Neuro Eye Disease Midterm PDF

65 questions: Which of the following is true about CT scan? It performs multiple cross-sectional X-rays. It uses iodinated contrast material Computer Tomography (CT + CAT) Denser tissues appear more dark than Bone and brain tissues are dark, whereas water and air are bright Which of the follow...

65 questions: Which of the following is true about CT scan? It performs multiple cross-sectional X-rays. It uses iodinated contrast material Computer Tomography (CT + CAT) Denser tissues appear more dark than Bone and brain tissues are dark, whereas water and air are bright Which of the following is true about helical CT imaging compared to conventional CT? It allows rapid scanning for CT angiography. It has more motion artifacts than conventional. It takes longer to complete than conventional. Which of the following is false about the indication of CT? Head fracture It uses non-ionizing radiation. CT is considered before orbital surgery of thyroid eye disease. It allows us to compare proptosis between the two eyes. Patients with chronic kidney disease and on hemodialysis have a higher risk of developing which of the following conditions after injection of contrast medium for MRI? Nephrogenic systemic fibrosis. Aneurysm Lung cancer The picture below: labeled A-D. which of the following is the optic nerve of the left eye? A because the image is read as you look facing the patient B C D A pic of the two images at the bottom. Which of the following is true? Pic A shows T2 MRI and pic B shows T2 weighted with fat suppression Pic A shows T1 MRI and pic B shows T2 MRI Pic A shows T1 MRI and pic B shows T1 with FLAIR Pic of transverse section MRI of the brain shows white matter is dark, gray matter is bright, and ventricle is bright: T1 T2 T2 weighted with FLAIR Which of the following measures the molecular diffusion of water within brain white matter? Diffusion tensor imaging fMRI PET 30 years old female presents to the clinic complaining of blurry vision in the right eye associated with right periorbital pain on eye movement (my DDx optic neuritis). Ocular and systemic history is unremarkable. VA 20/40 OD 20/20 OS. Color vision is abnormal. No diplopia. BP is 115/70. Anterior segment is unremarkable. HVF shows center scotoma. OCT shows zonal disruption of the elliptical and outer nuclear layer thinning(my DDx AZOOR). Which is the best electrodiagnostic test to perform? pVEP I think DDx is optic neuritis Flash VEP ERG I am leaning on R/O AZOOR ffERG What is the next step of neuroimaging? MRI CT Doppler Ultrasound of neck A case 50-60 yoa patient with symtoms and sign of GCA? Which of the following is true about MR angiography? Used to detect intracranial aneurysm Which of the following is most appropriate for identifying recent vascular infarctions? Diffusion weighted imaging CTA uses ionizing radiation and iodinated contrast material Which of the following is indication to use MR venography/ Papilledema Optic neuritis Thyroid eye disease Cranial palsy due arterial aneurysm Which of the following is a manifestation of MS in the brain? Periventricular region Juxtacortical region Corpus callosum All the above Which of the following result from rupture of the middle meningeal artery? Epidural hematoma Subdural hematoma Subarachnoid hemorrhage Intraventricular hemorrhage Which of the following carries the fibers to the iris sphincter and ciliary body? CN3 CN4 CN5 CN6 CN 7 Which of the following is false about intra aneurysm that affects CN3? Ipsilateral partial palsy Contralateral partial palsy The pupil is always spared Aberrant regeneration happens by the aneurysm Which is true about ocular myasthenia gravis? Diplopia is constant throughout the day Ptosis is due to weakness of levator palpebrae Eyelid retraction Pupils are involved Which of the following is true about OMG? Antibodies causes enlargement of the orbital neuron sheaths Cogan’s lid twitch sign Ptosis that improves towards the end of the day. Comitant deviation Which of the following is the best long term treatment for OMG? Rituximab Cyclosporine Pyridostigmine Steroids Which of the following tests is highly sensitive to myasthenia gravis? AcHR antibodies test EMG MuSK LRP4 MR: Which of the following is the best treatment for Grave’s ophthalmopathy? Smoking cessation Assessment and treat systemic thyroid disease Treatment of Graves’ ophthalmopathy is based on clinical activity, severity, and duration of the disease. Select all the above Which of the following can cause lesion in the oculomotor nucleus? Vascular ischemic disease??? 3rd, 4th,6th cranial nerves palsies with monocular vision loss? Orbital apex syndrome Optic neuritis Oculomotor nucleus lesion Case: adult men fell on the kitchen floor while he is changing the bulbs Hypertropia of the right eye greater in left gaze, Left head tilt, Excyclotorsion of the right eye. Negative forced duction test. The hypertropia deviation didn’t change in supine position. 4th CN palsy Brown’s syndrome Skew deviation Thyroid eye disease Which of the following tests is used to differentiate between skew deviation and 4th CN palsy? spine-upright test Modox rod Forced duction test Which of the following is not found in congenital right 4th CN palsy? Large vertical fusional amplitude Facial asymmetry Left head tilt Constant hypertropia of the right eye Which of the following is true about right 6th CN palsy? Greater eso at near than at distance Greater eso when patient looking left Limitation in right gaze Which of the following is true about left horizontal gaze palsy? Ipsilateral CNs 5,6,and 7? Foville syndrome Which of the following conditions are characterized by the combination of CPEO and pigmentary retinopathy? Kearns - Sayre syndrome 6 years old patient with limitation in right gaze of right eye and globe retraction with palpebral fissure narrowing of right eye on attempted left gaze? Duane syndrome Which of the following structures controls horizontal gaze? PPRF INC riMLF Lesion in the left MLF? adduction paresis of right eye and abducting nystagmus of left eye Which of the following is false about dorsal midbrain syndrome? Horizontal gaze limitation Light near dissociation Convergence retraction nystagmus Bilateral lid retraction Skew deviation, ocular torsion, and head tilt is known as Ocular tilt reaction Which is true about MAR electroimaging? Depressed a wave on ffERG Depressed b wave on ffERG Which of the following is true about transient pERG response in macular dystrophy? N95 shows abnormality in the retinal ganglion cell activities Smooth pursuit and OKN asymmetry during monocular viewing is seen in Fusional maldevelopment nystagmus syndrome Seesaw nystagmus Torsional nystagmus A question about spasmus nutans syndrome Gaze evoked nystagmus is wakened by Anticonvulsants meds Which is false about peripheral vestibular nystagmus? Mixed Horizontal or vertical waveform jerk nystagmus Nystagmus subsides in days Suppressed by visual fixation Which of the following happens in defect in the right vestibular organ? Slow phase towards the left gaze followed by fast phase towards the right gaze Which of the following is false about jerk nystagmus? Can has accelerating slow phase Can has decelerating fast phase Linear velocity Something else I cannot remember Case of patient with hypertension. VA is CF OD, 20/20 OS. cherry red spot in the fovea OD. Central retinal artery occlusion Case of 50 year old female present to clinic with transient monocular vision loss. She is on meds for DM, HTN and dyslipidemia. DFE shows pale, swollen disc and flame-shaped hemorrhage. Normal CV, EOM, VA. BP and HT are high. Palpable, tender temporal side of the face. What workup? Hemoglobin A1c LDL, HDL, and total cholesterol GCA Liver function test ERS and CRP Ischemia due to right posterior cerebral artery occlusion? Left homonymous hemianopsia Right homonymous hemianopsia Central scotoma Which of the following is false about migraines? Zig zag positive phenomena that expands across a visual field with time. Headaches last 4-72 hours Visual aura that last over x minutes Attending rock and roll concert makes it better Which of the following is true about 13-15 Glasgow Coma scale TBI? Normal MRI more than 30 min of loss of consciousness more than one day of amnesia More than 24 hours of alternation of mental state All are included in the scoring of Glasgow Coma scale except? Eye opening Verbal skills Motor skills Drawing subjects Which of the following will show abnormality in patient with bacterial meningitis? Increased protein levels Increased glucose levels Increased CO2 Decreased white blood cells