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Step 1 2019 First Aid Flashcards > Neuro - FA Patho Eye/Ear p520 -531 > Flashcards

Neuro - FA Patho Eye/Ear p520 -531 Flashcards

1
Q

Most common cause of conjunctivitis?

A

viral is most common, esp adenovirus

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2
Q

Extra ocular symptom of viral conjunctivitis?

A

swollen preauricular node

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3
Q

What is astigmatism?

A

Abnormal curvature of cornea –> different refractive power at different axes. Correct with cylindrical lens.

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4
Q

Why does presbyopia happen?

A

dec lens elasticity, changes in lens curvature, dec strength of ciliary m

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5
Q

Where is the light focused, in terms of retina, in the case of hyperopia and myopia?

A

In hyperopia, light focused behind retina, and in myopia light is focused in front of the retina

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6
Q

Presbyopia leads to an issue with ?

A

accommodation

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7
Q

Bacteria causing conjunctivitis?

A

H. influ, Chlamydia(follicular type), N gon

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8
Q

Causes of Neonatal conjunctivitis?

A

N. gonorrhea, HSV-1, Chlamydia - neonatal

Children - Measles ( the 3Cs coryza, conjunct., cough) Reactive arthritis.(Reiter syndrome)

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9
Q

What happens in cataracts

A

Painless, often bilateral, opacification of lens , often resulting in glare and dec vision, especially at night

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10
Q

long use of what drugs can lead to cataracts

A

excess alcohol use, or prolong corticosteroid use

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11
Q

Congenital risk factors of cataracts

A

classic galactosemia, galactokinase deficiency, trisomies (13, 18, 21), ToRCHeS infections (eg, rubella), Marfan syndrome, Alport syndrome, myotonic dystrophy, neurofibromatosis 2.

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12
Q

Optic disc atrophy with cupping?

A

Glaucoma

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13
Q

How does Diabetes lead to lens opacification?

A

Inc gluc in the lens –> sorbitol via aldose reductase, and also to fructose. Both fructose and sorbitol will stimulate water influx –> osmotic cell injury, lens becomes opaque

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14
Q

Open angle glaucoma is more common in which patient population?

A

African American

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15
Q

Cause of secondary closed angle glaucoma?

A

Hypoxia from retinal disease, like DB or vein occlusion - induces vasoproliferation in iris that contracts angle

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16
Q

halos, rock hard eye, frontal headache are symptoms of what

A

Glaucoma - acute closure

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17
Q

Chronic closure glaucoma - symptoms?

A

Mostly asymptomatic, but over time can lead to CN II issues, especially loss of periph vision

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18
Q

which ND is associated with early onset glaucoma?

A

Sturge Weber

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19
Q

explain the pathophysio behind early onset glaucoma in sturge weber

A

ipsilateral leptomeningeal angioma & episcleral hemangioma –> inc IOP –> early onset glaucoma

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20
Q

2ndary causes of open angle glaucoma

A

blocked trabecular meshwork from WBCs (eg, uveitis), RBCs (eg, vitreous hemorrhage), retinal elements (eg, retinal detachment).

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21
Q

Diseases associated with uveitis?

A

systemic inflammatory disorders - sarcoidosis, rhematoid arthritis, juvenile idiopathic arthritis, PAIR (HLA-B27) arthritides

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22
Q

Collection of pus in the anterior chamber is seen in ?

A

uveitis

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23
Q

What causes metamorphopsia and loss of central vision?

A

Age related macular degeneration - distortion and scotomas

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24
Q

In dry macular degeneration, what collects in the eye?

A

—Deposition of yellowish extracellular material (“Drusen”) in between Bruch membrane and retinal pigment epithelium

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25
Q

What makes wet macular degeneration wet - how to tx?

A

n due to bleeding 2° to choroidal neovascularization.
Treat with anti-VEGF (vascular endothelial growth factor) injections (eg, bevacizumab, ranibizumab).

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26
Q

What is seen in this picture? what are the arrows pointing to?

A

DB retinopathy
retinal hemorrhages

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27
Q

What is this a picture of?

What are the arrows pointing to?

A

HTN retinopathy
macular star = red arrow (exudate)

cotton wool spots = blue arrow

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28
Q

What is this a picture of?

A

Retinal v occlusion

arrows point to engorged veins and hemorrhage

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29
Q

Two types of DB retinopathy and describe them

A

Non proliferative - damaged capillaries leak blood –> lipids and fluid seep into retina –> hemorrhages and macular edema

Proliferative - chronic hypoxia result in new blood vessel formation with then traction on the retina

30
Q

Arrows in this photo point to?

A

crinkling of retinal tissue seen in retinal detachment

31
Q

What causes retinal vein occlusion?

A

compression from nearby arterial atherosclerosis

32
Q

What are the signs of retinal vein occlusion?

A

Retinal hemorrhage, venous engorgement, edema in affected areas

33
Q

Which two layers of the retina separate in retinal detachment?

A

Seperation of the rods and cones layers (neurosensory layer) from the outer pigmented epithelium

34
Q

Why the vision loss in retinal detachment?

A

Due to degeneration of photoreceptors

35
Q

Retinal breaks are more common in patients with a history of what?

A

high myopia or history of head trauma

36
Q

First symptoms that indicate retinal detachment?

A

“flashes” and “floaters” (from posterior vitreous detachment) and monocular loss of vision - like a “curtain drawn down”

37
Q

secondary causes of retinal detachment?

A

retinal breaks, DB traction, inflammatory effusions

38
Q

This sign is seen in what disease that isn’t congenital?

A

Central retinal a occlusion

Cherry red spot also seen in Neiman Pick and Tay Sachs

39
Q

Painless, progressive vision loss beginning with night blindness (rodsaffected first). (Inherited)

A

Retinitis Pigmentosa

40
Q

Bone spicule–shaped deposits around macula

A

Retinitis Pigmentosa

41
Q

Enlarged blind spot and
elevated optic disc with blurred margins, is due to?

A

Papilledema, Inc ICP

42
Q

Loss of red reflex in children due to?

A

in children include retinoblastoma, congenital cataract, toxocariasis.

43
Q

What is a Marcus Gunn pupil?

A

DEC bilateral pupillary constriction when light is shone in affected eye relative to unaffected eye

44
Q

How does one test for Marcus Gunn pupil?

A

Swinging flashlight test

45
Q

Causes of Horner syndrome by neuron?

A

ƒ 1st neuron: pontine hemorrhage, lateral medullary syndrome, spinal cord lesion above T1 (eg, Brown-Séquard syndrome, late-stage syringomyelia)
ƒ 2nd neuron: stellate ganglion compression by Pancoast tumor

ƒ 3rd neuron: carotid dissection (painful)

46
Q

To test the left superior oblique and inf oblique musc, which direction should pt look?

A

Obliques go Opposite (left SO and IO tested with patient looking right)

47
Q

Causes of CN III damage?

A
  • Ischemia –> pupil sparing (motor fibers affected more than parasympathetic fibers)
  • ƒ Uncal herniation –> coma
  • ƒ PCom aneurysm
  • ƒ Cavernous sinus thrombosis
  • ƒ Midbrain stroke
48
Q

Sx of CN III motor damage

A

ptosis, “down-and-out” gaze.

49
Q

If PANS is also affected along with motor inn in CN III, what added sx do you see

A

diminished or absent pupillary light reflex, “blown pupil” ( along with ptosis and down and out gaze)

50
Q

What disease lead to motor or PANS affected CN III

A

If just motor - usually vascular disease, if PANS, those fibers are on periphery and affected by compression (PComm, uncal herniation)

51
Q

Sx of CN VI damage

A

Pupil is higher in the affected eye, head tilt

52
Q

Sx of CN VI damage

A

Affected eye unable to abduct and is displaced medially

53
Q

Infections associated with retinitis?

A

CMV (HHV5) (HIV/immunocompromised), Toxoplasmosis (congenital), HSV, VZV

54
Q

Retinal edema and necrosis leading to a scar?

A

Retinitis

55
Q

Cause of retinal occlusion?

A

Atrial fibrillation

56
Q

Meyer loop is responsible for what part of retina? and what vision loss?

A

inferior –> Pie in the sky ( upper quadrantic anopia)

57
Q

Meyer loop

  1. which lobe
  2. what vision defect
  3. what blood supply
A
  1. temporal
  2. upper quadrantic anopia
  3. MCA
58
Q

you lesion the optic tract, what visual defect?

A

Homnoymous hemianopia
**** optic tract is in frontal lobe is supplied by MCA

59
Q

What else can cause Homnoymous hemianopia?

A

LGB complete lesion

60
Q

Meyer loop loops around?

A

Inferior horn of lateral ventricle

61
Q

Sx of cavernous sinus syndrome

A

—presents with variable ophthalmoplegia, dec corneal sensation, Horner syndrome and occasional decreased maxillary sensation.

62
Q

Cavernous sinus syndrome caused by?

A

2° to pituitary tumor mass effect, carotid-cavernous fistula, or cavernous sinus thrombosis related to infection.

63
Q

Why do you see optic neuritis in MS?

A

CN II is only nerve myelinated by oligodendrocytes

64
Q

What eye gets nystagmus in R-MLF lesion in L gaze?

A

L
Explanation: Abducting eye gets nystagmus (CN VI overfires to stimulate CN III)

65
Q

When you say this patient has R INO, it means what?

A

R eye paralyzed

66
Q

Bilateral INO seen in

A

MS, stroke

67
Q

what neurocutaneous dz is associated with optic gliomas?

A

NF type 1

68
Q

clinical symptom of lesions in frontal eye fields?

A

eyes look toward lesion

69
Q

what area is associated with extraocular movement during REM sleep?

A

paramedian pontine reticular formation

70
Q

what are the component of the outer ear

A

Pinna, auditory canal and eardrum

71
Q

what conducts and amplify sound from ear drums to inner ear

A

ossicles

Step 1 2019 First Aid Flashcards (63 decks)

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