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MD1 - FBS > PCP - Semester Two > Flashcards

PCP - Semester Two Flashcards

1
Q

Name for true muscle weakness?

Two other types of non-neuromuscular weakness?

A

Motor weakness

  1. Emotional Or physical fatigue
  2. Joint pain or stiffness
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2
Q

Two main groups of causes of muscle weakness?

A

Primary problem with muscles

Neurological conditions.

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3
Q

What is a well-known cause of generalised muscle weakness affecting the neuromuscular junction?

A

Myasthenia gravis

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4
Q

Common causes of muscle weakness?

A 
Immunological
Malignancy
Vascular events
Drugs
Metabolic disorders
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5
Q

How do you breakdown site of muscle weakness

A

General or localised

Localised: symmetric (proximal or distal) or asymmetric.

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6
Q

Another name for true muscle weakness?

A

Motor Weakness

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7
Q

Name two other common types of non neuromuscular weakness?

A

Physical or emotional Fatigue

Joint pain or stiffness

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8
Q

Two main Categories of causes of muscle weakness?

A 
Primary problem involving muscles OR
Neurological conditions (affecting the NM junction, Peripheral nerves, spinal nerve roots, anterior horn cells or corticospinal tracts
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9
Q

How do we classify muscle weakness?

A

General

Focal > Asymmetrical or symmetrical (distal or proximal)

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10
Q

Common cause of generalised muscle weakness affecting the NM junction?

A

Myasthenia gravis

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11
Q

Proximal weakness caused by what kind of disorders and which muscle groups?

A

Primary muscle disorders affecting axial muscle groups

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12
Q

Distal weakness caused by what kind of disorders and at which muscle groups?

A

Peripheral neuropathy and motor neuron disease

Hands and Feet

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13
Q

Common causes of muscle weakness?

A 
Immunological
malignancies
vascular events
Drugs
Metabolic disorders
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14
Q

Common causes of CNS sensory disturbances

A 
Cerebrovascular disease
MS
Tumours
Parkinsons
Huntingtons
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15
Q

Common causes of peripheral NS sensory disturbances?

A

Diabetes
Alcohol excess
Nerve entrapment

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16
Q

Four common patterns of sensory loss?

A

Hand or glove = peripheral neuropathy
Dermatomal pattern
Area supplied by a particular nerve eg Median Bar
Hemisensory loss (strokes or other cerebral events)

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17
Q

Two main types of sensation tested in clinical situation?

A

Primary sensation or Cortical sensory function

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18
Q

Order of Motor Exam modalities

A

Tone, Power, Reflexes, Sensation, Coordiantion/Clonus

Tall, People, Rule, South China

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19
Q

Which direction do you move to determine border of a sensory abnormatlity?

A

From abnormal to normal area

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20
Q

Five areas of basic eye exam?

A

Acuity, Field testing, Eye Movements, Pupils and Fundus examination.
All, fish, move, pretty, funny

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21
Q

Which cranial nerves are important to function of eyes?

A 
CN 2 (optic) - optic tracts from retina to visual cortex
CN 3 (occularmotor) - all eye muscles except LR and SO, levator palpebrae superioris and parasym to pupil (constriction -sphincter)
CN 4 (Trochlear) - SO muscles
CN 5 (Trigeminal) - Normal Sensation to Cornea
CN 6 (Abducens) - LR
CN 7 (Facial) - Closing of eyelid - Orbicularis oculi
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22
Q

What nerve division control pupil dilation? Where does the nerve come from?

A

Sympathetic - Superior Cervical Ganglion - dilator pupillae

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23
Q

Which muscles control eye movements?

A

LR6 - SO4 R3

Lateral Rectus (CN 6 - Abducens)
Superior Oblique (Trochlear CN4)
The rest Occulomotor aka CN3
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24
Q

Three ways to test visual acuity?

A

Unaided
Pinhole
Glasses

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25
Q

Four things you should check in the pupils?

A 
SSDC
Shape
Symmetry
Direct Response
Consensual Response
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26
Q

Severity of muscle weakness?

A

Function loss in affected area.

Move against gravity? Or paralysed?

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27
Q

Time course muscle weakness?

A

Sudden - vascular
Slower onset - tumour
Fluctuate? worse after activity?

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28
Q

Relieving factors Muscle weakness?

A

Does sitting, standing, sleeping help? Heat packs?

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29
Q

Aggravating Factors of Muscle weakness?

A

Triggering the episodes of weakness?

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30
Q

Associated Features of Muscle weakness

A

Medication - statins can cause myocytis

pain? Associated with sensory changes? Fever? Headache, back pain, breathing problems? pins and needles or memory.

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31
Q

What do you need to rule out before you know it is true muscle weakness?

A

Doesn’t want to move because of General Apathy/Fatigue or Joint pain.

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32
Q

What does the Stem plegia mean?

A

Complete loss of strength aka Paralysis

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33
Q

What does the stem paresis mean?

A

incomplete loss of strength

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34
Q

What does the stem Hemi mean?

A

Half

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35
Q

What does the stem Mono mean?

A

One of them, aka one limb

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36
Q

What does the stem Para mean?

A

Both lower limbs

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37
Q

What does Quad mean?

A

All four limbs?

38
Q

What is Para-aesthesia

A

Abnormal sensation perceived without a stimulus eg pins and needles

39
Q

What is Hyper-aesthesia

A

Abnormal increase in sensitivity to a stimulus

40
Q

What is Dysaesthesia

A

All positive Sensory changes including Para and Hyper aesthesia.

41
Q

Hyper-algesia

A

Heightened response to noxious stimulus

42
Q

Allodynia

A

Normal stimulus felt as pain eg clothes brushing body felt as pain

43
Q

Phrases used by patients around positive symptoms?

A

tingling, pins and needles, pricking, burning, tightness and electric shock or a sharp stabbing (pain)

44
Q

A numbness, coldness or loss of feeling is described as a what symptom?

A

Negative sensory symptom

45
Q

Diminished ability to perceive pain, temp or touch?

A

Hypo-aesthesia

46
Q

Complete inability to percieve pain, temp or touch?

A

Anaesthesia

47
Q

Analgesia?

A

Complete insensitivity to pain (can still feel temp and touch)

48
Q

Determining Site of the Sensory Dysfunction?

A

Ask them to point? Half body? whole limb? Sym or asym?

49
Q

Determining Quality of the Sensory Dysfunction?

A

Is it a postive or negative? characterise extent

50
Q

Determining Time course of the Sensory Dysfunction

A

Suddenly, over days or worse at night or during day

51
Q

Sensory Dysfunction Assoc Features?

A

EtOH, Medications, Diabetes (other Hx and Fx), other neuro symptoms eg muscle weakness or gait disturbances, injuries to effected area (eg burns or ulcers).

52
Q

Dermatome at anterior surface of knee

A

L3

53
Q

Dermatome behind the knee

A

S2

54
Q

Dermatome at medial malleous

A

L4

55
Q

Dermatome L2 test?

A

Upper Thigh lateral aspect

56
Q

Dermatome L1 test?

A

Just bellow undie line

57
Q

Lateral aspect of the calf Dermatome?

A

L5

58
Q

Heel?

A

S1

59
Q

Important Cardinal Features in an eye exam?

A

Time course: sudden (med ER) or gradual, degenerative?

, Site: unilateral, bilateral which visual fields, neglect?

60
Q

TOC is a common symptom. It affects what percentage of the population at some stage?

A

50%

61
Q 
What is not a bengin cause of syncope?
Cardiac syncope
Vasovagal syncope
Postural hypotension
Situational syncope
A

Cardiac Syncope

62
Q 
What is not a feature of syncope?
Sudden LOC
Amnesia
Sudden loss of postural tone
Spontaneous recovery
Complete recovery
A

Amnesia

63
Q 
Which of the following is not a key element of syncope?
Seizures
Global fall in blood flow
Reduction in O2 supply to brain
Inactivity of cerebral cortex
A

Seizures

64
Q 
What is not a cause of cardiac syncope?
MI
Aortic Stenosis
Vertigo
Bradycardia
Tachycardia
A

Vertigo

65
Q

What is the key difference in cerebral cortex activity between syncope and seizures?

A

The cerebral cortex is inactive in syncope and overactive in seizures.

66
Q

What is the key difference in blood flow between syncope and seizures?

A

Decreased global blood flow in syncope and increased in seizures

67
Q

During seizures electrical neuronal activity in the brain is:

  • Normal throughout
  • sudden and uncontrolled
  • Slowly rising to a crescendo
  • Sudden but in a distinct pattern.
A

Sudden and uncontrolled

68
Q

Tut 28: Possible causes of knee pain?

A 
injury to ligaments or menisci
loss of cartilage from osteoarthritis
inflammation bcz of rheumatoid or posoriatic arthritis
inflam of surrounding tendons and bursae
Reffered pain from hip or back
69
Q

Different sites of knee pain? And what they suggest? Radiation?

A

Anterior knee pain: osteoarthritis or patella problem
Lateral or medial: ligament sprain or meniscal tear.
Posterior knee: hamstring strain, bursitis or baker’s cyst or DVT.
Check that the knee is the only joint affected

70
Q

Time course and what it suggests? Knee pain

A

Acute: trauma or haemorrhage inot joint
Slow onset: consistent with arthritis, bursitis or tendonitis.
Is it worse in morning or after exercise?

71
Q

Context of Knee pain?

A

Ask about the postiono f the knee when injured, direction of force

72
Q

Ag or Rel factors of knee pain?

A

Certain movements making it worse? Tried any pain relief?

73
Q

Common Associated features of knee pain?

A

swelling, noises, popping sounds (esp acute injury).

Loss of Function: stiffness, locking, giving way.

74
Q

Severity of Knee Pain?

A

Rate the pain, What can’t they do (esp chronic eg stairs)

75
Q

Features of a Focal Seizure?

A
  • Abnormal activity starts focally and spreads across the brain
  • Or it stays focally
  • Symptoms depend on the function of the affected brain area
  • altered state of consciousness after the seizure has started.
76
Q

Which of the following are the two key features of the definition of epilepsy: Seizures that are:

  • Once off
  • Recurrent
  • Occur with a known cause
  • Unprovoked
A
  • Unprovoked and recurrent
77
Q

Which of these conditions is not associated with causing seizures?

  • Metabolic disorders
  • Infectious diseases
  • genetic disorders
  • Mild hypothermia
  • focal brain lesions due to stroke, tumour or head injury
A
  • Mild hypothermia
78
Q

What are some words used to describe a TLOC by patients?

A

Spell, Collapse, Blackout and Funny turn

79
Q

If the patient has not actually lost consciouness, which of the following is not related-type problem?

  • Light-headedness
  • Dizziness
  • Vertigo
  • Loss of balance
  • Narcolepsy
  • Muscle weakness
  • Psychiatric disturbances
A

Narcolepsy

80
Q

What two Cardinal Features are especially relevant for syncope and seizures?

A

Prodrome aka Context

Period after the event

81
Q

What three word classification can be used as an alternative information collection approach for syncope and seizures?

A

Before, During and After

82
Q

What is the typical cardiac syncope prodrome?

A

Typically no pro-drome, patient will not remember falling over/losing consciousness.

83
Q

What is not a characteristic of the tonic phase of a seizure?

  • Stiffening of limbs
  • Extension of back and limbs
  • Loss of postural tone
  • Eyes deviate upwards
  • May cry out involuntarily
A

Loss of Postural Tone

84
Q

Which of the following two characteristics apply to syncope but not to the clonic phase of seizures?

  • Generalized flexion contraction of muscles
  • Contractions alternate with relaxation
  • LOC usually less than 30 seconds
  • Convulsive movments can occur (usually only a few jerks)
  • LOC usually 1-2 minutes.
A

LOC usually lasts less than 30 seconds

Convulsive movements can occur but usually only a few jerks.

85
Q

Which two apply to both cardiac syncope and seizures?

  • Usually doesn’t occur when sitting or lying
  • Can occur while sitting or lying
  • Can occur during sleep
  • Self limiting
  • Lying flat assists recovery
A
  • Can occur while sitting or lying

- Self Limiting

86
Q

What are two common associated features are commonly found with syncope?

A

Pallor and Sweating

87
Q

Which two are descriptive of seizures?

  • Injury not common
  • injury may occur
  • injury common
  • protective reflexes are preserved
  • Muscle aches after the event
A
  • Muscle aches after the event

- injury common

88
Q

What could a “spell” be if there wasn’t a true LOC?

A

Vertigo
Disequilibrium
Pre-syncope
Non-specific dizziness

89
Q

Causes of Cardiac Syncope?

A

MI, Aortic Stenosis, Brady/Tacycardia, Arythmias

90
Q

Other causes of Seizures besdies epilepsy?

A

Recreational Drugs, Fever, Tumours, MI and strokes.

91
Q

Associated Features that diffentiate seizure from other TLOC?

A

Tongue biting, Head turning, Cyanosis, Cry or moan, Frothing at mouth, incontinence often occurs, usually not sweaty.

MD1 - FBS (12 decks)

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