OSCE questions

Case report : 

https://afrin125.blogspot.com/2023/12/pre-final-case.html

LEARNING POINTS : 

1.I learnt importance of history taking .

2. Difference between cerebellar ataxia and sensory ataxia .

3.I  learnt about Bppv .

4.evaluation of proprioception and vibration sensations

5.I learnt about  types of vertigo.

6.Vertebrobasillar insufficiency caused by fluorosis/spondyloarthopathy leading to intermittent vertigo (similar to angina) 

7.i learnt about CNS examination.

OSCE QUESTIONS : 

1.Difference between sensory ataxia and peripheral ataxia : 


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046926

2.Vertebrobasilar insufficiency is a condition characterized by poor blood flow to the posterior (back) portion of the brain, which is fed by two vertebral arteries that join to become the basilar artery. Blockage of these arteries occurs over time through a process called atherosclerosis, or the build-up of plaque.

Symptoms :

loss of vision in one or both eyes

double vision

dizziness or vertigo ( most common)  

numbness or tingling in the hands or feet

nausea and vomiting

slurred speech

Ataxia

changes in mental status, including confusion or loss of consciousness

sudden, severe weakness throughout your body, which is called a "drop attack"

loss of balance and coordination

difficulty swallowing

weakness in part of your body

Two vertebral arteries joins to form basilar artery. 

3.Patient is from a fluorosis  endemic area . Endemic fluorosis refers to that individuals living in a region characterized by high levels of fluorine in the drinking water; food and/or air are thereby exposed to excessive amounts of this ion that resulted in general chronic accumulated fluorosis among many of them.

https://pubmed.ncbi.nlm.nih.gov/3295994/

4.How fluorosis mimics cervical spondylosis :

Skeletal fluorosis can mimic various arthritis such as rheumatoid arthritis, osteoarthritis or spondyloarthropathy.The early stages of the disease may be asymptomatic or present as vague pain in the neck or back with rigidity, arthralgia and paraesthesia in the limbs,achilles tendinitis, and early morning stiffness

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9450208/

5.Cervical spondylosis is a progressive degenerative changes that affect all the components of cervical spine ( intervetebral discs,  joints..) in  general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs).

Cervical spondylosis is very common and worsens with age. More than 85% of people older than age 60 are affected by cervical spondylosis.

https://pubmed.ncbi.nlm.nih.gov/31855384/

6.How cervical spondylosis causing vertebrobasilar insufficiency :

 Vertebrobasilar insufficiency usually occurs in the presence of atherosclerosis or cervical spondylosis but symptoms can also arise when there is intermittent vertebral artery occlusion induced by extreme rotation or extension of the head. This mechanical compression of the vertebral arteries can occur along with other anomalies, including cervical osteophytes, fibrous bands, and osseous prominences.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC493808/


Comments

Post a Comment

Popular posts from this blog

65 F postural dizziness and vomiting

Image
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio . CASE :            65 year old housewife from Nalgonda Chief complaints-dizziness and  Vomiting 5 episodes 3 days ago History of present illness-  Patient was apparently alright 1 year back then developed vomiting associated with giddiness and pain. she came to our hospital and vomiting subsided with treatment. She was asked to take Vertin 24 (betahistine) at discharge. she took the medication for 3 months and then stopped after consulting with her physician. She had mild episodes of vomiting for the next months until 3 days
Read more

General medicine assessment

    General medicine assignment                                    125 Afrin shaik                                                      ( 3rd sem ) Question . 1    1 Case: Pulmonology  :  https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html       As chief complaints are pedal edema facial puffiness and shortness of breath for the past 15 days .As far the examinations done and investigations revealed that she is suffering from an exacerbation of COPD along with right heart failure associated with bronchiectasis.  2Case : Neurology    https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html   As the patient has been presented to the hospital with chief complaints of irrelevant talking and decreased food intake for 9 days .after lab investigations and radiological reports and the person is diagnosed with wernickes encephalopathy secondary to chronic alcohol dependence. Wernickes area is normal in the temporal lobe on the left side
Read more