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Hailey - Neuro > Block 3 More plz > Flashcards

Block 3 More plz Flashcards

1
Q

sympathetic NS

A 
mydriasis
a1 contracts pupillary dilator muscle
a1 contracts superior tarsal muscle
b2 relax ciliary muscle = increase long distance vision
b increase aq humor formation
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2
Q

parasympathetic NS

A 
miosis
ptosis
muscarinic receptors:
M3 contract pupillary sphincter
M3 contract ciliary muscle = increase near vision
M3 increase drainage of aq humor
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3
Q

mydriatic agents

A

ATROPINE: muscarinic receptor antagonist > cycloplegia (paralysis of ciliary muscle)

PHENYLEPHRINE a1 agonist, reverts ptosis in Horner’s syndrome
EPINEPHRINE a1 agonist, increases aq humor outflow, inhibits aq humor formation*

COCAINE blocks axoplasmic pump, inc NE
AMPHETAMINE release of NE

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4
Q

miotic agents

A

PILOCARPINE muscarinic agonist
ACETYLCHOLINE muscarinic agonist
NICOTINE activates para sympathetic nerves
PHYSOSTIGMINE anticholinesterase AChE

TERAZOSIN a1 antagonist

RESERPINE depletes NE

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5
Q

Tx for glaucoma

A

ECOTHIPHATE and PHYSOSTIGMINE anticholinesterases
PILOCARPINE muscarinic agonist
= increase outflow of aqueous humor

APROCLONIDINE a2 agonist
ACETAZOLAMIDE CA inhibitor
TIMOLOL b antagonist/blocker
= suppress aq humor formation

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6
Q

alpha agonists

A

phenylephrine a1
epinephrine a1
aproclonidine a2

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7
Q

muscarinic agonists

A

pilocarpine

acetylcholine

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8
Q

anticholinesterases

A

physostigmine

ecothiophate

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9
Q

botulism toxin

A

suppresses ACh release from neurons

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10
Q

optic nerve pathway

A

retinal ganglia > optic nerve > optic chiasm > optic tract > lateral geniculate nucleus > optic radiation > visual cortex (occipital lobe)

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11
Q

Meyer’s Loop/sublenticular

A

upper visual field fibers –> temporal lobe –> visual cortex

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12
Q

retrolenticular

A

lower visual field fibers –> parietal lobe –> visual cortex

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13
Q

Area 17

and 18 and 19

A

visual cortex in occipital lobe

then 18 and 19 association cortex

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14
Q

CN I special neurons

A

BIPOLAR

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15
Q

bipolar neurons through

A

cribriform plate to olfactory bulb

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16
Q

receptors and 1* neuron process

A
  1. activate receptor protein
  2. activates G protein (G-olf)
  3. inc cAMP
  4. cAMP opens ligand gated Na+ channel > DEPOLARIZATION
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17
Q

2* olfactory neuron called

A

mitral neuron, in olfactory bulb, which goes to synapse a bunch of places

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18
Q

primary olfaction cortex

A

piriform “pear shaped” cortex

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19
Q

orbital frontal cortex

A

where taste and smell meet to produce “flavor”

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20
Q

gustation involves which CN

A

CN V (touch and temp), VII (taste), IX (taste touch temp), X

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21
Q

gustation receptor cells are not

A

primary neurons
they are RECEPTOR CELLS
(100 receptor cells per taste bud, each cell does one of five tastes, receptor cells turn over q10days)

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22
Q

gustation process/pathway

A
  1. receptor is activate
  2. G protein (sweet, omami, bitter) / Na channel or proton closes K channel (sour, salty)
  3. 2nd mess (sweet, umami, bitter)
  4. open channel for DEPOLARIZATION
  5. open VG Ca++ or release intracellular Ca++
  6. AP
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23
Q

gustation receptor cell types

A

sweet, sour, bitter, omami, salty

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24
Q

taste buds (tip to back of tongue)

A

fungiform, foliate, circumivallate

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25
Q

CN XI origin

A

C 1-5 of spinal cord

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26
Q

CN XI stroke on right

Sx

A

weak SCM same side (can’t turn to opposite side)

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27
Q

CN IX glossopharyngeal supplies

A

tonsillar area and TM

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28
Q

retropharyngeal space

A

worry about infeciton

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29
Q

adenoidectomy

A

pharyngeal tonsils

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30
Q

cough afferent reflex

A

CN VII

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31
Q

cricothyroid muscle innervation

A

external branch of superior laryngeal nerve of vagus

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32
Q

piriform recess innervation

A

internal branch of superior laryngeal nerve of vagus

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33
Q

CN X vagus

A

cough swallow speech

PALATOGLOSSUS

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34
Q

4 gaze systems

A
  1. saccadic movements (rapid, jerky movements, scan to find salience)
  2. smooth pursuit (moving image centered on fovea)
  3. VOR (steady fovea during head movement)
  4. vergence (image on fovea when object is nearer or farther away)
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35
Q

MLF medial longitudinal fasciculus

A

nerves that supply pairs of eye muscles yoke together through this column of axons

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36
Q

UMN vs LMN anatomy

A

UMN: cortex to nucleus
LMN: nucleus to wherever (innervating or synapse)

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37
Q

anisocoria

A

pupils of different size

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38
Q

uveitis

A

iris
ciliary body
choroid

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39
Q

chorioretinitis

A

choroid

retinal layers

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40
Q

endophthalmitis

A

aqueous and vitreous humor
RECENT INTRAOCULAR SURGERY esp cataracts
normal flora: pseudomonas, staph, candida

Tx: fluoroquinolone or vance injected into eye

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41
Q

eye infections: route of infection

A 
trauma
paranasal sinuses
IC
anatomical abnormalities (dysfxn tear states)
blood born
sexually transmitted
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42
Q

tear include

A

sIgA and lysozome
lubrication

sIgA (secretory IgA = dimer) protects IgA from being degraded

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43
Q

why not use corticosteroids during eye infections?

A

corticosteroids facilitate corneal penetration

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44
Q

Chlamydia trachomatis serotypes

A

INCLUSION conjunctivits serotypes D-K
TRACHOMA serotypes A-C *leading cause of blindness worldwide (due to multiple inf and non lasting immunity, scar cornea each time)

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45
Q

Chlamydia trachomatis Dx

A

direct fluorescent ab

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46
Q

Chlamydia trachomatic inf

A

*co-infection with N. gonorrhea
BASOPHILIC INCLUSION BODIES
elementary bodies (rigid membrane) enter epithelia cell > change into reticulate bodies > replicates binary fission > leaves as EB

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47
Q

Tx chlamydia

A

AZITHROMYCIN

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48
Q

adenovirus

A 
ds DNA
non enveloped
lytic in epithelial cells
latent in lymphoid
highly contagious

*infects epithelia cells of RESPIRATORY TRACT, CONJUNCTIVA, ENTERIC ORGANS because antigen and ability to act on certain receptors > Sx

path: migration into (HOST CELL) microtubules > induce cell cycle > block apoptosis > block host mRNA transport and translation > disrupt cytokeratin network
(HOST ORG) antagonize interferon, TNF

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49
Q

how Dx adenovirus

A

ADENOPLUS test

detects hexon proteins (part of viral capsid)

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50
Q

chronic conjunctivitis associated with

A

blepharitis

staphylococcus

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51
Q

hordeolum

A 
STYE
Tx:
erythromycin ointment
warm compress
massage open
keep clean
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52
Q

allergic rhinoconjunctivitis

A

IgE response

Tx: antihistamines, avoid steroids

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53
Q

viral conjuctivitis
neonatal
adult

A 
HSV
adenovirus
Tx:
cold compress
topical vasoconstrictors
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54
Q

acute bacterial conjunctivitis
kids
adults

A

staph aureus+
strep pneumo+
h flu-

staph aureus+

Tx:
EMPIRIC (gram - and gram +)
TRIMETHOPRIM
POLYMYXIN OPHTHALMIC DROPS = POLYTRIM*

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55
Q

hyperacute bacterial conjunctivits

A

Neisseria gonorrheae
preauricular adenopathy
copious yellow/green PURULENT DISCHARGE

Tx:
CEFTRIAXONE

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56
Q

newborns receive prophylactic

A

erythromycin ointment

to prevent ophthalmia neonatorum

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57
Q

keratoconjunctivitis HSV

A

topical trifulridine and system acylovir

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58
Q

trifluridine

A

pyrimidine analog
*effective aginst acyclovir resistant virus bc can be phosphorylated BY HOST KINASES

TOXIC, TOPICAL ONLY

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59
Q

pseudomonas aeroginosa

A

gram -, rod, flagella
PYOCYANIN inhibits mto enz, disrupts ciliary beating
biofilms

adherence factors
secreted cytotoxins (destroy corneal epithelium)
host imm resp damages cornea > scarring, loss visual acuity

Tx:
POLYMYXCIN B

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60
Q

acanthamoeba

A

single cell, EUK
cysts and trophozoites in tissue

Tx: AZOLES

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61
Q

CMV retinitis

A

BRUSHFIRE

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62
Q

Toxoplasma

A

Dx: IgM serology
Tx: pyrimethamine and sulfadiazine

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63
Q

keratitis Sx

A

vision defects
photophobia
pain (cornea has lots nerve endings)
foreign body sensation

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64
Q

keratitis Tx

A

acyclovir and trifluridine VIRAL

moxifloxacin eyedrops

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65
Q

iritis (anterior uveitis)

A

notn infectious

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66
Q

chorioretinitis

A

IC or HIV: toxoplasma or CMV

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67
Q

conjunctivitis bilateral

A

allergic (usually)

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68
Q

conjunctivitis discharge type

A

viral, serous
Chlamydia, mucoid/mucopurulent
bacterial, mucopurulent

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69
Q

preauricular adenopathy

A

viral
chlamydia
neisseria gon

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70
Q

labyrinthitis

A

inner ear infection

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71
Q

associate recurrent OM (otitis media) with

A

conductive HL
meningitis
mastoiditis

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72
Q

commonly occur together, similar agents

A

bacterial conjunctivitis
otitis media
sinusitis

73
Q

Moraxella catarrhalis

A 
gram - diplococcus
OXIDASE +
FASTIDIOUS CHOCOLATE AGAR
95% produce BETA-LACTAMASES*
HOCKEY PUCK TEST
74
Q

Haemophilus influence NTHi

A 
gram - 
LPS > rash
CHOCOLATE AGAR
NONENCAPSULATED
BETA-LACTAMASES*
75
Q

Strep pneumo

A

gram + lancet shape diplococcus
many virulence
suscept: alcoholism, DM, chronic RD

76
Q

strep pneumo virulence

A

resistance
capsule
choline-biding prot (bind carb on surface epithel)
neuramoinidases (cleave host mucins)
pneumolysis (pore forming toxin, disrupts host cilia > HL, causes apoptosis
iron acquisition A (compete with host for iron)

77
Q

OM Tx

A
  1. amox
  2. augmentin (amok with clavulanate)
  3. azithromycin
  4. eartube insertion to drain fluid (8PM TM)
78
Q

Otitis externa Tx

A 
cleanse with acetic acid
topical abx: 
NEOMYCIN +
POLYMXYIN -
HYDROCORTISONE itch

*avoid flushing unless TM intact

79
Q

otitis media with effeusion

A

NOT AN INFECTION

fluid in eustachian tube > resolves on own

80
Q

complications of OM

A

CHOLESTEATOMA cyst of epithelial cells > erode IE or bone or brain, eardrum sucked inward
CONDUCTIVE HL
MASTOIDITIS red, hot, swollen behind ear

81
Q

otitis externa micro

A

staph +
pseudomonas -
aspergillus
candida

82
Q

otitis externa Sx and issues

A

Sx: unilateral, inflam ear canal, pain, itch, purulent ear draiage

  1. pustule with hair follicle
  2. itches, red canal, pain
    (can progress to)
  3. invasion adj bone and cartilage –> CN PALSY/DEATH
    (more common in elderly, poorly controlled DM, IC)
83
Q

Olfactory projections

A

Olfactory bulb > olfactory tract >

  1. olfactory tuburcle/amygdala > hypothalamus VISCERAL RXNS, HOMEOSTASIS, EMOTIONAL
  2. piriform cortex pear > MD thalamus > orbitofrontal cortex CONSCIOUS PERCEPTION, FLAVOR
  3. entorhinal cortex > hippocampus MEMORIES
84
Q

Gustatory projections

A

CN VII, IX, X (1*) > solitary tract > SOLITARY NUCLEUS >

  1. hypothalamus
  2. amydala (emotions)
  3. nucleus ambiguus (gag reflexes to stop intake of spoiled foods)
  4. salivatory nucleus
  5. hypoglossal nucleus
  6. BILATERAL (2) to VPM > (3) gustatory cortex (insula) > orbitofrontal cortex (combination of taste and smell = flavor)
85
Q 
sense of taste tells:
salt
sweet
umami
sour
bitter
A 
salt content
high-energy carbs
proteins
pH
toxic substances
86
Q

Spinal accessory nerves is special because

A

it is the only cranial nerve to both enter and exit the skull

87
Q

CN XII damage

when protrude the tongue…

A

deviates TOWARDS side of damaged NERVE

deviates AWAY side of lesioned CORTICOBULBAR TRACT

88
Q

rate of blinking can be diagnostic because

A

descengin control from basal ganglia and cortex is regulated by DOPAMINERGIC CIRCUITS

89
Q

epiphora
produced by
induced by

A

over-tearing
increased tear production
decreased outflow

CORNEAL STIMULATION reflex
strong emotional responses LIMBIC SYSTEM

90
Q

Refraction definition

A

bending light
inverted and reversed

light when hits cornea gets bent > lens is adjustable for refraction

91
Q

emmetropic

A

perfect vision: refracting normally, infinity in focus

92
Q

refractive power measured in

A

diopters

cornea + lens

93
Q

diplopia

A

oculomotor damage (or abducens or trochlear)

94
Q

what is happening when lens is flat?

A

see long-distance (sympathetic)
ciliary muscle relaxed
zonules tight

95
Q

what is happening when lens is FAT?

A

see close (parasympathetic)
ciliary muscle contracted (M3 Rec)
zonules relaxed

96
Q

hyperopia

myopia

A

farsightedness
eyeball too short

nearsightedness
eyeball too long

97
Q

presbyopia

A

decreased accommodative power with age

98
Q

cataract

A

glycoslylation of LENS proteins

99
Q

associate SYMPATHETIC EYE

A

superior cervical ganglion
NE and a1
superior tarsal (injury: ptosis)
pupillary DILATOR (injury: miosis)

100
Q

associate PARASYMPATHETIC EYE

A

ciliary ganglion
ACh and M3
pupillary SPHINCTER/CONSTRICTOR (injury: mydriasis)

101
Q

pupillary light reflex pathway

A

CN II > optic chiasm > optic tract > optic radiations > edinger westphal nucleus in midbrain > PREganglionic PARAsympathetic to ciliary ganglion > synapse at ciliary ganglion > POSTganglionic PARAsympathetic to pupillary sphincter > miosis

102
Q

aqueous humor production in

absorbed in

A

posterior chamber

anterior chamber (canal of Schlemm)

103
Q

increase outflow of aqueous humor by

A

MIOSIS: give AChE

104
Q

b2 increases concentration of

A

cAMP > increase aq humor volume > increased intraocular pressure

Beta blockers decrease aqueous humor formation

105
Q

inflow of aqueous humor

A
  1. b2 sympathetics increase [cAMP]

2. CA incrases osmotic bleh so Cl- secretion

106
Q

outflow of aqueous humor

A
  1. paraysmpathetics > miosis (AChEs)

2. PGF2 > relaxation of ciliary muscle

107
Q

glaucoma
open angle
closed angle

A

increased INTRAOCULAR PRESSURE
OPEN: common, slow progression, late symptoms
increased production, decreased outflow
normal angle

CLOSED: MEDICAL EMERGENCY
acute, suden onset
SEVERE PAIN, BLURRY, RED EYE
iris moves and blocks Schlemms canal

108
Q

closed angle glaucoma progression >

A

edema and decreased transparency = “halo effect”
damages PRs
neural conduction of CNII affected

109
Q

Muller cells (of eye)

A

specialized glial cells

110
Q

Retina 3 nuclear layers

A

most inner: ganglion cell bodies (axons form optic nerve)

middle: INNER NUCLEAR LAYER bipolar cell bodies
outer: OUTER NUCLEAR LAYER PRs cell bodies

111
Q

3 neurons that begin the process of visual perception

A

1* PRs
2* bipolar neurons
3* ganglion cells
ganglion axons go to form the optic nerve (CN II) > optic chiasm > optic tract > optic radiation > visual cortex

112
Q

___% cones are in fovea

113
Q

blind spot

A

optic disk, where all ganglion cell axons leave to go to brain
no PRs

114
Q

PRs adequate stimulus

A

LIGHT

350-750nM

115
Q

PRs encode

A 
frequency = color
intensity = brightness
116
Q

scotopic vision

photopic vision

A

can see in dark, RODS

vision in bright lights, CONES

117
Q

RODS

A 
scopotic vision
more pigment
more sensitive to single photon
saturate sooner
RHODOPSIN
integrated: low spatial and temporal resolution
slower
118
Q

CONES

A 
photopic vision
less pigment
less sensitive to detecting photons
bright light
color vision per certain wavelengths
precise, high temporal and spatial resolution
faster
119
Q

color vision wavelengths

A

blue: short wave
green: medium wave
red: long wave
* red doesn’t overlap -> red vision from cones

120
Q

types visual acuity

A
  1. spatial ( two points in space, eye chart)
  2. temporal (two events as separate, critical fusion freq: 50Hz)
  3. spectral (two colors as different)
121
Q

rhodopsin

A

light activated > change conformation > G protein > PDE > cGMP to GMP > CLOSE cAMP depending Na channels > HYPERPOLARIZATION

122
Q

rhodopsin/rod vision special because

A

stimulus CLOSES channel, not open it
HYPERPOLARIZATION
2nd messenger: get AMPLIFICATION > increased sensitivity > CAN SEE IN DARK

123
Q

Retinitis Pigmentosa and Retinopathy

A

neither involved in inflammation
both STOP PRs from working
NIGHT BLINDNESS FIRST

124
Q

Vitamin A deficiency

A

NIGHT BLIND because rods don’t work well

125
Q

Macular degeneration (Fitz)

A

degeneration in RPE

126
Q

rhodopsin cycle with RPE

A

light > rod > rhodopsin to opsin > all transretinal > all transretinol > TO RPE CELL > all transretinol > 11-cis-retinal > TO ROD > makes more rhodopsin

127
Q

adaptation definition

dark adaptation

A

decreased response to sustained stimulus

RPE pumps retinal components into rods > more rhodopsin > more sensitive

128
Q

upper visual fields project to

lower visual fields project to

A

lingual gyrus (of occipital)

cuneate gyrus (of occipital)

129
Q

macular representation in area 17

peripheral field representation in area 17

A

macular = most caudal = towards back of head

peripheral = rostral 2/3 of area 17 = back of head towards eyes

130
Q

dorsal stream (parietal and upper temporal visual association cortex)

ventral stream (inferior temporal visual association cortex)

A

“where”
(lying on back/dorsally in ocean, where am I?)

“what”
(lying on stomach/ventrally in ocean, what am I looking at?)

131
Q

projections to superior colliculus

A

via optic radiation and brachium of superior colliculus

i. SCANNING movement
ii. ACCOMMODATION/ CONVERGENCE reflex

132
Q

homonymous defects

A

right POST-CHIASMATIC defects
left homonymous hemianopsia
left upper homonymous quadrantanopsia
left homonymous hemianopsia with macular sparing

133
Q

heteronymous defects

A 
OPTIC CHIASM (can't see periphery)
bitemporal heteronmymous hemianopsia
134
Q

hemianopsia

A

defective vision or blindness in one half of visual field

bitemporal heteronymous hemianopsia, 
left homonymous (with and without macular sparing)
135
Q

accommodation reflex

A

(initiated when gaze is shifted from distant object to near one and image becomes blurred)
OCULAR CONVERGENCE both MR contract
MIOSIS constrictor pupillae sharpen image
LENS THICKENING ciliary muscle contracts, increasing refractive power of lens

136
Q

Horner’s Sx

A

ptosis
miosis
vasodilation (flushing of face)
anhidrosis (absence of sweating)

137
Q

Argyll Robertson pupil

A

pupil ACCOMMODATES to near objects but DOES NOT REACT TO LIGHT
(issues with pretectal area)

tabes dorsalis/tertiary syphilis, SLE, DM

138
Q

strabismus

A

squint: failure of coordination of extra ocular eye muscle, resulting in deviation of affected eye and diplopia

139
Q

amblyopia

A

lazy eye
decreased visual acuity in absence of anatomical defects in visual pathway

to avoid diplopia, vision in one eye is suppressed at level of the visual cortex

140
Q

scotoma

A

island of visual loss within visual field

141
Q

sphenoid sinus does not open into

A

middle nasal meatus

142
Q

nasolacrimal duct communicates with

A

inferior nasal meatus

143
Q

sensory neurons to roof of hard and soft palate

A

nasopalatine nerve of V

144
Q

tympanosclerosis

A

calcium plaque in ME

perforation of TM

145
Q

cholesteatoma

A

long standing retraction of TM into ME, negative pressure > skin cyst > cyst slowly erodes bone

Sx: facial paralysis, HL, dizziness, can erode brain cavity

146
Q

hemotympanium

A

blood in middle ear

BAD

147
Q

red eye, minor cold, clear eye drainage

A

adenovirus

148
Q

visual field deficit, most common in HIV infected individuals

149
Q

releases pnemolysin pore forming toxin

A

streptococcus pneumonea

150
Q

green/yellow discharge from eyes

A

neisseria gonorrhea

151
Q

ototoxic drugs

A

gentamicin, lasix, cisplatin, ASA/NSAIDS, antimalarials

152
Q

presbycusis

A

most common cause of loss of hair cells, progressive

153
Q

Otosclerosis

A

autosomal dominant
poor conduction
stapes needs fixing

154
Q

BPPV

A

most common
“roll out of bed, turn and room starts spinning”
Dix Hallpike

155
Q

Ostemoa

A

benign growth in ear canal
cold water exposure
nothing to do about it
looks like cholesteatoma

156
Q

Meniere’s

A

inner ear
spontaneous VERTIGO lapses
ENDOLYMPH LEAKING

157
Q

Acute Otitis Media

A 
2nd most common disease in children
Eustachian tube dysfunciton
s. pneumo
h. flu
moraxella
158
Q

Allergic rhinitis

A

IgE mediated hypersensitivity of nasal mucosa to foreign substances
affects 20% US pop
DOESN’T HAPPEN BEFORE AGE 2, BUT BY 20YO
M>F

Sx: sneezing, rhinorrhea, nasal congestion, lacrimation

159
Q

macular degeneration
dry
wet

A

DRY DRUSEN, can get wet

WET, BLOOD Subretinal hemorrhage, grayish = bad

160
Q

wet macular degneration Tx

161
Q

glaucoma

A

optic nerve cupping: ENLARGED OPTIC CUP

LOSS OF OPTIC NERVE FIBERS

162
Q

diabetic retinopathy

A

can cause BLINDNESS
NONPROLIFERATIVE
microanurysms, blot hem, exudates, macular edema, cotton wool spotaj

PREPROLIFERATIVE
venous beading, intraretinal microvascular changes, ischemic areas (cotton wool spots)

PROLIFERATIVE
BOAT HEMORRHAGE

163
Q

diabetic retinopathy Tx

A

anti-VEGF

proliferative; panretinal photocoagulation

164
Q

hypertensive retinopathy

A

silver wiring

cotton wool spots

165
Q

amaurosis fugax

A

sudden vision loss
no pain
vascular insufficiency
CARDIAC WORKUP

166
Q

ophthalmic migraine

A

hallmark: SCINTILLATINGN SCOTOMA: aura, colorful/shimmery aura
20-30 minutes
Spasm of arteriol in occipital cortex

167
Q

retinal arterial occlusion

A 
CHERRY RED SPOTS
sudden vision loss one eye
painless
BREATHE CO2
TIMOLOL
ACETAZOLAMIDE IV
168
Q

retinal vein occlusion

A

SQUASHED TOMATO

169
Q

temporal arteritis

A

history is key
EXTREME TENDER SCALP
STEROIDS IMMEDIATELY

170
Q

CN III palsy

A

“down and out”
mydriatic
ptosis
diplopia

171
Q

CN IV palsy

A

common
one eye slightly higher than other
vertical diplopia (not horizontal)

172
Q

CN VI palsy

A

one eye in “down and in”

173
Q

alkali eye injury

A

irrigate forever

174
Q

hyphema

A

DON’T MISS THIS

blood in anterior chamber

175
Q

subconjunctival hemorrhage

A

blood on surface of sclera, under conjunctiva

harmless

176
Q

sudden painless loss of vision

A

retinal detachment
retinal vein occlusion - squashed tomato
retinal artery occlusion - cherry red
vitreous hemorrhage

177
Q

sudden painful loss of vision

A

corneal abrasion
uveitis
traumatic hyphema
acute glaucoma

178
Q

sudden BILATERAL vision loss

A

painless: meds
painful: toxins, chemical exposure

179
Q

gradual vision loss

A

macular degeneration

cataracts

Hailey - Neuro (10 decks)

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