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FIRST aid 2015 - Sahaja > First Aid pg 480-484 Neuro > Flashcards

First Aid pg 480-484 Neuro Flashcards

1
Q

What primarily renal drug affects aq humor? how?

A

carbonic anhydrase inhibitors, dec formation

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2
Q

Which drugs dec the production of aq humor?

A

BB (timolol, other non sel BB), alpha agonists, carbonic anhydrase inhibitors

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3
Q

Which drugs inc out flow of aq humor?

A

Prostaglandin F2 alpha (+)’r - latanoprost, travoprost

Cholinomimetics - pilocarpine, carbachol

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4
Q

Where is the light focused, in terms of retina, in the case of hyperopia and myopia?

A

In hyperopia, light focused behind retina, and in myopia light is focused in front of the retina

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5
Q

Why does presbyopia happen?

A

dec lens elasticity, dec collagen IV

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6
Q

How does DB lead to lens opacification?

A

Inc gluc in the lens –> sorbitol via aldose reductase, and also to fructose. Both fructose and sorbitol will stimulate water influx –> osmotic cell injury, lens becomes opaque

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7
Q

Which drug can lead to cataracts?

A

Long term corticosteroid use

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8
Q

Which enzyme def leads to cataracts?

A

galactokinase, galactose 1 phosphate uridyltransferase

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9
Q

Which of the trisomies can lead to cataracts?

A

all of them

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10
Q

What AD disease of chromosome 22 can lead to juvenile cataracts? What other tumors come with?

A

NF2 - comes with bilat acoustic schwannomas, meningiomas, ependymomas

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11
Q

What AD disease of chr 15 lead to cataracts and also have a frontal fold closure issue?

A

Marfan syndrome

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12
Q

What disease leads to nephritis, hearing problems, and cataracts later in life? What molecule is affected?

A

Alport syndrome, collagen IV

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13
Q

Optic disc atrophy with cupping?

A

Glaucoma

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14
Q

Open angle glaucoma is more common in which patient population?

A

African American

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15
Q

Cause of secondary closed angle glaucoma?

A

Hypoxia from retinal disease, like DB or vein occlusion - induces vasoproliferation in iris that contracts angle

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16
Q

Why not give epi in acute closure glaucoma?

A

Mydriasis makes it worse

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17
Q

halos, rock hard eye, frontal headache

A

Glaucoma - acute closure

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18
Q

Most common cause of conjunctivitis?

A

viral is most common, esp adenovirus

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19
Q

Extra ocular symptom of viral conjunctivitis?

A

swollen preauricular node

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20
Q

Diseases associated with uveitis?

A

systemic inflammatory disorders - sarcoidosis, rhematoid arthritis, juvenile idiopathic arthritis, PAIR (HLA-B27) arthritides

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21
Q

What causes metamorphopsia and loss of central vision?

A

Age related macular degeneration - distortion and scotomas

22
Q

Two types of DB retinopathy and describe them

A

Non proliferative - damaged capillaries leak blood –> lipids and fluid seep into retina –> hemorrhages and macular edema

Proliferative - chronic hypoxia result in new blood vessel formation with then traction on the retina

23
Q

Tx for Non-prolif DB retinopathy?

A

blood sugar control, surgery

24
Q

Tx for Proliferative DB retinopathy?

A

Peripheral retinal photocoag, surgery, anti-VEGF (Bevacizumab)

25
Q

What causes retinal v occlusion?

A

compression from nearby arterial atherosclerosis

26
Q

What are the signs of retinal v occlusion?

A

Retinal hemorrhage, venous engorgement, edema in affected areas

27
Q

Which two layers of the retina separate in retinal detachment?

A

Seperation of the rods and cones layers (neurosensory layer) from the outer pigmented epithelium

28
Q

How does retinal detachment look on fundoscopy ?

A

crinkling of retinal tissue and changes in vessel direction

29
Q

Why the vision loss in retinal detachment?

A

Due to degeneration of photoreceptors

30
Q

Retinal breaks are more common in patients with a history of what?

A

high myopia or history of head trauma

31
Q

First symptoms that indicate retinal detachment?

A

“flashes” and “floaters” (from posterior vitreous detachment) and monocular loss of vision - like a “curtain drawn down”

32
Q

secondary causes of retinal detachment?

A

retinal breaks, DB traction, inflammatory effusions

33
Q

Retina cloudy with attenuated vessels and “cherry-red” spot at fovea

A

Central retinal artery occlusion

34
Q

Diseases with cherry red spots

A

Tay Sachs, Neimann Picks

35
Q

Painless, progressive vision loss beginning with night blindness (rodsaffected first). (Inherited)

A

Retinitis Pigmentosa

36
Q

Bone spicule–shaped deposits around macula

A

Retinitis Pigmentosa

37
Q

Infections associated with retinitis?

A

CMV (HHV5) (HIV/immunocompromised), Toxoplasmosis (congenital), HSV, VZV

38
Q

Retinal edema and necrosis leading to a scar?

A

Retinitis

39
Q

Treatment for congenital chorioretinitis?

A

Sulfadiazine + pyrimethamine

40
Q

Treatment for CMV retinitis?

A

Foscarnet, Cidofovir - if gancilovir fails

41
Q

Enlarged blind spot and

elevated optic disc with blurred margins

A

Papilledema

42
Q

Pathway of Miosis

A

ƒƒ 1st neuron: Edinger-Westphal nucleus to ciliary ganglion via CN III
ƒƒ 2nd neuron: short ciliary nerves to pupillary sphincter muscles

43
Q

Pathway of Mydriasis

A

ƒƒ 1st neuron: hypothalamus to ciliospinal center of Budge (C8–T2)

ƒƒ 2nd neuron: exit at T1 to superior cervical ganglion (travels along cervical sympathetic chain
near lung apex, subclavian vessels)

ƒƒ 3rd neuron: plexus along internal carotid, through cavernous sinus; enters orbit as long ciliary
nerve to pupillary dilator muscles.

Sympathetic fibers also innervate smooth muscle of eyelids (minor retractors) and sweat glands of forehead and face.

44
Q

Disease with Marcus Gunn Pupil

A

MS

45
Q

What is a Marcus Gunn pupil?

A

DEC bilateral pupillary constriction when light is shone in affected eye relative to unaffected eye

46
Q

How does one test for Marcus Gunn pupil?

A

Swinging flashlight test

47
Q

Symptoms of SNS denervation of face?

A 
ƒƒ Ptosis (slight drooping of eyelid: superior
tarsal muscle)
ƒƒ Anhidrosis (absence of sweating) and
flushing of affected side of face
ƒƒ Miosis (pupil constriction)
48
Q

Horner’s seen with which diseases?

A

Any lesion of spinal cord above T1 –> Pancoast tumor, Brown Sequard, Late stage syringomyelia,

Also seen with cluster headaches, Lung cancer, PICA injury, Cavernous sinus syndrome,

49
Q

Chronic closure glaucoma - sx?

A

Mostly asymptomatic, but over time can lead to CN II issues, especially loss of periph vision

50
Q

Bacteria causing conjunctivitis?

A

H. influ, Chlamydia(follicular type), N gon

51
Q

Causes of Neonatal conjunctivitis?

A

N. gonorrhea, HSV-1, Measles ( the 3Cs coryza, conjunct., cough) Reactive arthritis.(Reiter syndrome)

52
Q

Cause of retinal occlusion?

A

Atrial fib

FIRST aid 2015 - Sahaja (31 decks)

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