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Neuro Flashcards

1
Q

Pros and cons of eye ointments
Pros and cons of eye drops

A

Ointments:
Pros: Harder to apply
Cons: Lubricant, long lasting

Drops:
Pros: Easy to apply
Cons; Short duration, minimal lubriaction

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2
Q

What is the main first line treatment for minor ocular surface infections like conjunctivitis

A

Fusidic acid

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3
Q

Spectrum of fusidic acid

A

Narrow spectrum, mostly gram +ives

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4
Q

Use of Chloramphenicol

A

Broad spectrum AB used for Prophylaxis for ulcers and ocular surgery, bacterial conjunctivitis
(good for ulcers)

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5
Q

What 2 topical antibiotics are good treatments for melting/infected ulcers

A

Onfloxacin and ciprofloxacin

Gentamicin

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6
Q

Topical and systemic antibiotics for Feline chlaamydia conjunctivitis

A

Topical: Chlortetracycline (Ophtocycline)
Systemic: Doxycycline (Also mycoplasma)

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7
Q

What ocular condition can the systemic antibiotic Clindamycin treat

A

Toxoplasma gondii-induced uveitis in cats and dogs (treats bacteria and Protozoa)

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8
Q

What is the first line treatment for KCS and Pannus

A

Ciclosporin

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9
Q

What other drug is given to treat melting ulcers (with antibiotics)

A

Anti-collagenases;
Serum or stromease (new)

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10
Q

Drug of choice for acute primary glaucoma

A

Prostaglandin analogues (Latanoprost/travoprost)

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11
Q

3 mydriatics and their uses

A

Phenylephrine = diagnose horners
Tropicamide = diagnostic purposes
Atropine = treats anterior uveitis (long duration) (also in corneal ulcers when reflex AU can occur)

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12
Q

When should steroids never be used

A

Corneal ulcer cases

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13
Q

Is primary infectious conjunctivitis common in cats and dogs?

A

Cats = common
dogs = rare

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14
Q

Triad of pain signs

A

Blepharospasm
Photophobia
Increased lacrimation

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15
Q

When can follicular hyperplasia occur

A

Chronic conjunctivitis

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16
Q

common treatment for conjunctivitis

A

Fusidic acid
or Chloramphenicol

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17
Q

4 adnexal diseases that can lead to conjunctivitis

A

entropion
ectropion
eyelid mass
cilia disorders

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18
Q

Common cause of KCS

A

Immune-mediated destruction of lacrimal + nictitans gland in young to middle aged dogs

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19
Q

Signs of KCS

A

Bilateral (except neurogenic)
- Recurrent conjunctivitis
- Tacky, mucoid discharge
- Reduced vision

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20
Q

dx of KCS

A

Schirmer tear test

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21
Q

2 infectious causes of conjunctivitis in cats

A

Chlamydophila felis and FHV

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22
Q

signs of Chlamydophila felis

A
  • Unilateral conjunctivitis (bilateral after couple days
  • chemosis
  • no corneal signs
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23
Q

signs of FHV (Kittens V adults)

A

Kittens: Bilateral conjunctivitis, URT signs, +/- corneal ulceration

Adults: Unilateral discharge, mild conjunctivitis, hx of URT signs, other ocular sings (inc cornea)

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24
Q

Antibiotic of choice for feline chlamydia

A

Doxycycline

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25
Diagnostic test for corneal ulcers
Fluorescein stain may also see reduced palpebral and corneal reflex
26
Difference in appearance of the corneal ulcer types
Superficial: Sharp borders Stromal: Visible crater. Floors and walls stained Descementocoele: Black base of ulcer with green walls Perforated: rank Melting; Gelatinous discharge, melting edges, grim
27
3 drugs to treat a corneal ulcer
- Prevent secondary infection with chloramphenicol drops - Analgesia (NSAIDs) - Treat reflex uveitis (one drop of atropine) Recheck in 3/5 days
28
signs of corneal ulcers
triad of pain conjunctival hyperaemia discharge reflex uveitis !!
29
what are SCCEDs
- Spontaneous chronic corneal epithelial defect - Seen in Boxers lots - Superficial ulcer of middle-aged dogs - Epithelial loss ONLY
30
Appearance of SCCEDS with Fluorescein dye
see lip of epithelium that can't adhere to storm indistinct, irregular border
31
Treatment of SCCEDs
Need to disrupt basement membrane Debridement +/- keratotomy (needle) or keratectomy (diamond burr) NB keratotomy Contra-indicated in all other types of ulcers!
32
How to distinguish cataracts from nuclear sclerosis (normal ageing)
Distant direct Tapetal reflex = not a cataract
33
Signs of anterior uveitis
Pain Miosis Dull eyes Reduced IOP Corneal oedema (Blue eye)
34
Tx of anterior uveitis
Usually secondary to something (immune-mediated, infectious, metabolic, neoplastic) Treat underlying cause - Anti-inflammatories - Topical atropine
35
What is gPRA
Generalised progressive retinal atrophy (gPRA) Inherited photoreceptor atrophy in pedigree dogs - Bilateral symmetrical degeneration - Gradual vision loss (night first) - Secondary cataracts
36
what is Sudden Acquired Retinal Degeneration (SARDs)
Middle-aged to older - Acute vision loss (few days – weeks)
37
Signs of gPRA on distant direct
Thin retina = tapetum is more reflective pale optic dsic
38
Signs of SARDs
Dilated pupils (mydriasis) and absent PLs Fundus can be normal in early stages
39
Signs of Horner's syndrome
Damage to SNS Miosis, third eyelid protrusion, ptosis, enophthalmos
40
What nerve is effected if there is an absent palpebral and corneal reflex
Trigeminal supplies sensation
41
What nerve is effected if there is anisicoria
Damage to the ocular motor nerve
42
what is Chronic superficial keratitis (CSK) aka pannus
Cellular infiltrate into cornea See vascularisation Non painful
43
What is feline Eosinophilic keratitis
"Cottage cheese deposits”: white to pale pink elevated spots on cornea – may coalesce into a raised plaque Links to FHV-1
44
What is feline Corneal sequestrum
- Varies from amber corneal discolouration to dark brown plaque - Usually unilateral - Cause unknown Maybe predisposed by chronic irritation (brachys, entropion, grid keratotomy)
45
Distinctive sign of a retrobulbar abscess
Pain on opening the mouth
46
Diagnostic test for acute glaucoma
Tonometry Will detect a high IOP
47
signs of acute glaucoma
very painful vision loss (No PLR or dazzle) Fixed, dilated pupil can be secondary to anterior lens luxation
48
Signs of anterior lens luxation
very painful secondary glaucoma Corneal oedema (blue (take photo with flash if cloudy to see)
49
Breeds predisposed to anterior lens luxation and glaucoma And management
Terrier's for both Also purebred heredity for glaucoma Both conditions are bilateral so if one eye effected => other will be in future
50
What are the pupils doing in anterior uveitis V anterior lens luxation
AV: Miosis ALL: Mydriasis
51
When to do Schirmer tear tes
ALWAYS first (even before you shine light in)
52
what indicates eye Swabs or scrapes -
Conjunctival = cats with Chlamydia or FHV Corneal = suspected melting ulcers, neoplasia)
53
Distinctive sign of an FCE
Painless Asymmetrical paresis/monoparesis
54
First sign of IVDD
Spinal Pain Acute paresis of limbs
55
What neuro-like signs can neospora cause
Infectious myotis Progressive stiffness and rigid hindlimbs that can't be flexed
56
Signs of a neurological FIP infection
Rapidly progressive non-ambulatory paresis (mostly para-paresis) incoordination (most intense in posterior)
57
Signalment for Spinal luxation (atlanto-axial subluxation)
young toy breeds
58
Signs of Spinal luxation (atlanto-axial subluxation)
- Sudden onset of cervical pain and non-ambulatory paresis - Reluctance to move neck - All limbs voluntary movement and reflexes
59
Signalment for Steroid responsive meningitis arteritis
Young dogs with severe neck pain!!! top ddx Beagles
60
Signs and signalment of myelitis of unknown aetiology (MUO)
Signs: Various neurological signs +/- pain, neck pain, pyrexia Small breed dogs of any age
61
Signs of Discospondylitis
pain pyrexia systemic illness
62
dx and tx of Discospondylitis
May see destruction on radiographs Treat with broad-spectrum antibiotics like AM-C
63
Is cervical spondylopathy compressive or concussive?
- Compressive lesion (discs, joints, bone, soft tissue) - Large breeds
64
what clostridial diseases can show neurological signs
- Botulism = flaccid weakness - Tetanus = rigid paralysis
65
Presenting signs of syringomyelia
A CKCS in pain (not off legs)
66
Lesion localisation for seizures only
Forebrain
67
What aetiology are multi-focal cases of seizures typically (seizures + vestibular signs for example)
Inflammatory or neoplastic
68
How to narrow down the three categories of seizure differentials
Functional (idiopathic) = elimination Structural (neoplasia, MUO, truma, vascular) = Advanced imaging Metabolic = bloods
69
age of onset of idiopathic epilepsy
6 months to 1 year
70
signs of idiopathic epilepsy
- Seizures - Sudden onset - Normal between episodes - No neurological abnormalities - Often seizure when resting/sleeping
71
What drugs are licensed for the treatment of idiopathic epilepsy
Phenobarbitone and Imepitoin
72
Difference in clinical signs between IE and MUO/SRMA
Dullness and ataxia between seizures (IE normal) Other neuro signs (not in IE)
73
Why should you be cautious when doing the diagnostic test for MUO/SRMA when they have had seizures
Need to CSF sample Dullness often due to increased intracranial pressure => could herniate
74
What can be measured in blood if you lose control of seizures
Phenobarbitone levels
75
What protozoa can cause seizures? Diagnosis? Treatment?
Toxoplasmosis and Neospora Dx: PCR on CSF Tx: Clindamycin (+/- TMPS) with pyrimethamine
76
What 3 metabolic disease can cause seizures?
- Hypocalcaemia - Hepatic encephalopathy - Hypoglycaemia
77
Signs of seizures due to toxicity
Rapid onset Cluster seizures often
78
What is Paroxysmal dyskinesia
- Abnormal movement - Seizure-like activity not from cerebral cortex but basal ganglia
79
Status epileptic protocol
Rectal diazepam IV diazepam ==> IV phenobarbital ==> IV propofol (at anti-convulsant dose not anaesthetic dose)
80
Idiopathic epilepsy home treatment protocol
Phenobarbitone or Imepitoin If not working try other drug If still not working can add K+ Bromide, or Levetiracetam
81
How to distinguish peripheral vestibular disease from central
Peripheral = Horizontal nystagmus, head tilt, ataxia, circling ONLY (may have some facial paralysis if middle ear) Central = other neurological signs (like abnormal mentation, vertical nystagmus, cerebellar signs)
82
How to further investigate central vestibular disease
Brain trauma, haemmorage, neoplasia, inflammatory (MUO) So CSF and advanced imaging
83
common causes of peripheral vestibular disease
otitis media/interna middle ear tumour polyps
84
How to reach idiopathic vestibular disease dx
Peripheral investigation normal + no neurological signs + non progressive = IE
85
What nerve would be involved in unilateral facial asymmetry from (Temporal and masseter atrophy)
Trigeminal
86
Signs of Trigeminal neuropathy/neuritis
Idiopathic inflammation so bilateral dropped jaw sudden onset of dysfunction normal muscles
87
Signs of a trigeminal nerve sheath tumour
Unilateral and progressive muscle atrophy
88
Signs of masticatory myositis
Dog can't open jaw Very painful
89
Signs of Brucellosis
Reluctance to sit and climb stairs normal proprioception

Small animal (11 decks)

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