STATION 1 Hydrocephalus (a) Give three clinical features of hydrocephalus (3) (b) Give two common causes of communicating hydrocephalus (2) STATION 2 Spina Bifida (a) List signs suggestive of spina bifida occulta (3) (b) List two other congenital anomalies associated with spina bifida (2) STATION 1 & STATION 2
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STATION 1 & STATION 2 … · Papiledema Change in LOC ophthalmoplegia • B. Meningitis + SAH (d/t aneurysm rupture) Station 2 A. Skin lesions in midline – Dimple – Sinus tract
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STATION 1
Hydrocephalus (a) Give three clinical features of hydrocephalus (3) (b) Give two common causes of communicating hydrocephalus
(2)
STATION 2
Spina Bifida (a) List signs suggestive of spina bifida occulta (3)
(b) List two other congenital anomalies associated with spina bifida (2)
STATION 1 & STATION 2
Station 1
• A) 1. Children with open fontanels – Bulging anterior fontanel
– Splayed sutures
– Distended scalp veins
– Craniofascial disproportion
– Macrocrania
2. Adults and older kids: headache that gets progressively worse
Vomit
Papiledema
Change in LOC
ophthalmoplegia
• B. Meningitis + SAH (d/t aneurysm rupture)
Station 2
A. Skin lesions in midline
– Dimple
– Sinus tract
– Hemangioma
– Tuft of hair
– Hyperpigmentation
• B. Chiari Malformation and Hydrocephalus
• Syringomylia
• Intellectual impairment
STATION 3
Trauma Resuscitation
A. Describe principles of resuscitation in primary survey of a polytrauma patient
(3)
B. List two factors associated with poor prognosis in a head injured patient
(a) What are the clinical features of base of skull
fracture? (4)
(b) What is the diagnosis
on the CT scan shown below (1)
• A. Depends on if is anterior or middle cranial fossa # – Anterior fossa: racoon eyes, CSF rhinorrhea, subconjunctival hemorrhage (entire eye), asomnia
• B: Initial Fluid: Crystalloid – Ringers Lactate (2L) – good resus fluid (isotonic to plasma with similar electrolyte content) but short intravascular half life – Run fast, after this blood should ideally be available for further resus
– * if not can alternate between colloids (voluven) and crystalloid (RL)
STATION 4
• Patient was assaulted with a sharp object and sustained laceration with brain injury.
• (a) What is the diagnosis? (2)
• (b) How will you treat the patient?
(3)
• A. Skull fracture of vault (linear? Depressed?)
• B. ATLS priniciples – Airway: Px hypoxia
– Breathing: prevent hypoxia
– Circulation: Px hypotension
Clean wound + suture closed
Refer to Neurosurgery!!!
Station 5
Mr X, 56 years old, presented with seizures and progressive weakness on the left side of the body. Describe/interpret the scan (5)
• 1. Check date, pt name, scan orientation – check from outside to inside taking into account all structures. I will focus on the lesion:
• Located on the Right (frontal and parietal???)
• Not cross midline.
• No mass effect visible on this specific section.
• Tumor has various densities and not homogenous on enhancement