a) List six clinical features associated with myotonic dystrophy. (30% marks)
b) List five clinical signs of severity in chronic aortic regurgitation. (25% marks)
c) List three causes of coma with bilateral miosis. (15% marks)
d) List six clinical features of lateral medullary syndrome. (30% marks)
a) Question 30.1 from the first paper of 2017 also asked for six clinical features of myotonic dystrophy. Fourtunately, there's plenty to choose from:
One might expect that features suggestive of severity in chronic AR would be mainly features related to the effect of AR on cardiac function, not just generic features of AR
Generic features of AR are as follows:
From the wording of the question, it is not clear that the trainees were expected to know what these signs were; i.e. to list the eponyms would have been enough to pass. Their meaning is discussed elsewhere, in case anybody is interested
c) Bilateral miosis with coma:
d) The latery medullural syndrome (Wallenberg syndrome) consists of the following classical findings:
Mudge, Barbara J., Peter B. Taylor, and Abraham FL Vanderspek. "Perioperative hazards in myotonic dystrophy." Anaesthesia 35.5 (1980): 492-495.
Turner, Chris, and David Hilton-Jones. "The myotonic dystrophies: diagnosis and management." Journal of Neurology, Neurosurgery & Psychiatry 81.4 (2010): 358-367.
Sato, Hiromasa, Kosuke Naito, and Takao Hashimoto. "Acute isolated bilateral mydriasis: case reports and review of the literature." Case reports in neurology 6.1 (2014): 74-77.
Thomas, P. D. "The differential diagnosis of fixed dilated pupils: a case report and review." Critical Care and Resuscitation 2.1 (2000): 34.