First Aid pg 480-484 Neuro Flashcards Preview

FIRST aid 2015 - Sahaja > First Aid pg 480-484 Neuro > Flashcards

Flashcards in First Aid pg 480-484 Neuro Deck (52):
1

What primarily renal drug affects aq humor? how?

carbonic anhydrase inhibitors, dec formation

2

Which drugs dec the production of aq humor?

BB (timolol, other non sel BB), alpha agonists, carbonic anhydrase inhibitors

3

Which drugs inc out flow of aq humor?

Prostaglandin F2 alpha (+)'r - latanoprost, travoprost
Cholinomimetics - pilocarpine, carbachol

4

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

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

5

Why does presbyopia happen?

dec lens elasticity, dec collagen IV

6

How does DB lead to lens opacification?

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

7

Which drug can lead to cataracts?

Long term corticosteroid use

8

Which enzyme def leads to cataracts?

galactokinase, galactose 1 phosphate uridyltransferase

9

Which of the trisomies can lead to cataracts?

all of them

10

What AD disease of chromosome 22 can lead to juvenile cataracts? What other tumors come with?

NF2 - comes with bilat acoustic schwannomas, meningiomas, ependymomas

11

What AD disease of chr 15 lead to cataracts and also have a frontal fold closure issue?

Marfan syndrome

12

What disease leads to nephritis, hearing problems, and cataracts later in life? What molecule is affected?

Alport syndrome, collagen IV

13

Optic disc atrophy with cupping?

Glaucoma

14

Open angle glaucoma is more common in which patient population?

African American

15

Cause of secondary closed angle glaucoma?

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

16

Why not give epi in acute closure glaucoma?

Mydriasis makes it worse

17

halos, rock hard eye, frontal headache

Glaucoma - acute closure

18

Most common cause of conjunctivitis?

viral is most common, esp adenovirus

19

Extra ocular symptom of viral conjunctivitis?

swollen preauricular node

20

Diseases associated with uveitis?

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

21

What causes metamorphopsia and loss of central vision?

Age related macular degeneration - distortion and scotomas

22

Two types of DB retinopathy and describe them

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

23

Tx for Non-prolif DB retinopathy?

blood sugar control, surgery

24

Tx for Proliferative DB retinopathy?

Peripheral retinal photocoag, surgery, anti-VEGF (Bevacizumab)

25

What causes retinal v occlusion?

compression from nearby arterial atherosclerosis

26

What are the signs of retinal v occlusion?

Retinal hemorrhage, venous engorgement, edema in affected areas

27

Which two layers of the retina separate in retinal detachment?

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

28

How does retinal detachment look on fundoscopy ?

crinkling of retinal tissue and changes in vessel direction

29

Why the vision loss in retinal detachment?

Due to degeneration of photoreceptors

30

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

high myopia or history of head trauma

31

First symptoms that indicate retinal detachment?

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

32

secondary causes of retinal detachment?

retinal breaks, DB traction, inflammatory effusions

33

Retina cloudy with attenuated vessels and “cherry-red” spot at fovea

Central retinal artery occlusion

34

Diseases with cherry red spots

Tay Sachs, Neimann Picks

35

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

Retinitis Pigmentosa

36

Bone spicule–shaped deposits around macula

Retinitis Pigmentosa

37

Infections associated with retinitis?

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

38

Retinal edema and necrosis leading to a scar?

Retinitis

39

Treatment for congenital chorioretinitis?

Sulfadiazine + pyrimethamine

40

Treatment for CMV retinitis?

Foscarnet, Cidofovir - if gancilovir fails

41

Enlarged blind spot and
elevated optic disc with blurred margins

Papilledema

42

Pathway of Miosis

ƒƒ 1st neuron: Edinger-Westphal nucleus to ciliary ganglion via CN III
ƒƒ 2nd neuron: short ciliary nerves to pupillary sphincter muscles

43

Pathway of Mydriasis

ƒƒ 1st neuron: hypothalamus to ciliospinal center of Budge (C8–T2)

ƒƒ 2nd neuron: exit at T1 to superior cervical ganglion (travels along cervical sympathetic chain
near lung apex, subclavian vessels)

ƒƒ 3rd neuron: plexus along internal carotid, through cavernous sinus; enters orbit as long ciliary
nerve to pupillary dilator muscles.

Sympathetic fibers also innervate smooth muscle of eyelids (minor retractors) and sweat glands of forehead and face.

44

Disease with Marcus Gunn Pupil

MS

45

What is a Marcus Gunn pupil?

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

46

How does one test for Marcus Gunn pupil?

Swinging flashlight test

47

Symptoms of SNS denervation of face?

ƒƒ Ptosis (slight drooping of eyelid: superior
tarsal muscle)
ƒƒ Anhidrosis (absence of sweating) and
flushing of affected side of face
ƒƒ Miosis (pupil constriction)

48

Horner's seen with which diseases?

Any lesion of spinal cord above T1 --> Pancoast tumor, Brown Sequard, Late stage syringomyelia,

Also seen with cluster headaches, Lung cancer, PICA injury, Cavernous sinus syndrome,

49

Chronic closure glaucoma - sx?

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

50

Bacteria causing conjunctivitis?

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

51

Causes of Neonatal conjunctivitis?

N. gonorrhea, HSV-1, Measles ( the 3Cs coryza, conjunct., cough) Reactive arthritis.(Reiter syndrome)

52

Cause of retinal occlusion?

Atrial fib