Neuro

Question 0

Ddx light-near dissociation

Answer 0

1. Dorsal midbrain syndrome 2. Adies pupil 3. Argylle robertson sx

Question 1

What are the 4 findings in dorsal midbrain syndrome?

Answer 1

1. Impaired upgaze 2. Bilat lid retraction (colliers sign) 3. Headache 4. Dizziness

Question 2

Ddx cn3 palsy

Answer 2

1.Myasthenia (can cause any cranial neurop but never involves pupil) 2. Ischemia 3. Trauma to frontal bone 4. Ms 5. Tumor

Question 3

Whats a cecocentral scotoma on vf mean?

Answer 3

Optic nerve disorder eg compressive toxic optic neuritis

Question 4

Arcuate scotoma mean

Answer 4

Nfl defect along horiz raphe = glaucoma

Question 5

Whats a cecocentral scotoma?

Answer 5

Blind spot connect to central fixation

Question 6

What does homonomous defect mean?

Answer 6

Is it on the same side of the vertical

Question 7

What does it mean if the vf defect is vertical?

Answer 7

Its at the chiasm or behind The more congruous the defect the further back it is

Question 8

Bitemporal hemianopsia what should you ask about?

Answer 8

Galactorrhea Menstrual irregulation Weight fluctuation Get mri with gad

Question 9

Whats the ddx of a central scotoma on vf?

Answer 9

Csr Amd Toxic on Lebers hereditary on Infiltrative

Question 10

Pie in the sky defect Where localize to? What to order?

Answer 10

Temporal lobe (meyer loop) Order mri w and wo gad to look for tumor or stroke

Question 11

Bulateral homonmous inferior quadrantopsia Where localize to? What test to do?

Answer 11

Parietal lobe Check okn drum bc it tests smooth pusuit and if you lose parietal lobe you lose smooth pursuit

Question 12

What does homonomous mean?

Answer 12

Vf in Both eyes Occurs on same side of the vertical

Question 13

Where does arcuate or altitudnal defects localize to?

Answer 13

Optic nerve

Question 14

What does congruity mean?

Answer 14

How similar the two sides are. The more posterior you get in the brain the more congruous the defects are

Question 15

Atropine poisoning symptoms

Answer 15

Anti cholonergic so acts like a sympathetic drug Big pupils Decr Salivation Hot as a hare Dry as a bone Mad as a hatter

Question 16

Mg

Answer 16

Mg no ach Give tensilon = ach If adverse rxn Give atropine (anti ach)

Question 17

Whats the rx for atropine toxicity?

Answer 17

Tensilon (physostigmine)

Question 18

What does organophosphate poisoning look like?

Answer 18

Organophosphate are anti ach Just like atropine Can also look like mg (no ach) So give tensilon

Question 19

Ddx mg

Answer 19

Organophosphate poisoning Attopine poisoning Lambert eaton(no release of ach into the synapse) Miller fisher (varient of guillien barre that starts w eyes) Guillian barre Cpeo (mitochondrial do) Oculopharengeal muscular dystrophy Venoms Botulism poisoning- toxin prevent release from presynaptic terminal (likr lambert eaton)

Question 20

Rx of mg

Answer 20

Mestinon 60 or 180 Prednisone Thymectomy

Question 21

How do you work upmg?

Answer 21

Tensilon test (10mg) Have atropine ready Check anti ach ab Check anti musk ab Cxr to look for thymoma Ro other autoimmune do

Question 22

What cancer is lambert eaton ass w?

Answer 22

Small cell lung cancer

Question 23

Answer 23

left homonomous inferior quadrantopia, R parietal defect

Question 24

Answer 24

ALTITUNAL DEFECT could be optic neuritis or NAION

Question 25

Answer 25

CENTRAL SCOTOMA OU ddx: csr toxic optic neuropathy amd lebers hereditary optic neuropathy infiltrative

Question 26

Answer 26

R meyers loop in temporal lobe get mri w and wo gad

Question 27

Answer 27

bitemporal defect is chiasmal lesion until proven otherwise

Question 28

Answer 28

VF defects in both eyes densist part respects the horizontal midline- could be occipital lobe or could be paracentral scotoma

Question 29

Answer 29

inferior altitudnal defect (altitudnal defects do NOT cross the horizontal

Question 30

Answer 30

Right superior homonomous hemianopsia involving superior quadrant

Question 31

Answer 31

unilateral right central scotoma- either a problem with the macula or ON

Question 32

Answer 32

unilateral right VF defect with central sparing could be functional tunnel vision, if this were bilateral would think RP. can check for fxl vision loss w tangent screen

Question 33

Answer 33

clover leaf pattern

Question 34

Answer 34

bilateral paracentral scotoma OR Right homonomous incongruous hemianopia from L parietal or occipital lesion

Question 35

Answer 35

junctional scotoma, think about mass in chiasm

Question 36

Answer 36

defects ou either bitemporal hemianopia or a jxnal scotoma

Question 37

Answer 37

Left parietal lobe lesion

Question 38

Answer 38

left homonomous congruous defects could be occipital lesion b/c so congruous

Question 39

Answer 39

Right temporal lobe lesion

Question 40

Answer 40

left homonomous incongruous hemianopsia, must be retrochiasmal right tract lesion check an apd left eye and for a lesion in the right tract

Question 41

Answer 41

enlarged BS OU or possibly bitemporal hemianopsia, check to see if nerves are swollen, if so it could be enlarged blind spot

Question 42

Answer 42

non homonomous, not bi-temporal, could represent superior altitudnal defect- sequential optic neuropathy

Question 44

what is this?

Answer 44

pituitary adenoma

Question 45

whats this?

Answer 45

midbrain tumor