Neuro

Question 1

PEG tube

Answer 1

endoscope used to position PEG tube in stomach - goes through skin
usually sedation + LA but no GA, endoscope through mouth into stomach then cut skin and insert
Risks - breathing problems, aspiration, bleeding, perforation of the bowel, inflammation/infection
enteral nutrition nurse + home care team

Question 2

Multiple sclerosis

Answer 2

Unilateral eye signs, paraesthesia, muscle weakness, fatigue, bladder/bowel
MRI gadolinium, FBC, TFTs, B12, CSF
MDT approach to treatment
Treat with immunomodulators e.g. interferon beta (RR), and symptomatic e.g. gabapentin, baclofen
Acute relapse - methylpred

Question 3

Brown-Sequard syndrome

Answer 3

Ipsilateral loss of fine touch, vibration, proprioception (corticospinal)
Contralateral loss of pain and temperature (spinothalamic)