YEAR 5 QUICK REVISION

Question 1

Motor Tracts - name, modality & decussation

Answer 1

Corticospinal - motor
Cross in medulla

Question 2

Sensory (ascending) tracts - name, modality & decussation

Answer 2

DCML - fine touch, vibration, proprioception, cross in medulla
Spinothalamic - crude touch, pressure, pain & temperature, cross at level of spinal cord

Question 3

Cerebellar features on examination

Answer 3

'’DANISH’’
- Disdiadokinesis
- Ataxia
- Nstagmus
- Intention tremor
- Speech; slurring, staccato
- Hypotonia

Question 4

Management for Ventricular Tachycardia

Answer 4

Amiodarone

Question 5

Management for Narrow Complex Tachycardia

Answer 5

Regular: vagal manoeuvres –> adenosine –> verapamil or beta blocker —> syn DC cardioversion
Irregular (= probable AF): rate control with beta blocker, digoxin/amiodarone if in HF, anticoagulant if >48hrs

Question 6

PSA - Digoxin Details

Answer 6

ADVERSE EFFECTS
* Bradycardia
* Rash
* GI disturbances
* Arrhythmias - toxicity
* Dizziness
* Visual changes
○ Blurred/yellow vision

INDICATIONS
* Used in AF, atrial flutter & severe HF

MOA
* Reduces HF & increases force of contraction

RENAL
Reduced dose needed

CONTRAINDICATIONS & CAUTIONS
* 2nd degree or complete heart block
* At risk of ventricular arrhythmias
* Caution in electrolyte disturbances
○ hypoMg, hypoK or hyperCa

INTERACTIONS
* Loop & thiazide diuretics - hypoK
* Amiodarone
* CCB
* Spironolactone
* Quinine

MONITORING
* Best for effect = SYMPTOMS + HR
* ECG - check esp in acute illness or medication changes
○ ST depression can occur