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Question 1

Go through the steps for using an ophthalmoscope in clinical exam (can be in OSCE)

Answer 1

1. check for red reflex
2. colour of disc
3. working out from the disc assess the vessels in all 4 quadrants (supranasally, supratemporally etc.)
4. cup size (0.2-0.3 small and good if 0.8 - gluacoma)
5. contour (either well-defined or blurred)
6. macula (get patient to look at you or look temporally on model)

Question 2

What things can stop someone from having a red reflex?

Answer 2

Work from lids/lashes to retina

Lids/lashes
- ptosis

Anterior chamber
- infection - hyponyon
- bleed - Hyphema
- inflammation - anterior uveitis

Lens
- cataracts

Vitreous body
- vitreal haemorraghe

Retina
- retinal detachment
- retinoblastoma (in kids)

Question 3

What can cause papilloedema?

Answer 3

HAS TO BE BILATERAL

Raised ICP
- SOL
- IIH
- hydrocephalus

Question 4

What can cause unilateral disc swelling?

Answer 4

VINDICATE

vascular tumours, CRVO
infection - orbital cellulitis
neoplasm - mets in the orbit
d
inflammation - optic neuritis
c
autoimmune - graves
trauma
endocrine - diabetes

Question 5

What word is used to describe a more red disc?

Answer 5

Florid

Question 6

What is more common CRVO or CRAO?

Answer 6

CRVO

Question 7

What is a normal ICP?

Answer 7

<15mmHg

Question 8

What dementia presents with fluctuating cognition?

Answer 8

Lewy body dementia

Question 9

Where would the problem be in pts with hemiaponias with macular sparing

Answer 9

1. occipital visual cortex

Question 10

After the optic chiasm optic nerves become optic tracts - where do they synapse?
What lobes do the optic radiations pass through?

Answer 10

Lateral geniculate body

Temporal (responsible for superior field)
Parietal (responsible for inferior field)

Question 11

Go over the myotome mnemonic

Answer 11

look at song in notes
C2 - look at your shoe (neck flexion)
C3 - like a fallen tree (cervical ..)
C4 - i’m not sure (shoulder elevation)
C5 - arms out wide (shoulder abduction)
C6 - smell your wrists (elbow flexion and wrist extension)
C7 - no zombies in heaven (elbow extension and wrist flexion)
C8 - you’re doing great thumbs up (thumb extension)
T1 - over and done (finger adduction)

L2 - pick up your shoe (hip flexion)
L3 - extends the knee (knee extension)
L4 - stops the door (dorsiflexion)
L5 - big toe to the sky (great toe extension)
S1 - can lift a ton - on tippy toes (ankle plantarflexion)
S2 - brings knee back to you (knee flexion)