loss on the ipsliateral side and spinothalamic sensory loss on the contralateral side. Causes include trauma, disc, tumours, inflammation

72
Q

What is the difference between bulbar and pseudobulbar palsy?

A

Bulbar is lower motor neuron and can be unilateral or bilateral. Pseudobulbar palsy is upper motor neuron and must be bilateral.

73
Q

What are the causes of a bulbar palsy?

A

LMN - MND, basilar ischaemia, syringobulbia, brainstem tumour, polio, GBS, neurosyphilus, subacute meningitis
NMJ - myasthenia, botulism
Muscular - muscular dystrophy, polio

74
Q

What are the causes of a pseudobulbar palsy?

A 
MND 
Bihemispheric vascular disease 
Brainstem tumour 
MS 
Trauma
75
Q

What is an INO?

A

Internuclear opthalmoplegia. Due to damage to the medial longitudinal fasciulus. Means that the affected eye cannot adduction when gaze is moved to the contralateral side however when unaffected eye is covered there is a normal range of movement. There may be nystagmus of the unaffected eye.

76
Q

What is seen in bilateral INO?

A

Neither eye is able to adduct past the midline on contralateral gaze. When each eye is covered eye movements return to normal

77
Q

What are the causes of bilateral LMN weakness?

A

CIDP - symmetric motor predominant, can have sensory components
Motor neuron disease - UMN and LMN signs
Multifocal motor neuropathy - asymmetric distal>proximal
Polio - usually very asymmetric/unilateral
Spinal muscular atrophy - symmetric proximal weakness with only LMN signs
Other peripheral neuropathy - distal, sensory involvement

78
Q

What type of speech is seen in cerebellar disease?

A

Scanning speech - irregular and staccao. Imprecise consonants with omissions and distortions

79
Q

What type of speech is seen in bulbar palsy?

A

Imprecise nasal speech, weak and low volume

80
Q

What type of speech is seen in pseudobulbar palsy?

A

‘donald duck like’ high pitched and slow with a harsh, strained voice

81
Q

What are the speech patterns of expressive dysphasia? Where is it located?

A

Brocas area, posterior 3rd gyrus frontal lobe. Non-fluent speech with frustration. Comprehension intact, may be able to repeat with difficulty, unable to name. Able to read, dysgraphia.

82
Q

What are the speech patterns of receptive dysphasia? Where is it located?

A

Wernikes area, posterior part of the 1st temporal gyrus. Fluent incomprehensible speech, oblivious. Unable to complete any part of the speech exam. Able to write but content impaired

83
Q

What are the speech patterns of conductive dysphasia? Where is it located?

A

Arcuate fasciculus in temporal lobe. Fluent but incomprehensible speech. Able to follow commands but not repeat, name, read or describe. Dysgraphia

84
Q

What are the causes of nominal aphasia?

A

Lesion in the angular gyrus (temporal lobe). Can also be seen in recovery of another aphasia, encephalopathy and pressure due to mass effect

85
Q

What are the findings of a radial nerve palsy?

A

Wrist drop with weakness in wrist and MCP flexion. Weakness in supination. Weakness in elbow extension if lesion above spiral groove.
Sensory loss over anatomical snuff box
Triceps reflex loss if above spiral groove

86
Q

Causes of carpal tunnel?

A 
Idiopathic 
Arthropathy eg RA 
Endocrine - hypothyroidism, acromegaly 
Pregnancy 
Trauma and overuse
87
Q

What are the signs of a median nerve palsy?

A

Wasting of the thenar eminence
Weakness of thumb abduction, flexion and opposition
Loss of sensation over the palmar aspect of the1st 3 1/2 fingers

88
Q

What is Ochsners clasping test?

A

Patient clasps hands together. In a medial nerve palsy above the level of the cubital fossa the index finger is unable to flex

89
Q

How to differentiate an ulnar nerve lesion from a C8 nerve root/lower brachial plexus lesion?

A

Sensation loss in an ulnar nerve lesion is the 5th and medial aspect of the 4th finger and the thenar eminence is not wasted. In a C8/lower brachial plexus lesion the sensory loss extends above the wrist, there is wasting of the thenar eminence and there is weakness of abductor policis brevis

90
Q

What are the causes of wasting of the small muscles of the hands?

A
  1. Nerve lesions - ulnar, median, brachial plexus, motor peripheral neuropathy
  2. Anterior horn cell
  3. Myopathy
  4. Spinal cord lesion
  5. Trophic disease
91
Q

What are the features of Friedreichs ataxia?

A

Upper motor neuron pyramidal weakness
Dorsal column loss (vibration, proprioception)
Bilaterally cerebellar signs

92
Q

What is the pattern of pyramidal weakness?

A

Upper motor neuron signs
Flexion stronger than extension in upper limb
Extension stronger than extension in lower limb

93
Q

What is a relative afferent pupillary defect?

A

When there is a unilateral optic nerve lesion then the affected pupil dilates when a light is swung between the eyes from the unaffected to affected eye

94
Q

What is the surgical sieve?

A 
Malignant 
Vascular 
Inflammatory 
Infective 
Trauma 
Iatrogenic 
Congenital 
Nutritional 
Metabolic
95
Q

What are the causes of INO?

A 
MS 
Brainstem lesions 
Wernikes encephalopathy 
SLE 
Miller Fisher syndrome
96
Q

What are the causes of a foot drop?

A 
Common peroneal nerve lesion 
L4/5 nerve root lesion 
Sciatic nerve 
Lumbosacral plexus 
Peripheral motor neuropathy 
Distal myopathy 
Motor neuron disease 
Precentral gyrus lesion
97
Q

How to differentiate between a common peroneal nerve and L4/5 nerve root lesion?

A

Common peroneal nerve will have weakness in dorsiflexion and eversion, preserved inversion and ankle jerk. L4/5 nerve root lesion will also have weakness in inversion and hip abduction. Sensation is lost over the dorsum of the foot and lateral leg, in L4/5 lesions this extends more proximally.

98
Q

What is the clinical picture of a sciatic nerve lesion?

A

Weakness of knee flexion and all muscles below the knee. Preserved knee reflex, loss of ankle and plantar reflexes. Sensation loss posterior thigh and all below the knee.

99
Q

What is the clinical picture of a femoral nerve lesion?

A

Weakness of knee flexion and slight hip flexion weakness. Preserved adductor strength. Loss of knee jerk and sensory loss inner aspect of thigh and leg.

100
Q

What are the causes of peripheral neuropathy + proximal weakness?

A

Paraneoplastic conditions
Alcohol
Connective tissue disease

101
Q

What are the causes of myopathy?

A

Hereditary myopathies
Congenital myopathies
Drugs and toxins eg steroids, alcohol, chloroquinine
Neoplastic - carcinomas, paraneoplastic
Inflammatory - polymyositis, dermatomyositis, connective tissue disorders
Endocrine - thyroid, acroegaly, cushings, hypopituitism, periodic paralysis, osteomalacia
Infiltrative - sarcoidosis

102
Q

What are the causes of proximal weakness?

A

Myopathic
neuromuscular junction
Neurological - MND, polyradiculopathies

103
Q

What is myopathic facies?

A

Lean, lifeless, expressionless facial features. Seen is facio-scapulo-humeral dystrophy, myotonic dystrophy

104
Q

What is the clinical pattern of myotonic dystrophy?

A 
Myotonia 
Distal wasting and weakness  
Facial weakness and wasting, myotonic facies 
Frontal balding 
Mild peripheral neuropathy 
Hypogonadism  
Cardiac disease
105
Q

What are the non-muscular complications of myotonic dystrophy?

A 
Diabetes 
Cardiomyopathy 
Valvular heart disease 
Arrhythmias and conduction deficits 
Hypogonadism 
Gotire 
Mild intellectual disability
106
Q

What are the clinical features of a cerebellopontine angle lesion?

A

CN V, VII, VIII +/- CN IV palsies

If late then lower cranial nerves and cerebellar signs

107
Q

What are the causes of cerebellopontine lesions

A 
Acoustic neuromas 
Meningiomas 
Haemangioblastomas 
Granulomas 
Nasopharyngeal carcinoma 
Basilar artery aneurysm 
Metastasis
108
Q

What is the Child-Pugh classification

A

Bilirubin, ascites, encephalopathy, prolonged PT, albumin
A - score 5-6
B - score 7-9
C - >10

109
Q

What are the differentials of renal masses?

A 
Polycystic kidneys disease 
Hydronephrosis 
Renal cell carcinoma 
Acute renal vein thrombosis 
Amyloid, lymphoma and other infiltrative conditions 
Acromegaly
110
Q

What are the causes of generalised lymphadenopathy?

A 
Lymphoma   
Leukaemia 
Malignancy 
Infections eg mononucleosis, CMV, HIV, TB, toxoplasmosis 
Connective tissue disease 
Infiltrative - sarcoidosis 
Drugs - phenytoin
111
Q

What are the causes of a diffuse goitre?

A 
Idiopathic 
Puberty, pregnancy, postpartum 
Graves disease 
Thyroiditis 
Simple goitre (iodine deficiency) 
Toxins - iodine excess, lithium 
Inborn errors of thyroid hormone synthesis
112
Q

What is the examination picture of eisenmengers syndrome?

A

Pulmonary HTN with central cyanosis

113
Q

What are the causes of Eisenmengers syndrome?

A

Shunt reversal due to high right heart pressures

  • ASD
  • VSD
  • PDA
114
Q

What are the complications of Eisenmengers syndrome?

A 
Haemoptysis 
Right heart failure 
Paradoxical embolism 
Infective endocarditis 
Sudden death 
Polycythaemia and hyperviscosity 
Thrombosis 
Bleeding
115
Q

What is lights criteria?

A

Used to differentiate transudative and exudative pleural effusions.
Pleural protein: serum protein >0.5
Pleural LDH: serum LDH >0.6
Pleural LDH >2/3rds upper limit of normal of serum LDH

116
Q

What are the causes of bronchiectasis?

A 
Cystic fibrosis 
Recurrent infections 
Ciliary dyskinesis including kartagners syndrome 
Yellow nail syndrome 
Immunodeficiency 
HIV 
Rheumatological - SLE, RA 
Allergic bronchopulomary aspergillosis
117
Q

What are the causes of superior vena cava syndrome?

A 
Lung cancer 
Retrosternal tumours - lymphoma, thymoma
Retrosternal goitre 
Massive mediastinal lymphadenopathy 
Aortic aneurysm
118
Q

What is the clinical picture of a complete brachial plexus lesion?

A

LMN weakness of whole arm
Sensory loss whole arm
Horners syndrome (only if lesion in proximal part of lower plexus)

119
Q

What is the clinical picture of an upper trunk brachial plexus lesion?

A

Waiters tip positioning
LMN shoulder and elbow flexion weakness
Sensory loss lateral aspect of arm and thumb

120
Q

What is the clinical picture of a lower trunk brachial plexus lesion?

A

True claw hand with paralysis of all intrinsic muscles

Sensory loss along medial aspect of hand and forearm

121
Q

What are the complications of polycystic kidney disease?

A 
Cyst haemorrhage 
Cyst infection 
Cyst torsion 
Renal stones 
Nocturia 
Subarachnoid haemorrhage 
Aortic regurgitation 
Mitral valve prolapse
122
Q

What are the causes of a 6th nerve palsy?

A

Bilateral - trauma, wernikes, raised ICP, mononeuritis multiplex
Unilateral
Central - Vascular, tumour, wernikes, MS
Peripheral - Diabetes and other vascular lesions, trauma, idiopathic, raised ICP

Short cases (1 decks)

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