28/2

Question 1

Stye vs chalazion

Answer 1

Stye - staph infection of the lash follicle - PAINFUL

Chalazion - blockage of oil gland on eyelid - PAINLESS

Question 2

What is blepharitis?

How does it present?

Answer 2

Lid margin inflammation

Bilateral grittiness - worse in mornings

Eyelid hygiene - warm compresses, cotton wool/buds to clean

Question 3

How can you identify the difference between orbital and pre-septal?

Answer 3

Signs of optic neuritis
- decrease in visual acuity
- decrease in colour vision
- pain on ocular movement
- RAPD

Question 4

How can you tell the difference between bacterial, viral and allergic conjunctivitis?

If bacterial suspected how is it managed?
How is all managed?

Answer 4

Bacterial - purulent discharge
Viral - watery
Allergic - watery and itchy and seasonal

HAND HYIENE is so important to prevent spread to others esp. with viral and WARM compresses

Topical chloramphenicol eye drops

Question 5

Pre-auriciular lymphadenopathy is present in what kind of conjunctivitis?

Answer 5

Viral

Question 6

What are the causes of sudden visual loss?

Answer 6

ABCD

AMRD
Blocked blood vessel/bleed
Closed angle glaucoma
Detachment of retina

Question 7

What are the fundoscopy differences and clinical differences between central retinal artery and vein occlusion?

Answer 7

CRAO - pale fundoscopy
- carotid bruit (CRAO is a type of stroke and carotid artery disease is likely to cause

CRVO - retinal haemorrhage and “stormy-sunset” appearance

Question 8

What level of carotid artery occlusion does there have to be to indicate carotidectomy?

Answer 8

70%

Question 9

What must be assessed on fundoscopy?

Answer 9

3C’s
- cup
- colour
- contour (line of the disc)

Peripheral retina (vessels around, any signs of dot blots, cotton wool spots - signs of DM/HTN retinopathy)
Macula

Question 10

What do each of the following signs on fundoscopy indicate:
- increased Cup to disc ratio (CDR)
- very bright/pale colour
- blurred contour

Answer 10

Increased CDR - gluacoma in particular COAG

Very bright/pale colour - optic atrophy

VERY IMPORTANT

Blurred contour - papilloedema/papillitis (Optic nerve head inflammation)/CRVO/malignant HTN

Question 11

How can you tell if you are looking at the right or left eye on fundoscopy?

Answer 11

disc on r = r eye

Question 12

What joints are affected in the hand are affected by RA?

Answer 12

RA occurs more proximally in life -» affects the PROXIMAL (PIP) and MCP

OA affects DIP

Question 13

What is the first line treatment in sebahhoric dermatitis?

Answer 13

Ketoconazole

Question 14

What med is used to manage idiopathic intracranial HTN?

Answer 14

Acetazolamide (carbonic anhydrase inhibitor)

Question 15

What is the management of C.diff?

Answer 15

Vancomycin

Question 16

In what situation can papilloedema be diagnosed?

Answer 16

ONLY if bilateral and raised ICP

Question 17

Draw out stroke man to remember location of arteries affected

Answer 17

look at stroke notes

Question 18

What artery is affected in locked-in syndrome stroke?

Answer 18

Basillar

Question 19

Guillian Barre Syndrome presents as an ascending neuropathy following viral/bacterial infection

What is the pathophysiology?

What is the most important clinical investigation?

Answer 19

Autoimmune demyleination

Lung function tests - can cause respirator failure (NEED to know patients baseline)