08-29-2009, 07:38 PM
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googlelover high yield concepts: step2CKdiscussion - googlelover
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08-29-2009, 07:38 PM
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09-01-2009, 09:47 AM
medial medullary syndrome
corticospinal tract lesion, XII lesion and posterior cord fibres( vibration and postion sense) all three gone so hemiplegia, tounge deviation loss of position and vibration sense and if it extends to pons then it gives the medial pontine syndrome which is just the extension of the medial medullary but the invoved cranial nerves differ like VI and VII instead of XII great fun isnt it ??????
09-01-2009, 10:07 AM
and dont forget it is due to vertebral artry damage and all findings are on opposite side(contralateral) of lesion except tongue deviation(ipsilateral)
09-01-2009, 12:46 PM
Lateral medullary syndrome and lateral pontine syndrome
Lateral so the lesion spare the medial structures like corticospinal, and facilis gracilis and cuneatus connections so no hemiplegia (this is the big clue) but to remember : pain and tempr sensation is gone( ipsilateral on face,contralateral on lower parts) vertigo diplopia,nystagmus and vomiting ( VIII involved,vestibular system gone ) Dysphagia and Hoarseness ---Vagus and Gloss gone Horner syndrome (whenever you see that one then put lateral medullary blidnly!!!!!!!!!!!!) Ataaxia oh yes cerebellar signs are there as well Good news is it will be the same in lateral pontine syndorme but no XII,IX or Vestibualar involvement instead Vths is involved) Cannot remember them all............
10-20-2009, 06:48 AM
you are right. this is little bit complicated.
the test has 80% sens. & 90% spec. prevalence of 10%: let us imagine that the total population is 100 80% sens: so 8/10 true+ and test + (10 out of 100 diseased people; 2 FN and 8 TP) 90% specificity : 81/90 true - test - (90 out of 100 healthy people; 81 TN and 9 FP) now PPV is a piece of cake. 8/17=47% |
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