Pulmonary stenosis
25 Pulmonary stenosis Instruction Examine this patient’s heart. Salient features History • Patients may be asymptomatic. • Ask if there is a history of maternal rubella. • Dyspnoea on exertion…
Atrial septal defect
22 Atrial septal defect Instruction Examine this patient’s heart. Listen to her heart. Salient features History Ostium secundum defect (anatomically in the region of the fossa ovalis) • Asymptomatic particularly…
Cauda equina syndrome
91 Cauda equina syndrome Instruction This patient has bowel and bladder dysfunction; examine the lower limbs. Salient features History • Ask the patient whether there is pain (usually projected to…
Tetraplegia
89 Tetraplegia Instruction Carry out a neurological examination of this patient’s lower limbs. Salient features History • Ask about bladder symptoms and check sacral sensation • Ask about radicular pain…
Winging of the scapula
87 Winging of the scapula Instruction Look at this patient’s back. Salient features History • Difficulty in raising the arms above the level of the shoulders • Winging of the…
Bilateral spastic paralysis (spastic paraplegia)
36 Bilateral spastic paralysis (spastic paraplegia) Instruction Carry out a neurological examination of this patient’s lower limbs. Salient features History • Ask about onset, duration and course of symptoms •…
Wallenberg’s syndrome (lateral medullary syndrome)
86 Wallenberg’s syndrome (lateral medullary syndrome) Instruction Examine this patient’s cranial nerves. Salient features History • Severe nausea, vomiting, nystagmus (involvement of the lower vestibular nuclei) • Limb ataxia (involvement…
Bulbar palsy
85 Bulbar palsy Instruction Examine this patient’s cranial nerves. Ask the patient a few questions. Test this patient’s speech. Salient features History • Ask the patient about nasal regurgitation, dysphagia…
Pseudobulbar palsy
84 Pseudobulbar palsy Instruction Examine this patient’s cranial nerves. Salient features History • Ask the patient whether there is difficulty in swallowing or nasal regurgitation • Any changes in speech…
Hemiballismus
79 Hemiballismus Instruction Look at this patient. Salient features History • Sudden onset • Cardiovascular disease for source of emboli: atrial fibrillation, valvular heart disease or severe left ventricular dysfunction….
