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Y3 MedEd > CN and Opthalmology > Flashcards

CN and Opthalmology Flashcards

(85 cards)

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1
Q

Conditions that affect all CN (7)

A 
Diabetes mellitus
MS
Tumours
Sarcoid
Vasculitis
Systemic lupus erythematosus
Syphilis
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2
Q

Anosmia differentials (5)

A 
Ageing 
Traumatic Brain Injury
Parkinson’s
Alzheimer’s
Tumour
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3
Q

In which patients is anosmia more likely to be due to a tumour

A

Young patients

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4
Q

What is supposed to be prodromal of Parkinsons

A

Change in sense of smell

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5
Q

Which disease is a change in sense of smell meant to be prodromal of

A

Parkinsons

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6
Q

What suggests loss of vision due to MS (3)

A

Over a few hours
Painful
Young

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7
Q

What does sudden loss of vision suggest the cause is

A

An infarct

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8
Q

What are the differentials for loss of visual acuity (7)

A 
Refractive error
Ocular Media
cataracts 
diabetes
Retina
age related macular degeneration 
diabetic retinopathy
Optic neuropathy
MS
ischaemia
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9
Q

Which reason for loss of visual acuity is often bilateral

A

Age related macular degeneration

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10
Q

What is pink eye known as

A

Conjunctival hyperaemia

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11
Q

Bacterial conjunctivitis signs (4)

A

Unilateral
Thick discharge
Reduced vision
Urethritis/vaginal discharge

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12
Q

Viral conjunctivitis signs (4)

A

Bilateral
Watery discharge
Normal vision
Signs of viral infection (fever/lymphadenopathy)

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13
Q

Causes of allergic conjunctivitis (3)

A

pollen
dust
Chemical scents

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14
Q

What type of reaction is allergic conjuctivitis

A

T1 hypersensitivity IgE mediated

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15
Q

Which Ig is allergic conjunctivitis

A

IgE

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16
Q

If a patient complains of visual halos what does this suggest

A

Cataracts

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17
Q

What must you rule out in an acutely red painful eye

A

Closed angle glaucoma

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18
Q

What sign is seen on opthalmoscopy of glaucoma

A

Cupping of the optic disc

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19
Q

4 features of open angle glaucoma

Bi/unilateral
Onset
Pain
Associated symptoms

A

Bilateral
Progressive visual loss
Initially asymptomatic
Mild nonspecific symptoms

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20
Q

7 features of closed angle glaucoma

Bi/unilateral
Onset
Pain
Associated symptoms (4)

A

Unilateral
Sudden onset
Severely painful
N&V, cloudy cornea, head, dilated pupil

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21
Q

Anterior or posterior uveitis is associated with AI disease

A

Anterior

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22
Q

Which diseases are associated with and which type of uveitis (6)

A

Anterior

seronegative spondyloarthropathies, RA, sarcoidosis, SLE, IBD and Bechet’s

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23
Q

Anterior or posterior uveitis is associated with infective disease

A

Posterior

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24
Q

Infective causes of (and which type of) uveitis (6)

A

Posterior

CMV, EBC, VZV. Bacteria like syphilis and TB,

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25
Difference between anterior and posterior uveitis (3)
Anterior: Associated with AI conditions Painful ocular hyperaemia Increased lacrimation and photophobia Posterior: Infective causes Painless Floaters and scotomata
26
Prechiasmal main causes of loss of visual field (2)
Ischaemia | Inflammation
27
Chiasmal main causes of loss of visual field (2)
Pituitary tumour | Craniopharyngioma
28
Which lobe is damaged in neglect syndrome
Contralateral parietal lobe
29
Which 4 reflexes can you test in the eye
Direct pupillary Consensual pupillary Swinging light Accommodation
30
Which nerve detects light
Optic
31
Which nerve/s constrict the pupil
Parasympathetic and oculomotor
32
Which nerves are responsible for dilatation
Sympathetic
33
Which diseases have a Marcus Gunn pupil
Optic neuritis | Also optic neuritis MS
34
Horners differentials (3)
Carotid artery dissection Pancoast tumour Brainstem stroke/tumour
35
Triad in Horner's (3)
Ptosis Miosis Anhidrosis
36
Why is there is miosis and ptosis in Hormers
Ptosis as sympathetic supply is disrupted | Miosis as parasympathetic constriction of pupil is now unopposed
37
How can a brainstem stroke give Horner's
Sympathetic supply originates from hypothalamus and travels down brainstem, so therefore brainstem stroke or tumour can give Horner’s
38
Cause of medical third nerve palsy
DM
39
Cause of surgical third nerve palsy
Raised ICP | Rupture of aneurysm
40
What is internuclear ophthalmoplegia a sign of (2)
MS | Stroke
41
Corneal reflex afferent and efferent arms
Corneal reflex (afferent: V1, efferent VII)
42
Jaw jerk reflex afferent and efferent arms
Jaw-jerk (afferent: V3, efferent: motor V)
43
Causes of Bells palsy (4)
idiopathic compression of facial nerve within the facial canal inflammation, e.g. viral infection herpes simplex type 1 or varicella zoster
44
RF for Bells palsy
Diabetes
45
Which virus can result in Bells palsy
HSV1
46
Ix for Bells palsy
Serology
47
Mx of Bells palsy
Prevent corneal abrasions | Steroids - prednisolone
48
What is Ramsay Hunt syndrome
LMN facial nerve palsy due to varicella zoster
49
What causes Ramsay Hunt syndrome
Varicella zoster
50
Which other nerves can Ramsay Hunt syndrome affect and what can that cause
other cranial nerves like 8 – giving deafness and vertigo, also results in pain and vesicles on tongue, hard palate
51
Which age does Ramsay Hunt affect
Over 60
52
Which disease is caused by a reactivation of chicken pox (Varicella Zoster)
Ramsay Hunt syndrome
53
Forehead affected facial droop is caused by...
Bells palsy
54
Does UMN or LMN problems allow forehead sparing
UMN e.g. strokes for example
55
Which test is Rinne and which is Webers
Webers is in the middle of your forehead
56
Describe the results of a Webers test
Should normally be audible equally from both sides In conductive hearing loss it is louder towards the deficit In sensorineural loss it lateralises away from the deficit
57
Describe the results of a Rinne's test
AC > BC If BC > AC there is a conductive hearing problem and we use Weber to figure out which ear and if there is a combined loss
58
If Rinne in both ears is normal but Weber lateralises towards an ear what does that suggest
Sensorineural loss in the opposite ear
59
Causes of conductive hearing loss (3 external auditory canal, drum, 2 middle ear, oval window))
EAC Wax Foreign body Otitis externa Drum Perforation Middle ear Acute otitis media Serous otitis media OW Otosclerosis
60
Ways you can have sensorineural hearing loss (5)
``` Inflammation Tumour Ototoxic drugs Trauma Menieres disease ```
61
Examples of ototoxic drugs (3)
Aminoglycoside (gentamycin) antibiotics Aspirin (overdose) Loop diuretics
62
Examples of tumour causing sensorineural hearing loss
Acoustic neuroma
63
What causes of inflammation can cause sensorineural hearing loss (4)
Meningitis | MMR
64
``` Neurofibromatosis T1: Inheritance Gene Chromosome Presentation (5) Other features (3) ```
``` Inheritance Autosomal Dominant Gene NF1 Chromosome 17 Presentation Café-au-lait spots Freckling in skin folds Neurofibromas Lisch nodules Spinal scoliosis Other features Short stature Mild intellectual disability ```
65
Main 5 presentations of neurofibromatosis T1
``` Café-au-lait spots Freckling in skin folds Neurofibromas Lisch nodules Spinal scoliosis ```
66
``` Neurofibromatosis T2: Inheritance Gene Chromosome Presentation (3) Other features (2) ```
``` Autosomal Dominant NF2 22 Sensorineural hearing loss Bilateral acoustic neuromas Symptomatic by age 20 No/fewer café-au-lait spots Tinnitus/vertigo possibly ```
67
Main 3 presentations of neurofibromatosis T1
Sensorineural hearing loss Bilateral acoustic neuromas Symptomatic by age 20
68
What is the triad of Menieres disease
sensorineural hearing loss, vertigo and tinnitus
69
What result suggests sensorineural loss in the right ear
Normal Rinne in both ears and Weber lateralises left
70
What result suggests sensorineural loss in the left ear
Normal Rinne in both ears and Weber lateralises right
71
What result suggests conductive loss in the right ear
Rinne right BC>AC | Weber lateralises right
72
What result suggests conductive loss in the left ear
Rinne left BC>AC | Weber lateralises left
73
What result suggests combined conductive and sensorineural loss in the left ear
Rinne left BC>AC | Weber lateralises right
74
What result suggests combined conductive and sensorineural loss in the right ear
Rinne right BC>AC | Weber lateralises left
75
What does a negative Rinnes test suggest
Conductive loss
76
What does a Webers test suggest
Sensorineural loss
77
``` Bulbar palsy: Gag reflex Tongue (2) Palatal movement Jaw jerk Speech Emotions Other: ```
``` Gag reflex – absent Tongue – wasted, fasciculations Palatal movement – absent Jaw jerk – absent or normal Speech – nasal Emotions – normal Other – signs of the underlying cause, e.g. limb fasciculations. ```
78
``` Pseudobulbar palsy: Gag reflex Tongue Palatal movement Jaw jerk Speech Emotions Other: ```
Gag reflex – increased or normal Tongue – spastic Palatal movement – absent Jaw jerk – increased Speech: “a monotonous, slurred, high-pitched, ‘Donald Duck’ dysarthria”  Emotions – labile Bilateral upper motor neuron (long tract) limb signs
79
Which is LMN disease bulbar or pseudobulbar palsy
Bulbar
80
Which is UMN disease bulbar or pseudobulbar palsy
Pseudibulbar
81
Causes of pseudo bulbar palsy (3)
Stroke of internal capsule MS Motor neuron disease
82
Causes of bulbar palsy (2)
Motor neuron disease | Guillain-Barre
83
Which nerves are affected in bulbar palsy
V VII X XI XII
84
Which nerves are affected in bulbar palsy
X XI XII
85
Which changes emotions and how does it change them, bulbar or pseudo bulbar palsy
Pseudobulbar has labile emotions

Y3 MedEd (34 decks)

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