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

Read more

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

The applications of Gentian violet

Gentian violet also known as Crystal violet, . it is methyl violet The name is due to its color, it like that of the petals of a gentian flower
BUT……….not made from gentians or from violets
When dissolved in water the dye has a blue-violet colour.
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Gentian violet’s common side effect is the staining of skin and cloth, but it can easily be washed off skin with a solution of bleach and water.
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-It is generally safe for use on children and breastfeeding mothers.
It can be applied to the mouth and lips of premature infants
– gentian violet can be use for thrush on the nipple.
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Applications :Gentian violet has antibacterial, antifungal, and anthelmintic properties .

-Tinea; e.g. Athlete’s foot, jock itch, and ringworm

-Candida albicans and related infections; e.g. thrush, yeast infections.

-Mouth ulcers

-Impetigo, used primarily before the advent of antibiotics, but still useful to persons who may be allergic to penicillin, as it cleans the open sores and prevents spread of the contagion.

– It will prevent infection in almost any wound or burn and quickly help the epithelium form a scab. It does not burn when applied and temporary skin discoloration is a minor side effect.

-Marking the skin for surgery preparation and allergy testing .

– Bacteria stained with crystal violet .

– The dye is also used as a histological stain, particularly in Gram’s method for classifying bacteria

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