neuro upper limb

Question 1

wrist drop?
Ix?
Mx?
differential

Answer 1

radial nerve injury -

Ix
fbc - wcc, crp for any inflammatory markers GBS
imaging
Xray to ensure

fall asleep by back of arm compressed - compression of nerve
or injury on basis of fracture of humeral shaft

Question 2

radial nerve injury

how does it present on examination

Answer 2

wrist drop
extension of forearm impacted
extension of fingers and wrist also impacted

Question 3

Mx radial nerve injury

Answer 3

brace
cockup splint
therapy
emg and nerve studies

Question 4

extensory digitorum

Answer 4

MCP - 2-5

flexor digitroum profundus
digitorum superficialis

Question 5

what muscles aid in abducting and adducting the fingers?

Answer 5

lumbricals and interossei

Question 6

median nerve

Answer 6

flexor digitorum suoerficialis
radial 1/2 flexor digitorum profundus

1/2nd lumbricals
thenar eminence - moves thumb

Question 7

Ulnar nerve

Answer 7

ulnar 1/2 flexor digitorum profundus
3/4 lumbricals
interosseous muscles

adductor pollicis

Question 8

Radial

Answer 8

extensor digitorum

Question 9

claw hand?

Answer 9

injury to ulnar nerve

all interosseus muscle loss - so no abduction/adduction

Question 10

ape hand and sign of benedicton

Answer 10

high median nerve when attempt to form a fist

ative attempt to flex digits only pinky and ring finger are flexed

Question 11

which nerve is associated with carpal tunnel?

Answer 11

median nerve

Question 12

carpal tunnel syndrome
cause?
features

Answer 12

idiopathic
tingling and pain lateral arm / hand
waking up from sleep/worse in morning

Question 13

tinels sign

Answer 13

tapping nerve in carpal tunnel to elicit pain

Question 14

hold the wrist in flexion for 60s to elicit pain ?

Answer 14

phalens manouvre

Question 15

mx of carpal tunnel?

Answer 15

splint
steroid injection
surgical decompression

Question 16

Indomethacin is what?

eg contraindicated in?

Answer 16

NSAID

chronic heart failure as it can cause sodium and water retention and = worsen hf

Question 17

candersartan?

Answer 17

angiotensin receptor blocker

Question 18

carvedilol

Answer 18

beta blocker

Question 19

hydralazine and isosorbide dinitrite

Answer 19

vasodilators used in HF for afro-caribbean patients

Question 20

what is the responsibility of a1at?

Answer 20

protease protects against neutrophil elastase

it can mean lungs not protected leading to cirrhosis / emphysema

Question 21

primary biliary cirrhosis is associated with what antibody?

Answer 21

anti mitochondrial antibodies

Question 22

what antibody is autoimmune hepatitis associated with?

Answer 22

anti smooth muscle and anti nuclear antibody

Question 23

what is pagets disease of breast ?

Answer 23

of breast - eczema hardening of skin

2 to breast cancer

Question 24

acute causes of pancreatitis

Answer 24

gallstone
ethanol
trauma

steroids
mumps 
autoimmune 
scorpion venom 
hyperlipidaemia / calcaemia 
ERCP 
drugs : aza, sodium valproate

Question 25

management of SVT stepwise

and if pt is asthmatics?

Answer 25

1- vagal manouveres - valsalva
6mg IV adenosine
6mg
12mg

maybe amioadarone

calcium channel blocker verapamil

Question 26

loop diuretics work where?

Answer 26

furosemide

thick ascending limb of loop of henle

Question 27

where do spironolactone work ?

Answer 27

act on collecting ducts

Question 28

Carbonic anhydrase inhibitors act on

Answer 28

proximal convoluted tubule to increase bicarbonate excretion,

Question 29

thiazide diuretic which inhibits the Na+/Cl- transporter in the ______

Answer 29

dct

Question 30

A 70 kg man has a daily sodium and potassium requirement of

Answer 30

140 mmol and 60-70 mmol, respectively.

Question 31

High CSF protein in a patient with peripheral neuropathy and myopathy is suggestive of what?

Answer 31

GBS

Question 32

hypercalcaemia

raised ESR and back pain is suggestive of?

Answer 32

multiple myeloma

Question 33

how can multiple myeloma cause nephrotic syndrome?

Answer 33

IgG light chains . amyloid fibrils so multiple myeloma

. amyloidosis

Question 34

target cells associated with?

Answer 34

liver disease
hyposplenism
codocyte

Question 35

Spherocyte

Answer 35

hereditary or autoimmune haemolytic anaemia