OSCE Camp Neurological Tutorial for Medical Student Surat Tanprawate, MD, FRCPT Northern Neuroscience Center Department of Internal Medicine Chiangma...
Pediatric topic: Treatment Dengue 4th year MD student Somdej Sriracha hospital Burapha University
Descrição: Tutorial Pack Student ALTERDATA
survive
Descripción: health astro
nastranFull description
studentFull description
Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention,
Medical Mnemonics for Students
lecture on medical juris
Medical HypnosisFull description
astroFull description
medical negligenceFull description
Full description
Orgonomía
Neurological Tutorial for Medical Student Surat Tanprawate, MD, FRCPT Northern Neuroscience Center Department of Internal Medicine Chiangmai University
Topic Common short neurological case CSF interpretation
Common Neurological Short Case
OSCE Short cases • Facial weakness: Bell’s palsy • Entrapment neuropathy: Carpal tunnel syndrome Tremor: Parkinson’s disease, ET
Focus neurological examination • Ptosis • Uni- VS Bilateral Complete VS Incomplete • Extra-ocular movement •
• •
Resting and movement Distribution of eye movement
• Pupil • Normal, dilate, small
Interpretation Ptosis
Unilateral
Pupil
Dilate
EOM •Resting: •Movement: distribution of CN 3
Unilateral
Normal
•Resting: •Movement: distribution of CN 3
Unilateral, Incomplete ptosis
Small
•EOM: normal or plus CN 3,4,6 involved
Diagnosis CN III palsy from Post com a. aneurysm CN III palsy from Diabetes
Horner’s syndrome
Interpretation Ptosis
Bilateral
Pupil
Normal
EOM
Diagnosis
•Limited EOM distribution of • CN 3,4,6
•
facial weak
Myasthenia gravis
Tremor 1. Reading the instruction
5
Tremor 2. Key concept
1. Tremor 2.
Tremor 3 Parkinson’s disease
Essential tremor
Cerebellar tremor
3. Focus neurological examination
Type of Tremor: 3 &
1. Resting tremor
3. Focus neurological examination
Type of Tremor: 3
2. Postural tremor
3. Focus neurological examination
Type of Tremor: 3 Finger to nose test
3. Intention tremor
Resting tremor
•
signs
Tone cogwheel rigidity
•
Parkinson’s disease
Resting tremor
signs
• • •
Parkinson’s disease finger tapping
Bradykinesia
(stoop posture)
(festinating gait)
Resting tremor
signs
•
postural reflex
•
Postural instability
Parkinson’s disease
• • • •
Postural tremor signs
hyperthyroid lid retraction
Thyroid Heart Tachycardia?)
Pulse ( AF or
•
Intention tremor signs dysfunction
eye movement
cerebellar
nystagmus
rapid alternating movement: • dysdiadochokinesia?
•
tandem walk test: cerebellar gait ataxia tandem walk impair
Visual field defect 1. Reading the instruction
visual field, lesion
Visual field confrontation test
• •
(
) 4 quadrant
Report visual
Left Homonymous hemianopia Lesion at occipital lobe
Interpretation
Generalized muscle weakness Quadriparesis Lower extremity •Hip flex Hip addution and •abduction •Knee extension and flexion •Ankle dorsiflex and plantarflex
Upper extremity
Muscle testing DTR
•deltoid •bicep and tricep •wrist extensor and flexor •hand grip
Proximal m. weakness+ normal reflex: muscle disease, NMJ(MG) Distal muscle weakness+decrease reflex: polyneuropathy
CSF interpretation
CSF interpretation •
CSF profile
• Differential diagnosis • Treatment •
special test ex. Gram stain, AFB
• Interpret, diagnosis, treatment
CSF interpretation • General CSF profile • Open CSF pressure • Total cell count, differential cell count • CSF glucose/plasma ratio • CSF protein • Specific test • culture, stain: gram,AFB
