Passmed Notes Flashcards
What movements test for the C5 myotome?
Elbow flexion
What movements test for the C6 myotome?
Wrist extension
What movement tests for the C7 myotome?
Elbow extension
What movements test for the C8 myotome?
Finger flexion
What movements test for the T1 myotome?
Finger abduction
What movements test for L2 myotome?
Hip flexion
What movements test for the L3 myotome?
Knee extension
What movements test for L4 myotome?
Ankle dorsiflexion
What movements test for the L5 myotome?
Long toe extension
What movement tests for the S1 myotome?
Ankle plantar flexion
What pathology arises when there is damage to the common peroneal nerve?
Weakness in dorsiflexion and eversion. This results in the patients having a footdrop.
How do you differentiate between L5 radiculopathy and common peroneal nerve palsy?
L5 radiculopathy results in weakness in dorsiflexion, inversion and hip abduction.
What is the first line treatment for neuropathic pain?
Amitryptyline, Gabapentin, Duloxetine, Pregabalin
What happens if one neuropathic painkiller doesn’t work e.g. gabapentin?
You swap it with another neuropathic pain killer. You do not add neuropathic pain killers together!!
E.g. swap gabapentin for pregabalin/amitryptyline/duloxetine
What drug can be used as rescue therapy if first line neuropathic painkillers do not work?
Tramadol
What drug can be used for localised neuropathic pain e.g. post-herpetic neuralgia?
Topical capsacin
What is acute disseminated encephalomyelitis?
Acute disseminated encephalomyelitis is a condition where the autoimmune system attacks the myelin sheath of the CNS, often following a bacterial/viral infection.
What MRI features are characteristic of acute disseminated encephalomyelitis?
Demyelination in supra and infra-tentorial regions.
How quickly do patients with acute disseminated encepholomyelitis develop symptoms following a viral/bacterial infection?
Patients with acute disseminated encephalomyelitis develop neurological symptoms between few days to 2 months after onset of infection.
How do we treat acute disseminated encephalomyelitis?
Glucocorticoids & IVIG if glucocorticoids fail
What is the single most important blood marker for restless leg syndrome?
Serum ferritin
What are the clinical features of restless leg syndrome?
1) An uncontrollable urge to move legs (akathisia). This uncontrollable urge typically occurs at night, but as the condition progresses, patient may develop symptoms during the day.
2) This uncontrollable urge to move legs tends to be at its worst when the patient is at rest.
3) The patient may also have parasthesia –> crawling/throbbing sensations.
4) Periods of movements whilst patient is asleep may be noted by partner.
What are the main causes of restless leg syndrome?
In 50% of the cases, the cause is unknown –> idiopathic in nature.
However, other known causes of restless leg syndrome include:
1) Iron deficiency anaemia –> this is why knowing the ferritin level is really key blood marker for this condition.
2) Uraemia
3) Diabetes mellitus
4) Pregnancy
How do we treat restless leg syndrome?
1) Simple measures such as walking / stretching/ massaging affected limbs
2) Treating the iron deficiency anaemia
3) Dopamine agonists (such as pramipexole or ropinirole) are usually first line drug treatments
4) Benzodiazipines
5) Gabapentin
What are the clinical features of an essential tremor?
Tremor that is worse when the arms are outstretched.
What can make an essential tremor better?
Resting and alcohol
What is the first line treatment for essential tremor? Aside from first line treatment, what can sometimes be used?
Propranolol is first line ; primidone can sometimes be used.
