PNO Flashcards
Second line mood stabliser
Sodium valproate
Medications in OCD
SSRI first line. Clomipramine second line
DMARDs in MS
Interferon beta and monoclonal antibodies
First line in Lambert-Eaton syndrome
Amifampridine
Miller Fisher syndrome symptoms
Ataxia, areflexia, ophthalmoplegia
Antibodies in Miller Fisher syndrome
Anti-GQ1b
Medications that may speed up recovery in GBS
IVIg, plasma exchange
Causes of mononeuritis multiplex
Vasculitis, infection, drugs, inflammation, ischaemia
Progressive bulbar palsy symptoms
Talking and swallowing most affected
Medications that can help in MND
riluzole, edaravone
What is Gowers sign?
Children stand up by walking themselves up due to weakness
Age of Beckers muscular dystrophy
Early adolescence
Inclusion body myositis demographic
Middle aged men
Age of fasciopalatohumeral dystrophy
Children
Age of oculopharyngeal dystrophy
Older adults
Age of limb girdle dystrophy
Adolescents
Inclusion body myositis treatment
Supportive
Sex induced headache prophylaxis
Triptan or indomethacin an hour before sex
Trigeminal neuralgia symptoms
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
Trigeminal neuralgia management
Carbamazepine first line. Lamotrigine or gabapentin second line. Decompressive surgery if not responding
Venous sinus thrombosis symptoms
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
Venous sinus thrombosis management
IV abx and heparin (often continued for a few months)
Carotid artery dissection symptoms
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
Risk factors for carotid artery dissection
Middle aged, connective tissue disease, vasculitis, atherosclerosis, trauma, HTN
Carotid artery dissection management
Manage as stroke if there are stroke symptoms. Anticoagulation. Endovascular options
Vestibular schwannoma symptoms
The main symptoms are hearing loss, tinnitus and balance problems. There may also be facial nerve palsy
What is a nuclear cataract?
Inner lens affected. most common
What is a cortical cataract?
Outer lens affected
Procedure in cataracts
Phaecoemulsification
Complications of cataract surgery
complications involve endophthalmitis and corneal / macular oedema or long term complications such as retinal detachment or posterior capsule opacification
Vision loss in open angle glaucoma
Arc like scotoma either superiorly or inferiorly
Fundoscopy in open angle glaucoma
Raised cup to disc ratio
Investigation of glaucoma
tonometry to measure the intraocular pressure, which will be raised. Gonioscopy allows the anterior chamber and drainage system to be assessed
First line in open angle glaucoma
Latanoprost eye drops
Second line meds in open angle glaucoma
Other eye drops that can be added include beta blockers (e.g. timolol), a-agonists (e.g. iopidide), acetazolamide or miotics (e.g. pilocarpine).
Surgical options in open angle glaucoma
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
Medication options in angle closure glaucoma
Medical management is eye drops such as acetazolamide, beta blockers (e.g. timolol), sympathomimetics (e.g. brimonidine tartrate), or miotics (e.g. pilocarpine)
Vitreous haemorrhage causes
The most common cause is diabetic retinopathy but other causes include posterior vitreous detachment and trauma
Vitreous haemorrhage managment
Resolves spontaneously
Condition to exclude in CRAO
GCA
Anterior uveitis treatment
Steroids and dilating eye drops
Cause of episcleritis
Autoimmune conditions
Management of episcleritis
Conservative (resolves in a month)
Scleritis treatment
Steroids, NSAIDs and dilating eye drops
What is Siedel’s test?
Look for leakage of fluorescein from sclera to indicate perforation of eye
Investigaton of corneal ulcer
Corneal scrape and PCR
Optic neuritis treatment
is the same as a flare of MS with 5 days of oral methylprednisolone or 3-5 days of IV hydrocortisone
Endophthalmitis investigation
Vitreal tap for culture
Endophthalmitis treatment
Intravitreal abx
