Neuro-opthalmology Flashcards

1
Q

signs of optic nerve dysfunction?

A
decrease in visual acuity
visual colour impairment
visual field defects
diminished contrast sensitivity
RAPD
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2
Q

what is dyschromatopsia?

A

visual colour impairment

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3
Q

charcot’s triad of cerebellar dysfunction?

A

tremor
dysarthria
ataxia

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4
Q

describe uhthoff phenomenon

A

worsening of symptoms due to increase in temperature such as exercising or hot showers

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5
Q

autonomic features of MS

A

bladder
bowel
sexual dysfunction

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6
Q

a decreased visual acuity visual field defect is also called….

A

a central scotoma

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7
Q

Tx for optic neuritis?

A

methylprednisolone IV followed by oral prednisolone

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8
Q

GCA can cause what eye problem?

A

arteritic anterior ION

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9
Q

who gets non-arteritic AION

A

patients >50

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10
Q

what artery is occluded in AION?

A

short posterior ciliary artery

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11
Q

causes of non-arteritic AION?

A

idiopathic
hypertension
diabetes
sleep apnoea

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12
Q

sudden painless unilateral visual loss….

A

AION

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13
Q

does arteritic or non-arteritic AION have a higher risk of the other eye being affected?

A

arteritic

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14
Q

Tx of non-arteritic AION?

A

treat cause

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15
Q

Tx of arteritic AION?

A

high dose methylprednisolone IV

oral prednisolone + aspirin

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16
Q

what kind of visual loss presents in papilloedema?

A

transient visual loss lasting seconds

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17
Q

most common cause of horner’s in children

A

trauma

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18
Q

a painful horner’s syndrome should raise suspicion of…

A

carotid dissection

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19
Q

Ix for horners

A

apraclonidine to dilate pupils

CT/MRI for dissection

20
Q

define adie’s pupil?

A

loss of postganglionic parasympathetic innervation to the iris sphincter and ciliary muscle

21
Q

who gets adie’s pupil?

A

young females

22
Q

features of adie’s pupil?

A

anisocoria (left pupil larger) and blurs on near vision

light reflex absent

23
Q

Ix of adie’s pupil?

A

slit lamp

0.125% topical pilocarpine into both eyes (if affected pupil constricts = positive)

24
Q

bilateral, irregular, small pupils that dont react to light?

A

argyll robertson pupil

25
Q

an argyll robertson pupil will do what reflex correctly?

A

accomodation reflex

26
Q

ipsilateral 3rd nerve palsy with contralateral hemiparesis….

A

webers syndrome

27
Q

ipsilateral 3rd nerve palsy with contralateral tremor, ataxia, chorea….

A

benedikt’s syndrome

28
Q

main causes of CN4 palsy?

A

trauma

congenital

29
Q

clinical features of CN4 palsy?

A

vertical diplopia (check for head tilt)
hypertropia
can’t depress eye (SO not working)

30
Q

CN6 palsy features

A

horizontal double vision
esotropia
limited abduction

31
Q

what eye movement is decreased in CN6 palsy?

A

abduction

32
Q

most common cause of CN6 palsy

A

diabetes
hypertension
increases ICP

33
Q

pathophysiology of myaesthenia gravis?

A

autoimmune disease of ACh receptors at post-synaptic NM junctions

34
Q

who primarily gets myaesthenia gravis?

A

females in their 30s

35
Q

myaesthenia affects ___ muscle

A

skeletal

36
Q

what muscles are affected first in myaesthenia gravis?

A

smaller muscles

37
Q

presenting features of myaesthenia gravis?

A
bilateral ptosis worse at end of day
lid twitch
diplopia
opthalmoplegia
weakness of face and proximal limb muscles
38
Q

Ix of myaesthenia gravis?

A

ice test (See if ptosis improves after 2 mins)
antibodies
EMG
muscle biopsy

39
Q

Tx of myaesthenia gravis

A

pyridostigmine (ACh-esterase)
steroids
immunomodulators

40
Q

delayed muscle contraction and muscle wasting with ptosis and hypermetropia…

A

myotonic dystrophy

41
Q

what are lisch nodules and what condition are they found in?

A

hamartomous pigmented lesions protruding above the iris

NF1

42
Q

cataracts present in what NF type

A

NF2

43
Q

what happens in benign essential blepharospasm?

A

involuntary contraction of the orbicularis oculi muscle

44
Q

Tx of benign essential blepharospasm?

A

artificial tears

botox injection

45
Q

the lateral wall of the cavernous sinuses contain what cranial nerves (specifically)?

A

3, 4, CNV1, CNV2

46
Q

features of cavernous sinus syndrome?

A

features of CN 3 4, 5 loss