PNO

Question 1

Second line mood stabliser

Answer 1

Sodium valproate

Question 2

Medications in OCD

Answer 2

SSRI first line. Clomipramine second line

Question 3

DMARDs in MS

Answer 3

Interferon beta and monoclonal antibodies

Question 4

First line in Lambert-Eaton syndrome

Answer 4

Amifampridine

Question 5

Miller Fisher syndrome symptoms

Answer 5

Ataxia, areflexia, ophthalmoplegia

Question 6

Antibodies in Miller Fisher syndrome

Answer 6

Anti-GQ1b

Question 7

Medications that may speed up recovery in GBS

Answer 7

IVIg, plasma exchange

Question 8

Causes of mononeuritis multiplex

Answer 8

Vasculitis, infection, drugs, inflammation, ischaemia

Question 9

Progressive bulbar palsy symptoms

Answer 9

Talking and swallowing most affected

Question 10

Medications that can help in MND

Answer 10

riluzole, edaravone

Question 11

What is Gowers sign?

Answer 11

Children stand up by walking themselves up due to weakness

Question 12

Age of Beckers muscular dystrophy

Answer 12

Early adolescence

Question 13

Inclusion body myositis demographic

Answer 13

Middle aged men

Question 14

Age of fasciopalatohumeral dystrophy

Answer 14

Children

Question 15

Age of oculopharyngeal dystrophy

Answer 15

Older adults

Question 16

Age of limb girdle dystrophy

Answer 16

Adolescents

Question 17

Inclusion body myositis treatment

Answer 17

Supportive

Question 18

Sex induced headache prophylaxis

Answer 18

Triptan or indomethacin an hour before sex

Question 19

Trigeminal neuralgia symptoms

Answer 19

The classic presentation is short lived episodes (seconds to minutes) of electric shock like pain in the distribution of the trigeminal nerve. Attacks are recurrent and often triggered by cold air or eating

Question 20

Trigeminal neuralgia management

Answer 20

Carbamazepine first line. Lamotrigine or gabapentin second line. Decompressive surgery if not responding

Question 21

Venous sinus thrombosis symptoms

Answer 21

The main symptom is a sharp severe headache around the eyes associated with eye pain, redness and swelling and double vision. Other symptoms include fever, vomiting, seizures or confusion

Question 22

Venous sinus thrombosis management

Answer 22

IV abx and heparin (often continued for a few months)

Question 23

Carotid artery dissection symptoms

Answer 23

It can be asymptomatic or it can present with symptoms of a stroke, which is a common complication. Other common symptoms include tinnitus, Horner’s syndrome, headache or neck pain

Question 24

Risk factors for carotid artery dissection

Answer 24

Middle aged, connective tissue disease, vasculitis, atherosclerosis, trauma, HTN

Question 25

Carotid artery dissection management

Answer 25

Manage as stroke if there are stroke symptoms. Anticoagulation. Endovascular options

Question 26

Vestibular schwannoma symptoms

Answer 26

The main symptoms are hearing loss, tinnitus and balance problems. There may also be facial nerve palsy

Question 27

What is a nuclear cataract?

Answer 27

Inner lens affected. most common

Question 28

What is a cortical cataract?

Answer 28

Outer lens affected

Question 29

Procedure in cataracts

Answer 29

Phaecoemulsification

Question 30

Complications of cataract surgery

Answer 30

complications involve endophthalmitis and corneal / macular oedema or long term complications such as retinal detachment or posterior capsule opacification

Question 31

Vision loss in open angle glaucoma

Answer 31

Arc like scotoma either superiorly or inferiorly

Question 32

Fundoscopy in open angle glaucoma

Answer 32

Raised cup to disc ratio

Question 33

Investigation of glaucoma

Answer 33

tonometry to measure the intraocular pressure, which will be raised. Gonioscopy allows the anterior chamber and drainage system to be assessed

Question 34

First line in open angle glaucoma

Answer 34

Latanoprost eye drops

Question 35

Second line meds in open angle glaucoma

Answer 35

Other eye drops that can be added include beta blockers (e.g. timolol), a-agonists (e.g. iopidide), acetazolamide or miotics (e.g. pilocarpine).

Question 36

Surgical options in open angle glaucoma

Answer 36

Surgical options include trabeculoplasty to create a hole in the trabecular meshwork, ciliary body ablation to lower fluid production or trabeculectomy to create an extra drainage channel

Question 37

Medication options in angle closure glaucoma

Answer 37

Medical management is eye drops such as acetazolamide, beta blockers (e.g. timolol), sympathomimetics (e.g. brimonidine tartrate), or miotics (e.g. pilocarpine)

Question 38

Vitreous haemorrhage causes

Answer 38

The most common cause is diabetic retinopathy but other causes include posterior vitreous detachment and trauma

Question 39

Vitreous haemorrhage managment

Answer 39

Resolves spontaneously

Question 40

Condition to exclude in CRAO

Answer 40

GCA

Question 41

Anterior uveitis treatment

Answer 41

Steroids and dilating eye drops

Question 42

Cause of episcleritis

Answer 42

Autoimmune conditions

Question 43

Management of episcleritis

Answer 43

Conservative (resolves in a month)

Question 44

Scleritis treatment

Answer 44

Steroids, NSAIDs and dilating eye drops

Question 45

What is Siedel's test?

Answer 45

Look for leakage of fluorescein from sclera to indicate perforation of eye

Question 46

Investigaton of corneal ulcer

Answer 46

Corneal scrape and PCR

Question 47

Optic neuritis treatment

Answer 47

is the same as a flare of MS with 5 days of oral methylprednisolone or 3-5 days of IV hydrocortisone

Question 48

Endophthalmitis investigation

Answer 48

Vitreal tap for culture

Question 49

Endophthalmitis treatment

Answer 49

Intravitreal abx