Eye and ear Flashcards
What does the Medial Longitudinal Fasciculus do?
Maintains conjugate gaze
Patient has upper quadrantanopia. Where is the lesion?
Temporal lobe
Patient has lower quadrantanopia. Where is the lesion?
Parietal lobe
What causes uveitis?
Infection (viral, syphilis)
Autoimmune (ankylosing spondylitis, JIA)
Inflammatory (IBD)
Patient has pain and photophobia. What would be seen on slit lamp exam if this were anterior uveitis?
Inflammation of eye and keratin deposits on cornea
Patient has mild vision abnormalities. What would be seen on slit lamp exam if this were posterior uveitis?
Eye inflammation and retinal lesions
A patient has frequent changes of lens prescription. What should done?
Check ocular pressure…could have glaucoma
How is vision lost with open-angle glaucoma? What is seen on funduscopic exam?
Peripheral to central
Cupping of optic disc
What are treatment options for open angle glaucoma?
Topical beta-blockers (timolol) and alpha-adrenergic agonists decrease aqueous humor production
alpha-adrenergic agonists and cholinergic agonist (pilocarpine) increase aqueous removal
What shouldn’t you do to someone with closed angle glaucoma?
Dilate their eyes…further closes angle
How is closed angle glaucoma treated?
Acetazolamide decreases pressure
Pilocarpine (after pressure reduction) reduces obstruction
Laser iridotomy to prevent recurrence (done on both sides)
What is the most common cause of bilateral vision loss in old people?
Macular degeneration
How is vision lost with macular degeneration?
Central to peripheral
What is seen on funduscopic exam with macular degeneration?
Retinal pigmentation (atrophic type...slow) Retinal hemorrhage (exudative type...fast)
Possibly a detachment
What are treatment options for macular degeneration?
Supplements: vit C and E, beta-carotene, copper, zinc
Intravitreal ranibizumab may help with exudative lesions near fovea
Laser photocoagulation may delay progression
A patient has painless acute vision loss…“window shade pulled over eye” or “numerous floaters.” What likely happened? What would be seen on funduscopic exam?
Retinal detachment
Pigmented fragments or gray retina floating in vitreous humor
How is retinal detachment treated?
Laser photocoagulation or cryotherapy to halt progression and reattach…may not fully restore vision
Patient comes in with sudden, painless vision loss with a cherry red spot in fovea and poor arterial filling on funduscopic exam. What is going on? How is it treated?
Retinal artery occlusion…signs due to no blood
Thrombolysis w/in 8hrs
Acetazolamide and O2 to decrease congestion and increase perfusion
Patient comes in with gradual, painless vision loss and cotton wool spots, edema, retinal hemorrhages and dilated veins are seen on funduscopic exam. What is going on? How is it treated?
Retinal vein occlusion…signs due to increased pressure
Laser photocoagulation can help
How is otitis externa
(swimmer’s ear) treated?
Topical polymyxin, neomycin, and hydrocortisone
Oral cephalosporin or ciprofloxacin for Pseudomans infection…or if infection spreads to the skull
Topical drying agents to prevent recurrence
What is another name for Meniere disease? Besides the awful vertigo, what else happens with this disease?
Endolymphatic hydrops
Low-frequency hearing loss
How is miner disease treated?
Anticholinergics, antiemetics, and antihistamines improve exacerbations
Salt restriction and thiazides can reduce frequency of exacerbations
Surgical decompression is necessary in refractory cases
Patient comes in with hearing loss, dizziness, tinnitus, and unilateral facial palsy. On exam, he has decreased sensation of his face. What should be done?
MRI to localize acoustic neuroma (acoustic schwannoma…benign tumor)
