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ENT, neuro, eyes > Passmed neuro incl cauda equina > Flashcards

Passmed neuro incl cauda equina Flashcards

1
Q

What is charcot marie tooth disease

A

Hereditary sensory and motor peripheral neuropahty

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2
Q

What is prognosis of DUchennes musular dystrophy

A

Progressive degneration and weakness of specific muscle grouos -> lose ability to walk at 12, ventialtion by 25

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3
Q

SCDC presentation

A

Ataxic gait(degen of dorsal columns), mixed UMN and LMN signs (degne lateral motor tracts and peripheral erve)

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4
Q

How does charcot marie tooth syndrome present

A

V slow degenrative condition, hereditary. Sensory and motor - LMN in all libs and reduced sensation

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5
Q

What should be given before endoscopy with sus variceal haemorrhag e

A

Terlipressin and ceftriaxone

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6
Q

Nimodipine use

A

CCB - prevent cerebral vasospasm after aneurysmal SA

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7
Q

When is propanolol given with sus variceal bleed endoscopy

A

Afterwards
Prevention of variceal bleeding - indicated after bleeding cessation and post endoscopy

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8
Q

Acute spinal cord compression symptoms

A

Back pain
Bilateral motor loss
Sensory level
Loss of anal tone

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9
Q

What would poorly controlle DM and raising CRP/fever be a warning of neurologically

A

Epidural abscess
MRI, neurosurgery, prolonged IV antibiotics

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10
Q

Why do early falls occur in MS

A

Postural hypotnesion due to autonomic dysfucntion in MS

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11
Q

MS features

A

Urinary incontinence, erectile dysfunction, vulval insensitivity, severe REM sleep disorder, polyminimyoclonus fingers

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12
Q

PSP features

A

Backwards falls
Gaze palsy
Double vision
Dysarthria
Axial rigidity

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13
Q

Bloods for fatigue and sensory neural signs

A
  • FBC
  • U+Es
  • TFTs
  • HbA1c
  • B12/folate
  • Ferritin
  • Bone panel
  • LFTs
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14
Q

Summary of SACD

A

Demyelination of fibres of dorsal and lateral areas of spinal cord from B12 deficiency —>

Mix sensory and UMN signs

Reduced sensation, vibration, proprioception, ataxia, spastic loss of power and upgoing plantars - babinskis sign

B12 deficiency affects distal limbs in length dependent pattern

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15
Q

Raised MCV causes

A

Hypothyroidism
B12/folate
Alcohol

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16
Q

Red flag questions for backpain

A
  • Sciatica (pain radiating down back of leg)
  • Leg weakness
  • Saddle paraesthesia (numbness or changed sensation to the perineum)
  • Urinary symptoms (difficulty initiating urination, reduced sensation of urination, urinary incontinence)
  • Bowel symptoms (faecal incontinence)
  • Recent trauma
  • Fevers/Night sweats
  • Weight loss
  • Pain that disturbs sleep
  • History of intravenous drug use
  • Osteoporosis
  • Prolonged use of steroids (raises risk of osteoporosis)
17
Q

Investigations for cauda equina

A

PR exam - loss of anal tone, reduced sensation
Post void bladder scan- retention - complete CE
Full spine MRI

18
Q

What is gold standard in cauda equina

A

full spine MRI (within 1 hour preferable but not beyond 24)

19
Q

Symptoms of suspected cauda equina

A
  • Bilateral sciatica
  • Leg weakness
  • Saddle paraesthesia
  • Bladder disturbance
  • Bowel disturbance
20
Q

Complete auda equina symptoms

A
  • Urinary retention
  • Overflow urinary incontinence
  • Loss of anal tone and peri anal sensation
  • fAECAL INCONTINENCE = LATE SIGN
  • sADDLE PARAESTHESIA - WIDESPREAD and complete
21
Q

Incomplete cauda equina syndrome

A

Subjective reduced urination sensation
Difficult passng, poor stream
Reduced urge to void bladder
Anal tone/sensation may be normal
Pathcy unolateral paraesthetisa saddle
Reduced power and reflexes, sciatic pain

22
Q

Causes of cauda equina

A

Disc herniation
Haematoma
Malignancy
Spinal abscess
Stenosis Vertberal fracture

23
Q

Treatment of cauda equina

A

Emergency surgery in next 48 hours
Laminectomy, dicectomy
High dose steroids - reduce swelling and oedema
Analgesia #Bloods - group and sace and coag
Urethral catherer if needed
Monitor for deterioration

24
Q

Complications of cauda equina

A

Long term pain, motor function, badder/bowel disturbance, sexual dysfunction

25
Q

Differentials for bilateral leg weakness

A
  • Guillian Barre
  • Cauda equina
  • Stroke (unilateral)
  • Transverse myeltiis
  • Epidural abscess
  • Off legs
  • Spinal cord compression
26
Q

What tract controls voluntary movement

A

Down corticospinal tractn

27
Q

Which tract controls pain and temp

A

Lateral spinothalamic tract

28
Q

Wich tract ontrols vibration and proprioception

A

Dorsal column

29
Q

What does anterior spinal artery syndrome cause

A

Corticospinal and lateral spinothalamic affeted
Causes Increased tone. Reduced power in hip flexion. Reduced pain sensation. Reduced temperature sensation. Normal joint position sense. Normal vibratory sensation.

30
Q

What is anterior spina, artery sundrome

A

Anterior 2/3 cord affected by stroke to areterial supply to cord
Treat with anticaog
Poor prognosis

ENT, neuro, eyes (34 decks)

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