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6th Year Acute MJ > key > Flashcards

key Flashcards

1
Q

Causes of third nerve palsy (PHD)

A 
Posterior communicating artery aneurysm (painful- neurosurg emergency)
Hypertension
Diabetes
\+MS
\+trauma
\+bleed 
\+tumour
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2
Q

Surgical third nerve palsy - when does pupil dilate early or late

A

EARLY

  • due to PS nerves on outside of eye getting compressed early
  • whereas in diabetes (medical third n palsy) it happens from inside to out
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3
Q

Horners S triad

A

Ptosis
Miosis
Anhidrosis
Enopthalmos

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4
Q

Causes of Ptosis - unilateral or bilateral

A

Unilateral = HS, 3rd N Palsy, Myasthenia , congenital

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5
Q

Ptosis + pupil sizes

A

Large pupil = 3rd N Palsy
Small pupil = Horners S
Normal pupil = Myasthenia, dystrophia myotonica

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6
Q

Abducens nerve palsy

A 
LR - supplied by 6th CN
Causes: Similar to 3rd N P
-HTN
-DM
-MS
-RAISED ICP
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7
Q

Raised ICP signs

A

loss of retinal vein pulsation, Cushings triad – HTN, Bradycardia, Kussmaul Breathing, focal seizures, LoC

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8
Q

Raised ICP late sign in eye

A

papilloedema on fundoscopy

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9
Q

why is 6th n commonly affected by raised ICP

A

long intracranial tract

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10
Q

UMN spasticity vs rigidity

A 
Spasticity = velocity dependent, increased tone occurs early on, flexors in UL>extensors in LL
Rigidity = tone increased THROUGHOUT, velocity independent
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11
Q

Causes of UMN signs - MCMC

A

Multiple Sclerosis
Cord compression
MND
Cx Spondylosis

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12
Q

Causes of wasting of small muscles of gold - BILATERAL

A

Rheumatoid arthritis
Cervical Spondylosis
Rare - CMT, syringomyelia, bilateral cervical ribs

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13
Q

Causes of wasting of small muscles of gold - UNILATERAL

A

Pancoast Tumour
Brachial plexus trauma
Cervical rib

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14
Q

Patient with a stroke, 3 reasons for a CXR

A
  1. Aspiration pneumonia
  2. Lung cancer - mets
  3. Enlarged heart - CCF, HTN
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15
Q

Signs of a facial palsy

A
  • test facial muscles
  • loss of lacrimation (Schirmer’s test)
  • stapedius reflex
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16
Q

With a facial palsy what else would you want to examine

A
  • ears for HZ (Ramsay Hunt Syndrome) and acute otitis media
  • parotids
  • tongue (anterior 2/3)
17
Q

With a facial palsy , what 2 qs should you ask

A

Hyperacusis (incr in sound) + taste change

18
Q

FN palsy + 6th CN

A

pons lesion

19
Q

FN palsy + 5th + 8th CN

A

Cerebellopontine angle

-early sign = loss of corneal reflex

20
Q

Psoriasis complications in the nails (POSH)

A

Pitting
Onycholysis
Subungual hyperkeratosis
Haemorrhages (splinter)

21
Q

Psoriasis other parts of the body affected

A

Hands
Hip (sacroillitis)
Knee (Oligoarthritis)
RARE - arthritis mutilans

22
Q

Lichen Planus associated phenomenon

A

Koebners phenomenon

23
Q

Koebners phenomenon causes (VPLW)

A

Vitiligo
Psoriasis
Lichen planus
+Warts

24
Q

Complications of MI (FAM)

A

Failure
Arrythmias
Murmurs

25
Q

Cardiac causes of syncope other than Aortic Stenosis

A

Arrythmias

  • Bradyarrythmias: heart block, bradycardia
  • Tachyarrythmias: SVT, VT, VF
26
Q

Causes of Snycope (other than vasovagal- IMP to think about this) x 6

A 
PE
Ectopic
AAA
Aortic dissection
MI
SAH
27
Q

Aortic Stenosis Sx ASS

A

Angina
Syncope
SOB

28
Q

signs of clinically severe AS

A

Soft S2

Narrow pulse pressure

29
Q

How to differentiate A Stenosis from A Sclerosis

A

No radiation
Normal pulse
Normally elderly

30
Q

Causes of raised JVP

A 
Right sided HF
Fluid overload 
SVC obstruction
Complete heart block
Pericardial Effusion
CCF
Tricuspid regurgitation
31
Q

SVC obstruction JVP signs

A

Engorgement

non pulsatile

32
Q

Cx of Prosthetic heart valve : FIBAT

A 
Failure
Infection - IE
Bleeding - Warfarin or site
Anaemia - MAHA
Thromboembolic - PE
33
Q

Other causes of irregularly irregular pulse

A

AF
A flutter with variable block
Multiple ventricular ectopics

34
Q

Mitral stenosis define

A

LOW PITCHED RUMBLING MID – DIASTOLIC MURMUR, BEST HEARD IN MITRAL AREA, WITH PT IN LEFT LATERAL POSITION, ON EXPIRATION

35
Q

How breath accentuates murmur

A

Left sided murmurs louder on EXPIRATION

Right sided murmurs louder on INSPIRATION

36
Q

Cx of Mitral Stenosis

A

pulmonary hypertension

37
Q

signs of pulmonary hypertension

A

LOUD P2
L Parasternal heave
Graham Steele Murmur (early diastolic murmur due to pulmonary regurg)

6th Year Acute MJ (2 decks)

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