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Progress Tests > PT33 > Flashcards

PT33 Flashcards

1
Q

If the tongue can’t move, which main nerve is probably involved? Which side does tongue deviate to?

A

Hypoglossal n. (CN VII)

Neuro exam = tongue deviates to weak side

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2
Q

Cause of nappy rash and therefore why bb powder

A

Candida albicans

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3
Q

Why no beta blockers in asthma

A

If block Beta2 receptors in airways causes bronchoconstriction in patients w asthma which is bad

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4
Q

What is pan systolic murmur vs ejection systolic murmur? What valves do they respectively involve and which side are they each heard best (YES there are two different valves involved)

  • Description of the murmur
  • What valve/condition?
  • Which side heard best?

(Edited 29th March 2024: this is more for CVS Clinical Skills!)

What are the things we have learnt in CVS bedside tutorial from Dr Kalpee?

A

Pan systolic murmur

  • Whooshing sound THROUGHOUT the interval between s1 - s2 and same level throughout systole
  • Mitral regurgitation
  • Heard best at apex and radiating to axilla

Ejection systolic murmur

  • Incresendo and then decrease, bascially increase in sound and then a decrease sorta thing through systole
  • Aortic stenosis
  • The aortic stenosis murmur is actually heard best on the left sternal border (where the pulomonary valve is usually ascultated)

From the CVS beside teaching
- heart sounds
Abbormal heart sounds = 3 and 4
But do not even hear 4th heart sound in atrial fibrillation

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5
Q

An adverse effect of beta blocker

A

Beta blocker can cause Hypotension

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6
Q

Chronic vs acute subdural bleed

A

Acute - crescent shape after trauma
Chronic - arteries rupture then bleed into subdural space over time see progressive confusion or less of consciousness

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7
Q

Brain meninges and their bleeds

A

Epidural - around dura mater, so a round shape on ct, between bone and dura, so enforced by the bone to push out on the dura

Subdural - crescent moon shape because between meninges and nothing hard to push off on, under dura, between dura and arachnoid

Subarachnoid - between arachnoid and pia mater, which is the space where blood vessels are, see more squiggly lines as pia mater lines all the folds of the brain

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8
Q

Why is difference between glomerular filtration rate and renal clearance? And what are normal values?

A

GFR = measure by amount of inulin as body get rid of inulin only by filtration ie by GFR = vol of blood/time that blood go thru glomerular capillaries thru bowmans corpuscle = how fast glo capillaries get blood thru bowman corpuscle
Need to be 60 or higher

Renal clearance = vol of plasma or blood for a substance to be removed / the time it takes = how fast it takes to remove that substance from plasma or blood
Blood Plasma = liquid that has no blood cells
90-130mL/min

So GFR is purely on speed and blood flow
Clearance is how fast to remove somethjng

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9
Q

Graves and Goitre hyper or hypothyroidism?

A

Hyper

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10
Q

Why are thyroid antibodies relevant?

A

Majority thyroid disorder is autoimmune which is primary thyroid disorders
Anti TPO antibodies
TSH receptor antibodies
Thyroglobulin antibodies

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11
Q

What is common cause of chronic liver damage and how can we tell it’s chronic damage?

A

Chronic alc use

Cirrhosis from fibrotic scan imaging and six months history of symptoms

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12
Q

How to diagnose Hep A (HAV)?

A

Detection of anti HAV IgM in blood
HAV is acute

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13
Q

What is normal GFR?

A

> = 120 mL/ min

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14
Q

What is borderline GFR?

A

60 ml / min

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15
Q

AKI vs CKI timeframe

A

Acute kidney injury is hours to days whereas chronic kidney injury is wks mnths yrs

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16
Q

What release renin in response to what

A

Juxtaglomerular apparatus releases renin
In response to decreased renal perfusion

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17
Q

RAAS stand for

A

Renin angiotensin ii and aldosterone system

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18
Q

What is renin what does it do

A

Renin is an enzyme
It incr pd of angiotensin and angiotensin ii

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19
Q

What does angiotensin ii do

A

Systemic vasoconstriction
Incr Na absorption in proximal tubule PT
Reduced GFR by contracting Mesangial cells and efferent arteriole

Therefore incr BP

Induces thirst
Stimulate inc pd of aldosterone

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20
Q

What does aldosterone do: why what how

A

Stimulated by:
- angiotensin ii
- potassium

Action
- on distal convoluted tubule DCT and collecting duct to increase sodium and therefore water reabsorption

How
- upregulating Na/K ATPase and ENaC

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21
Q

Gentamicin for what gram?

A

Gram neg eg e coli

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22
Q

Movement in Hand Median N

A

Thumb abduction

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23
Q

Movement radial nerve in hand

A

Finger joint extension so holding fingers straight

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24
Q

Movement ulnar nerve in hand

A

Finger abducation

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25
Q

Movement of C5

A

Shoulder Abduction, lifting up chicken wings movement

26
Q

Movement of C6 and 7

A

Adduction of shoulders, going down of the chicken wings
Test by resistance against adduction so examiner pushes up and get patient to adduct shoulders

27
Q

Movement C7

A

Elbow extension

28
Q

Movement C5,6

A

Elbow extension

29
Q

Movement C6 in hand

A

Wrist extension
Cock wrist up against resistance

30
Q

C6, 7 in hand

A

Wrist flexion

31
Q

Sacral plexus roots range and major branches

A

L4-S4
Superior gluteal
Inferior gluteal
Sciatic: fibula then tibial
Posterior femoral
Pudendal

32
Q

Femoral nerve in relation to sacral plexus

A

Femoral nerve most anterior and sacral plexus is posterior

33
Q

Path musculocutaneous n

A

Lateral, thumb, radius side, axilla to forarm

34
Q

Path Median n from axilla to in the hand

A

Upper arm: travel medially
Elbow: middle
Forearm: between radius and ulna since called Median n
Carpal bones / wrist: main n stops

In the Hand:
- palmar
- thumb
- index
- middle
- later side of 4th digit

35
Q

Path of Radial n to in the hand

A

Upper arm: goes posterior of arm through medial and lateral heads of triceps
Elbow: comes anterior at radial groove on humerus, lateral
Forearm: down radius, the lateral bone in thumb side

In the hand:
- posterior = the back of hand
- thumb
- Index
- Lateral half of middle

36
Q

Path ulnar

A

Arm: Runs medial posteriorly
Elbow: posteriorly to medial epicondyle
Forearm: medial, digiti minimi side

In the hand:
- Anteriorly = medial one and a half fingers
- Posteriorly = medial two and a half fingers

37
Q

Hip flexion nerve roots

A

L1,2

38
Q

Hip extension

A

L5 S1

39
Q

Leg adduction

A

L2,3

40
Q

Leg Abduction

A

L4,5

41
Q

Femoral n roots

A

L2-4

42
Q

Knee flexion

A

S1

43
Q

Knee extension

A

S3-4

44
Q

Ankle dorsiflexion

A

Bring ankle upwards, flexing back of foot - dorsi
L4

45
Q

Ankle plantarflexion

A

Plantar = pointing toes
S1-2

46
Q

Big toe

A

L5,
Arises from branches from both deep and superficial fibular

47
Q

Ankle inversion

A

L4

48
Q

Ankle eversion

A

L5 S1

49
Q

Nervous system ganglion versus nucleus

A

Collection of cell bodies - Somas
In the CNS = nucleus
In the PNS = ganglion - ie throughout the body

50
Q

CN III

A

Oculomotor
- Eyelids dilated
- Eyes down and out
- Pupil dilated and fixed

51
Q

CN IV

A

Trochlear
Superior oblique that when contracts moves eyes down snd out
- Eyes vertical diplopia, unable to look down and out, so eyes shift upwards

52
Q

CN V

A

Trigeminal
V1
- Eyes: no corneal reflex (afferent)

V
- Face: no sensation

V3
- Muscles and mastication: can’t move
- Jaw: deviates to weak side

53
Q

CN VI

A

Abducens
Lateral rectus
- Eyes can’t abduct - horizontal diplopia so eyes can look laterally

54
Q

CN VII

A

Facial
- Face: can’t move
- Eyes: no corneal reflex (efferent)
- Taste anterior 2/3: no taste
- Auditory: sounds appear super loud hyperacusis

55
Q

CN VIII

A

Vestibulocochlear
- Auditory: hearing loss, acoustic neuroma
- Eyes: nystagmus
- General: vertigo - feeling of spinning and diszziness

56
Q

CN IX

A

Glossopharyngeal
- No gag reflex (afferent)

57
Q

CN X

A

Vagus
- Uvula deviating away from lesion side
- No gag reflex (efferent)

58
Q

CN XI

A

Accessory
- Head and shoulder: weakness turning to contralateral side, so the side can’t turn is opposite to the side with the week nerve
Ie if can’t turn right, then nerve lesion is on the left

59
Q

CN XII

A

Hypoglossal
- Tongue deviates to weak side

60
Q

Long QT and electrolyte associations

A

Hypo K Ca and Mg

Progress Tests (4 decks)

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