Neurological Cases Study Notes
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Questions and Answers

Which condition is NOT considered a differential diagnosis for 'thunderclap headache'?

  • Cluster headache
  • Analgesic abuse
  • Depression (correct)
  • Migraine
  • What is the most likely diagnosis for a 22-year-old man with a history of headache, using analgesics with temporary relief and no focal neurological signs?

  • Sinus headache
  • Cluster headache
  • Analgesic abuse (correct)
  • Tension-type headache
  • A 35-year-old woman reports headaches lasting 30 minutes to an hour, occurring at the same time daily, and is associated with eye symptoms. What is the most likely diagnosis?

  • Tension-type headache
  • Cluster headache (correct)
  • Cervicogenic headache
  • Migraine
  • What is the most likely diagnosis for a 45-year-old man with gradually worsening headaches, constant dull ache, neck stiffness, and photophobia?

    <p>Temporal arteritis (A)</p> Signup and view all the answers

    Which of the following conditions is characterized by localized pain to the right eye, with associated redness and tearing?

    <p>Cluster headache (D)</p> Signup and view all the answers

    What is the most likely diagnosis for a 32-year-old patient with spastic paraparesis, impaired coordination in the left limbs, pelvic organ dysfunction, and pallor of the temporal halves of the optic discs?

    <p>Multiple sclerosis (A)</p> Signup and view all the answers

    In a 25-year-old female patient with unsteady walking and a history of retrobulbar neuritis, what is the most likely diagnosis considering the evidence of cerebellar lesions?

    <p>Multiple sclerosis (B)</p> Signup and view all the answers

    Which symptom is least likely to be associated with multiple sclerosis based on the provided cases?

    <p>Unsteady walking due to cerebellar lesions (D)</p> Signup and view all the answers

    Which of the following diagnoses would most likely require imaging to confirm based on the symptoms provided?

    <p>Cerebellar tumor (B)</p> Signup and view all the answers

    Which condition is primarily characterized by lesions in the pyramidal pathways in the context of the discussed cases?

    <p>Multiple sclerosis (D)</p> Signup and view all the answers

    What infectious disease is associated with lower flaccid paralysis that did not recover after 6 months?

    <p>Polio (C)</p> Signup and view all the answers

    What is the most likely diagnosis for a patient with spasticity, hyperreflexia, and a positive Babinski sign, whose weakness does not improve with rest?

    <p>Amyotrophic Lateral Sclerosis (A)</p> Signup and view all the answers

    Which of the following conditions is not classified as a channelopathy?

    <p>Cystic fibrosis (B)</p> Signup and view all the answers

    What is the most likely diagnosis for a patient with tingling, numbness, weakness of extremities, and lack of bowel control?

    <p>Amyotrophic lateral sclerosis (ALS) (D)</p> Signup and view all the answers

    A 70-year-old woman has rigidity in her neck and arms and a shuffling gait without a tremor. What is the most likely diagnosis?

    <p>Parkinson’s Disease (C)</p> Signup and view all the answers

    What is the most appropriate drug for treating an acute attack of migraine?

    <p>Sumatriptan (B)</p> Signup and view all the answers

    Guillain-Barré syndrome is characterized by impairment primarily in which nervous system function?

    <p>Motor (C)</p> Signup and view all the answers

    Which symptom is NOT characteristic of Guillain-Barré polyneuropathy?

    <p>Involvement in one limb (A)</p> Signup and view all the answers

    What diagnosis is most likely for a 36-year-old female with diplopia and ptosis following headache episodes?

    <p>Ophthalmoplegic Migraine (B)</p> Signup and view all the answers

    A 29-year-old woman experiences headaches that last 4-72 hours, characterized as pulsating and unilateral. What condition does she likely have?

    <p>Migraine (A)</p> Signup and view all the answers

    In a patient with diabetes mellitus who has deformed joints and absent Achilles reflexes, which condition could be inferred?

    <p>Diabetic neuropathy (D)</p> Signup and view all the answers

    Which of the following conditions is least likely associated with spasticity, hyperreflexia, and a positive Babinski sign?

    <p>Parkinson’s Disease (B)</p> Signup and view all the answers

    What might the absence of knee reflexes indicate in a patient with type II diabetes mellitus?

    <p>Peripheral nerve damage (C)</p> Signup and view all the answers

    What investigation should be performed for a patient who experienced a seizure lasting 2 minutes followed by an hour of sleep?

    <p>Electroencephalography (D)</p> Signup and view all the answers

    Which of the following statements about polio is false?

    <p>It primarily affects sensory nerves. (D)</p> Signup and view all the answers

    In the case of headache disorders, what sets apart a diagnosis of normal pressure hydrocephalus from other common migraine disorders?

    <p>Presence of shuffling gait (C)</p> Signup and view all the answers

    What common symptom is associated with recurrent migraines, particularly those lasting several hours?

    <p>Sensitivity to light and sound (B)</p> Signup and view all the answers

    Given a 64-year-old male with high-grade fever, double vision, dysphagia, and unsteady gait, what could be the suspected diagnosis?

    <p>Brain stem lesion (B)</p> Signup and view all the answers

    What condition is indicated by excessive daytime sleepiness and episodes of uncontrollable sleep, particularly during meetings, along with vivid dreams and muscle weakness after laughter?

    <p>Narcolepsy (B)</p> Signup and view all the answers

    For a 60-year-old diabetic patient found unconscious with a pulse rate of 120/min and BP of 160/100 mm Hg, which is the next step in management?

    <p>Check blood glucose (B)</p> Signup and view all the answers

    What is a common symptom experienced by patients with narcolepsy during emotional stress?

    <p>Muscle weakness (B)</p> Signup and view all the answers

    What complaint does a 60-year-old woman with difficulty falling and staying asleep primarily exhibit?

    <p>Early morning awakenings (A)</p> Signup and view all the answers

    What distinguishing feature is often present in episodes of sleep for a person with narcolepsy?

    <p>Inability to stay awake at any time (A)</p> Signup and view all the answers

    In a case of a patient with a central nervous system disorder presenting with double vision and dysphagia, which diagnostic test would be least appropriate?

    <p>Electromyography (D)</p> Signup and view all the answers

    Which condition is characterized by the manifestation of 'pachymeningitis hemorrhagica interna'?

    <p>Subdural hematoma (C)</p> Signup and view all the answers

    What is the most appropriate treatment for a 12-year-old patient presenting with high fever, headache, vomiting, and positive Kernig's sign?

    <p>Antibiotics (A)</p> Signup and view all the answers

    What type of investigation should be performed for a 20-year-old patient with headache, vomiting, and positive Kernig's symptom?

    <p>Liquor analysis (A)</p> Signup and view all the answers

    Which nerve is predominantly affected in cases of uncal herniation?

    <p>IIIrd cranial nerve (D)</p> Signup and view all the answers

    In a lesion of the posterior column of the spinal cord, which sense remains unaffected?

    <p>Temperature sense (C)</p> Signup and view all the answers

    In Brown Séquard syndrome, which function is not involved?

    <p>Ipsilateral extensor response (B)</p> Signup and view all the answers

    What is the likely diagnosis for a 59-year-old patient with spastic tetraparesis and marked muscle hypotrophy?

    <p>Amyotrophic lateral sclerosis (A)</p> Signup and view all the answers

    What symptom might indicate the presence of spasticity in neurological conditions?

    <p>Pathologic Babinski's sign (A)</p> Signup and view all the answers

    Which method of investigation is most effective in determining the form of nonproliferative diabetic retinopathy?

    <p>Fluorescence angiography (B)</p> Signup and view all the answers

    Which laser procedure would be appropriate for treating persistent appositional-angle closure in a patient with nanophthalmos?

    <p>Laser gonioplasty (B)</p> Signup and view all the answers

    Which structure is primarily responsible for accommodation in the eye?

    <p>Ciliary body (C)</p> Signup and view all the answers

    Which of the following cell types is not derived from neural crest cells?

    <p>Ciliary muscle (D)</p> Signup and view all the answers

    When does eye morphogenesis begin during embryonic development?

    <p>15 days (C)</p> Signup and view all the answers

    Which feature is not typically present at birth in the human eye?

    <p>Lens is biconcave in shape (C)</p> Signup and view all the answers

    Which mechanism mediates ascorbic acid transport in the cornea?

    <p>Passive diffusion (A)</p> Signup and view all the answers

    Which condition is most likely to require prophylactic treatment due to the risk of endophthalmitis or retinal detachment?

    <p>Scleral perforation (D)</p> Signup and view all the answers

    Which treatment is most effective against common pathogens when treating maternal genital infections?

    <p>Povidon-iodine 2.5% solution (C)</p> Signup and view all the answers

    What finding in the discharge is most indicative of simple allergic conjunctivitis?

    <p>Copious mucous discharge (A)</p> Signup and view all the answers

    Which operation is indicated for treating cicatricial entropion?

    <p>Weiss operation (C)</p> Signup and view all the answers

    Which condition is least likely to cause ciliary staphyloma?

    <p>Retinal detachment (C)</p> Signup and view all the answers

    Intermediate uveitis is also known as?

    <p>Pars planitis (C)</p> Signup and view all the answers

    What is the most common symptom associated with sympathetic ophthalmitis?

    <p>Bilateral non-suppurative uveitis (C)</p> Signup and view all the answers

    Which anti-fungal medication can be administered intravitreally?

    <p>Clotrimazole (A)</p> Signup and view all the answers

    Which of the following conditions is not associated with uveal effusion syndrome?

    <p>Chronic glaucoma (A)</p> Signup and view all the answers

    In which age range is fixation of visual reflexes typically accomplished?

    <p>1 year (D)</p> Signup and view all the answers

    Which surgical outcome is not typically considered a complication?

    <p>Unsatisfactory alignment (C)</p> Signup and view all the answers

    Botulinum toxin injection is least suitable for which type of strabismus?

    <p>Nystagmus (C)</p> Signup and view all the answers

    Which procedure is typically the treatment of choice for a 2-month-old child with symptoms of watering and eye discharge?

    <p>Syringing and probing (C)</p> Signup and view all the answers

    A positive photostress test is typically seen in which condition?

    <p>Optic neuritis (D)</p> Signup and view all the answers

    The indentation tonometer operates based on which principle?

    <p>More indentation in a soft eye (A)</p> Signup and view all the answers

    Which examination is least useful for a patient with sudden and painless vision loss?

    <p>Schirmer's test (D)</p> Signup and view all the answers

    Which diagnostic test is least appropriate for evaluating a penetrating injury with an intraocular foreign body?

    <p>MRI (D)</p> Signup and view all the answers

    Which pathology is characterized by lipogranulomatous inflammation?

    <p>Tuberculosis (A)</p> Signup and view all the answers

    What is the most common type of ptosis?

    <p>Aponeurotic (D)</p> Signup and view all the answers

    Which condition is associated with decreased corneal sensation?

    <p>Herpes simplex (C)</p> Signup and view all the answers

    What is the expected diagnosis for a patient with conjunctival congestion and eyelids with yellow crusts in the morning?

    <p>Acute bacterial conjunctivitis (A)</p> Signup and view all the answers

    Which of the following is NOT a source of error in applanation tonometry?

    <p>Astigmatism (C)</p> Signup and view all the answers

    What drug is the treatment of choice in trachoma endemic areas?

    <p>Azithromycin (C)</p> Signup and view all the answers

    Which management approach increases the effect of anti-allergic drops in a patient with allergic conjunctivitis?

    <p>None of the stated (B)</p> Signup and view all the answers

    Which condition is associated with bitemporal hemianopia and intact visual acuity?

    <p>Craniopharyngioma (A)</p> Signup and view all the answers

    Which type of uveitis is characterized by inflammation in all segments of the uvea?

    <p>Panuveitis (B)</p> Signup and view all the answers

    What complication after cataract surgery is most likely to result in uncontrolled hypertension?

    <p>Suprachoroidal hemorrhage (A)</p> Signup and view all the answers

    Which diagnosis is most likely for a patient experiencing difficulty reading in bright sunlight?

    <p>Posterior subcapsular cataract (C)</p> Signup and view all the answers

    Aniseikonia is primarily caused by which of the following?

    <p>Different size images in the fundus of both eyes (B)</p> Signup and view all the answers

    In a patient suspected of having open-angle glaucoma, which finding is most crucial for diagnosis?

    <p>Cupping of the disc (A)</p> Signup and view all the answers

    Which medication is least suitable for a hypertensive patient with glaucoma?

    <p>Dipivefrine (B)</p> Signup and view all the answers

    Which type of cataract is associated with fluctuating refractive errors?

    <p>Intumescent cataract (A)</p> Signup and view all the answers

    In a diabetic patient who has undergone pan-retinal photocoagulation, which medication is not appropriate for managing elevated intraocular pressure?

    <p>Pilocarpine (D)</p> Signup and view all the answers

    What conjunctivitis is suspected in a patient with central necrosis of the cornea after a history of severe conjunctivitis?

    <p>Hyperacute conjunctivitis of adult (D)</p> Signup and view all the answers

    What is the position of the main focus in a hyperopic eye?

    <p>Behind the retina (B)</p> Signup and view all the answers

    Which structure of the eye contributes the greatest refractive power?

    <p>Cornea (D)</p> Signup and view all the answers

    What causes presbyopia in individuals?

    <p>Age-related decrease in accommodation due to the hardness of the crystalline lens (A)</p> Signup and view all the answers

    Which of the following is an expected complication of congenital cataract surgery compared to senile cataract surgery?

    <p>Higher incidence of posterior capsular opacification (C)</p> Signup and view all the answers

    Why does a straw appear to be broken when placed in water?

    <p>Refraction (D)</p> Signup and view all the answers

    What is the likely diagnosis for a 35-year-old man with normal distance vision but difficulty with near vision, showing +2.0D sphere in retinoscopy?

    <p>Presbyopia (D)</p> Signup and view all the answers

    What is the primary purpose of mydriatic drops in a pediatric patient?

    <p>Ophthalmoscopy (C)</p> Signup and view all the answers

    Flashcards

    Multiple sclerosis (MS)

    A neurological disorder characterized by inflammation and damage to the myelin sheath that covers nerve fibers in the brain and spinal cord. This leads to a wide range of symptoms including spasticity, impaired coordination, optic nerve involvement, and bladder/bowel dysfunction.

    Ischemic stroke

    A type of stroke where a blood clot blocks the blood supply to part of the brain, leading to damage to the brain tissue.

    Hemorrhagic stroke

    A type of stroke that occurs when a blood vessel in the brain ruptures, causing bleeding into the surrounding brain tissue.

    Encephalitis

    A disease characterized by inflammation of the brain, often caused by viruses, bacteria, or other infectious agents.

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    Cerebellar tumor

    A tumor located in the cerebellum, a part of the brain responsible for coordination and balance, causing symptoms like unsteady gait and difficulty with movement.

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    Thunderclap Headache

    A headache characterized by sudden onset, severe intensity, and a peak within 1 minute. It's often described as a "thunderclap" because of its rapid onset.

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    Migraine

    A chronic headache disorder characterized by frequent headaches that are often unilateral (affecting one side of the head), throbbing, and associated with nausea, vomiting, and sensitivity to light and sound.

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    Cluster Headache

    A type of headache that is characterized by a severe, sharp, stabbing pain that is localized to one side of the face and usually affects the area around the eye, temple, cheek, forehead, and/or jaw.

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    Tension-Type Headache

    A type of headache that is characterized by a dull, achy pain that is usually located on both sides of the head and is often accompanied by neck stiffness and photophobia (sensitivity to light).

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    Meningitis

    A type of headache that is characterized by a severe, sudden onset of headache that is associated with stiff neck, fever, and other signs of meningitis.

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    Electroencephalography

    A procedure that records the electrical activity of the brain using electrodes placed on the scalp.

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    CT Scan of the Brain

    A medical imaging technique that uses X-rays to create detailed images of the brain.

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    Narcolepsy

    A neurologic disorder characterized by excessive daytime sleepiness, sudden attacks of sleep, and vivid dreams.

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    MRI of the Brain

    An imaging technique that uses strong magnetic fields and radio waves to create detailed images of the brain and spinal cord.

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    Lumbar Puncture

    A procedure involving the withdrawal of cerebrospinal fluid (CSF) from the spinal canal for diagnostic testing.

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    Restless Leg Syndrome

    A neurological disorder characterized by episodes of involuntary muscle contractions, particularly in the legs, especially at night.

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    Brain Stem Lesion

    A condition characterized by inflammation of the brain, often caused by bacterial or viral infections. The patient's symptoms likely include fever, headache, confusion, and neurological deficits.

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    Unconscious Patient

    A medical emergency that requires immediate attention and prompt evaluation of the patient's condition.

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    Amyotrophic Lateral Sclerosis (ALS)

    A neurological disorder characterized by progressive weakness and muscle atrophy, often affecting the hands and limbs. It can also include fasciculations (muscle twitches) and hyperreflexia (exaggerated reflexes).

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    Cerebellar Ataxia

    A neurological condition characterized by impaired coordination and balance, often involving the cerebellum. It can manifest as gait abnormalities, tremors, and difficulty with fine motor skills.

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    Migraine Headache

    A common neurological condition characterized by recurrent, severe headaches that often involve pulsating pain, nausea, vomiting, and sensitivity to light and sound. Migraines can have aura (visual disturbances) and typically last for several hours.

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    Migraine with Aura

    A type of migraine headache that is characterized by transient neurological symptoms such as visual disturbances, numbness, or weakness, which occur before or during the headache. It is often accompanied by a headache.

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    Parkinson's Disease

    A debilitating neurological disorder characterized by progressive loss of dopamine-producing brain cells. This leads to tremor, rigidity, slowness of movement, and postural instability. It primarily affects motor function.

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    Ophthalmoplegic Migraine

    A rare neurological disorder that involves inflammation of the optic nerve. It often presents with pain around the eye, blurred vision, and sometimes double vision. It can occur with or without migraine headaches.

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    Guillain-Barré Syndrome

    A rare neurological condition characterized by weakness, numbness, and pain in the limbs, usually caused by an autoimmune attack on the peripheral nerves. It can occur after an infection or vaccination.

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    What is Pachymeningitis Hemorrhagica Interna?

    A rare condition that can lead to bleeding under the dura mater causing a hematoma. It can potentially occur following head trauma, infection, or certain medications. Symptoms can include headaches, confusion, and seizures. It's important to note that this is a serious condition that needs prompt medical attention.

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    What is the recommended treatment for a 12-year-old patient presenting with high fever, headache, vomiting, altered consciousness, neck stiffness, and positive Kernig's sign?

    Antibiotics are used to treat bacterial infections and are the preferred treatment option for bacterial meningitis, which can be a life-threatening condition. The patient's symptoms indicate a bacterial infection, so antibiotics are crucial to fight the infection.

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    What investigation should be performed for a 20-year-old patient presenting with headache, vomiting, altered consciousness, neck stiffness, and positive Kernig's sign?

    An MRI (Magnetic Resonance Imaging) is a vital diagnostic tool for suspected meningitis. It provides detailed images of the brain and spinal cord, allowing healthcare professionals to visualize any inflammation, swelling, or other abnormalities related to meningitis.

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    Which cranial nerve is commonly affected in uncal herniation?

    The oculomotor nerve (IIIrd cranial nerve) is most commonly affected by an uncal herniation. This type of herniation occurs when brain tissue presses on the oculomotor nerve, leading to symptoms like dilated pupils, eye drooping, and impaired eye movements.

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    What sensory function is NOT affected in a lesion of the posterior column of the spinal cord?

    The posterior column of the spinal cord is responsible for carrying sensory information about vibration, position (proprioception), and touch. The sense of temperature is carried by the spinothalamic tract.

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    In Brown Séquard syndrome, what is NOT involved?

    Brown Séquard syndrome is a rare neurological condition caused by damage to one side of the spinal cord. The contralateral (opposite side) posterior column is affected, while the ipsilateral (same side) pyramidal tract (responsible for motor control) is also damaged.

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    What disorder is indicated by a gradual onset of spastic tetraparesis, Babinski's sign, muscle atrophy, and fibrillary twitches?

    Amyotrophic Lateral Sclerosis (ALS) is characterized by progressive muscle weakness and atrophy, along with spasticity (increased muscle tone). It affects both upper and lower motor neurons, leading to a combination of weakness and stiffness.

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    What disease is characterized by gradual onset of spastic tetraparesis, Babinski's sign, muscle atrophy, and fibrillary twitches?

    Multiple Sclerosis (MS) is an autoimmune disease affecting the central nervous system. It causes inflammation and damage to myelin, the protective covering of nerve fibers. Symptoms can vary widely and include weakness, numbness, fatigue, vision problems, and cognitive impairment.

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    What infectious disease causes lower flaccid paralysis?

    A neurodegenerative disease characterized by lower flaccid paralysis, often due to an infection with the poliovirus.

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    What is a Channelopathy?

    A genetic disorder caused by dysfunctional ion channels, leading to various symptoms depending on the specific channel affected.

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    What is the likely diagnosis for a patient with tingling, numbness, weakness, and lack of bowel control?

    Loss of control over bladder and bowels, along with tingling, numbness, and weakness in extremities, suggesting a neurological condition affecting the spinal cord or peripheral nerves.

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    What is Guillain-Barré syndrome?

    A condition where the body's immune system attacks the peripheral nerves, causing inflammation and damage. This leads to weakness and paralysis, which can affect different parts of the body.

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    What is the primary nervous system function impaired in Guillain-Barré syndrome?

    Guillain-Barré syndrome mainly affects the motor functions of the nervous system, leading to weakness and paralysis. It can also affect sensory functions, but motor function is the primary one.

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    What is Diabetic Neuropathy?

    A type of peripheral neuropathy (nerve damage) seen in individuals with long-term diabetes. It is characterized by damage to the nerves of the feet, causing symptoms like pain, numbness, tingling, and loss of sensation.

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    Is Diabetic Neuropathy the same as Guillain-Barré syndrome?

    This condition is not a direct result of diabetes. It is a distinct neurological disorder that affects the nerves in the body.

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    How can Diabetic Neuropathy be differentiated from Guillain-Barré syndrome?

    The symptoms of diabetic neuropathy are very similar to Guillain-Barré syndrome, making differential diagnosis important. Both conditions result in weakness, pain, and numbness, but the underlying cause is different.

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    Keratoconus

    A condition where the eye's clear outer layer (cornea) becomes thinner and weakened, leading to a bulge or protrusion. This weakens the cornea.

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    Allergic Conjuntivitis

    A type of conjunctivitis (inflammation of the conjunctiva) caused by an allergic reaction. Symptoms include itching, burning, watery discharge, and eye redness.

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    Dacryocystitis

    A condition where the tear duct becomes blocked, causing excessive tearing and discharge. This can be caused by a blockage at the lacrimal sac opening.

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    Intermediate Uveitis

    A type of uveitis (inflammation of the middle layer of the eye) that affects the middle portion of the eye, specifically the pars plana. Intermediate uveitis is also known as pars planitis.

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    Sympathetic Ophthalmia

    A rare and serious immune-mediated condition that affects both eyes. It occurs after an eye injury or surgery and leads to inflammation in the uninjured eye.

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    Uveal Effusion Syndrome

    A rare condition characterized by fluid buildup in the eye's middle layer (uveal tract), leading to increased pressure. This can be associated with various factors like myopia, detachment of the choroid, and scleral defects.

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    Ocular Fungal Infection

    A fungal infection that can affect various parts of the eye, including the retina. It is often treated with anti-fungal medications like Voriconazole and Fluconazole.

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    Posterior Uveitis

    A type of inflammatory eye condition characterized by redness, pain, and decreased vision. It is commonly associated with autoimmune disorders like spondyloarthritis and often presents with yellow-white lesions in the back of the eye.

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    What is Fluorescence Angiography used for?

    A diagnostic method that uses fluorescent dye to highlight blood vessels in the retina, particularly helpful in identifying diabetic retinopathy.

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    What is an Iridotomy?

    A medical procedure that uses a laser to create a small hole in the iris, aimed at relieving pressure buildup in the eye by allowing fluid to flow.

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    What is Laser Trabeculoplasty?

    A surgical procedure that uses a laser to alter the trabecular meshwork, a structure in the eye that helps regulate fluid drainage, to improve fluid flow and reduce pressure.

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    What is the Ciliary Body responsible for?

    A part of the eye responsible for the ability to focus on objects at varying distances, achieved by changing the shape of the lens.

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    What is a Neural Crest Derivative?

    The neural crest is a group of cells that develop into various tissues in the body. Melanocytes, which produce pigment, are an example.

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    When does eye morphogenesis start?

    The process of eye development begins approximately 22 days after conception.

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    What is a feature of the eye at birth?

    Myelination of nerve fibers in the eye is not fully complete at birth, and extends out to the lamina cribrosa, the area where the optic nerve fibers leave the eye.

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    When is visual fixation established?

    The ability to fixate on a visual target develops gradually over the first year of life.

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    Hyperopia

    A condition where the main focus of light falls behind the retina, leading to blurry vision at near distances and clear vision at a distance.

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    Myopia

    A condition where the main focus of light falls in front of the retina, leading to blurry vision at a distance and clear vision at near distances.

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    Presbyopia

    A condition characterized by a gradual loss of accommodation due to the hardening of the crystalline lens, leading to difficulty focusing on near objects.

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    Aniseikonia

    A condition where the refractive power of the eye differs between the two eyes, resulting in an uneven size perception of objects.

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    Optic Neuritis

    A condition involving inflammation of the optic nerve, often causing pain, blurred vision, and sometimes double vision.

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    Craniopharyngioma

    A condition characterized by a tumor at the base of the brain (sellar region), often causing hormonal imbalances and visual field defects.

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    Refractometry

    A type of eye exam used to determine the refractive power of the eye, requiring the use of mydriatic drops to dilate the pupils.

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    Ophthalmoscopy

    A medical procedure involving the use of an ophthalmoscope to examine the interior of the eye, typically requiring mydriatic drops to dilate the pupils.

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    What is Aponeurotic Ptosis?

    The most common type of ptosis, which is the drooping of the upper eyelid, caused by weakening or stretching of the levator palpebrae superioris muscle.

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    What is Conjunctivitis?

    A condition characterized by inflammation of the conjunctiva, the clear membrane that lines the inside of the eyelid and covers the white part of the eye. Symptoms include redness, itching, discharge, and sometimes blurry vision.

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    What is Allergic Conjunctivitis?

    A type of conjunctivitis that is caused by an allergic reaction. It is characterized by intense itching, watery discharge, and eye redness.

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    What is Neurogenic Ptosis?

    This is a type of ptosis that is caused by problems with the nerves that control the eyelid muscles, such as nerve damage.

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    What is Acute Bacterial Conjunctivitis?

    This is an inflammation of the conjunctiva (the transparent membrane that lines the inside of the eyelid) caused by bacterial infection, leading to symptoms like redness, discharge, and sometimes blurry vision.

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    What is Dacryocystitis?

    An eye condition caused by inflammation of the tear sac (lacrimal sac) situated at the inner corner of the eye. It is often accompanied by symptoms like redness, swelling, and excessive tearing.

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    What is Azithromycin?

    The drug of choice in areas with high incidence of Trachoma, a bacterial infection causing scarring of the conjunctiva and eyelids.

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    What is Viral Conjunctivitis?

    This is a type of conjunctivitis caused by a virus, usually characterized by a watery discharge, mild redness, and a feeling of grittiness.

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    Study Notes

    Neurological Cases Study Notes

    • Case 1: A 40-year-old male presented with transient dysphagia, episodic headaches, and increased sensitivity to light. He felt some weakness on his left side. Diagnosis unclear from provided information.

    • Case 2: A 60-year-old woman presented with constant headaches, worsened in the morning and improved throughout the day. She had a history of intermittent visual disturbances and recent scalp tenderness. Her ESR was elevated. Likely diagnosis: Temporal arteritis.

    • Case 3: A 24-year-old female (Ms. Deepa) with a history of recurrent migraines (diagnosed 12 months earlier) sought treatment options. Drugs for migraine prophylaxis include Amitriptyline, Propranolol, Sumatriptan, and Ergotamine.

    • Case 4: A 28-year-old female presented with recurrent throbbing headaches, typically unilateral, often accompanied by nausea, vomiting, and photosensitivity. This points to migraine diagnosis.

    • Case 5: A 35-year-old woman described unilateral throbbing headaches lasting 4-72 hours, often accompanied by visual disturbances (aura), nausea, and vomiting. A likely diagnosis of migraine.

    • Case 6: A 40-year-old man presented with a severe, sudden headache around his neck and back of the head, associated with nausea and photophobia. Elevated blood pressure and stiff neck suggest subarachnoid hemorrhage as a likely diagnosis.

    • Case 7: Pathology of the peripheral or central nervous system can lead to autonomic nervous system disorders.

    • Case 8: All are examples of upper motor neuron lesions except Anterior Horn Cell Disease.

    • Case 9: A 30-year-old male presented with rapid, involuntary muscle contractions, particularly in his neck and shoulders. This suggests dystonia as a likely diagnosis.

    • Case 10: Pseudotumor cerebri is caused by vitamin toxicity.

    • Case 11: Upper motor neuron lesions are characterized by weakness and spasticity.

    • Case 12: A 45-year-old woman presented with difficulty initiating movement, rigidity, and tremor. Parkinson's disease is a likely possibility.

    • Case 13: A 55-year-old male with involuntary, jerky movements (worse with stress), with a family history of similar symptoms, suggests a diagnosis of Huntington's Disease.

    • Case 14: A 60-year-old woman with difficulty swallowing, slurred speech, and muscle weakness over a year, suggests amyotrophic lateral sclerosis (ALS).

    • Case 15: A 72-year-old woman presented with headache, nausea, and vomiting, associated with a red painful eye, suggests diagnosis of glaucoma.

    • Case 16: A 61-year-old female with sudden, sharp stabbing facial pain (9/10), lasting 5-10 seconds, triggered by talking or cold wind, may have diagnosis of trigeminal neuralgia.

    • Case 17: A 40-year-old woman with a dull, bilateral headache that lasts for hours, is likely experiencing a tension-type headache.

    • Case 18: A 60-year-old man with persistent headaches, located in the temples, along with jaw claudication, fatigue, and elevated ESR, suggests temporal arteritis.

    • Case 19: A 33-year-old female with a thunderclap headache is likely to have acute aneurismal hemorrhage. The other possibilities are acute ischemia of the mid-brain, acute encephalitis, and Meningitis.

    • Case 20: A 22-year-old man with frontal region headaches, occasionally with nausea, being treated with pain medication temporarily but no lasting relief, may indicate analgesic abuse.

    • Case 21: A 35-year-old woman with headaches that last 30 minutes to an hour, occurring around the same time every day, associated with eye redness, tearing, and nasal congestion, suggests a possible cluster headache diagnosis.

    • Case 22: A 45-year-old male with a gradually worsening, dull headache, neck stiffness, and photophobia likely has cervicogenic headaches.

    • Case 23: Right-sided disc herniation at the LS-51 level often causes low back pain and sciatica. Weakness in the right foot with preserved right ankle reflex is common.

    • Case 24: A 55-year-old male presenting with chronic neck pain, stiffness, and decreased range of motion, with degenerative changes at C5-C6 and tingling in the fingers, suggests cervical spondylosis.

    • ... (Remaining cases): These cases cover a wide range of neurological conditions and symptoms. Information is extracted from these cases based on patient demographics, symptoms, medical history findings and diagnostic considerations. The summary of each case is specific to the provided information and may not be indicative of all possible diagnoses, depending on the particular circumstances of the case.

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    Ophthalmology Past Paper PDF

    Description

    Explore various neurological case studies involving different age groups and symptoms, from migraines to temporal arteritis. This quiz will test your understanding of presented symptoms, potential diagnoses, and treatment options. Enhance your clinical reasoning skills with real patient scenarios.

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