amboss 7/9

Question 1

what are risk factors for simple febrile seizures

Answer 1

high fever, viral infection (especially HHV-6 and influenza), a family history of febrile seizure, and recent immunization (especially DTP and MMR) are all known risk factors.

Question 2

what is an effective way to reduce fevers

Answer 2

acetaminophen

Question 3

what is a neurological SE of gentamicin

Answer 3

ototoxicity and cochlear dysfunction. they damage hair cells in the inner ear
there is typically no vertigo; but patients will experience oscillopsia or an abnormal head thrust test in both directions

Question 4

differences between BPPV, menières, suppurative labrythitis and vestibulobasilar insufficiency

Answer 4

BPPV –vertigo while changing head position that lasts 1 min.
menieres –tinnitus, vertigo, hearing loss
labyrinthitis –chronic otitis media tinnitus and oscillopsia.
vestiulobasilar insufficiency –episodic tinnitus, and unsteady gait usually with dysarthria, dysphagia, paresthesias.

Question 5

what is the most common cause of bacterial keratitis in contact lens wearers

Answer 5

pseudomonas aeruginosa

Question 6

what is the course of pseudomonas kerititis

Answer 6

rapidly progressive and can lead to corneal perforation within 2-5 days

Question 7

what is the treatment of pseudomonas kerititis

Answer 7

Prompt treatment with topical broad-spectrum antibiotics (e.g., cefazolin with tobramycin/gentamicin) should be initiated.

Question 8

what is the best way to identify corneal abrasion

Answer 8

slit lamp with fluorescein staining

Question 9

what is a common cause of sudden painless vision loss for diabetics

Answer 9

vitreous hemorrhage from sites of bleeding neovascularization. will present with blurry vision, dark streaks in the field, fundoscopic exam will be occluded

Question 10

is noise-induced hearing loss sensorineural or conductive

Answer 10

sensorineural due to hair cell destruction from loud noises

Question 11

what is the most likely cause of bilateral conductive hearing loss in a 20-30 year old

Answer 11

otosclerosis

Question 12

what is otosclerosis

Answer 12

overgrowth of the footplate of the stapes bone in the middle ear leading to progressive fixation of the bone and decreased sound conduction. Usually initially unilateral but becomes bilateral in most cases.

Question 13

what is the presentation of otosclerosis

Answer 13

constellation of tinnitus and insidious bilateral conductive hearing loss. About 25% of patients with otosclerosis would also complain of mild vertigo (often described by patients as “dizziness”). Patients with otosclerosis often report being able to hear better in noisy rather than quiet surroundings (paracusis of Willis) and characteristically develop a soft, monotonous speech.

Question 14

what is the treatment for myasthenia crisis

Answer 14

if respiratory depression is severe enough then intubate. but if they do not require intubation then proceed with IVIG

Question 15

what is the treatment for Menieres

Answer 15

no direct treatment for menieres disease.

Question 16

what are the dietary and lifestyle triggers for menieres

Answer 16

caffeine, alcohol, stress.

Question 17

what medical therapies can help menieres

Answer 17

Acute: vestibular suppressants (e.g., dimenhydrinate, benzodiazepines, meclizine); antiemetics (e.g., promethazine, ondansetron)
Prophylaxis: histamine analog (betahistine); diuretics (hydrochlorothiazide or triamterene)

Question 18

what does hypertension do to the small communicating arteries

Answer 18

causes lipohyalinosis and eventually aneurysmal formation and risk for rupture and hemorrhagic stroke

Question 19

what is the diagnosis of unilateral facial pain, cyclical headache, pupillary constriction differences, lacrimation and rhinorrhea

Answer 19

cluster headache

Question 20

what is the presentation of diabetic autonomic neuropathy

Answer 20

orthostatic hypotension, urinary retention, gastroparesis, erectile dysfunction

Question 21

what is cerebral venous thrombosis

Answer 21

thrombotic obstruction of the cerebral veins and/or related anatomical structures (dural sinuses) which drain blood from the brain. Women are affected more often than men. Predisposing factors include prothrombotic conditions, pregnancy, oral contraceptive use, malignancy, and infection.

Question 22

what is the presentation of cerebral venous thrombosis

Answer 22

progressive worsening headache, chemosis, cranial nerve VI palsy (impaired right-sided lateral gaze), increased intracranial pressure (evident by headache and bilateral papilledema), and the occlusive lesion in a cerebral sinus on imaging indicates cerebral venous thrombosis (CVT).

Question 23

what is the treatment for cerebral venous thrombosis

Answer 23

Administration of a low molecular weight heparin (LMWH), such as dalteparin, is the most appropriate next step in the management of a patient with acute (aseptic) CVT, as the drug acts to both dissolve the clot and prevent formation of a new clot. The typical duration is two weeks, after which treatment is switched to an extended duration oral anticoagulant (e.g., warfarin).