You have an emotionally labile patient in the department who sounds like 'Donald duck'. Before rounding up some students to 'pimp' you decide to test yourself on bulbar and pseudobulbar palsies so that you don't get caught out...
4 more scenarios for Peter Gates Brainstem Rule of 4. Neurological lesion identification and neuro examination quiz
4 more scenarios for Peter Gates Brainstem Rule of 4. Neurological lesion identification and neuro examination quiz
You are asked to review a 65 year-old man who is comatose (GCS 3) with small pupils (2 mm bilaterally). He has a history of diabetes mellitus and bipolar disorder. He was discharged from hospital yesterday, following a surgical procedure.
Refractory shock in trauma is still most likely due to occult ongoing haemorrhage; shock may be due to the underlying cause of trauma e.g. MI leading to car crash
Apply ATLS/APLS protocol: primary survey to exclude life-threatening injuries, secondary survey, re-evaluation and definitive care.
Consider a 45 year-old HIV positive male with right hemiparesis and fluctuating conscious state. His CT head is shown below.
Cyanide is a potentially lethal toxic agent that can be found in liquid and gaseous form. First discovered in 1786 by Scheele, who extracted it from the dye Prussian blue - and promptly died from exposure to the vapours
Salicylate poisoning: mechanisms of toxicity: acid-base disturbance, uncoupling of oxidative phosphorylation, disordered glucose metabolism
Standardised Mortality Ratio SMR is the ratio of the observed or actual hospital mortality and the predicted hospital mortality for a specified time period.
Diaphragmatic Palsy: unilateral can be asymptomatic depending on patients underlying respiratory reserve; bilateral -> most mechanical ventilation dependent
Palmar erythema is a non-specific finding characterised by a redness of the palmar skin.