Brainscape's Knowledge GenomeTM

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


See full index

3rd Year BDS > GHD > Flashcards

GHD Flashcards

1
Q

Typpes of vavular heart disease?

A

Valvular stenosis
Valvular regurg
Aortic coarctation
CHD

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

Symptoms of aortic stenosis?

A

Angina
Breathlessness on exertion
Dizziness

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

Symptoms of aortic regurg?

A

Dyspnoea
Orthoponea
Nocturnal angina

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

Symptoms of Mitral valve disease?

A

Breathlessness
Palpitations due to Atrial fibrillation
Embolisation

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

What do Apixaban, Rivaroxaban and Edoxaban target?

A

Factor X

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

What does Dabigatran target?

A

Prothrombin

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

INR for AF?

A

2-3

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

INR for Metallic heart valves?

A

2.4-4.0

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

Contraindications for NSAIDs prescription to patients?

A

Taking oral anticoagulation tablets

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

Definition of infectvive endocarditis?

A

Infection on the cardiac or vasc endo

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

Predisposing factors for infective endocarditis?

A 
Endothelium subjected to turbulent flow
Any valvular or cardiac abnormality
Prosthetic heart valves
Bacteriaemia
IVDU
Dental procedures
Surgical procedures at infected sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aetiology for infective endocarditis?

A 
Bacteria
- Streptococcus, Staphylococcus, Enterococcus, Pneumococcus, Gram-cocco-bacilli
Fungi
Mycobacteria
Rickettsiae
Chlamydia
Mycoplasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms for infective endocarditis?

A 
Fever
Malaise, anorexia, weight loss
Heart failure due to acute valvular destruction
Systemic embolisation: occult 	stroke
Acute renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How to manage a patient with infective endocarditis?

A

Good oral hygiene
Regular dental review: twice/year in high risk patients and yearly in all others
Extra care taken for procedures requiring manipulation of the gingival or peri-apical region of the teeth or perforation of the oral mucosa (including scaling and root canal procedures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Prophylaxis for infective endocarditis patient before dental treatment?

A

Amoxy 3g adult 60 mins prior
Amoxy 50mg per kg for child, max 3g
Clindamycin 600mg 60 mins prior adult
Clindamycin 30mg/kg child, max 600mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of cardiovascular disease?

A 
Ischaemic heart disease
- Angina
- Myocardial Infarction
Heart failure
Cerebrovascular disease
- Transient ischaemic attack
- Thrombotic stroke
Arrhythmias
- Atrial Fibrillation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe atherosclerosis?

A 
Damage to vessel wall 
- Smoking
- Wall stress (High BP)
Healing process
- Activation of platelets
- Inflammatory cells
- Incorporation of Cholesterol
Fibrous cap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe atherosclerosis?

A 
Damage to vessel wall 
- Smoking
- Wall stress (High BP)
Healing process
- Activation of platelets
- Inflammatory cells
- Incorporation of Cholesterol
Fibrous cap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Types of antiplatelet drugs and their targets?

A

Aspirin- Thromboxane A2 (COX-1)
Clopidogrel/ Ticagrelor/ Prasugrel- P2Y12 ADP receptors
(Dipyridimole- Phosphodiesterase inhibitors )
(Abcicimab fibrinogen receptor antagonists)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Implications of antiplatelets for dental practice?

A

Patients bleed for longer
Aim for bloodless technique
Ensure primary haemostasis obtained before patient leaves practice
Interaction with NSAIDS
- Potent COX inhibitors
- Increased bleeding Risk- particularly GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Beta 1 receptor action?

A

Heart- SA, AV Nodes and myocardial cells.
Kidneys- reduce secretion of Renin (see ACE inhibitors)
Positive Effect- Slows heart rate and conduction (Negatively Chronotropic (and Dromotropic)), Increases Diastolic Time, Reduces BP, Protects heart from effects of Catecholamines
Negative Effects- reduces contractility (negatively Inotropic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Beta 2 receptor actions?

A

Smooth muscle eg Airways, Peripheral vasculature
Skeletal Muscle
Positive Effects- Reduces tremor?!?!?
Negative Effects- potentially lethal bronchospasm in asthmatics, vasoconstriction and PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Beta 1 and Beta 2 blockers?

A 
Beta 1:
- Bisoprolol
- Atenolol
- Carvediol
- Metoprolol
Beta 1 and 2:
- Propanalol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the renin-agiotensin-aldosterone axis?

A

Angiotensinogen produced by liver
Converted to Angiotensin I by Renin and enzyme released by the kidney in response to reduction in perfusion pressure
Angiotensin I converted into Angiotensin II by ACE and Endothelial enzyme found predominantly in the lungs
Angiotensin II acts on the adrenals leading to the release of aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Function of ANG II?

A

Vasoconstrictor

  • peripheral vasc
  • efferemt arteriole of glom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Function of aldosertone?

A

Retain Na and H20

Lose K in DCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

ACE inhibitor action and examples?

A

Ramipril
Lisinopril
Captopril
Perindopril

Positive effects- Reduce blood pressure, reduce afterload on heart, prevents aberrant remodelling after MI and reduces proteinuria
Negative effects- reduces perfusion pressure in glomerulus, cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

ARBs action and examples?

A

Losartan and candersartan

Positive effects- Reduce blood pressure, reduce afterload on heart, prevents aberrant remodelling and reduces proteinuria
Negative effects- reduces perfusion pressure in glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Aldosterone antagonists?

A

Spironolactone and eplenerone
Enhanced diuretic effect
Never with NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Ca channel blockers types?

A

Dihydropyridine

Non-dihydropyrdine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Affect of dihydropyridine and examples?

A

Block calcium entry into smooth muscle
Less effect on myocardial pacemaking tissue

Eg. Amlodipine, felodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Affect of non-dihydropyridine and examples?

A 
Block calcium entry to smooth muscle 
Blocks calcium entry in the myocardial pacemaking tissue
Slow SA node function
Slow AV conduction
Eg. Verapamil and Diltiazem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Dental implications for Ca channel blockers?

A

Gingival hypertrophy
Particularly dihydropyridine
Poor dental hygiene and gingival inflammation are a risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How statins works?

A

Hydroxy-methyl-glutaryl Coenzyme A (HMGCoA)reductase inhibitor
Rate limiting step in production of cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Implicaitons of statins in dental practice?

A

No clarithromycin for Simvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Implicaitons for anticoagulations in the dental practice?

A

Interactions with antibiotics commonly used

  • Enhanced anticoagulant effect via inhibition cP450 eg. Clarithromycin, Azole anti fungals
  • Reduced anticoagulant effect via induction of cP450 eg. Rifampycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Risk factors for HT?

A 
Cigarette smoking 
Diabetes mellitus 
Renal disease
Male 2X risk
Hyperlipidaemia
Previous MI or stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Other factors for HT aetiology?

A 
Age
• Genetics and family history
• Environment
• Weight
• Alcohol intake
• Race
• Birth weigh
- salt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Causes of 2nd HT?

A

Renal disease
Drug Induced
Pregnancy
Endocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why treat HT?

A

reduce cerebrovascular disease by 40-50%

– reduce MI by 16-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Defintion of Stroke?

A

is the sudden onset of focal neurological
symptoms caused by ischaemia or
haemorrhage and lasting more than 24
hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Definition of TIA?

A

TRANSIENT ISCHAEMIC ATTACK (TIA)
is the term used if the symptoms resolve
within 24 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Difference between haemorrhagic and ischaemic stroke?

A

Haemorrhage/blood leaks into brain tissue

Ischaemic is where a clot stops the blood supply to an area of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Signs and symptoms of Stroke?

A 
Motor (clumsy or weak limb)
• Sensory (loss of feeling)
• Speech: Dysarthria/Dysphasia
• Neglect / visuospatial problems
• Vision: loss in one eye, or hemianopia
• Gaze palsy
• Ataxia/ vertigo / incoordination / nystagmus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Signs and symptoms for a posterior circulation stroke?l

A

ataxia, vertigo incoordination, nystagmus, loss of

consciousness, cardiorespiratory control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Types of Strokes?

A 
Brainstem stroke (brainstem)
Cortical stroke (cortex)
Lacunar stroke (small vessel)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Stroke mimics?

A 
Migraine
• Epilepsy
• Structural brain lesions
– SDH, Tumour, abscess
• Metabolic/toxic disorders
– hypoglycemia
• Vestibular disorders
• Psychological disorders
• Demyelination
• Mononeuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Why Strokes happen?

A

Problems in the large arteries
• Problems in the small arteries
• Clots that come from the heart

Carotid stenosis
Carotid disease
Cardioembolic stroke (AF)
Carotid dissection - clot tears artery wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Non-modifiable RF for Stroke?

A

Previous stroke
–Being old
–Being male
– Having a family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Modifiable RF for Stroke?

A 
HT
Diabetes x3
Smoking x2
Lipids
Alcohol
Weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

FAST?

A

Facial weakness
Arm weakness
Speech problems
Time to call 999

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Early management for stroke treatment?

A 
Swallowing
• Fluids and oxygen
• Early therapy involvement
• Good nursing care
• Aspirin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

TIA risk of Stroke?

A 
Almost inevitable 1/2 days prior
Meds to reduce chances
Antiplatelets
Antihypertensives
Statins+Endarterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Relevant patient information for exodontia?

A 
Bleeding disorders.
SDCEP guidance and implementation advice.
Antibiotics Prophylaxis.
Anticoagulants and Antiplatelets.
Bisphosphonates.
MRONJ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Relevant medical information fro patient for exodontia?

A

Head and neck radiotherapy.
Chemotherapy.
Liver failure.
Haemophilia.

55
Q

Name respiratory conditions?

A 
Asthma and COPD
Pneumonia
Obstructive sleep apnoea
Pulmonary Embolism
Pneumothorax
Lung Cancer
Chronic cough
Bronchiectasis
Interstitial Lung Disease
56
Q

Respiratory symptoms?

A 
Dyspnoea (breathlesssness)
Cough
Sputum
Haemoptysis
Chest Pain
Wheeze
57
Q

How to assess respiraotry disease?

A 
Physical examination
- Pulse rate
- Pulse oximeter
- Respiratory rate
- Listen to breathing
- Lung auscultation
Oxygen saturation
Arterial Blood gas
- pH, PO2, PCO2
Chest X-ray (CxR)
Peak Flow
Lung Function
CT scan
Bronchoscopy
58
Q

Equipment for respiratory assessment in the dental practice?

A

Pulse oximeter

Peak flow meter

59
Q

TI respiratory failure?

A

Low PO2
Normal or low PCO2
Examples include acute asthma, pneumonia

60
Q

TII respiratory failure?

A

Low PO2
High PCO2
Examples include severe COPD, obesity hypoventilation syndrome

61
Q

Symptoms for Asthma and COPD?

A

Airways disease
Breathlessness
Wheeze
Cough

62
Q

Description of Asthma?

A 
reversible airflow obstruction
not caused by smoking
intermittent symptoms
common in childhood
Treat with bronchodilators (salbutamol) and corticosteroids (beclomethasone)
63
Q

Description of COPD?

A

irreversible airflow obstruction
caused by smoking
continuous symptoms
tends to occur in older adults

64
Q

Symptoms of Pneuomina?

A

Acute illness

Fever, myalgia, headache

Cough, chest pain, sputum, dyspnoea

May require admission to hospital

May have type I respiratory failure

Consolidation on CxR

Treated with antibiotics, oxygen, intravenous fluids

65
Q

Description of a Pulmonary embolism and risk factors?

A 
Blood clot to the lung
Typically arises in leg veins
Major risk factors include
- Recent major operation
- Recent major trauma
- Immobility
- Major chronic disease e.g. cancer
66
Q

Symptoms of Pulmonary embolism and treatment?

A 
breathlessness
chest pain
haemoptysis
Type I respiratory failure
Near normal CxR
Treated with anticoagulation e.g. warfarin, rivaroxaban, apixaban
67
Q

Description of Pneumothorax?

A

Collapsed lung
Primary (no cause) or secondary (underlying lung disease)
May pres

68
Q

Symtpoms of pneumothorax?

A

chest pain (sudden onset)
dyspnoea
clinical examination and CxR

69
Q

Description of Chronic cough?

A

Cough lasting > 8 weeks

70
Q

Causes of Chronic cough?

A

asthma
gastro-oesophageal reflux
postnasal drip

71
Q

Description of Bronchiectasis?

A

Dilated, damaged airways

72
Q

Symptoms for Bronchiectasis?

A

cough
sputum, often copious
haemoptysis

73
Q

Description of intersitial lung disease?

A

Thickening, inflammation of interstitium of lung

74
Q

Symptoms of interstitial ling disease?

A

dyspnoea

dry cough

75
Q

Types of neurodegenarative disease?

A

Dementia
Parkinson’s
Motor neuron disease

76
Q

Definition of dementia?

A

Progressive impairment of multiple domains of cognitive function in alert patient leading to loss of acquired skills and interference in occupational and social role

77
Q

Common features of neurodegenarative disease?

A

usually late onset
gradual progression
neuronal loss (specific neuropathology)
structural imaging often just atrophy

78
Q

Causes of dementia?

A

Late onset (65+ yrs)

Alzheimer’s (55%)
Vascular (20%)
Lewy body (20%)
Others (5%)

Young onset (<65 yrs)

Alzheimer’s (33%)
Vascular (15%)
Frontotemporal (15%)
Other (33%)

79
Q

How to diagnose dementia?

A

History (independent witness)
type of deficit, progression, risk factors, FH

Examination:
cognitive function, neurological, vascular

Investigations
routine - bloods, brain imaging

80
Q

Dementia screening tests?

A

Clock drawing

81
Q

Types of dementia?

A

Temporo-parietal dementia

  • Early memory disturbance
  • Language and visuospatial problems
  • Personality preserved until later

Frontotemporal dementia

  • Early change in personality / behaviour
  • Often change in eating habits
  • Early dysphasia
  • Memory / visuospatial relatively preserved

Vascular dementia

  • Mixed picture
  • Stepwise decline
82
Q

Treatment for Alzheimer’s?

A

Cholinesterase inhibitors (cholinergic deficit)
- Donepezil, rivastigmine, galantamine
- Small symptomatic improvement in cognition (wash-out)
- No delay in institutionalisation
NMDA antagonist (memantine)

83
Q

Dental complications for Alzheimer’s?

A 
poor comprehension (consent / capacity)
easily confused (strange environments / pain)
poor speech
Excess saliva (medications)
Neglect of dental care
84
Q

Approach for Alzheimer patients?

A 
Time & explanation
Best if with friend / family
Calm approach
Show as well as say
Plan with patient early in dementia
Think ahead
prevention / long-term management 
Specialist / hospital services e.g. sedation
85
Q

Diagnosis of Parkinson’s disease?

A

Bradykinesia + ≥1 tremor, rigidity, postural instability
No other cause / atypical features
Slowly progressive (> 5-10 yrs)

Supported by asymmetrical onset, rest tremor, response to treatment

86
Q

Treatment for Parkinson’s?

A

COMT inhib:
entacapone
tolcapone
opicapone

Dopamine agonists:
ropinirole
pramipexole
rotigotine

MAO-B inhib:
selegiline
rasagiline

87
Q

Dental issues for Parkinson’s?

A 
Movement problems
Dementia
Swallowing
Drooling
Dry mouth (rarer)
Dentures
Deep brain stimulators: antibiotics
88
Q

Parkinson’s managment dentally?

A 
Give time to respond (speech & action)
Minimise distractions & clutter
Advice – local PDS society / medic / nurse
Specialist hospital Rx / sedation
Speech and language therapy
Saliva management
Good denture care
89
Q

Parkinson’s managment dentally?

A 
Give time to respond (speech & action)
Minimise distractions & clutter
Advice – local PDS society / medic / nurse
Specialist hospital Rx / sedation
Speech and language therapy
Saliva management
Good denture care
90
Q

Definition of Motor Neurone Disease?

A

Combination of upper and lower motor neuron signs
LMN = muscle fasciculations, wasting, weakness
UMN = spasticity, brisk reflexes, extensor plantars
No sensory involvement
10%+ have cognitive decline

91
Q

Dental issues for Motor Neurone Disease?

A

dysarthria/weakness, saliva, swallow, survival

92
Q

Other movement disorders?

A

Tremour

Dystonia

93
Q

Definiton of tension headache?

A

Most frequent primary headache, but is NOT disabling and rarely presents to doctors

94
Q

Symtpoms of tension hedache?

A

Mild, bilateral headache
pressing or tightening in quality
no significant associated features
not aggravated by routine physical activity

95
Q

Treat tension headache?

A

NSAID or paracetamol

Tricyclic antidepressant if a preventative required

96
Q

Definition of migraine?

A

Most frequent DISABLING primary headache

97
Q

Migraine treatment?

A 
Lifestyle
Diet: don’t miss meals, drink plenty of fluids
Sleep: avoid changes in sleep patterns
Regular exercise
Trigger avoidance

Acute treatment
Aspirin or NSAIDs
Triptans
Limit to 10 days per month (~2 days per week) to avoid the development of medication overuse headache

Prophylactic treatment
B-Blockers (propranolol)
Anti-epileptics (Topiramate, Valproate, Gabapentin)
Tricyclic antidepressants (amitriptyline, dothiepin, nortriptyline)
Others

98
Q

Definiton of chronic migarines?

A

Headache on ≥ 15 days per month, of which ≥ 8 days have to be migraine, for more than 3 months

99
Q

Definition of cluster headache?

A 
Pain: mainly orbital and temporal
Attacks are strictly unilateral
Rapid onset (max within 9 mins in 86%)
Duration: 15 mins to 3 hours (majority 45-90 mins)
Rapid cessation of pain
100
Q

Definition of cluster headache?

A 
Pain: mainly orbital and temporal
Attacks are strictly unilateral
Rapid onset (max within 9 mins in 86%)
Duration: 15 mins to 3 hours (majority 45-90 mins)
Rapid cessation of pain
101
Q

symptoms of cluster headache?

A

Premonitory symptoms: tiredness, yawning

Associated symptoms: nausea, vomiting, photophobia, phonophobia

102
Q

Paroxysmal hemicarnia defintion?

A

Pain: mainly orbital and temporal

Attacks are strictly unilateral
Rapid onset
Duration: 2-30 mins
Rapid cessation of pain

103
Q

Neuralgia defintion?

A

An intense burning or stabbing pain
The pain is usually brief but may be severe.
Pain extends along the course of the affected nerve.
Usually caused by irritation of or damage to a nerve

104
Q

Causes of trigeminal neuralgia?

A

Vascular compression of the
trigeminal nerve

Uncommon
Multiple sclerosis
Intracranial arteriovenous
	malformation
Intracranial tumour
Brainstem lesions
105
Q

Symptoms of trigeminal neuralgia?

A

Unilateral maxillary or mandibular division pain > ophthalmic division
Stabbing pain
5 - 10 seconds duration

106
Q

Definition of atypical facial pain?

A

Pain
Poorly localized featureless pain
Typically involving eye, nose, cheek, temple or jaw, but can involve areas supplied by the cervical roots
Continuous with no paroxysms, distinguishing it from trigeminal neuralgia
No triggers

107
Q

Definition of burning mouth syndrome?

A

An intraoral burning or dysaesthetic sensation, recurring daily for more than 2 hours per day over more than 3 months, without clinically evident causative lesions.

108
Q

Symptoms of burning mouth syndrome?

A

Pain is usually spontaneous, but can be triggered by foods especially spicy or acidic

109
Q

Symtpoms of sinus headache?

A

Purulent anterior rhinorrhoea
Nasal congestion
Postnasal drip
Continuous facial or dental pain / pressure
Cough (frequently has a night time component)

110
Q

Definiton of thunderclap headache?

A

A high intensity headache reaching maximum intensity in less than 1 minute
Majority peak instantaneously
1/10 actually have a subarachnoid haemorrhage

111
Q

Eye movements and their cranial nerves?

A

SO4 - superior oblqiue rotates - pulles eye towards the nose
LR6 - lateral rectus - moves eye laterally

All others for CN III

112
Q

Lesions that cause visual field defects?

A

Optic nerve - 1 sided blindness
Optic chiasma - half vision in both eyes
Optic radiations - variable in both eyes
Occipital visual cortex - variable in both eyes

113
Q

IVth nerve pasly definition?

A

Trochlear nerve innervates superior oblique
Intorts depresses and abducts the globe (eye)
Vertical diplopia,  tortion
Diplopia worse looking down to opposite side of IVth CN palsy
Can have head tilt away from affected side

114
Q

III nerve palsy?

A

dilated pupil/ oculomotor abnormalities

innervates levator palpebrae superioris

115
Q

Myasthenia Gravis definition?

A 
Auto-immune disorder
Antibodies against acetylcholine receptor
Associated with thymoma and thymic hyperplasia
Pure ocular MG
Generalised MG
Extra-ocular
Bulborespiratory muscles
Limbs – proximal>distal
116
Q

Treat Myasthenia Gravis?

A

Acetylcholinesterase inhibitors (pyridostigmine, neostigmine)
Immunosuppression
Steroids
IV immunoglobulin, plasma exchange
Azathioprine, cyclosporin, cyclophosphamide, methotrexate

117
Q

Definition of Bell’s Palsy?

A

right or left facial paralysis
Noises sound louder on RHS or left
dilated pupil in right or left eye

118
Q

UMN vs LMN facial paralysis?

A

UMN:

  • stroke
  • tumour

LMN:

  • Bell’s palsy
  • carcoid
119
Q

CN XII palsy definition?

A

Tongue deviates to side of lesion+ fasciculations + wasting

120
Q

Causes of transient loss of consciousness?

A 
Vasovagal							20%
Reflex	 syncope					14%				
Cardiogenic syncope			                18%
Epilepsy								8%
Other (provoked seizure)		                2%
Metabolic							4%
Unknown							34%
- Non-epileptic
121
Q

Types of syncope?

A

Reflex
Orthostaic
Cardiogenic

122
Q

Cardiogenic syncope symptoms?

A

On exertion
Chest pain, palpitations, SOB
Clammy/sweaty

Witness account:

  • Suddenly went floppy
  • Looked grey/ashen white
  • Seemed to stop breathing
  • Unable to feel a pulse
123
Q

Definition of epilepsy?

A

Epilepsy is the tendency to recurrent seizures

124
Q

Factors which increase seizure risk?

A

Missed medications (most common)
Sleep disturbance, fatigue
Hormonal changes
Drug/alcohol use, drug interactions
Stress/Anxiety
Photosensitivity in a small group of patients
Other rarer reflex epilepsies (visual patterns, music)

125
Q

Basic classifcaitions of seizures?

A

Generalised seizures

Focal seizures

126
Q

Generalised seziure types?

A 
Absence seizures
Generalised tonic-clonic seizures
Myoclonic seizures
Juvenile myoclonic epilepsy
Atonic seizures
127
Q

Focal seizures types?

A

Simple partial seizures
Complex partial seizures
Secondary generalised

128
Q

Difference between Generalised and Focal?

A 
Generalised:
No warning
< 25 years
May have history of absences and myoclonic jerks as well as GTCS e.g in juvenile myoclonic epilepsy
Generalised abnormality on EEG
May have family history

Focal:
May get an “aura”
Any age – cause can be any focal brain abnormality
Simple partial and complex partial seizures can become secondarily generalised
Focal abnormality on EEG
MRI may show cause

129
Q

Signs of a generalsied tonic clonic seizure?

A

Groaning sound
Tonic (rigid phase)
Then generalised jerking in all four limbs
Eyes open
Staring/ roll upwards
Foaming at the mouth
Jerking for a few minutes and then groggy for 15-30mins

130
Q

Signs of an absence seizure?

A

Sudden arrest of activity for a few seconds
Brief staring
May have eye-lid fluttering

131
Q

Signs of a complez partial seizure?

A 
Sudden arrest in activity
Staring blankly into space
Automatisms
Lip smacking
Repetitive picking at clothes
132
Q

Signs of status epilepticus?

A

Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery period between seizures
Be wary of non-convulsive status epilepticus

133
Q

Treatment of status epilepticus?

A

Midazolam: 10mg by buccal or intra-nasal route, repeated after 10mins if necessary
Lorazepam: 0.07mg/kg, usually 4mg bolus repeated once after 10 mins
Diazepam: 10 - 20mg iv or rectally, repeated after 15 mins if necessary

134
Q

Signs of pseudoseizure?

A

May recognise stress as a trigger (even if patient doesn’t)
May report signs of patient retaining awareness
Tracking eye movements, still some verbalisation during episodes
Movements not typical of seizures
Pelvic thrusting
Asynchronous movements, tremor
Episodes waxing and waining

135
Q

Causes of orthostatic syncope?

A

Dehydration, medication related (anti-hypertensive)

Endocrine, autonomic nervous system

136
Q

Causes of reflex syncope?

A

Taking blood/medical situations

Cough, Micturation

3rd Year BDS (21 decks)

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