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Question 1

What is ‘spondylosis’?

Answer 1

Degenerative changes in the spine that are increasingly common with age

It can lead to radiculopathy and myelopathy (if causing misalignment of the spine and instability

Question 2

Sciatica defintion?

Answer 2

Non-specific clinical description of pain affecting the back and/or leg

Question 3

Red flags for back pain

Answer 3

Night time waking
Thoracic back pain
Multiple different sites
Fever
Widespread neurological sx
Bowel and bladder sx

Question 4

UMN vs LMN presentation

Answer 4

Upper = more
Lower = less

Both are weak

Tone
UMN = increased
LMN = decreased

Reflexes
UMN = increased
LMN = decreased

Muscle bulk
UMN = normal
LMN = decreased

Question 5

UMN or LMN with fascinations?

Answer 5

LMN

Question 6

UMN or LMN with forehead sparing?
UMN or LMN vs ipsilateral or contralateral side?

Answer 6

UMN = forehead sparing - think stroke

UMN = contralateral side - think stroke

Question 7

In what situation is eye movement desnsitsation and reprocessing not 1st line in PTSD?

Answer 7

Combat-related trauma - trauma-focused CBT 1st

Question 8

Where is the femoral pulse best palpated?

Answer 8

Mid-inguinal point

Halfway between the ASIS and pubic symphsis

Question 9

When is aspirin given in a stroke?

Answer 9

ONLY once haemorraghic is excluded

Question 10

Eye palsies

Draw the eye and where each of the muscles are

Describe the squints assoc. with each eye palsy

Answer 10

SO4 - upwards
LR6 - inwards
AO3 - down and out

H shape

if drawing R eye

SR IO
LR MR
IR SO

Question 11

What kind of stroke is characterised by ipsilateral CN III palsy and contralateral hemiparesis?

Answer 11

Weber’s syndrome - midbrain stroke

Question 12

How to record snellen chart?

If can’t read snellen chart?

Answer 12

Measure with glasses on always

Top number = distance (should be 6)

Bottom number = line of letters they can read

Normal = 6/6

Higher the bottom number = worse the sight

1. Count fingers
2. Hand movement (wave hand and ask what direction)
3. Light perception (shine light - is light on/off)

Question 13

What is the commonest cause of blindness in the UK?

Answer 13

Macular degeneration

Question 14

What kind of ARMD is assoc. with drusen?

How are wet and dry managed?

What kind of vision loss is each type assoc. with?

Answer 14

Dry - drusen = proteins and lipids below the retina (appear as yellow dots)

Wet - anti-VEGF injections
Dry - no cure, stop smoking and high-dose beta-carotene and vitamin C and E

Dry = central scotoma
Wet = rapid vision loss and metamorphosia (waving of straight lines)

Question 15

What is an optical coherence technology used to invx?

Answer 15

ARMD

Question 16

How do you manage MG crisis? (sudden worsening of MG)

Answer 16

Immunoglobulins and plasmapheresis

Question 17

What drugs must be avoided in PD?

Answer 17

Any that can cause extra-pyramidal side effects

Anti-emetics
Metroclopramide (metroclopyrazide - think of pyramid at the end to remember)

Anti-psyschotics - typical
Haloperidol