May 12 b doxycycline c streptomycin d vancomyin

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May 12) b) Doxycycline c) Streptomycin d) Vancomyin + Ceftriaxone 518
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Recommendations for empiric antimicrobial therapy for purulent meningitis based on patient age and specific predisposing condition : 519
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A 45 year old man presents with history of frequent falls. He has difficulty in looking down also. What is the most probable diagnosis - (AIIMS Nov 2000) a) Normal pressure hydro-cephalus b) Parkinson’s disease c) Alzheimer’s disease d) Progressive supranuclear palsy 520
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History of frequent falls and difficulty in looking downwards suggests the diagnosis of progressive supranuclear palsy. 521
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“This is a disorder of Basal ganglia. ” . The structures involved are:- - Globus pallidus - Subthalamic nucleus - Substantia nigra - And other brainstem nuclei 522
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Clinical features:- The clinical picture of typical progressive supranuclear palsy is unmistakable. Most patient present with the following two characteristic clinical futures:- - Most common presenting feature is the difficulty in walking with rapid development of falling typically within a year of onset. - The second salient feature is the development of supranuclear downgaze palsy. 523
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Besides these two characteristic abnormality patient also presents with other variable extrapyramidal symptoms particularly dystonia of the neck and other features resembling pseudo bulbar palsy which are dysarthria , dysphagia. • Sometimes when characteristic features of supranuclear palsy are late to develop, then it may be confused with parkinsons disease. 524
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The features which help to differntiate it from Parkinsons disease are:- - Early falling - Rarity of tremor - Axial rigidity (cervical dystonia) - Lack of response to l-dopa 525
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In steel richardson syndrome following are seen except- (PGI-DEC97) a) Convulsion b) Ataxia c) Progressive supranuclear palsy d) Dementia 526
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The illness is progressive and is characterized by - - Akinesia axial rigidity, - Postural imbalance, - Dysarthria, - A supranuclear paralysis of voluntary vertical eye movements and - Mental changes, with onset in middle or later life. Mental function is impaired6 the patient gives an impression of dementia with difficulty memory and loss of intellectual power. 527
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In steel richardson syndrome following are seen except- (PGI-DEC97) a) Convulsion b) Ataxia c) Progressive supranuclear palsy d) Dementia Convulsion is not a feature of Steel- Richardson syndrome. 528
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PARKINSONS DISEASE 529
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All are features of Parkinson's disease, except - (Sep 96) a) Resting tremors b) Brady or hypokinesia c) Rigidity d) Preserved postural reflexes 530
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531
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Parkinson’s Tremor:- . Classical rest tremors (most noticeable at rest) . Less prominent or absent with action or posture.
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  • Winter '16
  • jean grey

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