Special Senses Flashcards
How to manage acute angle closure glaucoma
IV acetazolamide, timolol, pilocarpine and apraclonidine eyedrops
Acetazolamide reduces aqueous humour production
Timolol is a BB which does the same
Pilo and apra constrict the pupil to further reduce the IOP
Gold standard investigation for optic neuritis
Contrast MRI of brain and orbits
Definitive management for wet age-related macula degeneration
Anti-vascular endothelial growth factor (anti-VEGF)
Anti-VEGF is a potent mitogen and drives increased vascular permeability in patients with wet ARMD, decreasing the leakage
How to differentiate between anterior uveitis, scleritis and episcleritis
All red eye
AU has red, painful eye with photophobia with small pupil and blurred vision
Scleritis is red, painful eye with photophobia and gradual reduction in vision worse with movement and eye watering. Associated with autoimmunity
Episcleritis is painless red eye
What is the mechanism and terminology of near/far sightedness
Near-sighted = myopia = either lens is too strong or eye is too long meaning light is focused in front of the retina= can’t see things far away
Far-sighted= hypermetropia= either lens is too weak or eye is too short meaning light is focused behind the retina= can’t see things close
How to treat anterior uveititis
Topical steroid e.g. pred
and topical cycloplegic (mydriatic) drops e.g. atropine that dilate the eye
How to manage optic neuritis
IM corticosteroids e.g. hydrocortisone
And MRI of the brain and orbits to investigate underlying cause
How to distinguish between the cause of an upper quadrant bitemporal hemianopia and lower quadrant bitemporal hemianopia
Upper is caused by Pituitary adenoma which compresses the inferior chiasm causing upper loss
Lower is caused by craniopharyngioma which compresses the superior chiasm causing lower loss
What is the definitive treatment for acute angle-closure glaucoma
Laser peripheral iridotomy
Cherry-red spot on the retina and painless vision loss in one eye which condition
Central retinal artery occlusion
Normal consensual light reaction but poor direct pupillary response
Blood in vitreous humour with painless loss of vision
Vitreous haemorrhage
CRAO presents with same but cherry-red spot on retina
how to differentiate between horner’s syndrome and third nerve palsy
both present with ptosis (drooping eyelid)
Third nerve palsy has a DILATED pupil whereas horner’s has a CONSTRICTED pupil
how to treat ramsay-hunt syndrome
aciclovir AND prednisolone
also give lubricating eye drops
for herpes zoster opthalmicus which is the same disease but opthalmic divison give oral antivirals for 7-10 days, topical steroids if secondary eye inflam
which way is esotropia and exotropia
esotropia is towards the nose
exotropia is towards the temple (out)
what is endophtalmitis and how to manage
inflammation of inner contents of the eye
usually caused by infection and a rare but serious complication of cataract surgery
Mx with intravitreal Abx injected directly into eye
what acute eye conditions do long-sighted and short-sightedness predispose you to
Myopia= short sighted-> primary open angle closure glaucoma AND retinal detachment
Hypermetropia= long-sighted-> acute angle closure glaucoma
optic neuritis gold-standard investigation
contrast MRI of brain and orbits
In conductive hearing loss, does Weber’s test localize best to the affected or unaffected ear
Affected ear
I.e. if sound localises to bad ear = conductive hearing loss of that ear
Tonsilar squamous cell cancer is associated with which virus
Human papillomavirus (HPV)
Management of Ménière’s disease
Prochlorperazine to manage Sx during attacks
Prophylaxis with:
Betahistine
Low salt diet
Diuretics
