Revise!

Question 1

بسم الله الرحمن الرحيم
__________________
Pyramidal tract weakness: D>P, in UL: E>F, in LL: F>E
Capsular lesions&raquo_space;> ……………hemiplegia
Brain stem unilateral lesions&raquo_space;> ………………..
In cervical cord lesions&raquo_space;> pyramidal ………………
In dorsal cord lesions&raquo_space;> pyramidal ……………………..
In polyneuropathy&raquo_space;> …………………………….
In muscle disease&raquo_space;> mostly P>D

Answer 1

Capsuler contralateral
Brainstem : cROSSed Hemiplegia
Cervical : pyramidal quadriplegia
Dorsal cord: Paraplegia
Polynerupathy distal flaccid paralysis

Question 2

Rt UL weakness
Just Wrist drop

Answer 2

Radian nerve injury

Question 3

Hyporeflexia or lost DTJ in cases of LMNL

Answer 3

(e.g polyneuropathy)

Question 4

Focal loss of DTJ may indicate focal root or nerve pathology (e.g. loss of triceps reflex in …………..).

Answer 4

radial nerve injury

Question 5

WRIST+Patellar+ Ankle CLONUS
Hoffman sign
Finger jerk
Wartenburg sign
refers to ?

Answer 5

UMNL

Question 6

Optic nerve can be tested by

Answer 6

A. Vision (as visual acuity, color vision, visual field and visual
evoked potential)
B. Pupillary light reflex.

Question 7

inflammation of the axons of the optic nerve
due to infective or non-infective causes

Answer 7

Optic neuritis

Question 8

Optic neuritis may be in the form of

Answer 8

papillitis
Retrobulbar neuritis

Question 9

inflammation of the optic disc head (the
papillae), common in children with viral optic neuritis.

Answer 9

papillitis

Question 10

Inflammation of the part of the
nerve behind the eye, common in demyelinating diseases.

Answer 10

Retrobulbar neuritis

Question 11

clinical picture of optic neurits

Answer 11

Drop of vision
washed out colors
afferent papillary light reflex defect

Question 12

Fundus: changes in papillitis and ischemic neuropathy, or
normal if …………….?

Answer 12

Retrobulbar neuritis

Question 13

Painful eye movement in MS and inflammatory causes refers to

Answer 13

Optic neurtits

Question 14

Central or centrocecal scotoma + attidudinal Field defect in

Answer 14

Viusal field examination of optic neuritis

Question 15

Bilateral delay in P100 latency refers to ?

Answer 15

Optic nerutits
Visaul evoked potential VEP

Question 16

Investigations of OPtic neutitis :-

Answer 16

1-Visaul fields = Centrocecal scatoma + attudinal field defect in( ischemic neuropathy )
2-Visual Evoked potential
3-MRI for brain in multiple sclerosis

Question 17

ttt of Optic neuritis

Answer 17

Steroids as Methylperidinsolone
Treatments of causes and avoding Risk factors
vitamine supplements

Question 18

Bilateral swelling of the optic disc head due to
increased intracranial tension

Answer 18

Papilledema

Question 19

Causes of papilledema

Answer 19

Increased ICP :-
Space occyping lesions
Cerebral venous thrombosis
Obstruction of flow as cerebral acqudct stenosis

Question 20

Patient complain of his eye
Heache + Projecetile vomiting
Normal vision but transiently lost in ? coughing
?
what is the fate of his vision if neglected
Fundus examination reveals?

Answer 20

Papilledema
Lost
________________
Early papilledema : blurring of disc margins nasally
Established papilledema : blurring + Engorement of veins + Hge + cotton wool spots
Chronic papilledema : Elevation + the cotton wool and Hge subsides
Post papilledemic Otpic atrophy

Question 21

Mentio investigations of Papilledema

Answer 21

Brain MRI most important!
Visual field
CSF lumbar puncture

Question 22

ttt of Papilledema

Answer 22

Neurosurgery + Acetazolamide + Ventriculoperitoneal shunt

Question 23

Pallor of the optic disc due to death of the ganglion cells

Answer 23

Optic Atrophy

Question 24

Compare between primary optic atrophy and secondary one

Answer 24

Primary: with no edema as retrobulbar neuritis
Secondarya after edema as Papillitis + Papilledema

Question 25

Consecutive otpic atrophy due to ?

Answer 25

Central retinal artery occlusion Retinis pigmentosa

Question 26

+RAPD Relative afferent pupillary defect

Answer 26

Failure of OPtic nerve to inform pretectal nuclei in case of ? Optic nerve lesions + Retinal dam

Question 27

It’s caused by interruption of the sympathetic supply of the eye due to any lesion along the sympathetic pathway

Answer 27

Brain tumors Syringomyelia Pancost tumor of lung Carotid artery dissection

Question 28

Ptosis + Miosis + Anyhydrosis + Enopthalmosis + Flushing

Answer 28

Horner's syndrome

Question 29

one of the causes of Anisocoria It’s a dilated pupil due to inflammation of the ciliary ganglion or the short ciliary nerves leading to cut of parasympathetic supply to the eye.

Answer 29

Adie's pupil Light -nearer dissociation Pilocarpine 0.125% confirms diagnosis where Adie’s pupil constricts due to denervation hypersensitivity

Question 30

Neurosyphilis, demyelination, tumours, or haemorrhage interruption of fibres in the area of pretectal nucleus in mid brain which is the centre of light reflex. * This causes Light-Near dissociation: Light reflex is lost but near reflex is intac

Answer 30

Argyll Robertson pupil

Question 31

Sensory supply of eye

Answer 31

OPthalmic of Trigemnial

Question 32

esotropia

Answer 32

6th nerve palsy is characterised by esotropia where the medial rectus muscle takes the upper hand.

Question 33

hypertropia

Answer 33

4 th nerve palsy is characterised by hypertropia where the inferior oblique takes the upper hand.

Question 34

ptosis and the eye is shifted down and out divergent squint

Answer 34

ptosis and the eye is shifted down and out

Question 35

Bell’s palsy causes ...................and............... of the eye

Answer 35

Lagopthalmosis + dryness of eye

Question 36

CSF pressure ranges .... mm H2O (infants) - .... mm H2O (adults).

Answer 36

40-140mm Hg

Question 37

Conditions with elevated ICP and associated CSF rhinorrhea MENTION

Answer 37

1-non traumatic CSF rhinorrhea 2-BIH benigin intracranial Hypertension 3-ESS Empty sella Syndrome

Question 38

CSF rhinorrhea testing of secretion ?

Answer 38

B2 Transferrin Glucoes + protein determination

Question 39

CSF Rhinorrhea ◼ Most important step– identify the............ ◼ High resolution .......... of sinuses (1mm) ◼ Coronal good for ......................... ◼ Axial good for ....................... ◼ Problem is volume averaging ◼ Look in ...........................and ...... ..................................

Answer 39

Site CT ____________ ANterior skull base coronal ! Axial for posterior wall of Frontal sinus _________________ Ciribriform Niche + Latreal wall of Shpenoid bone

Question 40

Obtain if HRCT fails to show the defect? CSF rhinorrhea

Answer 40

CT cisternogram

Question 41

Obtain if HRCT fails to show the defect? CSF rhinorrhea

Answer 41

CT cisternogram ◼ MR cisternography—misnomer as no intrathecal contrast ◼ Poor bony detail ◼ Uses highly T2 weighted images

Question 42

Radioisotope cisternography If positive?

Answer 42

If positive– intrathecal florescein

Question 43

GRAFT MATERIALS ( Endoscopic Technique )

Answer 43

Fascia lata Abdominal fat

Question 44

◼,,,,,,,,,,,, and ,,,,,,,,,,,,,,,,,,,,,, are easy to harvest and easy to be applied to the site of the leak. ◼ The endoscopic approach is effective and safe with minimal morbidity ◼ ,,,,,,,,,,,,,,, is very helpful when the site of the leak is difficult to be found.

Answer 44

Septal graft - middle turbinate flap ____________________ Fluorescin

Question 45

Stapdius reflex tests ?

Answer 45

8th and 7th Cranial nerves

Question 46

supplies the anterior third of the lateral nasal wall and adjacent septum

Answer 46

ant ethmoidal artery

Question 47

Supplie the superior turbinate Posterior superior lateral nasal wall, and septum.

Answer 47

Post ethmoidal artery

Question 48

The sphenopalatine artery, – arises from the .................. artery – enters the nose just posterior to the posteroinferior tip of the .................. turbinate. *A ..............branch supplies much of the.................. * may be injured during ESS * as it crosses the anterior inferior face of the sphenoid sinus. *A lateral branch supplies the i....+.....

Answer 48

iNTERNAL maxillary artery __________________ middle _________________ medial = much of septum ________________ lateral branch supplies inferior+middle turbinates

Question 49

Compare between ant and post epistaxis

Answer 49

ant : kissel bach's post : Woordrouf's HTN

Question 50

Epistaxis RFs

Answer 50

Warm - dry air Recurrent UTRI Allergic bacterial viral rhinosinusitis

Question 51

Bilateral nasal obstruction+ Bilateral mucopurulent nasal discharge Mouth breather

Answer 51

Adenoid

Question 52

Unilateral nasal obstrctuon since birth + unilateral Mucopurulent exudate

Answer 52

Unilateral Chonal atresia

Question 53

Cold mirror test –ve unilateral X-ray with lipidol dye

Answer 53

Unilateral chonal atresia canalization

Question 54

Bilateral mucopurulent thick nasal discharge+ Failure to Thrrive + Cyclic Cyanosis

Answer 54

Bilateral choanal atresia

Question 54

Chronic sinsutits resistance cases

Answer 54

FESS for resistant cases

Question 55

White bony hard swellings in the deep meatus

Answer 55

ostemoa 'swimmer's osteomas as t irrigation of the bony meatus with cold water produces a periostitis

Question 56

Absence of the pinna or gross deformity

Answer 56

MICROTIA 1st and 2nd branchial arches

Question 57

hypoplasia of the maxilla and mandible and eye-lid deformities

Answer 57

Treacher-Collins syndrome

Question 58

Facial part The narrowest part → most susceptible to compression by edema

Answer 58

Labrunthine part

Question 59

-A test in which The Facial nerve is excited by electrical current after its exit from the stylomastoid foramen and the lowest intensity needed to cause muscle twitches is recorded in milli-amperes and compared to the healthy side. A difference:less than 5 mA ......... more than 5 mA ................ - The test is repeated in frequent days to see if there is progressive degeneration or not.

Answer 59

NET Nerve Exitiability test Minmal stimulation test ____________________ Neuropraxia Degenration

Question 60

Investigations for facial palsy

Answer 60

CT-MRI Revealing :- Fracture + Cholestatmoa +Neuroma compressing CN 7,8 Audiological test

Question 61

How to deal with facial palsy

Answer 61

eye care: artifical tears + Eye ointment + sunglassess Lateral Tarsoraphy + Spring Impalantation Muscle care: Massage + Gulvanic stimulation

Question 62

“It is the commonest cause of LMN facial paralysis”

Answer 62

Bell's palsy Viral prodrome+Pain+impairment of taste PhonoPhobia

Question 63

“It is the commonest cause of LMN facial paralysis”

Answer 63

Bell's palsy Viral prodrome+Pain+impairment of taste PhonoPhobia ttt: Predinsolone + Acyclovir

Question 64

HERPES ZOSTER OTICUS(RAMSAY HUNT SYNDROME) The virus affects the................of the facial nerve. C.P. 1- Lower motor neuron facial N. paralysis at level of the geniculate ganglion. 2- Ear pain. 3- ,,,,,,,,,,on the auricle and external auditory meatus. 4- SNHL & Vertigo if 8th nerve is affected. Treatment: Acyclovir systemically and locally. - Analgesic for pain .

Answer 64

Geniculate ganglion _________ Vesicles

Question 65

Kallman's syndrome

Answer 65

hypogonadism with partial or complete loss of smell

Question 66

Parkinson and alzhemir causes ..anosmia

Answer 66

Permenatn

Question 67

Olfactory area formed

Answer 67

Prepyruform and pyriform cortex cortical amygdaloid nuclei

Question 68

قال صلى الله عليه وسلم: "أتدرون من المفلس؟ قالوا المفلس فينا من لا درهم له ولا متاع، قال:إن المفلس من أمتي من يأتي يوم القيامة بصلاة وصيام وزكاة، ويأتي وقد شتم هذا وضرب هذا وأكل مال هذا وسفك دم هذا، فيأخذ هذا من حسناته وهذا من حسناته فإن فنيت حسناته قبل أن يوفي الذي عليه أخذ من سيئات صاحبه ثم طرحت عليه ثم طرح في النار" رواه الترمذي، قال حسن صحيح. "قل يا عبادي الذين أسرفوا علي أنفسهم لا تقنطوا من رحمة الله إن الله يغفر الذنوب جميعا إنه هو الغفور الرحيم " يغفر الله ذنوب العباد في حقه لانه الغفور الرحيم لكن لا تغقر ذنوب حقوق وظلم العباد إلا برضاهم "ووضع الكتاب فتري المجرمين مشفقين مما فيه ويقولون يا ويلتنا مال هذا الكتاب لايغادر صغيرة ولا كبيرة إلا أحصاها ووجدوا ماعملوا حاضرا ولا يظلم ربك أحدا"

Question 69

PAIN = blurred margins + vision = Transient =

Answer 69

OPTIC NEURITS papilledema papilledema