Ear, Eye

Question 1

D/Ds for triad: sensorineural hearing loss, vertigo, tinnitus

Answer 1

Meniere disease: recurrent vertigo

acoustic neuroma (CN VIII schwannoma): persistent and progressive rather than episodic

Question 2

Pearly mass behind tympanic membrane

Answer 2

cholestetoma

Question 3

bluish black gelatinous mass behind tympanic membrane

Answer 3

cholesterol granuloma after hemorrhage

Question 4

weakest bone in orbit

Answer 4

medial and inferior

Question 5

Astigmatism

Answer 5

Abnormal curvature of cornea →different refractive power at different axes

Question 6

Untreated strabismus leads to ______

Answer 6

unilateral visual cortex suppression to avoid diplopia → amblyopia (↓ visual acuity)

Question 7

Aqueous humor Produced by ______

Answer 7

nonpigmented epithelium on ciliary body

Question 8

↑IOP leads to death of ____ cells

Answer 8

ganglion

Question 9

Closed- or narrow angle glaucoma
Primary:
secondary:

Answer 9

Primary—enlargement or anterior movement of lens against central iris (pupil margin}

Secondary—hypoxia from retinal disease (eg, diabetes mellitus, vein occlusion) induces vasoproliferation in iris that contracts angle

Question 10

Acute angle closure glaucoma presentation:

Answer 10

Very painful, red eye , sudden vision loss, halos around lights, frontal headache, fixed and mid-dilated pupil, nausea and vomiting

Question 11

Anterior segment:

Answer 11

Anterior chamber + posterior chamber

Question 12

Posterior segment:

Answer 12

Vitreous chamber

Question 13

hypopyon (accumulation of pus in ______ )

seen in ____

Answer 13

anterior chamber

uveitis

Question 14

Most common cause of blindness in people >50 in US is _____

Answer 14

Age-related macular degeneration

Question 15

Age-related macular degeneration causes _______ and eventual loss of ______

Answer 15

distortion (metamorphopsia)

central vision (scotomas)

Question 16

Fundoscopic findings in wet AMD:

Answer 16

Greyish green subretinal discoloration with adjacent fluid/hemorrhage

Question 17

Retinal vein occlusion
Blockage of central or branch retinal vein due to ______

appearance ____

Answer 17

compression from nearby arterial atherosclerosis.

“blood and thunder appearance”

Question 18

Retinal detachment : Visualized on fundoscopy as _____

Answer 18

crinkling of retinal tissue and changes in vessel direction.

Question 19

Retinitis pigmentosa deposits are ——– shaped

Answer 19

Bone spicule-shaped deposits

Question 20

Papilledema is the swelling of _______

mechanism:

Answer 20

Optic disc

build up of pressure compresses optic nerve externally → impaired exoplasmic flow within optic nerve → bilateral optic disc edema (papilledema)

Question 21

Leukocoria: Important causes in children include _____

Answer 21

retinoblastoma, congenital cataract, toxocariasis.

Question 22

Painful horner syndrome

Answer 22

3rd neuron: carotid dissection (painful)

Question 23

Only cranial nerve that decussate before innervating its target

Answer 23

CN IV

Question 24

Pupil is higher in the affected eye

Answer 24

CN IV damage

Question 25

Affected eye is displaced medially in primary position of gaze

Answer 25

CN VI damage

Question 26

Hypertropia and extortion seen in

Answer 26

CN IV damage

Question 27

Binasal hemianopia caused by

Answer 27

calcified carotid arteries, congenital hydrocephalus, bilateral atherosclerosis or aneurysms of the internal carotid arteries

Question 28

In INO _______ eye displays nystagmus

Answer 28

Abducting | (CN VI overfires to stimulate CN III)

Question 29

Directional term (eg, right INO, left INO) refers to the eye that is unable to ______

Answer 29

adduct.

Question 30

Anti-histamine side effects on eye:

Answer 30

1. loss of accomodation (muscarinic receptors on ciliary muscles 2. Pupillary sphincter → pupillary dilation