UCL MBBS (Subject) / Core presentations (Lesson)

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• Sensory disturbance Numbness, tingling, pins & needles Lower limb Bilateral: Spinal cord level Disassociation → Brown-Sequard Hemiparesthesia: cortical Glove-and-stocking: length-dependent neuropathy Ant-post asymmetry: cauda equina syndrome Dermatome: radiculopathy Saddle sparing: internal cord compression
• Ainetic-rigidity DDX Idiopathic Parkinson's Parkinson-plus syndromes Multiple Systems Atrophy Progressive Supranuclear Palsy Corticobasal degeneration Drug-induced Vascular Genetic
• Lower-motor neuron signs Sites Radiculopathy Plexopathy Nerve axonal vs demyelinating mononeuritis (multiplex) polyneuropathy → diabetes&leprosy, glove'n'stocking distribution; length dependent Signs Wasting, fasciculations normal / decreased tone -- flaccid paralysis Decreased  power Decreased or absent reflexes
• Rigidity Lead pipe -- Parkinson, synkinesia Clasp knife -- spasticity: catch Cogwheel -- increased tone + resting tremor
• Kidney transplant Findings: Mass right illiac fossa, fistulae, PD scars DDx: Crohn's colitis Relevant questions Indication: Imunosuppression: Induction → maintenance; calcineuin Ix (tacrolimus), antimetabolite (azathioprine, mycophenolate mofetil), steroids Follow-up: Complications: acute / chronic rejection; failure
• Depression Hx ---
• Joint pain hx Trauma, septic, rheum, pseudo-/gout, OA Pattern Check skin and systemic features + risk factors, family history
• HIV Hx ---

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