Ophthalmology - Abo/okap - Neuro-Ophth

Front 1

Causes of optociliary shunt vessels

Back 1

CRVO, ON meningioma, sphenoid meningioma, chronic papilledema, chronic glaucoma, ON glioma

Front 2

Leber's hereditary ON
1. inheritance
2. acute ON appearance
3. late ON appearance

Back 2

1. passed maternally, mitochondrial DNA
2. hyperemic, swollen, telangiectatic vessels (does not leak on FA)
3. optic atrophy

Front 3

define duction and version

Back 3

Duction: movement of one eye
version: movement of both eyes

Front 4

Describe the pathways of all oculomotor nerves that are not ipsilateral

Back 4

levator palpebrae is a common fused central nucleus. nerves to SR and SO are contralateral.

Front 5

sympathetic pathway from cav sinus to iris

Back 5

ICA- CN VI - CN V1- long ciliary

Front 6

Describe Eaton-Lambert syndrome

Back 6

Auto immune d/o similar to MG, ocular manifestations are less common

Front 7

Identify the mechanism of CPEO

Back 7

primary myopathy. Mutation in mitochondrial DNA

Front 8

Kearns-Sayre syndrome
(4)

Back 8

mitochondrial DNA abnormality
"ragged red fibers" on histology
pigmentary retinopathy
cardiac conduction abnormalities

Front 9

Bendikt's Syn

Back 9

CN3 with CL decreased sensation and tremor
red nucleus
Think of eggs benedict with a red yoke and tremulous whites that causes a bad sensation

Front 10

Weber's Syn

Back 10

CN3 with CL hemiparesis
Cerebral peduncle.
think of a grill with one of it's legs broken and not working

Front 11

Nothnagel's syndrome

Back 11

CN3 with ipsi ataxia
brachium conjunctivum/cerebellar peduncle
Not = does NOT cross
gel = giggles/shaky like ataxia

Front 12

Do ischemic events cause aberrant regeneration

Back 12

No

Front 13

formed visual hallucinations are associated with

Back 13

Temporal lobe damage

Front 14

unformed visual hallucinations are associated with

Back 14

occipital lobe damage

Front 15

parietal lobe damage is associated with what visual phenomenon?

Back 15

poor ipsilateral pursuing motions. abnormal OKN in the direction of the lesion

Front 16

Identify three causes of downbeat nystagmus

Back 16

Lithium use
paraneoplastic syndrome
craniocervical junction abnormalities

Front 17

Parinaud's dorsal midbrain syndrome

Back 17

bad LUCC
Light-near dissociation (+accommodative abnormalities)
upgaze palsy
contraction-retraction nystagmus
Collier's sign (eyelid retraction)

Front 18

Optic tract injury can cause an APD where

Back 18

Contralateral. 52% of the nasal side crosses the midline

Front 19

Bourneville's syndrome synonym
1. give three CNS features
2. give 4 skin findings

Back 19

tuberous sclerosis
1. MR, seizures, calcified CNS lesions (tubers)
2. Adenoma sebaceum, ash leaf, Cafe spots, periungual fibromas

Front 20

von Recklinghausen's syndrome synonym
Which Chromosome

Back 20

neurofibromatosis 1
17

Front 21

Louis-Bar syndrome synonym
1. inheritance?
2. systemic findings

Back 21

ataxia-telangiectasia
1. AR
2. Thymic hypoplasia defective T-cell and IgA (increased infection)

Front 22

Vertical gaze pathway

Back 22

frontal eye fields/superior colliculus - riMLF - CN3&4

Front 23

PPRF is involved with what eye movments?

Back 23

Horizontal

Front 24

von Hippel-Lindau
synonym
1. vascular lesions
2. systemic findings

Back 24

angiomatosis retinae
1. capillary angioma of retina & cerebellum (ataxia)
2. panc/hepatic/renal cysts, renal cell CA, pheochromocytoma

Front 25

What percentage of optic neuritis patients present with disk edema

Back 25

35%

Front 26

Which sinus system aerates first?

Back 26

Ethmoid

Front 27

Which form of immunization last longer, active or passive?

Back 27

Active (administration of antigen). Passive is parenteral administration of antibody.

Front 28

Cell that is cytotoxic but requires antibody activation

Back 28

Killer or K cell

Front 29

first step in the antigen - antibody process

Back 29

macrophage (antigen presenting cell)

Front 30

HLA gene is on which chromosome

Back 30

6

Front 31

Name a tumor that has a tendency to involve multiple CN's noncontiguously

Back 31

Nasopharyngeal carcinoma

Front 32

1. Nonstop, random, directionally unpredictable saccades are called what?
2. They have a high association with what Dz?

Back 32

1. Opsoclonus
2. Malignancy (neuroblastoma, small cell)

Front 33

Order of frequency of involved muscles in graves Dz

Back 33

I M Stuart Little: inf rect> MR> SR > LR

Front 34

MG:
1. % with ocular Sx at onset
2. % with only ocular Sx at onset
3. % with ocular sx after Dz has developed

Back 34

1. 75%
2. 33-50%
3. 90%

Front 35

Monocular nystagmus is associated with

Back 35

Chiasmal and hypothalamic gliomas

Front 36

Identify the origination of:
1. Saccades
2. persuits

Back 36

1. contralateral frontal lobe
2. ipsilateral parietal lobe

Front 37

What type of eye movement is affected in Parkinson's Dz

Back 37

spontaneous/reflexive

Front 38

Is Jaw-Winking caused by abarent regeneration?

Back 38

no, it is congenital

Front 39

T or F: Horner's syndrome can cause conj injection, hypotony and a mild A/C rxn

Back 39

True: decreased symp vasodilation, reduced aquous secretion, breakdown of blood-ocular barrier

Front 40

Describe the Pulfrich phenomenon

Back 40

preception of 3D movement when there is only 2D movement in ONopthy

Front 41

Features of chiasmal injury

Back 41

Postfixation blindness
Bitemporal hemianopia
decreased color
diplopia/"hemifield slip"

Front 42

Slowed but present adduction. Dx?

Back 42

INO>MG

Front 43

Vertical gaze abnormalities:
1. Difficult upgaze
2. difficult downgaze

Back 43

1. Dorsal midbrain
2. (early sign) progressive supranuclear palsy

Front 44

Oculomotor apraxia:
1. definition
2. types
3. compensations
4. Horizontal Vs. vertical
5. effect on different types of eye movments

Back 44

1. inability to initiate eye movements
2. Congenital and aquired (bilateral frontal lobe strokes)
3. head thrust (congenital), eye closure (to break fixation) followed by head movement.
4. typically horizontal
5. saccades effected. pursuit is usually not affected

Front 45

1. Clinical signs of CRVO but vision is 20/20 and pt is young. Dx?
2. Tx?
3. f/u?

Back 45

1. Papillophlebitis
2. observation
3. monthly to r/o NV

Front 46

isolated pupillary dilation can occur in which disorders?

Back 46

Uncal herniation
basilar meningitis

Front 47

Does having a family member with MS increase the risk of having MS

Back 47

yes - 20-fold increase

Front 48

How long should you wait to ensure the patient with ocular MG that it is not systemic?

Back 48

2yrs

Front 49

percentage of MG patients that will get graves dz?

Back 49

5%

Front 50

Most common cause of death following CRAO?

Back 50

MI

Front 51

Tx for patients with downbeat nystagmus with Arnold-Chiari malformation?

Back 51

Clonazapam and suboccipital craniotomy

Front 52

Cortical locations responsible for saccades and pursuit movments

Back 52

Sac: contralateral frontal eye fields
pursuit: ipsilateral parietal lobe

Front 53

IIH:
1. Diamox dose?
2. workup

Back 53

1. 1-4grams/day
2. CT or MRI/MRV, THEN LP in decubitus without sedation, CSF eval, consider sleep study

Front 54

Tx for AAION

Back 54

Hospitalize for IV solumedrol 250mg Q6 for 72 hrs. Then PO pred 60-80mg/day

Front 55

Disc swelling on one side and pallor on the other.
1. w/u
2. Dx

Back 55

1. Neuro imaging
2. Foster Kennedy syn if compressive lesion
- bilat non simultanious NAAION of no lesion

Front 56

Demylinating lesions in the spinal cord and/or optic nerve. negative for MS workup.
1. Dx
2. further workup
3. Tx

Back 56

1. Devic's Dz (neuromyelitis optica)
2. test for aquaporin-4 Ig
3. plasmapheresis, immune modulation

Front 57

ON glioma in child with mildly decreased VA ipsilaterally.
1. Tx?

Back 57

1. Patch opposite eye. ?amblyopia
- chemo/XRT if not responsive.

Front 58

What are the inheritable optic neuropathies?

Back 58

Leber's - Mitochondrial inher. (11778 best prognosis), Cardiac w/u, Co-Q
Kjer's/dominant optic atrophy. temporal disc pallor, blue/yellow defect, OPA-1 on Chrom 3
Behrs - AR, ataxia, MR

Front 59

Bow tie atrophy =?

Back 59

chiasmal defect

Front 60

Skew Deviation
1. describe the signs
2. etiology?
3. Tx

Back 60

1. vertical tropia
2. abnormal vestibular input through the MLF
3. Observe, if chronic consider prism vs Sx

Front 61

Ocular neuromyotonia
1. describe it
2. when does it occur
3. which nerves

Back 61

1. failure of muscle to relax
2. after RadTx to parasellar region
3. 3,6>4

Front 62

1. What is Foville's syn
2. What is Millard-Gubler syn

Back 62

6th N fascicle syndromes:
1. ipsi 6,7,8 and horners (dorsal)
2. 6 and contra hemiplegia (ventral)

Front 63

Ataxia, areflexia, ophthalmoplegia, with increased CSF protein and normal cell count
Dx?

Back 63

Guillain - Barre (Fisher variant)