Prep 1 Flashcards
A 35-year-old woman is moving spontaneously and opening her eyes but uttering only unintelligible sounds. Her husband reports that she has been unwell for about 48 hours. She initially seemed lethargic and a bit vague. This morning her speech was hesitant, and she had difficulty finding the words she was looking for. She has now had 2 generalized tonic-clonic epileptic seizures. She has previously been in good health. Her temp is 39.9 degrees
herpes simplex encephalitis
What is often first damaged in diabetic neuropathy?
dorsal column (fine touch, vibration and conscious proprioception)
Pain on eating or shaving
trigeminal neuralgia
Nerve supply to quadraceps?
Femoral nerve
Nerve supply to lateral thigh?
lateral cutaneous nerve of the thigh
Nerve damage when doing IM injection at buttock?
sciatic nerve
What does sciatic nerve divide into at popliteal fossa?
tibial nerve (posterior compartment) common peroneal nerve (anterior and lateral compartments)
What supplies web space of great toe?
deep peroneal nerve
What are the accessory muscles of inspiration and innervation?
sternocleidomastoid and scalenous CN XI (accessory nerve)
What is the recurrent laryngeal nerve a branch of?
CN X (vagus)
Where do the left and right recurrent laryngeal nerves loop?
Left under arch of aorta
Right under right subclavian artery
CNXII palsy?
tongue deviates to affected side
Tremor with past pointing and unsteady gait
cerebeller
Resting tremor that disapears when stretching out hand
PD
Part of the brain that controls temperature?
hypothalamus
Muscle that raises eyebrows and innervation?
frontalis muscle
Facial nerve CN VII
Muscles of mastication innervation?
trigeminal V3
Visual field defect by pituitary adenoma compressing optic chiasm?
bitemporal hemianopia
Nerve supply to medial aspect of the shin?
L4 saphenous nerve (femoral)
Sensory nerve fibres associated with dull aching pain?
C fibres
What part of the brain is involved in motor actions without conscious control?
cerebellum
What pathophysiological cause of headache is suggested when headache is worse in the morning and on bending forward, coughing, sneezing, streaming and lying down?
raised intracranial pressure
What is L-dopa metabolised to?
dopamine
used in PD
What side does fine touch ascend?
ipsilateral (dorsal columns)
What CSF finding supports SAH 6 hours post headache?
xanthochromia
Previous hx of optic neuritis, new onset sensory disturbance from T11 downwards. Significant right leg weakness, loss of proprioception and vibration. Left leg numbness and loss of pain and temperature
MS
Dermatome lateral border of the foot
S1
Dermatome in perianal area
S5
Sudden severe headache
SAH until proven otherwise
Micrographia is a feature of?
PD
What causes adam’s-strokes attacks?
lack of blood to the brain due to arrythmias (heart block)
Head injury months previously and now increasingly confused?
chronic subdural haematoma
test to distinguish haemorrhagic stroke from ischemic
CT
What drugs can impair folate absorption and lead to macrocytic anemia?
phenytoin
carbamazpine
barbiturates
Bacterial meningitis following splenectomy
S.pneumoniae
Nerve commonly damaged by slipped disc?
L5
Rigidity, bradykinesia, resting tremor and intention tremor. Ataxia and positive babinskis
Multi system atrophy
Build up of urophorphinogen
Porphyria cutanea tarda
Child crying in direct sunlight
erythropoietic protoporphyria
Slapped cheek
Parvovirus 19
Cluster of shiny red/purple papules with fine white streaks. Itchy. Often on flexor surfaces of arm?
Lichen planus
Exclamation point hair?
allopecia
1st line treatment for acne rosacea
topical metronidizole
1st line treatment for acne vulgaris
topical retinoid (isotretinoin) or benzoyl peroxide
What conditions are ass with koebner phenomenan?
psoriasis
lichen planus
vitiligo
Management of impetigo?
topical fusidic acid or oral flucloxacillin if severe
Difference between impetigo and erysipelas?
both are superficial skin infections
impetigo caused by staph aureus
erysipelas caused by strep pyogenes (GAS)
What is cellulitis?
deeper dermal infection of skin and soft tissue
caused by strep pyogenes (GAS) and staph aureus
Crepitus in the skin?
gas in the skin caused by CO2 produced by anaerobic bacteria in necrotising fascitis
What causes staphlococcal scalded skin syndrome?
epidermolytic exotoxin A&B released by staph aureas
odland bodies
granular layer
polyhedral cells with lots of desmosomes
prickle cell layer
commonest sweat gland on the face, role in temperature, moistens palms and soles for grip
eccrine
gland affected in acne, androgen surge at puberty stimulates sebum, maintains skin barrier
sebaceous glands
scent gland
appocrine
hard and densely packed keratin similar to hair
nails
Phases of hair growth
anagen
catagen
telogen
transient pressure sensation
pacinian corpuscles
pain and temperature sensation
free nerve endings
tactile, light touch and vibration sensation in hairless skin
meissners
light touch located in hair follicles
merkel discs
Waterproof layer of skin
keratin
regulation of temperature in skin
blood vessels
location of vitamin d metabolism
keratinocytes
when do sweat glads develop
at 6 months
where are nuclei lost
granular layer
hyperkeratosis
increased thickness of keratin layer
parakeratosis
retention of nuclei in keratin layer
acanthosis
thickening of epidermis
spongiosis
oedema between keratinocytes
Ash leaf macule
Tuberose sclerosis
What virus causes warts?
HPV
What is mild acne?
facial open and closed comedomes
Management of cellulitis
flucloxacillin (doxycyclin if pen allergic)
Management of necrotising fasciitis
surgical debridement
Management of ringworm
clotrimazole cream or terbinafine orally if extensive
Management of candida skin infections
clotrimazole cream
oral fluconazole
oral nystatin
Treatment of scabies
permethrin cream
or malathion lotion ( not in pregnancy or <6months)
Treat all family member
Apply to skin for 24hrs
Treatment options for lice
malathion (toxic)
dimeticone (non-toxic, coats the lice)
combing
Common HPV in wart, genital warts and cervical Ca?
Warts/verrucas 1-4
Genital warts 6&11
Cervical Ca 16&18
Management options for warts/verrucas?
self resolving
cyrotherapy >7yrs
topical salicyclic acid (keratolytic)
What is ramsey hunt syndrome?
reactivation of VZV in geniculate ganglion (nerve cell bundle of facial nerve)
Most common skin cancer in the UK
BCC
Purple lesions on elbows in elderly man
lichen planus
