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Neuro - uworld Flashcards

1
Q

Which nerve is involved in ocular sensation?

A

Trigeminal

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2
Q

Pt felt warm and nauseous prior to a syncopal episode

A

Neurocardiogenic (or vasovagal) syncope
Occurs due to excessive vagal tone
Preceded by n/v, bradycardia, or pallor
Precipitated by pain or stress

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3
Q

How do you correct over coagulation in a warfarin pt

A

Vit K and prothrombin complex concentrate (has Vit K dependent clotting factors)

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4
Q

Initial Tx of Guillain-Barre?

A

IVIG or plasmaphoresis

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5
Q

Wacky, wobly, wet

A

normal pressure hydrocephaly

Enlarged ventricles on MRI but normal opening pressure on LP

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6
Q

Dystonia of the SCM

A

Torticollis

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7
Q

Pt develops decreased hearing acuity and vestibular syx weeks after starting abx

A

Aminoglycoside (gentamicin) toxicity - hearing loss and vestibular syx
oscillopsia - sensation of objects moving in the visual field

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8
Q

Pt has consistent dull HA, decreased libido, and hemianopsia

A

Craniopharyngioma
Benign suprasellar tumor with visual defect, HA, and syx of pituitary changes
Arise from the remnant of Rathke’s pouch

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9
Q

Bitemporal heminopsia

A

Optic chiasm

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10
Q

Young obese female with constant dull HA and papilledema

A

Pseudotumor cerebri
Brain tumor w/ NL imaging and elevated CSF pressure
Tx - weight reduction and acetazolamide
If untreated - blindness

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11
Q

Causes of chemo induced peripheral neuropathy

A

Vincristine (Vinca alkaloid)
Cisplatin (platinum)
Paclitaxel (taxanes)
symmetrical parathesia in stocking and glove pattern

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12
Q

Pronator drift tests?

A

UMN or Pyramidal tract dz dz of the UE

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13
Q

Affected eye is unable to adduct and the contralateral eye abducts w/ nystagmus

A

Internuclear ophtalmoplegia
Convergence is preserved
Damage in the MLF

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14
Q

Worsening frontal HA’s, blurred vision when leading forward

A 
Intracranial HTN (ICH
Can have HA, n/v/ AMS,
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15
Q

ALS involves damage to?

A

the UMN (spasticity, hyperreflexia) and LMN (fasiculations)

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16
Q

Following a minor skin break in the face pt has severe HA, periorbital edema, EOM deficits

A

Cavernous sinus thrombosis

Edema because the venous system in the cavernous sisnus does not have valves

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17
Q

What finding confirms CNS lymphoma in a HIV +?

A

EBV DNA in the CSF

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18
Q

CT reveal global cerebral atrophy that is worse in the temporal and parietal lobes

A

Alzheimers

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19
Q

Parkinson’s is caused by an accumulation of

A

alpha synuclein w/in the substantia nigran

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20
Q

3 classic signs of PD?

A

resting tremor
rigidity
Bradykinesia
Best way to dx - at least two of these on PE

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21
Q

Pt has sparse and non fluent speech, impaired repitition, but can follow commands

A

Broca aphasia
can have right hemiparesis
Affects dominant temporal lobe (ie, R handed man, L hemisphere is dominant)

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22
Q

Lots of words w/o meaning, not able to follow commands, poor repeating

A

Wernicke aphasia

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23
Q

Fluent but with phonemic errors (sunny vs. funny), able to follow commands, no repeating

A

Conductive aphasia

Can see this in severe forms of Broca’s aphasia that extends to the arcuate fasciculus

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24
Q

loss pain and temp on ipsi face, contra body
Vertigo, nystagmus
ipsi hornor’s syndrome

A

Lateral medullary infarct (Wallenberg syndrome)
Occlusion of the PICA or intracerebral vertebral a.
Motor function is spared

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25
Q

Acute, unilateral, severe retro-orbital pain that wakes a pt up

A

Cluster HA
tx - oxygen
Ppx - verapamil, lithium

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26
Q

Pt with new onset CVA syx has a negative CT, now what?

A

Give TPA
Negative CT means non hemorrhagic so give TPA for best neurologic outcomes
Contra’s - hx of intracerebral bleed, BP>185/110, Platelets <100,000
INR>1.7

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27
Q

Pt is treated for CVA w/ sudden loss of contra senses, weeks later now has burning pain and develops allodynia (excessive pain in response to light touch) on the affected side

A

Thalamic pain syndrome
Pt likely had a Lacunar stroke of the posterolateral thalamus (pure sensory lacunar stroke)
Occlusion of deep branches of the PCA

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28
Q

Elderly w/ onset of confusion and lethargy x hours and hyperdense mass in parietal lobe

A

Parietal lobe hemorrhage

Most likely cause is - cerebral AMYLOID angiopathy. Most common cause of spontaneous lobar hemorrhage in an adult >60

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29
Q

Pt has months hx of right hand clumsiness and decreased sensation over 4th and 5th fingers

A

Ulnar n. syndrome
Clumsiness = weak grip
ulnar n. entrapment in the medial epicondylar groove (elbow)
Entrapment is typically caused by leaning on the elbows during work (for long periods, ie, at a desk or table)
Apparently extremely high yield for USMLE

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30
Q

Most common dementia in the US?

A

Alzheimer’s
Early memory and visospatial impairments
Can have gait impairement in advanced dz

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31
Q

Blindness in one eye

A 
optic n. damage (pre chiasm)
#1
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32
Q

Loss of left visiual field in each eye

A

Left homonymous hemianopia
Optic tract damage (post chiasm) OR
loss of optic radiations (temporal AND parietal)
#3 or #6

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33
Q

loss of bottom left corner of visiual field in each eye

A

Left inferior homonymous quadrantonopia

Defect in parietal optic radiations (usually #4)

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34
Q

Loss up top left corner of visual field

A

Left superior homonymous quadrantonopia

Defect in optic radiations to the temporal lobe or Meyers loop #5

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35
Q

Loss of left half of visual field with sparing of the center of vision

A

Left homonymous hemianopia w/ macular sparing
Defect in occipital cortex
Usually #7 or most posterior option

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36
Q

Papilledema refers to swelling of the

A

Optic disc

Caused by increased ICP

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37
Q

Ipsilateral optic disc atrophy due to compression by a space occupying lesion in the frontal lobe
papilledema in contra optic disc due to increased ICP

A

Foster-Kennedy syndrome

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38
Q

Morning HA, transient visual oscuration

A

Increased ICP

Caused by space occupying lesion (tumor, AVM, anuerysm, pseudotomor cerebri (IIH))

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39
Q

Large blind spot with intact visual acuity

A

Drusen (pseudopapilledema)
Caused by small hyaline concretions
Fundoscopic exam - glistening hyaline bodies

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40
Q

Painful visual loss that is worth with hot baths or exercise, retro-orbital pain

A

Optic neuritis
Suggestive of demyelination
tx - IV methylprednisone

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41
Q

Sudden painless visual loss in pt >50 w/ HTN or DM

A 
Ischemia (AION)
Vascular cause (occlusion, TIA) or temporal arteritis
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42
Q

Misalignment of the eyes

A

strabismus

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43
Q

What does the doll’s eyes test assess?

A

Useful in unconscious pt to evaluate integrity of the vestibular and oculomotor apparatus
Tests vestibulo-ocular movement, CN III, IV, and VIII
If intact, the reflex will rotate the eyes in the direction opposite of the head movement
Suggests nuclear dysfunction

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44
Q

horizontal gaze center

A

Paramediane Pontine reticular formation (PPRF)

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45
Q

Defects in MLF produce?

A

INO

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46
Q

Defect in PPRF and ipsilateral MLF

A

one-and-a-half syndrome

Gaze palsy to the ipsilateral side and INO in contralateral gaze

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47
Q

Vertical gaze center

A

riMLF

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48
Q

What is saccades?

A

Rapid conjugate movement of the eyes to look at objects

Defect - oculomotor apraxia

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49
Q

How do you tell if nystagmus is central or peripheral?

A

Peripheral - unilateral

Central - bilateral

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50
Q

Initial Tx for symptomatic myasthinia gravis?

A

Pyridostigmine
Achesterase inhibitor
If resistant - add an immunosuppresive like a steroid

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51
Q

Pt present to ER w/ new onset seizure. Now what?

A

labs - electrolytes
Utox
CT w/o contrast

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52
Q

Pt has stroke syx quickly followed by n/v

A

Suggestive in intracrainial hemorrhage. n/v because of increased intracranial pressure

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53
Q

Age-related hearing loss

A

Presbycusis
Progressive, b/l, symmetric
Sensorineural loss

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54
Q

What deficits are found in DM?

A

alterations of sensation and proprioception

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55
Q

How do you work up idiopathic UMN findings?

A

MRI of the spine

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56
Q

Most likely cause of hemorrhagic stroke in a hypertensive pt?

A

hypertensive vasculopathy

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57
Q

Fever, general muscle rigidity, autonomic instability, AMS

A

Neuroleptic malignant syndrome
Life threatining idiosyncratic drug rxn to DA antagonists
Look for a recent schizo or psychosis episode that would lead to taking an antipsychotic (usually in last 2 weeks), especially 1st gen antipsychotic (haloperidol)
Type B rxn - INdependent of drug dose
Tx - remove aggravating agent and provide supportive care +/- Dantrolene as needed

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58
Q

What are the two ways that MS will present?

A
  1. optic neuritis - mononuclear blindness, painful eye movement
  2. Transverse myelitis - motor and sensory loss below the level of the lesion, incontinence
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59
Q

Tx for depression w/ pseudodementia

A

SSRI

Psedodementia is a reversible cognitive impairment

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60
Q

When do you order an MRI for a pt with a hx of HA’s?

A

When the HA differs in character from the prior
Present when awakening in the morning
Causing frequent nausea, vomiting, or blurry vision
New seizure, AMS, new HA at >40, trauma

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61
Q

Pathophysiology of normal pressure hydrocephaly

A

Decreased CSF absorption -> transient increase in ICP causing ventricular enlargement w/o chronically increased pressure

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62
Q

Stroke presenting with unilateral motor impairment

A

Posterior limb of internal capsule (lacunar infarct)

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63
Q

Stroke involving contra motor (face arm leg)
Eye deviates toward the lesion
Homonymous hemianopia

A

MCA occlusion
Aphasia when affecting dominant hemisphere
Hemineglect when affecting nondominant
Can affect upper and lower extremities but usually upper is worse

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64
Q

Stroke involving sensory and motor of lower extremity
Abulia (lack of will, initiative)
Dyspraxia, emotional distubrance, urine incontinence

A

ACA occlusion

Can involve upper and lower extremities but usually the lower is worse

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65
Q

Stroke contra hemiplegia and ipsi CN involvement

ataxia possible

A

Vertebrobasilar system lesion

Supplies the brain stem, so think more basal fxn deficits

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66
Q

Stroke presenting with homonymous hemianopia
Visual hallucinations
Sensory syx
CN III palsy

A

PCA occlusion

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67
Q

Pathophys of lacunar strokes

A

Microatheroma formation and lipohyalinosis of the small penetrating arteries
RF’s - HTN, HLD, DM, and smoking
Pure motor hemiparesis = internal capsule
Often CT negative

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68
Q

Parkinson’s is a progressive loss of dopaminergic neurons in the

A

Basal Ganglia

Interrupts the neurologic connections between the thalamus and motor cortex

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69
Q

MG is caused by autoAb’s against ACh receptors at the

A

Motor end plate

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70
Q

What gait is characteristic in PD?

A

Shuffling gait (hypokinetic)

71
Q

Essential findings to declare brin death

A

Absent cortical and brain stem fxns

However spinal cord can still be fxn’ing so DTR’s may be present

72
Q

Side effects of amitriptyline

A 
Orthostatic hypotension (alpha andrenergic), lethargy (H1), anticholinergic syx (M1; dry mouth, constipation, urinary retention)
Tx - d/c TCA
73
Q

Exaggerated hip and knee flexion while walking

A

“steppage” gait
Common peroneal neuropathy
L5 radiculopathy

74
Q

Cancer that commonly metastasizes to brain in a male

A

Lung
MRI - multiple well-circumscribed lesions with vasogenic edema ant the gray white matter junction
Look for hx of tobacco use + new onset seizures

75
Q

Acute onset of vertigo, n/v

A

Vestibular neuronitis

76
Q

Episodic vertigo, n/v, fluctuating but progressive hearing loss, tinnitus, sensation of ear fullness

A

Meniere dz

Caused by intermitten increase in endolymphatic volume

77
Q

ear popping at time of sneezing, nose-blowing, coughing, straining followed by acute onset of vertigo

A

Perilymph fistula

78
Q

Vertigo precipitated by changes in position

A

Benign position paroxysmal vertigo (BPPV)
attacks usually last seconds-minutes
Caused by freely moving calcium carbonate crystals
Dix-Hallpike test - offending ear will be closest to the ground during the test

79
Q

Pt complains of an intermittant limp with foot tingling/numbness. On PE, impaired dorsiflexion and great toe extension. DTR’s intact

A

Common peroneal n.impingement
Associated with immobilization (cast), prolonged leg crossing, squatting
Dx w/ EMG, NCS
Tx - splinting, PT

80
Q

If you suspect Vit B12 deficiency, what else should be checked in addition to Sr B12?

A 
Methylmalonic acid (MMA)
More sensitive in detecting B12 deficiency
81
Q

AMS + T>40C (105F)

A

Heat stroke

Complications include: rhabdo, ARF, ARDS, and coagulopathic bleeding

82
Q

How do you assess an elderly pt with gradual onset of forgetfulness

A

Neurocognitive testing
Will likely involve the mini-mental state exam
Differentiates between aging and dementia

83
Q

Most common causes of a single brain abscess

A

Staph aureus
Strep viridians
CT with ring enhancing lesion in a immunocompetent pt

84
Q

Brain CT/MRI reveals a butterfly appearing lesion with central necrosis

A

Glioblastoma multiforme

Shape is similar to the spinal cord

85
Q

Sudden onset unilateral orbitofrontal HA w/ n/v, unilateral eye pain w/ injected conjunctiva, dilated pupil w/ poor light response

A

angle closure glaucoma
Sudden narrowing of the anterior chamber angle
Asian woman >40
Can see aura’s. Sounds like a mix of migraine and cluster HA in stem

86
Q

Areflexic weakness in b/l UE and sensory loss in a cape like distribution

A

Syringomyelia
fluid-filled cavity w/in the cervical and thoracic spinal cord
Associated with chiari type 1

87
Q

Tx for Botulism

A

Equine antitoxin

Botulism toxin inhibits presynaptic ACh release

88
Q

What medications can cause idiopathic intracranial HTN (IIH)?

A

Growth hormone
Tetracyclines
Excessive vit A

89
Q

New onset seizure + LP with RBC’s and elevated protein

A

HSV encephalitis

Get a PCR of CSF

90
Q

Major complications after a SAH?

A

1st 24 hours - rebleeding
3-10 days - Vasospasm, vasonarrowing at the base of the brain due to degeneration of the vessels leads to infarction, dx with Ct angio and prevent with nimodipine

91
Q

Pathophys of tetanus

A

Disorder of the presynaptic neuromuscular junction
Clostridium tetani toxin
Blocks the release of inhibitory NT’s (glycine, and GABA)
Fever, muscle spasms (trismus)
Tx - debride, abx, IF against tetanus toxin, tetanus toxoid

92
Q

Tx of IIH?

A

Long term - Acetazolamid +/- furosemide

Acute - LP, steroids

93
Q

Vertical or horizontal gaze palsy

A

Progressive supranuclear palsy (PSP)

In the spectrum of a parkinsonian dz

94
Q

Startle myoclonus

A

CJD

95
Q

Tx for Tics

A

Antipsychotics

anti DA drugs

96
Q

Myasthenia gravis + ARF

A

Myasthenic crisis

97
Q

Where is the damage in cauda equina syndrome?

A

Spinal n. roots

Damage can happen b/l but assymetrically vs conus medullaris will be symmetric

98
Q

What side effects are expected soon after initiation of levodopa/carbidopa?

A

hallucinations, dizziness, HA, agitation

After many years - involuntary movements

99
Q

Sudden unilateral vision loss + fundoscopy exam with cherry red macula and retinal whitening

A

Central retinal a. occlusion
Mononuclear painless acute vision loss
Embolization from ICA or heart
Tx - manage underlying atherosclerosis or cardiac anomaly

100
Q

Rapidly progressing dementia + sharp wave changes on EEG

A

CJD

101
Q

MOA of benzo’s

A

Enhance GABA -> inhibitory influence on neurons

102
Q

Pt is unable to raise eyebrow, close the eye, facial drop, no nasolabial fold

A

Bell’s palsy

CN VII

103
Q

Left sided hemineglect is due to damage at the?

A

Right (non dominant) Parietal

104
Q

What do you do for people that have been in contact with a person that had bacterial meningitis?

A

Abx prophylaxis

105
Q

Teenager frequently falls asleep in class and has episodes of neck/knee muscles when socializing

A

Narcolepsy

Episodes are likely cateplexy

106
Q

What is useful in dx’ing if a pt has acute angle gluacoma?

A

Tonometry

Measures intraocular pressure

107
Q

Pt has exercise intolerance (muscle pain, fatigue, cramps) and has redish urine shortly after

A

McArdle Dz (Muscle phosphorylase deficiency)
Defect in glycogen storage
Myoglobinuria shortly after exercise (due to rhabdo)
“Second wind” phenomenon

108
Q

Quickest way to decrease intracerebral pressure?

A

Intubation and hyperventialtion
Can give IV mannitol once stable
Decrease in CO2 -> vasoconstriciton

109
Q

Syncopal episodes, sig decreased BP in one arm

A

Subclavian steal syndrome

Decreased brain stem perfusion due to reversal of flow in one vertebral artery

110
Q

Increased cholinergic activity is caused by?

A

Organophosphate activity

111
Q

Tx for Restless leg syndrome

A

Pramipexole

112
Q

Pt has vomiting/diarrhea, tinnitus, + rash (erythematous patches, hyperpigmented macules, depigmented macules, nails with white lines), decreased sensation absent ankle reflexes

A

Arsenic poisoning

113
Q

Most common cause of movement disorders?

A

Metoclopramide (used to treat gastroparesis)

Can cause neuroleptic malignant syndrome

114
Q

Pt does not meet all the criteria of SIGE CAPS but has had depressed mood x 3 years

A

Dysthymia
Chronic depression that persists for at lease two years
Less acute and severe than MDD

115
Q

Atrophic gastritis pt has LMN and UMN signs

A

Vit B12 deficiency

116
Q

Pt has a stroke syx x 4hrs + vegetations on heart valve. How do you manage?

A

Blood cultures and abx

117
Q

Osteoblastic bone met most likely came from

A

Prostate

118
Q

Osteolytic bone met most likely came from

A

Lung

119
Q

Unilateral decrease in hearing

Turning fork over forehead lateralizes to the NL ear

A

Neurofibromatosis

Sensorineural hearing loss

120
Q

Kid w/ seizures, suprasellar mass with specs of calcium

A

Craniopharyngioma

121
Q

Temporary (hours) total disruption of short term memory

A

Transient global amnesia

Don’t need to do anything unless it is recurrent

122
Q

Initial Tx for Shingles

A

po Acyclovir

123
Q

Degeneration of striatal GABA neurons

A

Huntington’s Dz

Atrophy of caudate on CT

124
Q

Sinus infection leading to diplopia, partial loss of vision in one eye

A

Cavernous sinus thrombosis

125
Q

1RF for Stroke

A

HTN

126
Q

Best management for a solitary brain met?

A

Surgical resection

Multiple - radiation

127
Q

Following trauma:
Decreased motor, pain, and temp fxn b/l
Proprioception, vibration, light touch intact

A

Anterior cord syndome
Caused by damage to the anterior spinal artery
Vibration, proprioception, and light touch are fed by dorsal column arteries

128
Q

At what point during a seizure is a pt at risk of hypoxic injury?

A

Status elepticus lasting >5min

129
Q

Young adult presents with tremor, muscular rigidity, clumsy gait + liver dz. how do you confirm dx?

A

Slit lamp (kayser-Fleischer rings) + Low Serum ceruloplasmin level
Wilsons dz
ar, abn copper deposition

130
Q

Hemorrhagic stroke with occipital HA, nuchal rigidity, n/v, nystagmus, ipsi hemiataxia

A

Cerebellar hemorrhage
Confirm with CT
Get emergency surgical decompression

131
Q

How do you manage a pt that hasn’t had breakthrough seizures in > 2 years on phenytoin but contemplating pregnancy

A 
Slowly taper and d/c phenytoin
Known tertogen (fetal hydantoin syndrome)
Slowly taper to prevent chance of withdrawl seizure
132
Q

Ppx tx for pt w/ frequent migraines

A

Topiramate
Divalproex sodium
TCA’s
Beta blockers

133
Q

Following a trauma, Head HT reveals numerous punctuate hemorrhages w/ blurring of the gray-white matter interface

A

Diffuse axonal injury (TBI)
Caused by sudden accelration-deceleration impact
Can cause LOC -> vegetative state

134
Q

How do you work up a pt with transient (<10m) painless monocular vision loss? “Curtain falling over the R eye”

A

Duplex u/s of the carotids
Suspicious for amaurosis fugax
Retinal ischemia due to atherosclerotic emboli from the ipsi carotid a.

135
Q

Band like HA around temporal and occipatal lobes

A

Tension type HA
Tx - NSAIDS
If persistent/frequent - TCA’s

136
Q

Decreased sensation over thumb and index finger suggests damage to which nerve root?

A

C6

137
Q

Post MVA pt is comatose, has CN III palsy, and is hyperventilating. This is concerning for?

A

Uncal herniation

Can compress CN 3 and midbrain compression -> decerebrate and coma

138
Q

What CSF finding is diagnostic for CJD?

A

Increased 14-3-3 protein

139
Q

Brain MRI reveals abn T2 signal in basal ganglia

A

CJD

140
Q

Left honomynous hemyanopsia
Left sided neglect
Speech intact

A

R PCA

141
Q

Lambort-Eaton involves pre-synaptic Ab attack at the?

A

Myoneural junction

142
Q

Following administration of haloperidol pt has reptitive neck extension and uncontrollable eye movements. Tx?

A

Give Anticholinergic

she is having dystonias in response to the antipsychotic

143
Q

How do you manage a pt with syx of temporal arteritis and new onset of dim vision in one eye

A

Corticosteroid therapy now and temporal artery biopsy within 3 days
This helps to prevent blindness

144
Q

Initial workup for a pt with difficulty using hand

A

Electrophysiology studies

145
Q

Homebrewer has 2 wk hx of progressive weakness, no UMN signs, microcytic anemia and hyperuricemia

A

Lead poisoning

146
Q

Progressive visual dimming in the eye x hours + Decreased acuity + NL CT

A

Optic neuritis

147
Q

Child w/ hx of strep infection presents with involuntary movements and OCD

A

PANDAS

Autoimmune disorder of the basal ganglia

148
Q

Child w/ hx of strep infection presents with involuntary movements, emotional liability, and hypotonia

A

Sydenham Chorea

149
Q

Progressive muscle weaknees + elevated EST + elevated creatinine kinase

A

Polymyositis

Dx with an EMG

150
Q

DM pt is presenting w/ neuropathic pain and some numbness after taking a course of steroids

A

Diabetic Neuropathy

Exacerbation due to steroid use (hyperglycemia)

151
Q

Immediate tx for a spinal tumor causing mass effect

A 
IV dexamethasone (steroids)
Future - surgical resection
152
Q

Younger male with back pain that is most severe when waking. Tenderness over insertion of the Achilles

A

Ankylosing spondylitis

153
Q

Epileptic pt has superior quadrant honomynous hemianopsia. Where is the lesion?

A

Temporal lobe

Look for complex (LOC) partial (not full body) seizure

154
Q

Tx for narcolepsy

A

Modanfinil

155
Q

College student presents with seizure after drinking a lot of water at a party. Hyponatremic, Elevated Cr kinase

A

Ecstasy OD

156
Q

Neurofibromatosis type 1 is associated with

A

Nodules on the lips and tongue
Cafe au lait spots
Optic nerve glioma

157
Q

NF type II is associated with?

A

B/l acoustic Schwanomas

158
Q

Tx for TIA

A

Start Aspirin, statin

Modify RF’s to improve BP control

159
Q

PD pt presents with acute angle-closure glaucoma. Why?

A

Trihexyphenidyl (anticholinergic used in PD)

160
Q

Elderly pt w/ spondylosis presents w/ weakness that is more pronounced in the UE than the LE following a trauma

A

Central cord syndrome
Occurs w/ hyperextension injury in a elderly pt with pre-existing deenerative changes
Damage to the lateral spinothalamic tract

161
Q

pt has sudden burst of flashing lights, blurred vision. Opthalmoscope reveals retinal tears and grayish appearing retina

A

Retinal detachment
Sudden onset of photopsia and floaters
“Curtain coming down over my eyes”

162
Q

Fundoscopy reveals “blood and thunder” appearance of optic disk swelling, retinal hemorrhages, dilated veins, cotton wool spots

A

Central retinal vein occlusion
painless loss of vision\
if the thrombi comes from the ICA = amaurosis fugax, tends to be more temporary

163
Q

Pain and swelling over inner aspect of the eye, pressure causes expression of purulent discharge

A

Dacrocystitis
Infection of the lacrimal sac caused by staph or strep
Infants and adults>40
Tx - systemic abx

164
Q

Pt with progressive vision loss is asked to cover his left eye and look at a small spot on a grid and describes the vertical lines as bent and wavy. Why?

A

Macular degeneration
Most common cause of blindness in industrial countries
Lose fine visual acuity first

165
Q

Corneal vescles and dendritic ulcers

A

Herpes simplex keratitis
Frequent cause of corneal blindness
Tx - top or po Antiviral

166
Q

Painful slwelling of the eyelid with no changes of the eye itself

A

External hordeolum (stye)
inflammatory disorder of the eyelash follicle or tear gland
Tx - warm compress
Can have a residual painless nodule that resolves within months after (Chalazion)

167
Q

Parkinsonism + orthostatic hypotension, impotence

A

Shy-Dager (Multiple system atrophy)

Tx- Intervascular volume expansion

168
Q

Loss of pain/temp over ipsi face, contra body
Vertigo, nystagmus
Horner’s

A

Lateral medullary infarct (wallenbery)
Motor fxn is spared
Occlusion of vertebral a.

169
Q

CNVII defect that is below the pons

A

Bell’s palsy, pt can’t close eye or lift eyebrows

Above the pons will spare the forehead (Facial n. palsy)

170
Q

Pramipexole (RLS tx) alters?

A

DA agonist

171
Q

CSF finding in Guillain Barre?

A

Elevated protein
NL cell count
(albuminocytologic dissociation)

172
Q

Broca’s aphasia is caused by a lesion in?

A

Dominant frontal lobe
Spares, nonfluent speech
Associated with Right face and UE hemiparesis

173
Q

What can happen if pseudotumor cerebri is left untreated?

A

Blindness

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