Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

One-2-One Medicine Clinical Case Masterclass > Case 2 - Blackout > Flashcards

Case 2 - Blackout Flashcards

1
Q

Differential Diagnosis of a blackout - it may fall into … or ….

A

Cardiac (Cerebral hypoperfusion) or neurological (cerebral dysfunction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cardiac differentials of a blackout (5)

A
  • Vasovagal ‘faint’
  • Postural hypotension
  • Arrhythmia
  • Ischaemic
  • Structural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Neurological differentials of a blackout (4)

A
  • Epilepsy
  • Cerebrovascular disease
  • Psychogenic
  • Substance abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would you expect to see on examination (end of bed) in someone with myotonic dystrophy? (3)

A
  • Bilateral ptosis
  • Frontal balding
  • Long apathetic face
    Also a slow-relaxing hand shake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What AMTS is considered to be ‘confusion’?

A

Under 8/10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AV block means it is …

A

Above the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

AV Block types

A

1st degree
2nd degree mobitz T1 (Wenckeback)
2nd degree mobits T2
3rd degree (complete)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What block has an increased risk of becoming complete heart block?

A

Mobitz type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

AV block - 1st degree - what is seen on ECG?

A

PR interval is prolonged (over 200ms, over 5 small squares)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

AV block - 2nd degree Mobitz T1 (Wenckebach) what is seen on ECG?

A

PR interval gradually increased then a failed beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

AV block - 2nd degree Mobitz T2 what is seen on ECG?

A

PR interval stays the same but there are dropped beats (may be 2:1, 3:1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AV block - Complete heart block - what is seen on ECG?

A

Complete dissociation between atria and ventricles - failure of AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

High-output vs low-output cardiac failure - HF with … ejection fraction?

A

High-output is also known as HF with preserved ejection fraction
Low-output is also known as HF with reduced ejection fraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

High-output cardiac failure - causes (4)

A
  • Hyperthyroidism
  • Anaemia
  • Pregnancy
  • Other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Low-output cardiac failure - causes (5)

A
  • Valvular
  • Hypertensive
  • Ischaemic
  • Arrhythmic
  • Other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Endocardial - cardiac failure

A 
Valvular disease
(Endocarditis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Myocardial causes - cardiac failure (4)

A

Ischaemic
Hypertensive
Arrhythmic
Cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pericardial causes - Cardiac failure (3)

A
  • Effusion
  • Tamponade
  • Constrictive
19
Q

Congestive cardiac failure - how to diagnose (what investigations? 4)

A

BNP, ECG, CXR, ECHO

20
Q

Treatment for congestive cardiac failure (prognosis AND symptoms)

A

Beta-blocker and ACEi

21
Q

Treatment for congestive cardiac failure (symptoms only)

A

Furosemide - helps with pulmonary and peripheral oedema

22
Q

Weakness can be due to 4 types of problems…

A
  • Upper motor neurone lesion
  • Lower motor neurone lesion (E.g. trauma)
  • Neuromuscular junction disorder (e.g. myasthenia gravis)
  • Myopathy (e.g. duchenne muscular dystrophy)
23
Q

Proximal Myopathy - Signs and symptoms (gait, mobilising?)

A
  • Waddling gait
  • Can’t climb stairs
  • Difficulty getting out of chair
24
Q

Proximal Myopathy - Is there wasting? Reflexes? Tone? Fasciculations? Sensation?

A 
Wasting yes 
Reflexes normal
Normal /reduced tone
No fasciculations
Normal sensation
25
Q

Distal myopathy - … hand movement

A

Clumsy hand movement

26
Q

Congenital myopathies (3)

A

Duchenne muscular dystrophy (most severe)
Becker muscular dystrophy (less severe)
Myotonic dystrophy

27
Q

Metabolic myopathies

A

Hypokalaemia, thyroid, vitamin D deficiency

28
Q

Drug causes of myopathy - examples

A

Alcohol, long term steroids in proximal myopathy

29
Q

Myotonic dystrophy - is it dominant or recessive?

A

Autosomal dominant

30
Q

Myotonic dystrophy - can present with what cardiac conditions?

A

Cardiomyopathy and heart block

31
Q

Increased risk of developing what condition with myotonic dystrophy?

A

T2 DM

32
Q

What dementia do people with myotonic dystrophy tend to get?

A

Fronto-temporal dementia

33
Q

Unilateral ptosis - complete vs partial?

A 
Complete = cranial nerve III palsy
Partial = Horner syndrome
34
Q

Bilateral ptosis - may be … or as a result of a …

A

Congenital or a myopathy

35
Q

Horner syndrome is a symptom of …

A

Pancoast tumour (lung cancer at Alice’s)

36
Q

Dementia vs Delirium

A

Dementia - normal consciousness, chronic, day-to-day similar, worse at night
Delirium - altered consciousness, acute, fluctuates, worse at night

37
Q

Reversible dementia examples

A

B12 deficiency, Subdural haematoma

38
Q

Dissociation of p-waves and QRS complexes =

A

Complete heart block

39
Q

Suddenly collapse with no warning signs but rapidly re-gains consciousness = …

A

Arrhythmic cardiac syncope

40
Q

Slow-relaxing handshake is seen in people with …

A

Myotonic dystrophy

41
Q

Stepwise deterioration is seen in which time of dementia?

A

Vascular dementia

42
Q

Visual hallucinations and fluctuation in function is seen in which type of dementia?

A

Lewy body dementia

43
Q

What drug can you add in severe heart failure for mortality and symptom benefit?

A

Spironolactone

44
Q

… disease is a specific form of fronto-temporal dementia with ‘knife-blade gyri’

A

Pick’s disease

One-2-One Medicine Clinical Case Masterclass (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions