ESSENTIALS OF NEUROLOGY
DRUGS THAT ARE AVOIDED IN MYASTHENIA GRAVIS
1 BETA BLOCKERS
2 CALCIUM CHANNEL BLOCKERS - VERAPAMIL
3 PROCAINAMIDE , QUINIDINE , QUININE
4 ANTI CONVULSANTS - PHENYTOIN , GABAPENTIN , CARBAMAZEPINE
5 ANTIPSYCHOTICS - PHENOTHIAZINE , LITHIUM
6 TIMOLOL
7 CHLOROQUINE
8 AMINOGLYCOSIDES , TETRACYCLINES , SULFONAMIDES , PENICILLIN , NITROFURANTOIN , FLUROQUINOLONES
Sites of lytic bone lesions
1 skull
2 ribs
3 pelvis
4 vertebrae
5 long bones
Different sites of neuropathy in lower limbs
1 sciatic neuropathy - compression by piriformis muscle
2 lateral femoral cutaneous nerve - along pelvis , exciting pelvisc
3 iliac crest and ASIS
4 peroneal nerve - fibular neck
5 tibial nerve - lancinate ligament ( tarsal tunnel )
WEIGHT RELIEVING ORTHOSIS
A ) PTB ORTHOSIS - HAS A PLASTIC CIRCUMFERENTIAL BRIM WHICH SUPPORTS SUBSTANTIAL LOAD ON PATELLAR LIGAMENT AND TIBIAL FLARE , LOAD IS TRANSMITTED TO SHOE BY METAL UPRIGHTS
INDICATIONS - FRACTURE FIBULA , FOOT GANGRENE
B ) ISCHIAL WEIGHT RELIEVING ORTHOSIS - USES A QUADRILATERAL BRIM OR ISCHIAL ( THOMAS ) RING TO TRANSFER FORCE FROM PELVIS ONTO UPRIGHTS OF BRACE FOR PARTIAL UNLOADING OF LEG
C ) PATTEN BOTTOM ORTHOSIS - USES UPRIGHTS THAT TERMINATE IN FLOOR PAD DISTAL TO SHOE
DEEP VEIN THROMBOSIS
1 REFERS TO THE FORMATION OF ONE OR MORE BLOOD CLOTS ( A BLOOD CLOT - THROMBUS ) ( MULTIPLE CLOTS - THROMBI ) IN ONE OF THE BODY LARGE VEINS ( MOST COMMONLY IN LOWER LIMBS ( LOWER LEG OR CALF )
2 VIRCHOW TRIAD - ENDOTHELIAL INJURY , ABNORMAL BLOOD FLOW AND HYPERCOAGULABILITY
3 HOMAN SIGN - PAIN IN CALF ON FORCED DORSIFLEXION
4 RISK FACTORS -
1 AGE MORE THAN 40 YRS
2 FAMILY HX OF DVT OR PE
3 PELVIC FRACTURES OR LOWER EXT FRACTURES
4 IMMOBILISATION OF MORE THAN 3 DAYS
5 OCP USE
6 PREGNANCY
7 RECENT SURGERY
5 DIFFERENTIATING FEATURE FROM CELLULITIS
A ) ABSENT HOMAN SIGN
B ) SUP TENDERNESS ONLY
C ) DOPPLER ULTRASOUND NEGATIVE
D ) D DIMER NEGATIVE
E ) PYREXIA
F ) SIGNS OF INFECTION
6 COMPLICATIONS
PULMONARY EMBOLISM
7 DOSE OF LWMH
PREVENTIVE - 40 m g subcutaneous once daily
THERAPEUTIC - 1 mg / kg / bw
8 DOSE OF WARFARIN
10 Mg on day 1 and 2 and 5 mg on day 3 then repeat INR
IN ELDERLY - 5 mg , 5 mg - check INR
9 DAYS FOR WHICH IT IS CONTINUED
A ) DISTAL DVT - 3 MONTHS
B ) PROXIMAL - 6 MONTHS
C ) RECURRENT - 6 MONTHS
D ) PE - 6 MONTHS