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[h] Neurology System Flashcards

[i] Master this session in just 5 minutes.

[q] …………. is inflammation of uvea. Present with hypopyon (accumulation of pus in anterior chamber) and conjunctival redness. Associated with systemic inflammatory disorders (sarcoidosis, rheumatoid arthritis, juvenile idiopathic arthritis, HLA-B27–associated conditions).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFV2ZWl0aXMu[Qq]

[q] ……………… occurs due to deposition of yellowish extracellular material in between Bruch membrane and retinal pigment epithelium (Drusen). It causes distortion (metamorphopsia) and eventual loss of central vision (scotomas). Prevent progression with multivitamin and antioxidant supplements.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERyeSAobm9uZXh1ZGF0aXZlKSBBZ2UtcmVsYXRlZCBtYWN1bGFyIGRlZ2VuZXJhdGlvbiAoQU1EKS4=[Qq]

[q]  …………………. occurs due to rapid loss of vision due to bleeding 2° to choroidal neovascularization. It causes distortion (metamorphopsia) and eventual loss of central vision (scotomas). Treat with anti-VEGF (vascular endothelial growth factor) injections (ranibizumab) or laser.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFdldCAoZXh1ZGF0aXZlKSBBZ2UtcmVsYXRlZCBtYWN1bGFyIGRlZ2VuZXJhdGlvbiAoQU1EKS4=[Qq]

[q] Diabetic retinopathy is the leading cause of blindness in the USA. Retinal damage occurs due to ………………….?

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[f]IGNocm9uaWMgaHlwZXJnbHljZW1pYSBpbmR1Y2VkIG1pY3JvdmFzY3VsYXIgaW5qdXJ5Lg==[Qq]

[q] Dot-blot and flame-shapped hemorrhages, Hard exudates and macular edema, and cotton wool spots without neovascularization during fundoscopy of diabetic patient is characteristic for ……………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5vbnByb2xpZmVyYXRpdmUgRGlhYmV0aWMgcmV0aW5vcGF0aHku

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[Qq]

[q] Dot-blot and flame-shapped hemorrhages, Hard exudates and macular edema, cotton wool spots, neovascularization that rupture causing vitreous hemorrhage and detachment of the retina during fundoscopy of diabetic patient is characteristic for ……………?

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[f]IHByb2xpZmVyYXRpdmUgZGlhYmV0aWMgcmV0aW5vcGF0aHku

[q] Thickening of the arteriolar walls (“copper or silver wiring”), compression of the associated veins (arteriovenous nicking), and small, white foci of retinal ischemia (cotton-wool spots) are characteristic for ………………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVydGVuc2l2ZSByZXRpbm9wYXRoeS4=

[q] …………….. cause acute and painless monocular vision loss. Specific fundoscopic findings include a pale retina and cherry red macula.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGVudHJhbCBhcnRlcnkgb2NjbHVzaW9uLg==[Qq]

[q] ……………. is the most common cause of central artery occlusion.

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[f]IEVtYm9saXNtLg==[Qq]

[q] ……………. usually present with subacute monocular visual loss. The characteristic changes on funduscopic examination are sometimes referred to as the “blood and thunder” appearance and include optic disk swelling, retinal hemorrhage, dilated veins, and cotton wool spots.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENlbnRyYWwgcmV0aW5hbCB2ZWluIG9jY2x1c2lvbi4=[Qq]

[q] ………….. occurs due to separation of neurosensory layer of retina (photoreceptor layer with rods and cones) from outermost pigmented epithelium (normally shields excess light, supports retina) —> degeneration of photoreceptors —> vision loss. Often preceded by posterior vitreous detachment (“flashes” and “floaters”) and eventual monocular loss of vision like a “curtain drawn down.”

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJldGluYWwgZGV0YWNobWVudC4=

[q] ……………. is inherited retinal degeneration. Present with painless, progressive vision loss beginning with night and peripheral blindness (rods affected first). Fundoscopy Bone spicule-shaped deposits around macula.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJldGluaXRpcyBwaWdtZW50b3NhLg==[Qq]

[q] What is the most likely diagnosis?

HIV positive patient with CD4 count less than 30 presenting with visual disturbance +  funduscopy reveals yellow-white, fluffy retinal lesions near the retinal vessels with associated hemorrhage?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENNViBSZXRpbml0aXMu[Qq]

[q] Treatment with ………………. is required to prevent blindness in CMV retinitis in HIV positive patient?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGdhbmNpY2xvdmlyLg==[Qq]

[q] ………… is optic disc swelling (usually bilateral) due to ↑ ICP (2° to mass effect). This buildup of pressure compresses the optic nerves externally, which in turn cause elevation of the optic disc with blurred disc margins.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBhcGlsbGVkZW1hLg==

[q] Every case of leukocoria in children is considered a …………….., until proven otherwise. These patients have an increased risk of secondary tumors, especially ………… later in life.

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[f]IHJldGlub2JsYXN0b21hLCBvc3Rlb3NhcmNvbWFzLg==

[q] The weakest plates of bone in the orbit are …………………, are common sites of fracture. Fracture is typically evident on radiographic imaging, and fluid (blood) or herniation of the orbital contents can often be visualized in the adjacent normally air-filled sinuses.

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[f]IHRoZSBtZWRpYWwgYW5kIGluZmVyaW9yIHdhbGxzLg==

[q] Opioid Analgesic work on presynaptic neurons causing ……………, and on postsynaptic neurons causing ………………..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

JiM4MjExOyBQcmVzeW5hcHRpYyByZWNlcHRvcnMgJiM4MjEyOyZndDsg4oaTIENhIGluZmx1eCAmIzgyMTI7Jmd0OyDihpMgc3Vic3RhbmNlIFAgcmVsZWFzZSAocGFpbiBuZXVyb3RyYW5zbWl0dGVyKS4=

JiM4MjExOyBQb3N0c3luYXB0aWMgcmVjZXB0b3JzICYjODIxMjsmZ3Q7IOKGkSBLIGVmZmx1eCAmIzgyMTI7Jmd0OyBtZW1icmFuZSBoeXBlcnBvbGFyaXphdGlvbi4=[Qq]

[q] ………… and ………. are prodrugs that is converted by the cytochrome P450 into active full opioid agonist. Cytochrome P450 inducers will increase its active form and may lead to toxicity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENvZGVpbmUsIE1lcGVyaWRpbmUu[Qq]

[q] …………. is a full opioid agonist that increase the serotonin level and should be avoid with SSRI because it may cause serotonin syndrome. It also has  antimuscarinic action (has the opposite of morphine’s smooth muscle effect), So, no miosis, no spasm of GI / GU/ Gallbladder, and tachycardia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1lcGVyaWRpbmUu[Qq]

[q]……………. is a long-acting opioid drug used in maintenance of opiate addiction (opioid detoxification).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1ldGhhZG9uZS4=[Qq]

[q] ……….., ……….., and ………… shouldn’t be given to a patient on a full agonist —> it will act as antagonist —> precipitation of withdrawal.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

MS4gQnVwcmVub3JwaGluZSAoUGFydGlhbCBhZ29uaXN0IG9waW9pZHMpLg==

Mi4gTmFsYnVwaGluZSwgcGVudGF6b2NpbmUgKG8gzrogYWdvbmlzdCBhbmQgzrwgYW50YWdvbmlzdCku

3. Butorphanol ( o κ-opioid receptor agonist and μ-opioid receptor partial agonist).

[q] ………….. is IV opioid antagonist that is used for reversal for respiratory depression in acute opioid toxicity.

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[f]wqBOYWxveG9uZS4=[Qq]

[q] …………. is per oral opioid antagonist that is used for ↓ craving for alcohol and used in opiate addiction.

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[q] …………. is opioid derivative that can be used for treatment of diarrhea.

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[f]IExvcGVyYW1pZGUsIERpcGhlbm94eWxhdGUu[Qq]

[q] …………. is opioid derivative that can be used for treatment of cough.

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[f]IERleHRyb21ldGhvcnBoYW4u[Qq]

[q] Morphine should be avoided in patients with pulmonary dysfunction except …………..?

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[f]IHB1bG1vbmFyeSBlZGVtYS4=[Qq]

[q] Morphine should be avoided in patients with head trauma because ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IMKgdmFzb2RpbGF0YXRpb24gZHVlIHRvIGhpc3RhbWluZSByZWxlYXNlICYjODIxMTsmZ3Q7IGNlcmVicmFsIHZlc3NlbCBWRCAmIzgyMTE7Jmd0OyBpbmNyZWFzZWQgY2VyZWJyYWwgYmxvb2QgZmxvdyAmIzgyMTE7Jmd0OyDihpEgSUNQIChhdm9pZCBpbiBoZWFkIHRyYXVtYSku[Qq]

[q] Acute toxicity of …………. causes a classic triad of Pinpoint pupil, Respiratory depression, Coma. And should be treated with ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG9waW9pZCwgU3VwcG9ydGl2ZSB0cmVhdG1lbnQgKyBJViBuYWxveG9uZS4=[Qq]

[q] In animal studies, NMDA receptors antagonists, like ………., block the actions of glutamate and effectively block morphine tolerance.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

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[q] Tolerance to the different side effects of opioids is expected to occur. However, tolerance to ………… and ……….. does not readily occur.

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[f]IGNvbnN0aXBhdGlvbiBhbmQgbWlvc2lzLg==[Qq]

[q] ………… is very weak opioid agonist, also inhibits 5-HT and norepinephrine reuptake and can cause Serotonin syndrome.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRyYW1hZG9sLg==[Qq]

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