Sensory Day

Question 1

a lesion of the optic nerve would result in

Answer 1

ipsilateral monocular vision loss

Question 2

a pituitary lesion affecting the optic chiasm would result in

Answer 2

bitemporal homonymous hemianopnia

(pituitary adenona, craniopharyngoma, ACA aneurysm)

Question 3

a lesion of the optic nerve just outside the optic chiasm would result in

Answer 3

ipsilateral nasal hemianopnia

(internal carotid artery aneurysm)

Question 4

Lesions to areas after the optic chiasm result in […]ocular and homonymous […]lateral deficits in vision

Answer 4

Lesions to areas after the optic chiasm result in [bi]ocular and homonymous [contra]lateral deficits in vision

Question 5

What visual deficit results from lesion of the optic tract or lateral geniculate body?

Answer 5

Contralateral homonymous hemianopia

Question 6

What visual deficit results from a lesion of Meyer’s loop?

Answer 6

Contralateral homonymous superior quadrantanopia

(temporal lesion, MCA occlusion)

Question 7

What visual deficit results from lesion of the dorsal optic radiation?

Answer 7

Contralateral homonymous inferior quadrantanopia

(parietal lesion, MCA occlusion)

Question 8

What visual deficit results from a lesion of primary visual cortex?

Answer 8

Contralateral homonymous hemianopia with macular sparing

(PCA occlusion)

Question 9

What visual field defect is associated with Wernicke aphasia secondary to middle cerebral artery stroke?

Answer 9

Contralateral homonymous superior quadrantanopia

(temporal lobe defect)

Question 10

Contralateral homonymous hemianopia is a visual deficit associated most commonly with an […] or with an […] lesion

Answer 10

optic tract
LGN

Question 11

Contralateral homonymous inferior quadrantanopia is a visual deficit associated with lesion of the […] lobe

Answer 11

parietal

(MCA infarct)

Question 12

Contralateral homonymous superior quadrantanopia is a visual deficit associated with lesion of the […] lobe

Answer 12

temporal

(MCA infarct)

Question 13

describe the path of trabecular outflow

Answer 13

Ciliary body → posterior chamber → pupil → anterior chamber → trabecular meshwork → canal of Schlemm → episcleral vessels

Question 14

trabecular outflow is increased by […] agonists

Answer 14

M3

(pilocarpine, carbachol)

Question 15

Answer 15

papilledema

elevated optic disc with blurred margins

Question 16

Answer 16

central retinal artery occlusion

“cherry red” fovea

Question 17

Answer 17

optic neuritis

Question 18

Answer 18

hypertensive retinopathy

micro aneurysms, hemorrhages, cotton wool spots

Question 19

sudden, painless loss of vision that lasts for seconds to minutes and is followed by spontaneous recovery

Answer 19

amaurosis fugax

Question 20

what causes amaurosis fugax and why is it important?

Answer 20

transient central retinal artery occlusion

caused by serious conditions like carotid stenosis, thrombosis, vasculitis.

Reduce CVD risk factors and treat temporal vasculitis with low dose corticosteroids.

Question 21

noise induced hearing loss is caused by damage to [….] cells in the organ of Corti

Answer 21

sterociliated

Question 22

noise induced hearing loss is characterized by loss of […] frequency hearing first

Answer 22

high

Question 23

in the inner ear, the cochlea contains the […] membrane that vibrates secondary to sound waves

Answer 23

basilar

Question 24

each […] leads to vibration at a specific location on the basilar membrane

Answer 24

frequency

(tonotopy)

Question 25

low frequency noises are heard at the [...] of the basilar membrane

Answer 25

apex (wide and flexible)

Question 26

high frequency noises are heard at the [...] of the basilar membrane

Answer 26

base (thin and rigid)

Question 27

why does otosclerosis cause conductive hearing loss?

Answer 27

3 ossicles of the middle ear conduct and amplify sound from the tympanic membrane to the middle ear

Question 28

If there is unilateral [...] hearing loss, the Weber test localizes to the affected ear

Answer 28

conductive

Question 29

If there is unilateral [...] hearing loss, the Weber test localizes to the normal ear

Answer 29

sensorineural

Question 30

If there is unilateral conductive hearing loss, the Rinne test demonstrates

Answer 30

Bone conduction > air conduction

Question 31

in the Rinne test, the tuning fork in front of the ear tests [...] conduction

Answer 31

air

Question 32

in the Rinne test, the tuning fork on the mastoid tests [...] conduction

Answer 32

bone

Question 33

If there is unilateral sensorineural hearing loss, the Rinne test demonstrates

Answer 33

air conduction > bone condution

Question 34

inherited inability to amplify sound due to bony overgrowth of the stapes

Answer 34

otosclerosis

Question 35

Causes of [...] hearing loss include damage to the cochlea, CN VIII, or central auditory connections

Answer 35

sensorineural

Question 36

Causes of [...] hearing loss include obstruction, otosclerosis, and otitis media

Answer 36

conductive

Question 37

Episodic vertigo triggered by certain changes in the position of the head

Answer 37

benign paroxysmal peripheral vertigo

Question 38

vertigo symptoms for seconds after change in head position

Answer 38

benign paroxysmal peripheral vertigo

Question 39

brief vertigo precipitated by movements normal examination

Answer 39

benign paroxysmal peripheral vertigo

Question 40

high endolymphatic pressure-acute symptoms with rupture of membranous labyrinth vertigo symptoms >20 min to a few hours

Answer 40

meniere's

Question 41

intense vertigo lasting several hours associated with hearing loss

Answer 41

meniere's

Question 42

in peripheral vertigo, nystagmus [is/is not] suppressible with visual fixation

Answer 42

is

Question 43

in central vertigo, nystagmus [is/is not] suppressible with visual fixation

Answer 43

is not

Question 44

hearing loss or tinnitus ipsilateral to the vestibular lesion favors a [...] lesion

Answer 44

peripheral

Question 45

vertical or direction changing nystagmus indicates a [...] lesion

Answer 45

central

Question 46

Meniere's triad

Answer 46

vertigo sensorineural hearing loss tinnitus

Question 47

the uncus is the medial [...] lobe

Answer 47

temporal

Question 48

what is an uncal herniation?

Answer 48

mass effect caused by a supratentorial lesion → medial and downward displacement of the uncus at the tentorial incisure

Question 49

findings consistent with central vertigo

Answer 49

vertical nystagmus torsional or gaze evoked nystagmus negative head impulse test

Question 50

positive head impulse test suggests [...] vertigo

Answer 50

peripheral (corrective saccade following head turn)

Question 51

negative head impulse test suggests [...] vertigo

Answer 51

central (eyes remained fixated while head is turned)

Question 52

presbycusis is [...] hearing loss

Answer 52

sensorineural (AC>BC)

Question 53

presbycusis is due to destruction of hair cells at the [...] of the cochlea

Answer 53

base (loss of high pitch hearing)

Question 54

BPPV is provoked by observing [...] on Dix-hallpike test

Answer 54

nystagmus

Question 55

Endolymphatic hydrops, which results in endolymph accumulation within the membranous labyrinth, is the underlying mechanism of [...]

Answer 55

meniere's

Question 56

What visual deficit results from lesion of the macula?

Answer 56

central scotoma

Question 57

muscarinic antagonists can precipitate [...] glaucoma

Answer 57

acute angle (atropine)

Question 58

a1 agonists can be used to treat [...] angle glaucoma

Answer 58

open angle (decreases aqueous humor production, but induces mydriasis so not for closed angle)

Question 59

positional exacerbation is typical of [...] vertigo

Answer 59

peripheral (central is typically continuous, regardless of positional)

Question 60

horizontal nystagmus is associated with [...] vertigo

Answer 60

peripheral (vertical with central)