Stroke syndrome

Adapted from Neurology Journal

Some said this blog is too simple. Just a challenging one.

Hint : It is a stroke

1) Where is the lesion ?

2) What is the syndrome called ?

PACES

Meningitis

MCQ QUESTION !

Which of the following is not part of the empirical treatment of bacterial meningitis

A) IV Ceftriaxone

B) IV Dexamethasone

C) IV Hydrocortisone

D) IV Ampicillin

E) IV Cefotaxime

4th MRCP PACES Preparatory Course 2010 Penang

APPLICATION FOR PARTICIPATION CLOSED . 3 June 2010.

It has been sometime since I last wrote. It has been a busy year. Neurology is a wonderful field. It makes you grow more grey matter and white hair.

It is the time of the year again. Well, this year a little early because some of us will be going to Kuala Lumpur soon.

This year the course will be in Penang General Hospital, 31 July 2010 to 1 Aug 2010.

Sits are limited !!

Thank you for the quick response. We have exceeded the number of candidates.

The course is confirmed to be only 2 days - On the 31st July 2010 and 1st August 2010

4^th PENANG MRCP PACES COURSE TIMETABLE

VENUE : ACC BUILDING PENANG GENERAL HOSPITAL

Day 1 (Saturday, 31^st July 2010)

	Abd A	Abd B	Resp A	Resp B	CVS A	CVS B	Hx A	Hx B
0800 – 0830		REGISTRATION
0830 – 0900		BRIEFING
0900 – 0945	1a	1b	2a	2b	3a	3b	4a	4b
0945 – 1030	1b	1a	2b	2a	3b	3a	4b	4a
1030 – 1115	4a	4b	1a	1b	2a	2b	3a	3b
1115 – 1200	4b	4a	1b	1a	2b	2a	3b	3a
1200 – 1230		BOEHRINGER	LUNCH	TALK
1230 – 1330			LUNCH
1330 – 1415	3a	3b	4a	4b	1a	1b	2a	2b
1415 – 1500	3b	3a	4b	4a	1b	1a	2b	2a
1500 – 1545	2a	2b	3a	3b	4a	4b	1a	1b
1545 – 1630	2b	2a	3b	3a	4b	4a	1b	1a

Day 2 (Sunday, 1^st August 2010)

	CNS A	CNS B	COMM A	COMM B	St 5 A	St 5 B
0830 – 0930			LECTURE	(PROF	RAYMOND)
0930 – 1030	A1	A2	B1	B2	C1	C2
1030 – 1130	A2	A1	B2	B1	C2	C1
1130 – 1230	C1	C2	A1	A2	B1	B2
1230 – 1330	C2	C1	A2	A1	B2	B1
1330 – 1430			LUNCH
1430 – 1530	B1	B2	C1	C2	A1	A2
1530 - 1630	B2	B1	C2	C1	A2	A1
1630 – 1700			FEEDBACK

Dermatology Symposium

Hi !! Guess the picture on top ! If you can't or can, pls attend this symposium :)

Department of Dermatology, Penang General Hospital will organise Penang Dermatology Symposium at Auditorium, Ambulatory Care Center (ACC) Penang General Hospital on 8^th – 9^th May 2010 (Saturday-Sunday).

The symposium is organised in collaboration with PGMES, Hospital Pulau Pinang, Dermatological Society of Malaysia (PDM) and Faculty of Dermatology, Academy of Medicine, Malaysia

Penang Dermatology Symposium is specially dedicated to doctors with special interest in Dermatology. This symposium is opened to all doctors (both government & private).

The aims for this event are to provide a regular continuous medical education (CME) programme in dermatology for practicing practitioners and to provide an update of various topics in dermatology.

Please help us to spread the news to all doctors in your practising hospital and your friends.

Thank You

Regards,

Dr Tan Wooi Chiang

Department of Dermatology

Hospital Pulau Pinang

CONTACT

MA Lim Tong Sun

SN Siti Rafeah

Department of Dermatology

Hospital Pulau Pinang,

Tel: 04-2225250

Fax: 04-2281737

Clubbing

It's been some while since I last wrote. I have been busy with Neurology. Well, this patient is a 60 years old Malay man who was admitted to my ward with progressive L sided weakness over a week. He is non toxic looking and there is no stigmata of chronic liver disease. He has been a chronic smoker. To tell the truth, I was rather upset that 2 of my house officers could not come to a conclusion even after I mentioned the gross clubbing in this patient.

I hope medical students reading this will practice what has been learned in medical student years.

This is a clear cut case of Ca lung with metastasis to the brain.

What I would like to stress here is - Do not forget the causes of clubbing !

Respiratory :

Ca lung

Pulmonary fibrosis

Bronchiectasis

Chronic suppurative lung diseases

Cystic fibrosis

CVS :

Congenital cyanotic heart disease

Eisenmenger syndrome

Infective endocarditis

GI :

Chronic liver disease (Cirrhosis)

Inflammatory bowel disease

Thyrotoxicosis (pseudoclubbing - acropachy)

Plantar Response - Other than Babinski

Other than Babinski sign, what other signs do you know ?

In upper motor neuron lesion, the big toe will dorsiflex with the following :

Gordon reflex – On applying pressure to the muscle of the calf

Oppenheim sign – on applying heavy pressure with thumb and index finger to the shin, stroking downwords from below the knee down to the ankle

Bing reflex – when the dorsum of the toe is pricked with a pin

Schaefer reflex – pinching the Achilles tendon sufficiently to cause pain

Chadock reflex – on stroking the lateral side of the foot, beginning below the malleolus and extending anteriorly along the dorsum of the foot to the base of the big toe

Gonda reflex – grasping the small toes between the fingers, slowly and forcibly flexing the toe and then suddenly releasing the toe

I know an MRCP examiner who likes to ask this question. Try practicing it !  Physical examination is the most crucial step in Neurology.