66 results
Upper Motor Neuron (UMN) lesions are lesions occurring anywhere in the CNS from the brain up
Motor Neuron (UMN ... However, in UMN ... UMC & LMN lesions ... UMN lesions are ... #LMN #Muscleweakness
Incomplete spinal cord syndromes (ISCS)
 • Central - Small Lesion - Suspended sensory deficit, classic cape
Disproportionate motor (UMN ... Ipsilateral weakness (UMN ... small band of LMN ... paraparesis (mixed UMN ... and LMN types)
Bilateral LMN palsy with tongue weakness, wasting and fasciculations.  →  Bulbar motor Neuron disease

Note
Bilateral LMN palsy ... differentiates this from an UMN ... fasciculations #LMN
Amyotrophic Lateral Sclerosis (ALS) Summary
ALS: combination of the clinical examination finding of amyotrophy with the pathologic
involving both UMN ... combination of UMN ... sclerosis with pure UMN ... involvement • UMN ... combination of UMN
Generalized Weakness - Differential Diagnosis Framework
"l feel weak":
 • Infectious: Influenza, EBV, PNA, Bacteremia, Sepsis
 •
Infection • Neuro: UMN ... stroke, tumor), LMN
Causes of Proximal Muscle Weakness That May Mimic Inflammatory Myopathy
 • Central or peripheral neurologic disease
#Proximal #MuscleWeakness
Spontaneous Bacterial Peritonitis
DIAGNOSTICS
Paracentesis: 
 • Calculate absolute PMN count (total WBC x PMN %)
 • Correct
Calculate absolute PMN ... count (total WBC x PMN ... %) • Correct PMN ... RBCs (subtract 1 PMN ... 50mg/dL, LDH > ULN
Liver Function Test (LFTs) Elevation
AST - Cardiac and skeletal muscle, kidney, brain
ALT - More specific for
Phosphatase, ALT ≥ 3x ULN ... Transaminase, ALP ≥ 2x ULN ... Value = (ALT / ULN ... ALT) / (ALP / ULN
Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis
Spontaneous Bacterial Peritonitis
 • Cirrhosis (high SAAG)
) + ascites w/ PMN ... glucose < 50, LDH ULN
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Severe ALT > 15x ULN ... Moderate ALT 5-15x ULN ... Mild ALT < 5x ULN