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Y3 MedEd > CN and Opthalmology > Flashcards

CN and Opthalmology Flashcards

1
Q

Conditions that affect all CN (7)

A 
Diabetes mellitus
MS
Tumours
Sarcoid
Vasculitis
Systemic lupus erythematosus
Syphilis
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2
Q

Anosmia differentials (5)

A 
Ageing 
Traumatic Brain Injury
Parkinson’s
Alzheimer’s
Tumour
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3
Q

In which patients is anosmia more likely to be due to a tumour

A

Young patients

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4
Q

What is supposed to be prodromal of Parkinsons

A

Change in sense of smell

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5
Q

Which disease is a change in sense of smell meant to be prodromal of

A

Parkinsons

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6
Q

What suggests loss of vision due to MS (3)

A

Over a few hours
Painful
Young

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7
Q

What does sudden loss of vision suggest the cause is

A

An infarct

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8
Q

What are the differentials for loss of visual acuity (7)

A 
Refractive error
Ocular Media
cataracts 
diabetes
Retina
age related macular degeneration 
diabetic retinopathy
Optic neuropathy
MS
ischaemia
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9
Q

Which reason for loss of visual acuity is often bilateral

A

Age related macular degeneration

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10
Q

What is pink eye known as

A

Conjunctival hyperaemia

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11
Q

Bacterial conjunctivitis signs (4)

A

Unilateral
Thick discharge
Reduced vision
Urethritis/vaginal discharge

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12
Q

Viral conjunctivitis signs (4)

A

Bilateral
Watery discharge
Normal vision
Signs of viral infection (fever/lymphadenopathy)

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13
Q

Causes of allergic conjunctivitis (3)

A

pollen
dust
Chemical scents

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14
Q

What type of reaction is allergic conjuctivitis

A

T1 hypersensitivity IgE mediated

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15
Q

Which Ig is allergic conjunctivitis

A

IgE

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16
Q

If a patient complains of visual halos what does this suggest

A

Cataracts

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17
Q

What must you rule out in an acutely red painful eye

A

Closed angle glaucoma

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18
Q

What sign is seen on opthalmoscopy of glaucoma

A

Cupping of the optic disc

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19
Q

4 features of open angle glaucoma

Bi/unilateral
Onset
Pain
Associated symptoms

A

Bilateral
Progressive visual loss
Initially asymptomatic
Mild nonspecific symptoms

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20
Q

7 features of closed angle glaucoma

Bi/unilateral
Onset
Pain
Associated symptoms (4)

A

Unilateral
Sudden onset
Severely painful
N&V, cloudy cornea, head, dilated pupil

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21
Q

Anterior or posterior uveitis is associated with AI disease

A

Anterior

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22
Q

Which diseases are associated with and which type of uveitis (6)

A

Anterior

seronegative spondyloarthropathies, RA, sarcoidosis, SLE, IBD and Bechet’s

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23
Q

Anterior or posterior uveitis is associated with infective disease

A

Posterior

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24
Q

Infective causes of (and which type of) uveitis (6)

A

Posterior

CMV, EBC, VZV. Bacteria like syphilis and TB,

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25
Q

Difference between anterior and posterior uveitis (3)

A

Anterior:
Associated with AI conditions
Painful ocular hyperaemia
Increased lacrimation and photophobia

Posterior:
Infective causes
Painless
Floaters and scotomata

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26
Q

Prechiasmal main causes of loss of visual field (2)

A

Ischaemia

Inflammation

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27
Q

Chiasmal main causes of loss of visual field (2)

A

Pituitary tumour

Craniopharyngioma

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28
Q

Which lobe is damaged in neglect syndrome

A

Contralateral parietal lobe

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29
Q

Which 4 reflexes can you test in the eye

A

Direct pupillary
Consensual pupillary
Swinging light
Accommodation

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30
Q

Which nerve detects light

A

Optic

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31
Q

Which nerve/s constrict the pupil

A

Parasympathetic and oculomotor

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32
Q

Which nerves are responsible for dilatation

A

Sympathetic

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33
Q

Which diseases have a Marcus Gunn pupil

A

Optic neuritis

Also optic neuritis MS

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34
Q

Horners differentials (3)

A

Carotid artery dissection
Pancoast tumour
Brainstem stroke/tumour

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35
Q

Triad in Horner’s (3)

A

Ptosis
Miosis
Anhidrosis

36
Q

Why is there is miosis and ptosis in Hormers

A

Ptosis as sympathetic supply is disrupted

Miosis as parasympathetic constriction of pupil is now unopposed

37
Q

How can a brainstem stroke give Horner’s

A

Sympathetic supply originates from hypothalamus and travels down brainstem, so therefore brainstem stroke or tumour can give Horner’s

38
Q

Cause of medical third nerve palsy

A

DM

39
Q

Cause of surgical third nerve palsy

A

Raised ICP

Rupture of aneurysm

40
Q

What is internuclear ophthalmoplegia a sign of (2)

A

MS

Stroke

41
Q

Corneal reflex afferent and efferent arms

A

Corneal reflex (afferent: V1, efferent VII)

42
Q

Jaw jerk reflex afferent and efferent arms

A

Jaw-jerk (afferent: V3, efferent: motor V)

43
Q

Causes of Bells palsy (4)

A

idiopathic
compression of facial nerve within the facial canal
inflammation, e.g. viral infection
herpes simplex type 1 or varicella zoster

44
Q

RF for Bells palsy

A

Diabetes

45
Q

Which virus can result in Bells palsy

A

HSV1

46
Q

Ix for Bells palsy

A

Serology

47
Q

Mx of Bells palsy

A

Prevent corneal abrasions

Steroids - prednisolone

48
Q

What is Ramsay Hunt syndrome

A

LMN facial nerve palsy due to varicella zoster

49
Q

What causes Ramsay Hunt syndrome

A

Varicella zoster

50
Q

Which other nerves can Ramsay Hunt syndrome affect and what can that cause

A

other cranial nerves like 8 – giving deafness and vertigo, also results in pain and vesicles on tongue, hard palate

51
Q

Which age does Ramsay Hunt affect

A

Over 60

52
Q

Which disease is caused by a reactivation of chicken pox (Varicella Zoster)

A

Ramsay Hunt syndrome

53
Q

Forehead affected facial droop is caused by…

A

Bells palsy

54
Q

Does UMN or LMN problems allow forehead sparing

A

UMN e.g. strokes for example

55
Q

Which test is Rinne and which is Webers

A

Webers is in the middle of your forehead

56
Q

Describe the results of a Webers test

A

Should normally be audible equally from both sides
In conductive hearing loss it is louder towards the deficit
In sensorineural loss it lateralises away from the deficit

57
Q

Describe the results of a Rinne’s test

A

AC > BC
If BC > AC there is a conductive hearing problem and we use Weber to figure out which ear and if there is a combined loss

58
Q

If Rinne in both ears is normal but Weber lateralises towards an ear what does that suggest

A

Sensorineural loss in the opposite ear

59
Q

Causes of conductive hearing loss (3 external auditory canal, drum, 2 middle ear, oval window))

A

EAC
Wax
Foreign body
Otitis externa

Drum
Perforation

Middle ear
Acute otitis media
Serous otitis media

OW
Otosclerosis

60
Q

Ways you can have sensorineural hearing loss (5)

A 
Inflammation
Tumour
Ototoxic drugs
Trauma
Menieres disease
61
Q

Examples of ototoxic drugs (3)

A

Aminoglycoside (gentamycin) antibiotics
Aspirin (overdose)
Loop diuretics

62
Q

Examples of tumour causing sensorineural hearing loss

A

Acoustic neuroma

63
Q

What causes of inflammation can cause sensorineural hearing loss (4)

A

Meningitis

MMR

64
Q 
Neurofibromatosis T1:
Inheritance
Gene
Chromosome
Presentation (5)
Other features (3)
A 
Inheritance
Autosomal Dominant
Gene
NF1
Chromosome
17
Presentation
Café-au-lait spots
Freckling in skin folds
Neurofibromas
Lisch nodules
Spinal scoliosis
Other features
Short stature
Mild intellectual disability
65
Q

Main 5 presentations of neurofibromatosis T1

A 
Café-au-lait spots
Freckling in skin folds
Neurofibromas
Lisch nodules
Spinal scoliosis
66
Q 
Neurofibromatosis T2:
Inheritance
Gene
Chromosome
Presentation (3)
Other features (2)
A 
Autosomal Dominant
NF2
22
Sensorineural hearing loss
Bilateral acoustic neuromas
Symptomatic by age 20
No/fewer café-au-lait spots
Tinnitus/vertigo possibly
67
Q

Main 3 presentations of neurofibromatosis T1

A

Sensorineural hearing loss
Bilateral acoustic neuromas
Symptomatic by age 20

68
Q

What is the triad of Menieres disease

A

sensorineural hearing loss, vertigo and tinnitus

69
Q

What result suggests sensorineural loss in the right ear

A

Normal Rinne in both ears and Weber lateralises left

70
Q

What result suggests sensorineural loss in the left ear

A

Normal Rinne in both ears and Weber lateralises right

71
Q

What result suggests conductive loss in the right ear

A

Rinne right BC>AC

Weber lateralises right

72
Q

What result suggests conductive loss in the left ear

A

Rinne left BC>AC

Weber lateralises left

73
Q

What result suggests combined conductive and sensorineural loss in the left ear

A

Rinne left BC>AC

Weber lateralises right

74
Q

What result suggests combined conductive and sensorineural loss in the right ear

A

Rinne right BC>AC

Weber lateralises left

75
Q

What does a negative Rinnes test suggest

A

Conductive loss

76
Q

What does a Webers test suggest

A

Sensorineural loss

77
Q 
Bulbar palsy:
Gag reflex
Tongue (2)
Palatal movement
Jaw jerk
Speech
Emotions
Other:
A 
Gag reflex – absent
Tongue – wasted, fasciculations
Palatal movement – absent
Jaw jerk – absent or normal
Speech – nasal
Emotions – normal
Other – signs of the underlying cause, e.g. limb fasciculations.
78
Q 
Pseudobulbar palsy:
Gag reflex
Tongue
Palatal movement
Jaw jerk
Speech
Emotions
Other:
A

Gag reflex – increased or normal
Tongue – spastic
Palatal movement – absent
Jaw jerk – increased
Speech: “a monotonous, slurred, high-pitched, ‘Donald Duck’ dysarthria”
Emotions – labile
Bilateral upper motor neuron (long tract) limb signs

79
Q

Which is LMN disease bulbar or pseudobulbar palsy

A

Bulbar

80
Q

Which is UMN disease bulbar or pseudobulbar palsy

A

Pseudibulbar

81
Q

Causes of pseudo bulbar palsy (3)

A

Stroke of internal capsule
MS
Motor neuron disease

82
Q

Causes of bulbar palsy (2)

A

Motor neuron disease

Guillain-Barre

83
Q

Which nerves are affected in bulbar palsy

A

V VII X XI XII

84
Q

Which nerves are affected in bulbar palsy

A

X XI XII

85
Q

Which changes emotions and how does it change them, bulbar or pseudo bulbar palsy

A

Pseudobulbar has labile emotions

Y3 MedEd (34 decks)

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