Neuro-optho Flashcards

1
Q

How can you distinguish causes of VA problems?

A

use pinhole test - if visual acuity improves, likely a refractive rather than neuro issue

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2
Q

What is Adie’s pupil and how can it be demonstrated?

A

dilated tonic pupil, - give pilocarpine and affected pupil contracts more

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3
Q

What are Argyll Robertson pupils?

A

small irregular pupils associated with syphillis

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4
Q

What are the most common casues of unilateral optic disk swelling?

A

optic neuritis, acute ischemic optic neuropathy, orbital compressive lesions

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5
Q

What is Foster Kennedy syndrome?

A

ipsilateral disk atrophy due to optic nerve compression and papilledema in contralateral optic disk due to increased ICP from frontal lobe tumor

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6
Q

A patient presents with an asymptomatic enlarged blind spot and hyaline bodies on fundus exam. This is..

A

pseudopapilledma from small hyaline concretions - use CT to see bodies

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7
Q

What is the difference between comitant and incomitant strabismus?

A

incomitant - degree of misalignment varies with direction of gaze

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8
Q

A patient presents with oblique diplopia worse on down gaze. What is this? What will improve symptoms?

A

4th nerve palsy - tilting head away from lesion helps

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9
Q

What is the difference between a “phoria” and a “tropia”

A

tropia - misalignment of eyes when both eyes are opened and binocular vision is possible
phoria - misalignment when binocular vision is not present; does not cause diplopia because eyes are aligned when both are open

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10
Q

What is a one-and-a-half syndrome?

A

lesion involving PPRF, VIth nerve nucleus and adjacent ipsilateral MLF - patient can only abduct contralateral eye
(inability to adduct = INO)
(causes gaze palsy to ipsilateral side and INO in contralateral gaze)

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11
Q

A patient has an upgaze disturbance. This is..

A

perinaud’s syndrome - likely caused by pineal tumor compressing dorsal midbrain

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12
Q

What is oculomotor apraxia?

A

Inability to produce saccades

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13
Q

What conditions are associated with periodic alternating nystagmus?

A

MS, bilateral blindness, craniocervical junction abnormalities, anticonvulsant toxicity

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14
Q

What conditions are associated with upbeating nystagmus?

A

lesions of cerebellar vermis, Wernicke’s,

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15
Q

What conditions are associated with a downbeating nystagmus?

A

spinocerebellar degeneration, MS, familial periodic ataxia, drug intoxication

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16
Q

What are key differences between central and peripheral nystagmus?

A

peripheral - usually unilateral, unidirectional, never vertical, tinnitus often present, severe vertigo
central - bidirectional, bilateral; mild vertigo

17
Q

Where are horizontal saccades initiated?

A

contralateral frontal eye fields, superior colliculus

18
Q

Where are vertical saccades initiated?

A

bilateral frontal eye fields or superior colliculus

19
Q

A young woman with MS develops a severe headache and her BP drops after delivery. This is..

A

pituitary apoplexy

20
Q

A patient who has been on chronic corticosteroids for asthma presets with blurred vision and her fundus can’t be visualized. This is..

A

lens opacity from chronic steroids

21
Q

A patient has sudden double vision and when she looks to the left, the right eye does not fully adduct and there is nystagmus of the abducting left eye. This is..

22
Q

A patient presents pain on movement of her right eye and dimming vision. The fundus shows central scotoma. This isi..

A

optic neuritis

23
Q

A 13 year old patient presents with dizziness, slurred speech and double vision. It goes away in 15 minutes and then he has a severe headache and begins vomiting. This is a …

A

basilar migraine

24
Q

A 38 year old woman collapses and begins vomiting. Her neck is rigid, she has a dilated left pupil, her left lid droops and her left eye is abducted. This is..

A

PCOM aneurysm

25
Q

A patient presents with a re eye, cloudiness in the cornea and a large right pupil. This is ..

A

acute angle glaucoma

26
Q

A woman comes in with visual problems involving loss sparing central vision. The field remains the same no matter how far the testing screen is performed. This is..

A

tunnel vision

27
Q

A patient Presents with blindness in 1 eye after 4 hours of decreased vision. Fundoscopic exam shows edema, enlarged veins and several hemorrhages. This is…

A

Central retinal vein occlusion