Neuro-opthalmology

Question 1

signs of optic nerve dysfunction?

Answer 1

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

Question 2

what is dyschromatopsia?

Answer 2

visual colour impairment

Question 3

charcot’s triad of cerebellar dysfunction?

Answer 3

tremor
dysarthria
ataxia

Question 4

describe uhthoff phenomenon

Answer 4

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

Question 5

autonomic features of MS

Answer 5

bladder
bowel
sexual dysfunction

Question 6

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

Answer 6

a central scotoma

Question 7

Tx for optic neuritis?

Answer 7

methylprednisolone IV followed by oral prednisolone

Question 8

GCA can cause what eye problem?

Answer 8

arteritic anterior ION

Question 9

who gets non-arteritic AION

Answer 9

patients >50

Question 10

what artery is occluded in AION?

Answer 10

short posterior ciliary artery

Question 11

causes of non-arteritic AION?

Answer 11

idiopathic
hypertension
diabetes
sleep apnoea

Question 12

sudden painless unilateral visual loss….

Answer 12

AION

Question 13

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

Answer 13

arteritic

Question 14

Tx of non-arteritic AION?

Answer 14

treat cause

Question 15

Tx of arteritic AION?

Answer 15

high dose methylprednisolone IV

oral prednisolone + aspirin

Question 16

what kind of visual loss presents in papilloedema?

Answer 16

transient visual loss lasting seconds

Question 17

most common cause of horner’s in children

Answer 17

trauma

Question 18

a painful horner’s syndrome should raise suspicion of…

Answer 18

carotid dissection

Question 19

Ix for horners

Answer 19

apraclonidine to dilate pupils

CT/MRI for dissection

Question 20

define adie’s pupil?

Answer 20

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

Question 21

who gets adie’s pupil?

Answer 21

young females

Question 22

features of adie’s pupil?

Answer 22

anisocoria (left pupil larger) and blurs on near vision

light reflex absent

Question 23

Ix of adie’s pupil?

Answer 23

slit lamp

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

Question 24

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

Answer 24

argyll robertson pupil

Question 25

an argyll robertson pupil will do what reflex correctly?

Answer 25

accomodation reflex

Question 26

ipsilateral 3rd nerve palsy with contralateral hemiparesis....

Answer 26

webers syndrome

Question 27

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

Answer 27

benedikt's syndrome

Question 28

main causes of CN4 palsy?

Answer 28

trauma | congenital

Question 29

clinical features of CN4 palsy?

Answer 29

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

Question 30

CN6 palsy features

Answer 30

horizontal double vision esotropia limited abduction

Question 31

what eye movement is decreased in CN6 palsy?

Answer 31

abduction

Question 32

most common cause of CN6 palsy

Answer 32

diabetes hypertension increases ICP

Question 33

pathophysiology of myaesthenia gravis?

Answer 33

autoimmune disease of ACh receptors at post-synaptic NM junctions

Question 34

who primarily gets myaesthenia gravis?

Answer 34

females in their 30s

Question 35

myaesthenia affects ___ muscle

Answer 35

skeletal

Question 36

what muscles are affected first in myaesthenia gravis?

Answer 36

smaller muscles

Question 37

presenting features of myaesthenia gravis?

Answer 37

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

Question 38

Ix of myaesthenia gravis?

Answer 38

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

Question 39

Tx of myaesthenia gravis

Answer 39

pyridostigmine (ACh-esterase) steroids immunomodulators

Question 40

delayed muscle contraction and muscle wasting with ptosis and hypermetropia...

Answer 40

myotonic dystrophy

Question 41

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

Answer 41

hamartomous pigmented lesions protruding above the iris | NF1

Question 42

cataracts present in what NF type

Answer 42

NF2

Question 43

what happens in benign essential blepharospasm?

Answer 43

involuntary contraction of the orbicularis oculi muscle

Question 44

Tx of benign essential blepharospasm?

Answer 44

artificial tears | botox injection

Question 45

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

Answer 45

3, 4, CNV1, CNV2

Question 46

features of cavernous sinus syndrome?

Answer 46

features of CN 3 4, 5 loss