All of the following conditions that affect the trigeminal nerve present with signifi cant sensory loss EXCEPT:
B. Trigeminal neuralgia is characterized by episodic shooting pain in facial areas supplied by trigeminal nerve. It often follows specific sensory triggers in the trigeminal zone, for example shaving one’s beard, brushing teeth, etc. It is often idiopathic though at times cases of arteriovenous malformations in brainstem around the site where the trigeminal nerve exits the brain stem have been found. An essential feature of trigeminal neuralgia is that objective signs of sensory loss cannot be demonstrated on examination. All the other choices present with trigeminal neuropathy, which is characterized by an objective sign of sensory loss in the distribution of the division of the trigeminal nerve involved.
Reference:
Which of the following is a cause of bilateral facial nerve palsy?
E. Causes of bilateral facial palsy include granulomatous and connective tissue diseases such as systemic lupus erythematosus, Sjögren’s syndrome, sarcoidosis; infections such as meningitis, encephalitis, mastoiditis, leprosy; neoplasms, including pontine glioma and meningioma; trauma resulting in fracture of the temporal bone and birth injury. Miscellaneous known causes include prenatal exposure to thalidomide and chronic diabetes.
A patient known to have bipolar illness is on lithium.
Which of the following will prompt you to check his lithium levels?
C. Lithium toxicity results in two major groups of symptoms – neurological and gastrointestinal. Delayed ankle jerk is secondary to hypothyroidism. Hypothyroidism in lithium users correlates with pre-existent tendency to develop antithyroid antibodies. This is not dependent on the dose of lithium administered. Coarse (4 to 7 Hz) rather than fi ne (8 to 12 Hz) tremors indicate lithium toxicity. The fine postural tremor associated with lithium therapy decreases with longer duration of treatment. Alopecia is independent of serum lithium levels.
Which one of the following is a physical sign noted in anorexia nervosa?
A. Lanugo hair is thin, infantile hair noted on the torso and limbs of severely anorexic patient. Alopecia areata is an autoimmune skin lesion.
Sleep spindles and K complexes on electroencephalogram (EEG) are seen in which of the following phase of sleep?
C. During sleep, the body goes through two types of physiological states. This has been divided into REM and NREM phase according to EEG studies. NREM is further divided into four stages. At stage 1 smaller slower waves of theta frequency are noted. Stage 2 consists of K complexes and sleep spindles. Stages 3 and 4 are called slow wave sleep as they show dominant delta activity. Stage 3 consists of less than 50% delta activity while stage 4 consists of more than 50% delta waves. REM sleep is comprised of saw-tooth activity. In adults, 75% of sleep is NREM.
Click to expand