Neurology and opthalmology

Question 1

ALS

Answer 1

Causes motor cortex neuronal cell damage and anterior horn cell damage. Causes lack of voluntary muscle control and eventual breathing difficulties and death. Patients may also develop fronto-temporal dementia

Question 2

ABCD2

Answer 2

Risk calculator for future stroke risk after TIA

Question 3

Empty Sella Syndrome

Answer 3

enlargement of the sella turnica where the pituitary gland and the space fills with with CSF. Sx = headaches, high BP and nose bleeds

Question 4

Grand Mal seizure

Answer 4

loss of consciousness with violent muscle contractions

Question 5

Myasthenia Gravis

Answer 5

affects neuromuscular junctions causing skeletal muscle weakness. Commonly affects eyes and face but limb movements and breathing may become impaired, giving restrictive spirometry results

Question 6

Meralgia Paresthetica

Answer 6

burning/tingling sensation on the lateral aspect pf the thigh

TX - looser clothing, OTC painkillers, gabapentin/pregabalin

Question 7

Optic Neuritis

Answer 7

inflammation of the optic nerve causing pain with eye movement and temporary loss of vision in one eye. Commonly occurs with MS, lupus, or other systemic inflammatory conditions

Question 8

Rubeosis

Answer 8

blood vessel proliferation along the surface of the iris caused by diabetic retinopathy or central retinal venous occlusion

Question 9

Retinal detachment

Answer 9

Unclear cause but more likely with age, trauma, or fhx

Sx - new or increased floaters, flashes of light, sudden blurred vision, dark curtain or shadow over vision

Question 10

Retinal artery occlusion

Answer 10

pts usually experience painless, complete visual loss in one eye. Most commonly caused by artherosclerosis

O/E cherry-red spot on fundoscopy

Question 11

Temporal Arteritis

Answer 11

Inflamed and constricted temporal arteries causing jaw pain, sight problems, headaches, and pain when brushing hair. If not treated quickly could cause damage to eyesight, aneurysm or stroke

Diagnosed with ESR and CRP for inflammation
Tx - toalizumab, prednisolone

Question 12

Trigeminal neuralgia

Answer 12

pain usually on one side of the face in sudden attacks lasting around 2 minutes. Nerve pain caused by compression of trigeminal nerve

Tx - carbamazepine (other nerve pain drugs used off-license)

Question 13

Vitreous haemorrhage

Answer 13

leakage of blood into the vitreous area of the eye. Caused by diabetic retinopathy, vitreous detachment and trauma to the eye. Patients describe painless loss of vision with black spots and often red film over their vision

Question 14

Vestibular neuritis

Answer 14

Acute, isolated, spontaneous vertigo caused by inflammation of the vestibular nerve. No hearing loss or hearing loss

Question 15

Anterior uveitis

Answer 15

One of the important differentials of a red eye. It is also referred to as iritis. Anterior uveitis describes inflammation of the anterior portion of the uvea - iris and ciliary body.

acute onset
ocular discomfort & pain (may increase with use)
pupil may be small +/- irregular due to sphincter muscle contraction
photophobia (often intense)
blurred vision
red eye
lacrimation
ciliary flush: a ring of red spreading outwards
hypopyon; describes pus and inflammatory cells in the anterior chamber, often resulting in a visible fluid level
visual acuity initially normal → impaired

Associated conditions
ankylosing spondylitis
reactive arthritis
ulcerative colitis, Crohn's disease
Behcet's disease
sarcoidosis: bilateral disease may be seen