Peds

Question 1

6 yo w rapid progressive proptosis 
Dx?
Where is lesion?
What's worst type?
What r other types? 
Most common? Best prognosis?

Answer 1

Rhabdo
Superonasal most common

Embryonal- most common
Alveolar- Inferior, worst prog
Pleomorphic - least common, best prognosis
Botyroid- type on embryonal, grape like, originates in conj

Question 2

Cut off for V pattern?

A pattern?

Answer 2

V- 15 prism diopters

A- 10

Question 3

Reversal of OKN

What’s dx?
What other features?

Answer 3

Congenital nystagmus

Horizontal in every gaze
Dampens with convergence (base out prisms can help)

Question 4

For Latent nystagmus, which direction does it beat?

Which gaze increases intensity?

Answer 4

Beats away from covered eye
Normal OKN (unlike congen)
Intensity increases Lookin toward fast phase (Alexander’s rule)

Question 5

Triad of spasmus nutans

Answer 5

Torticollis
head bobbing
eye movements (high freq, low amplitude)