Bell’s Palsy

Bell's Palsy
Bell's Palsy
Rt
  1. Name 2 findings in the picture & what is the diagnosis
  2. What else do you want to examine and what is the site of lesion in this condition?
  3. How you will treat the patient?

Answer Sheet:

  1. Name 2 findings in the picture & what is the diagnosis?

http://en.wikipedia.org/wiki/Bells_palsy

Findings of Bell’s Palsy: (2)

  • Failure of wrinkling of forehead
  • Showing teeth- lips drawn to left
  • Drooping of right corner of mouth.
  • Nasolabial fold: Less pronounced

Diagnosis: Right sided Bell’s Palsy (The nerve of the effected side will be weaken, so lips drawn to opposite side)

  1. What else do you want to examine and what is the site of lesion in bell’s palsy?

  • Other examination:
    • Taste sensation in anterior 2/3rd of the tongue (Chorda tympani)
    • Palate and external auditory meatus to see any vesicle. (Ramsay Hunt syndrome)
    • Evidence of hyperacusis (reduced tolerance to sound).
  • Site of Lesion: within Facial canal in petrous part of temporal bone(in stylomastoid foramen).
  1. How you will treat the patient?

Treatment of Bell’s palsy:

  • Prednisolone 40-60mg daily for 7 days.
  • Aciclovir also recommended.
  • Artificial tear & ointment.
  • Physiotherapy

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Pneumothorax

X-Ray Pneumothorax
  1. X-Ray PneumothoraxWhat are your radiological findings?
  2. Name 4 clinical signs of this condition?
  3. Name 4 causes of this condition?
  4. Name the treatment option.

Answer Sheet:

  1. Left sided Pneumothorax
  2. Clinical Signs (4):
    1. Breathlessness
    2. Unilateral pleuritic chest pain
    3. On inspection: Restricted movement
    4. On palpation: Trachea & Apex beat shifted to the right (as Lt. sided)
    5. On percussion: Hyperresonance, but normal in right side. (as Lt. sided)
    6. On auscultation: Breath sound diminished or absent but vesicular in left side.
  3. Causes (4):
    1. Rupture of subpleural bleb
    2. Rupture of emphysematous bullae
    3. Chronic bronchitis with emphysema.
    4. Tuberculosis
    5. Traumatic: Chest wall injury

Name Some Premalignant Conditions

Premalignant Condition
Premalignant ConditionA) In skin:

 

  1. Xeroderma pigmentosa
  2. Solar actinic keratosis
  3. Marjolin’s ulcer
  4. Dysplastic nevi
  5. Leukoplakia
  6. Bowen’s disease
  7. Radiodermatitis
B) In Penis:

 

  1. Leukoplakia of penis
C) Female genital tract:
  1. Endometrial hyperplasia
  2. Cervical dysplasia
  3. Dysplasia of vulva
D) In Breast:
  1. Intra ductal epithelial hyperplasia
E) In Mouth:
  1. Leukoplakia
  2. Paterson-kelly syndrome
F) In Oesophagus:
  1. Barrette’s oesophagus
G) In Stomach:
  1. Chronic atropic gastritis
  2. Adenomatous polyp
  3. Chronic gastric ulcer
H) In Small Intestine:
  1. Crohn’s disease
I) In colon:
  1. Adenomatus polyp
  2. Chronic ulcerative colitis
J) In Liver:
  1. Cirrhosis of liver
K) Lungs:
  1. Bronchial metaplasia & dysplasia
L) In Thyroid gland:
  1. Auto immune thyroiditis
M) In Bone:
  1. Paget’s disease

Clinical Feature of brain tumours

Clinical Feature of brain tumours:
1) Headache
2) Nausea & Vomiting
3) Disturbed vision/ Blurred vision
4) Bradycardia
5) Hypertension
6) Papilloedema
++(1-6 c/f of raised ICP)

7) Progressive focal neurological deficit.
8) Deterioration of level of consciousness.
9) Organic mental changes.
10) Sezures.
11) Late onset of epilepsy.
[Ref: Bailey & Love’s 25th/631]

Causes of small intestinal bacterial overgrowth

A. (Due to Hypochlorohydria /Achlorhydria
• Pernicious anemia
• Partial gastrectomy
• Long term PPI therapy

B. Due to impaired intestinal motility
• Scleroderma
• Diabetic autonomic neuropathy
• Chronic intestinal pseudo obstruction

C. Due to structural abnormalities
• Gastric surgery
• Jejunal diverticulosis
• Enterocolic fistula
• Extensive small bowel resection
• Stricture (e.g. Crohn’s disease)

D. Due to impaired immune functions
• Hypogammaglobulinemia

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