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Phase 3a conditions list flashcards > Neurology - part 2 > Flashcards

Neurology - part 2 Flashcards

1
Q

What is meningitis?

A

Infection of the meninges

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2
Q

What is the difference between viral vs bacterial meningitis in terms of severity and frequency?

A
  • Viral = more common, less severe
  • Bacterial = less common, more severe
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3
Q

What are some risk factors for meningitis (4)?

A
  • Immunocompromised
  • Neonate
  • Non-vaccinated
  • University student
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4
Q

What are the most common viral causes of meningitis? (4)

A
  • HSV (-2)
  • VZV
  • Enteroviruses (e.g. coxackie)
  • Measles/ mumps
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5
Q

What are the most common bacterial causes of meningitis in 0-3 months (3)?

A
  • GBS = mc
  • Listeria monocytongenes
  • E. coli
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6
Q

What are the most common causes of meningitis in 3 month - 6 year olds (3)?

A
  • N. meningitidis
  • S. pneumoniae
  • H. influenziae (less common due to vaccinations)
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7
Q

What are the two most common causes of meningitis in 6 years - 60 years?

A
  • N. meningitidis
  • S. pneumoniae
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8
Q

What are the three most common causes in over 60s?

A
  • N. meningitidis
  • S. pneumoniae
  • Listeria monocytogenes
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9
Q

What types of meningitis are immunocompromised at risk of (2)?

A
  • Listeria monocytogenes
  • Cyptococcus (fungal)
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10
Q

What type of bacteria are S. pneumoniae and GBS?

A

+ve coccus in chains

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11
Q

What type of bacteria is N. meningitidis?

A

-ve diplococcus

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12
Q

What type of bacteria is HIB?

A

-ve coccobacillus

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13
Q

What type of bacteria is listeria?

A

+ve bacillus

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14
Q

What are the signs/ symptoms of meningitis (7)?

A
  • Meningism - headache, photophobia, neck stiffness
  • N+V
  • Fever
  • Drowsiness
  • Kernig
  • Brudzinski
  • Non-blanching purpuric rash
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15
Q

What is Kernig sign?

A

Flexing hip, then extending knee = PAIN

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16
Q

What is Brudzinski sign?

A

Flexing neck –> involuntary flexion of hips

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17
Q

How is meningitis investigated (2)?

A
  • Bloods + cultures
  • Lumbar puncture
    CT not usually indicated unless signs of raised ICP
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18
Q

What would contraindicate/ delay a LP (3)?

A
  • Sepsis/ meningococcal rash
  • Severe illness
  • Raised ICP
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19
Q

What are some signs of raised ICP (4)?

A
  • Pappiloedema
  • Seizures
  • Focal neurological signs
  • GCS < 12
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20
Q

What are the results of LP for bacteria vs viral vs fungal/TB in terms of appearance?

A
  • Bacterial = cloudy
  • Viral = clear
  • Fungal/ TB = cloudy
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21
Q

What are the results of LP for bacteria vs viral vs fungal/TB in terms of glucose?

A
  • Bacterial = low
  • Viral = normal
  • Fungal/ TB = low
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22
Q

What are the results of LP for bacteria vs viral vs fungal/TB in terms of protein?

A
  • Bacterial = high
  • Viral = normal
  • Fungal/TB = high
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23
Q

What are the results of LP for bacteria vs viral vs fungal/TB in terms of WCC?

A
  • Bacteria = neutrophils
  • Viral = lymphocytes
  • Fungal/TB = lymphocytes
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24
Q

What are the results of LP for bacteria vs viral vs fungal/TB in terms of opening pressure?

A
  • Bacterial = raised
  • Viral = normal
  • Fungal/TB = normal or raised
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25
How is meningitis treated?
* Under 3 months = IV cefotaxime + amoxicillin (for listeria) * Over 3 months = ceftriaxone (or cefotaxime) + dexamethasone (+ amoxicillin if over 50)
26
When should dexamethasone not be given for meningitis (2)?
* NBP rash/ septic shock * Under 3 months
27
What should be given if meningitis is suspected in GP?
IM ben pen
28
What should be given to close contacts of those with meningitis?
1. Ciprofloxacin + vaccine 2. Rifampicin
29
Why is cefotaxime given in place of ceftriaxone in neonates?
Ceftriaxone can displace bilirubin causing **kernicterus**
30
What are some complications of meningitis (4)?
* **Sensorineural hearing loss** = mc * Seizures * Focal neurological deficits * Waterhouse-friderichsen syndrome
31
What is Waterhouse-friderichsen syndrome?
Adrenal haemorrhage (due to meningococcal septicaemia) --> adrenal insufficiency --> shock
32
What is encephalitis?
Parenchymal
33
What is the cause of encephalitis (7)?
* **HSV-1** - (95%) * TB * Lymes * Meningitis * CMV * VZV * Toxoplasmosis
34
What is another non-infective cause of encephalitis?
Autoimmune encephalitis
35
What antibodies are usually present in the CSF and blood of those with autoimmune encephalitis?
Anti NMDA-R antibodies
36
What are the signs/ symptoms of encephalitis (5)?
* Seizures * Focal neurological deficit * Reduced GCS + confusion * Fever * Headache
37
How is encephalitis investigated (3)?
* LP * CT/ MRI * EEG
38
How should CSF be analysed in those with suspected encephalitis?
**PCR** - for HSV, VZV, etc
39
What might an EEG show in those with encephalitis?
Periodic 2 Hz firing
40
How is encephalitis treated?
IV Aciclovir
41
What is a brain abscess?
Intracranial collection of pus
42
What are some risk factors for brain abscesses (4)?
* Immunocompromised (HIV, T2DM) * Congenital heart disease + endocarditis * Neurosurgery * Local infection (e.g. ear, mastoiditis)
43
When are brain abscesses most common in life?
30-40 years old
44
What organisms most commonly cause brain abscesses (4)?
* **Strep intermedius** * Staph aureus * Strep pneumoniae * TB (in immunocompromised) *also fungal, parasitic infections (toxoplasmosis)*
45
What are the signs/ symptoms of a brain abscess (3)?
* Fever * Headache * Focal neurological sign
46
How would a spinal abscess present (3)?
* Lower back pain * Fever * Neurological signs (below lesion) *most have T2DM*
47
How is a brain abscess diagnosed?
CT with contrast
48
What feature would a brain abscess CT show?
Ring enhancing lesion
49
How is brain abscess managed (2)?
* Surgical debridement * IV Abx
50
What antibiotics are used for a brain abscess (3)?
* **Ceftriaxone** (broad spectrum -ve/ some +ve) * **Metronidazole** (anaerobes) * Vancomycin (if from trauma/ neurosurgery)
51
What constitutes brain death (3)?
* GCS 3 (comatose) * Brainstem signs * Apnoea > 5 min
52
What are 2 postures that may be held in patients who are comatosed?
* Decorticate * Decerebrate
53
What is the decorticate position?
Fore-arms flexed to chest - lesion in the cortex *good prognosis*
54
What is the decerebrate position?
Forearm extended, internally rotated and wrist flexed - lesion at brain stem *poor prognosis*
55
What does it suggest if a decorticate position turns into a decerebrate position?
Tonsillar herniation/ coning
56
What is Gillian barre syndrome?
Immune mediated demyelination of the nerves in the PNS (Schwann cells)
57
What usually precedes guillian barre syndrome?
Gastroenteritis *or URTI*
58
What organism commonly causes guillian barre?
**Campylobacter jejuni**
59
What is the pathophysiology of guillian barre?
Antibodies produced against campylobacter attack the Schwann cells/ axons in the PNS
60
What is it known as when antibodies produced against a pathogen attack the body?
Molecular mimicry
61
What are the signs/ symptoms of guillian barre (5)?
* **Ascending symmetrical weakness** * **Reduced reflexes** * Sensory loss * Neuropathic pain (back/leg) * Reduced FVC
62
How is guillian barre investigated (3)?
* Nerve conduction studies * Lumbar puncture * Serology
63
What would nerve conduction studies show in guillian barre?
Reduced nerve conduction speed
64
What would LP show in guillian barre (2)?
* **Raised protein** * Normal WCC
65
What is sometimes positive on serology of those with guillian barre?
Anti GM1
66
How is guillian barre managed (2)?
* IVIg * Plasmapheresis *for 5 days*
67
What is important to monitor in those with guillian barre?
FVC
68
What is miller fisher syndrome?
Variant of guillian barre, but with descending weakness, starting with the eyes instead of ascending weakness
69
What are the most common types of brain tumours?
Secondary metastases
70
Where do brain mets often come from?
* **B**reast * **K**idney * **M**elanoma * **L**ungs = MC * **C**olorectal
71
What are the common types of brain tumours (6)?
* Astrocytoma = mc * Meningiomas * Pituitary adenomas * Craniopharyngiomas * Vestibular schwannoma * Pinealoma
72
What are the 3 types of gliomas?
* Astrocytomas = mc * Oligodendrogliomas * Ependymomas *arise from glial cell (protect and support neurones)*
73
What is the most aggressive astrocytoma?
Glioblastoma multiforme (grade 4)
74
What is a craniopharyngioma?
Slow growing tumour near the pituitary gland
75
What can a pinealoma cause?
Non communicating hydrocephalus
76
What are some signs/ symptoms of a brain tumour (5)?
* Headache * Seizures * Focal neuro symptoms * N+V * Raised ICP Sx
77
What are some red flags for brain tumour headaches (4)?
* Morning headache * Headache worsened by valsalvar * Vomiting with headache * Constant headache
78
What are some symptoms of raised ICP (5)?
* Pappilloedema * N+V * Seizures * CN3,6 palsy * Visual field defects
79
How are brain tumours investigated?
MRI
80
How does a glioblastoma multiforme appear on a MRI?
Ring enhancing lesion (with contrast)
81
How are brain tumours treated (3)?
* Dexamethasone * Surgery * Chemo/ radiotherapy
82
What is a neuropathy?
Any condition affecting the nerves outside of the CNS
83
What are the patterns of neuropathy (3)?
* **Mononeuropathy** (1 nerve affected) * **Mononeuritis multiplex** (multiple single nerves affected) * **Polyneuropathy** (symmetrical nerves affected, 'glove + stocking' distribution)
84
What are some causes of mononeuritis multiplex (4)?
* Vasculitis (e.g. polyarteritis nodosa) * Rheumatoid arthritis * SLE * Diabetes
85
What are some causes of polyneuropathy?
* **A**lcohol * **B**12 deficiency * **C**hemotherapy * **D**iabetes * **E**very vasculitis * **G**uillian barre
86
What is a **r**adiculopathy?
The compression of the nerve at the ROOT
87
What is myelopathy?
Compression of spinal cord
88
What are some specific mononeuropathies to be aware of (5)?
* Median nerve (carpal tunnel syndrome) * Ulnar nerve * Radial nerve * L5 radiculopathy * Common perineal nerve
89
What are the nerve roots of the median nerve?
C6-T1
90
What are some causes of carpal tunnel syndrome (4)?
* RA * Acromegaly * Hypothyroid * Repetitive overuse
91
What are the signs/ symptoms of carpal tunnel syndrome (2)?
* Parasthesia * Thenar muscle waisting
92
What two specific tests can indicate carpal tunnel syndrome?
* Tinels * Phalens
93
What would a nerve conduction study show in someone with carpal tunnel?
Decreased velocity/ amplitude
94
How is carpal tunnel treated (2)?
* 1st = splint * Gold = surgery
95
What is the nerve distribution of the ulnar nerve?
C8-T1
96
What is the presentation of an ulnar nerve lesion?
Claw hand *ulnar nerve should flex pinky + ring*
97
What fracture would cause an ulnar nerve lesion?
Medial epicondyle
98
What is the nerve distribution of the radial nerve?
C5-T1
99
What is the presentation of a radial nerve lesion?
Wrist drop "Saturday night palsy" *can't extend wrist*
100
What fracture would cause a radial nerve palsy?
Midshaft humorous fracture
101
What is the presentation of L5 radiculopathy vs common peroneal nerve lesion (3)?
* L5 radiculopathy = foot drop + **weak inversion** + **present** ankle jerk * Common peroneal nerve = foot drop + **weak eversion** + **absent** ankle jerk
102
What is the anatomy of the optic nerve (7)?
Eye --> optic nerve --> optic chiasm (temporal vision desiccates) --> optic tracts --> lateral geniculate nucleus (thalamus) --> optic radiation --> visual cortex
103
What are the key points relating to visual field defects to know for the exam (6)?
* (left) Optic tract lesion = (right) homonymous hemianopia * Homonymous quadrantanopias (temporal = superior; parietal = inferior) * Congruous defect = optic radiation lesion * Incongruess defect = optic tract lesion * Pituitary adenoma = bitemporal superior quadrantanopia * Craniopharyngioma = bitemporal inferior quadrantanopia
104
What is the presentation of CN 3,4,6 lesions?
* CN3 = down + out + ptosis * CN4 = can't look down * CN6 = impaired abduction
105
CN7 lesion presentation?
Non forehead sparing facial droop
106
What frequently causes CN7 lesion?
Bells palsy
107
How is bells palsy managed (2)?
* 72 hours PO prednisolone * Eye care (as difficult to shut eye)
108
What is sometimes the underlying cause of bilateral bells palsy + optic neuritis?
Sarcoidosis
109
How is sarcoidosis investigated (2)?
* CXR * Raised serum ACE
110
What is a differential for bells palsy?
Ramsay hunt syndrome
111
What is the cause of ramsay hunt syndrome?
VZV reactivation
112
What is an additional finding in those with Ramsay hunt syndrome?
Blisters in ears (otoscopy)
113
How is Ramsay hunt treated (2)?
* Aciclovir * Prednisolone
114
What are the symptoms of a CN5 lesion (4)?
* Masseter muscle (weak on palpation) * Loss of sensation in face * Lack of corneal reflex * Jaw jerk
115
CN8 lesion presentation (2)?
* Sensorineural hearing loss * Balance + vertigo problems
116
What is the presentation of CN9/10 lesion (3)?
* Uvula deviation (away from lesion) * Weak cough * Swallow difficulty
117
CN11 lesion presentation (2)?
* Weak head turn * Weak shoulder shrug
118
CN12 lesion presentation (1)?
Ipsilateral tongue deviation
119
What are some types of complete cord compression (2)?
* Myelopathy * Cauda equina
120
Where does myelopathy usually affect?
Cervical spine
121
What are the signs/ symptoms of myelopathy?
* UMN signs BELOW lesion * LMN signs AT lesion
122
What are the signs/ symptoms of cauda equina (4)?
* Saddle anaesthesia * Low back pain * Weakness + parenthesis in legs * Faecal incontinence (late sign)
123
What are some partial cord compressions and how do they present?
* Anterior cord = motor Sx * Posterior cord = DCML Sx * Hemisection (brown sequards) = ipsilateral corticospinal + DCML *and* contralateral spinothalamic
124
What are some causes of cord compression (5)?
* Trauma * Malignancy * Arthritis * Slipped discs * Spinal stenosis (degenerative cervical myelopathy)
125
What is hoffmans sign and what is it suggestive of?
Tap middle finger and thumb + index flex *suggestive of cervical spine damage*
126
How are cord compressions investigated?
Urgent MRI whole cord
127
How are cord compression treated (2)?
* IV dexamethasone * Surgical decompression
128
What is horners syndrome?
Lesion in the ascending sympathetic chain
129
What are the signs/ symptoms of horners syndrome (3)?
* Miosis * Ptosis * Anhidrosis
130
What are the causes of horners syndrome (5)?
* Pancoast tumours (upper lobe of lung) * Trauma * Thyroidectomy * Congenital (difference in eye colour) * Stroke
131
What are 3 types of muscular dystrophy?
* Duchennes * Becker * Myotonic dystrophy
132
What is the inheritance of duchennes muscular dystrophy?
X-linked recessive *deletion in dystrophin gene*
133
What is the inheritance of Beckers muscular dystrophy?
X-linked recessive *missense mutation*
134
What is the inheritance of Myotonic dystrophy (3 features)?
* Autosomal dominant * Trinucleotide repeat * Anticipation
135
What is the presentation of myotonic dystrophy?
Hand shake and can't let go
136
What are the signs/ symptoms of duchennes muscular dystrophy (3)?
* Progressive proximal muscle weakness * Calf pseudo hypertrophy * Gowers sign (patients stand by climbing up body with hands)
137
When does duchennes present?
Usually around **age 5**
138
What is the difference between beckners and duchennes muscular dystrophy?
Beckners presents later after **10 years**, but similar symptoms
139
What is a common complication of duchennes?
Dilated cardiomyopathy
140
How is duchennes investigated?
* Bloods = raised creatinine kinase * EMG = abnormal * Gold standard = **genetic testing** *muscle biopsy no longer gold standard*
141
How is duchennes treated (2)?
* Supportive - corticosteroids can prolong muscle functioning * Regular echo scans for DCM
142
What is the prognosis for duchennes (2)?
* Cant walk at 12 years * Die at 25-30
143
What are two early onset hereditary ataxias (2)?
* Friedrichs ataxia * Ataxia telangiectasia (one of the combined inherited immunodeficiency disorders)
144
What is the inheritance pattern of these two early onset hereditary ataxias?
Autosomal recessive
145
What is the most common early onset hereditary ataxias?
Friedrichs ataxia
146
How does friedrichs ataxia present (2)?
* Gait ataxia * Kyphoscoliosis
147
What age does friedrichs ataxia present?
10-15 years
148
What sort of genetic mutation is seen in friedrichs ataxia?
Trinuleotide repeat *unusual in that it does not show anticipation however*
149
How does ataxia telangiectasia present (2)?
* Cerebellar ataxia * Telangiectasia
150
What age does ataxia telangiectasia present?
Much earlier than friedrichs at **2-5 years** old
151
What is hydrocephalus?
Excessive volume of CSF in the ventricular system
152
What are the two broad categories hydrocephalus can be divided into?
* Communicating * **Non-communicating** = mc
153
What is the underlying cause of communicating hydrocephalus (2)?
* Increased production of CSF (from choroid plexus) * Decreased absorption of CSF (at arachnoid granulations)
154
What is a cause of communicating hydrocephalus?
TB meningitis (causing decreased absorption)
155
What is the underlying cause of non-communicating hydrocephalus?
Obstruction in the flow of CSF causing an increased volume + pressure proximal to the blockage
156
What are some causes of non-communicating hydrocephalus (5)?
* Spina bifida * Dandy walker (underdeveloped cerebellar vermis --> obstructed 4th ventricle) * Chiari malformation * Tumours * Acute haemorrhage
157
What are the signs/ symptoms of hydrocephalus (6)?
* Headache * N+V * Papilloedema * Bulging anterior fontanelle * Macrocephaly * **Downturned eyes**
158
How is hydrocephalus investigated (3)?
* CT = first * MRI * LP
159
What would a CT head show for hydrocephalus (2)?
* Ventriculomegaly * Obstruction?
160
What would an LP show in those with hydrocephalus?
Raised opening pressure *also therapeutic as drains some of the CSF*
161
How is hydrocephalus treated (3)?
* External ventricular drain * Ventricular peritoneal (VP) shunt * Endoscopic ventriculostomy (creating an alternative pathway for CSF)
162
What is a unique form of hydrocephalus that usually occurs in older people?
Normal pressure hydrocephalus
163
What age does normal pressure hydrocephalus usually occur?
Over 65
164
What is the triad of symptoms for normal pressure hydrocephalus?
* Wet (incontinent) * Wacky (dementia) * Wobbly (ataxic gait)
165
What is the triad of symptoms in normal pressure hydrocephalus known as?
**Hakims** triad
166
How is normal pressure hydrocephalus investigated (2)?
* CT = venticulomegaly * LP = normal opening pressure
167
What is idiopathic intracranial hypertension?
Raised intracranial pressure for an unidentifiable reason
168
What are some risk factors for IIH (5)?
* Female * Obesity * 20-50 * Pregnancy * Medications
169
What medications are risk factors for IIH (3)?
* COCP * Tetracyclines (e.g. doxycycline) * Vitamin A
170
What are some signs/ symptoms of IIH (3)?
* Headache * Blurred vision * Bilateral papilloedema
171
How is IIH investigated (2)?
* CT/ MRI (tortuous optic nerve) * LP = raised opening pressure
172
How is IIH managed (2)?
* Weight loss * Acetazolemide (carbonic anhydrase inhibitor)
173
What is a complication of IIH?
Optic nerve damage *Tx = surgical optic nerve fenestration*
174
What is the medical name for chronic fatigue syndrome?
Myalgic encephalomyelitis
175
What is the presentation of chronic fatigue syndrome?
Extreme fatigue *also dizziness, nausea, sleep problem...*
176
What often precedes the development of chronic fatigue syndrome?
Infections (e.g. COVID-19, EBV)
177
What in functional neurological disorder (conversion disorder)?
A disease with an unexplained cause whereby the patient experiences neurological symptoms
178
What are some common symptoms of FND (3)?
* Weakness * Loss of sensation * Convulsions
179
What is a sign associated with FND?
Hoovers sign
180
What is hoovers sign?
1. Patient asked to extend leg (and they can't) 2. Patient asked to flex opposite leg, extension of original leg then assess (and it is extending)
181
What is syringomyelia?
Fluid filled cyst in spinal cord
182
What are some causes of syringomyelia (4)?
* Chiari malformation * Trauma * Tumour * Meningitis
183
What are the signs/ symptoms of syringomyelia (3)?
* Abnormal sensations in hands * Weakness in arms + legs * Pain + temperature loss in cape distribution (arms + upper chest)
184
What is a intracranial venous sinus thrombosis?
A clot in the sinuses in the dura (usually accompanied by clots in the veins of the brain)
185
Why does a intracranial venous sinus thrombosis cause ischemia of the brain?
Congestion of the veins blocks arterial supply of blood
186
What is the most common sinus affected by intracranial venous sinus thrombosis?
Superior sagital sinus *can also affect transverse and signmoid (50% of time)*
187
What are some risk factors for intracranial venous sinus thrombosis (6)?
* Factor 5 leiden * aPL * SLE * COCP * Pregnant * DIC
188
What are the signs/ symptoms of intracranial venous sinus thrombosis (6)?
* Headache (gradually worsens, but can have thunderclap) * Seizures * Focal neurological Sx * Reduced consciousness * N+V * Papilloedema
189
How is intracranial venous sinus thrombosis investigated (2)?
* CT * **MRI venogram** = gold *'empty delta' sign seen on imaging*
190
How is intracranial venous sinus thrombosis treated?
LMWH
191
What are the two types of neurocutaneous diseases?
* Neurofibromatosis * Tuberous sclerosis
192
What are the two subtypes of neurofibromatosis?
* Type 1 = mc * Type 2
193
How is neurofibromatosis inherited?
Autosomal dominant *however 50% spontaneously mutate during early development*
194
What chromosome is neurofibromatosis 1 found on?
17
195
What are the 4 features of neurofibromatosis 1?
* Cafe au lait spots * Neurofibroma (skin lesions) * Scoliosis * Headaches
196
What chromosome is neurofibromatosis 2 found on?
22
197
What are the 3 features of neurofibromatosis 2?
* Early onset hearing loss + tinnitus * Cataracts * Balance problems
198
What is neurofibromatosis particularly associated with?
Bilateral vestibular schwannoma
199
What are some complications of neurofibromatosis (4)?
* Brain tumours * Vision loss * Epilepsy * Increased risk of various other tumours
200
What is the presentation of tuberous sclerosis (4)?
* Poliosis (white patch of hair) * Nail lesions * Angiofibromas (lesions on cheeks/ under eyes) * Ash leaf spots (depigmented areas of skin) *cafe au lait spots can also occur*
201
What are growths that can occur on different organs in tuberous sclerosis called?
Hamartomas
202
Where do most vestibular schwannomas (acoustic neuromas) occur?
Cerebellopontine tumours
203
Other than the vestibular nerve what other nerve can cerebellopontine tumours affect?
CN 5
204
What are the signs/ symptoms of vestibular schwannoma (4)?
* Tinnitus * Hearing loss * Vertigo * CN 5 lesion Sx
205
How is vestibular schwannoma investigated (2)?
* Hearing tests * MRI
206
How are vestibular schwannomas managed?
Surgery, radiotherapy or observation
207
What are 4 similar diseases that affect the ears and cause various different symptoms (4)?
* Menieres * Acoustic neuroma * Vestibular neuronitis * Viral labarynthitis
208
What is menieres disease?
Disease of the inner ear occurring for unclear reasons
209
What are the 4 features of menieres disease (5)?
* Hearing loss (sensorineural) * Vertigo * Tinitus * **Ear fullness** * Unidirectional nystagmus
210
Who is typically affected by menieres?
**40-50** year old **man**
211
What sign is often present in those with menieres?
Rombergs +ve
212
How is menieres treated (3)?
* Antihistamines (cyclizine for vomiting) * **Betahistine** * Vestibular rehabilitation exercises
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What is thought might be the underlying cause of BPPV?
"Crystals" dislodged in the inner ear
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What is the presentation of BPPV?
Episodes of vertigo lasting 20 seconds triggered by postural change
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What manoeuvre would exacerbate BPPV?
Hallpike *lying backward with head over end of bed*
216
How is BPPV treated?
Epley manoeuvre
217
What is the cause of vestibular neuronitis and viral labyrinthitis?
Post viral inflammation of ear (vestibular nerve or labyrinth)
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What is the presentation of vestibular neuronitis (3)?
* Tinnitus * N+V * **No hearing loss**
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What is the presentation of viral labyrinthitis (3)?
* Tinnitus * N+V * **Sensorineural hearing loss**
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How are vestibular neuronitis and viral labyrinthitis treated (2)?
* Prochlorperazine (antihistamine) * Vestibular rehabilitation exercises
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How is visual acuity measured?
6/12 vision = vision at 12 meters is that of the reference value at 6 meters *6/6 is considered normal vision*
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What are the signs/ symptoms of optic neuritis (4)?
* Central scomota (poor central vision) * Relative afferent pupillary defect * Poor discrimination of colours * Blurry vision
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How is optic neuritis investigated?
MRI of brain + orbits with contrast
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What causes an "eye stroke"?
Central retinal artery occlusion
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What are the signs/ symptoms of a central retinal artery occlusion (3)?
* Painless amaurosis fugax * Relative afferent pupillary defect * 'Cherry red' macular spot
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What is anterior ischemic optic neuropathy?
Blockage in blood supply to the anterior part of optic nerve
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What is often the cause of anterior ischemic optic neuropathy?
GCA
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What is the presentation of anterior ischemic optic neuropathy?
Visual field defects
229
What are the two types of glaucoma?
* Open angle (usually acute) * Closed angle (usually slower onset)
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What is the pathophysiology of acute angle glaucoma?
Blockage of aqueous humour --> raised intraocular pressure --> optic nerve damage
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What is the presentation of acute angle glaucoma?
* Painful red eye * Halos around lights * Hazy cornea * N+V
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How is acute angle glaucoma treated (2)?
* Acetazolamide (lowers IOP) * Pilocarpine (causes miosis)
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What are two causes of flashes and floaters in the vision?
* Retinal detachment * Vitreous haemorrhage
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What is the presentation of retinal detachment (4)?
* Floaters * Flashes * Dark curtain across vision * Blurred vision
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What is the presentation of vitreous haemorrhage (4)?
* Floaters * Flashes * Red tinged vision * Blurred vision
236
What are 2 risk factors for vitreous haemorrhage?
* T2DM * Macular degeneration
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Phase 3a conditions list flashcards (31 decks)

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