Archives for 2019

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 4

Questions:
23. What is left-sided hemineglect?
24. How does one test for hemineglect?
25. What clinical signs are associated with left-sided hemineglect?
26. Where is the lesion in left-sided hemineglect?
27. What is topographagnosia?
28. What are the symptoms of topographagnosia?
29. What clinical signs are associated with topographagnosia?
30. Where is the lesion in topographagnosia?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 3

Questions:
15. What is visual object agnosia?
16. How does one test for visual object agnosia?
17. What clinical signs are associated with object agnosia?
18. Where is the lesion in visual object agnosia?
19. What is optic aphasia?
20. How does one test for optic aphasia?
21. What clinical signs are associated with optic aphasia?
22. Where is the lesion in optic aphasia?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 2

Questions:
7. What is hemiachromatopsia?
8. Where is the lesion in hemiachromatopsia?
9. How does one test hemiachromatopsia?
10. What clinical signs are associated with hemiachromatopsia?
11. What is prosopagnosia?
12. How does one test for prosopagnosia?
13. What clinical signs are associated with prosopagnosia?
14. Where is the lesion in acquired prosopagnosia?

Neuro-ophthalmology Illustrated Chapter 10 – Specific Disorders of Higher Cortical Function 1

Questions:
1. What is the role of the inferior (ventral) or occipitotemporal pathway?
2. What is the role of the superior (dorsal) or occipitoparietal pathway?
3. What is alexia without agraphia?
4. How does one test for alexia without agraphia?
5. Where is the lesion in alexia without agraphia?
6. What clinical finding is associated with alexia without agraphia

Neuro-ophthalmology Illustrated Chapter 9 – Disk Edema 3

Questions:
34. What are the symptoms and signs of idiopathic intracranial hypertension (IIH)?
35. What are the diagnostic criteria for IIH?
36. What is the ideal imaging test when evaluating a patient with presumed papilledema?
37. A patient with bilateral disc swelling has a normal brain MRI. What test should be done next?
38. What should one consider if the headaches of IIH do not improve (at least transiently) after a lumbar puncture?
39. What does a normal Brain MRI in the setting of papilledema suggest?
40. What should be evaluated next in a patient with bilateral swollen discs, normal BP, normal CT with and without contrast, LP opening pressure >250mm and normal or abnormal CSF contents?
41. What should be evaluated next in a patient with bilateral swollen discs, normal BP, normal MRI with and without contrast, LP opening pressure >250mm and normal or abnormal CSF contents? 
42. What items are most commonly associated with IIH?
43. What condition can mimic the symptoms of cerebral venous thrombosis?
44. What can early recognition of cerebral venous thrombosis prevent?
45. Should papilledema from a meningeal process or cerebral venous thrombosis be classified as IIH?
46. What are the goals of IIH management?
47. What are the main factors that drive the management of IIH?
48. What MRI findings are supportive of the diagnosis of IIH?
49. When the predominant symptom of a patient with IIH is severe headaches, which surgical procedure is preferred?
50. How often does a lumboperitoneal or ventriculoperitoneal shunt need to be repaired?
51. When the predominant symptom of a patient with IIH is vision loss and headaches are no more than mild, which surgical procedure is preferred?
52. Does optic nerve sheath fenestration usually need to be performed on both optic nerves?
53. How often does optic nerve sheath fenestration fail?

Neuro-ophthalmology Illustrated Chapter 9 – Disk Edema 2

Questions:
17. Once optic disc edema is confirmed, what should be determined?
18. In anterior optic neuropathy with disk edema, is visual acuity usually decreased?
19. In papilledema is visual acuity usually decreased?
20. In anterior optic neuropathy with disk edema is color vision usually decreased?
21. In papilledema is color vision usually decreased?
22. What are the usual characteristics of visual field defects in anterior optic neuropathy with disk edema?
23. What are the usual characteristics of visual field defects in papilledema
24. Is anterior optic neuropathy with disk edema usually unilateral?
25. Is papilledema usually unilateral?
26. What findings are often associated with papilledema?
27. Does the absence of disc edema rule-out raised intracranial pressure in a patient presenting with headache?
28. What visual symptoms are associated with papilledema?
29. When is central visual acuity loss experienced in papilledema, early or late?
30. What type of visual field defect is found initially with papilledema?
31. What type of visual field loss is experienced in long-standing papilledema?
32. Can visual loss from papilledema occur with any cause of papilledema?
33. What should be assessed next in a patient found to have papilledema?

Neuro-ophthalmology Illustrated Chapter 9 – Disk Edema 1

Questions:
1. What is the term reserved for optic disk swelling with increased intracranial pressure?
2. Does pseudoedema of the optic disk have elevated optic nerve head?
3. Does pseudoedema of the optic disk have sharp margins?
4. Does pseudoedema of the optic disk have obscured vessels?
5. Does pseudoedema of the optic disk have a central cup?
6. Does pseudoedema of the optic disk have anomalous retinal vasculature?
7. Does pseudoedema of the optic disk leak on FA?
8. Does pseudoedema of the optic disk have peripapillary hemorrhages and exudates?
9. Does pseudoedema of the optic disk have venous dilation and tortuosity? 10. Does true disc edema of the optic disk have elevated optic nerve head?
11. Does true disc edema of the optic disk have sharp margins?
12. Does true disc edema of the optic disk have obscured vessels?
13. Does true disc edema of the optic disk have venous dilation and tortuosity?
14. Does true disc edema of the optic disk have anomalous retinal vasculature?
15. Does true disc edema of the optic disk have peripapillary hemorrhages and exudates?
16. Does true disc edema of the optic disk leak on FA?

Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 11

Questions:
130. What type of traumatic optic neuropathy may require emergent treatment?
131. What is the management of indirect traumatic optic neuropathy?
132. What should be done in all cases of head trauma?
133. What potential alternative causes of optic neuropathy should be ruled out when considering the diagnosis of low-tension glaucoma?
134. Are optic nerve head drusen usually unilateral or bilateral?
135. Do patients with optic nerve head drusen experience transient visual obscurations?
136. What are optic nerve head drusen?
137. What should be done if a patient presents with visual symptoms of optic neuropathy and is found to have optic nerve head drusen?
138. What is the most common congenital optic nerve anomaly?
139. What are the characteristics of optic nerve hypoplasia?
140. What conditions are associated with optic nerve hypoplasia?
141. What is an optic disk coloboma?
142. What conditions are associated with optic disk coloboma?
143. What are the characteristics of the “morning glory” disk anomaly?
144. What is the mechanism behind the morning glory disk anomaly?
145. What conditions are associated with the “morning glory” disk anomaly?
146. What is the mechanism of optic pit development?
147. What are the characteristics of an optic pit?
148. What are the characteristics of the tilted disk anomaly?
149. What is the usual field defect seen with myelinated retinal nerve fibers around the disk?

Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 10

Questions:
116. What are the characteristic features of toxic and nutritional optic neuropathies?
117. Is visual loss in toxic or nutritional optic neuropathy commonly the result of a single cause?
118. Is treatment by stopping the toxic agent or replacing a missing vitamin that is causing an optic neuropathy usually effective in improving visual function?
119. What are the common toxins linked to optic neuropathies?
120. What are the nutritional causes linked to optic neuropathies?
121. What is the most common agent in toxic optic neuropathy?
122. What are the findings of methanol-related optic neuropathy and what is its course?
123. What are the characteristics of ethylene glycol-related optic neuropathy?
124. What is the most common medication that causes toxic optic neuropathy?
125. What are the characteristics of ethambutol-related optic neuropathy?
126. What are the characteristics of amiodarone-related optic neuropathy?
127. What should be always be excluded when considering the diagnosis of toxic optic neuropathy?
128. What is often the first sign of vitamin B12 deficiency?
129. What are the characteristics of Vitamin B12 deficiency?

Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 9

Questions:
101. What are the characteristics of hereditary optic neuropathies?
102. When should hereditary optic neuropathies be suspected?
103. What is the most common hereditary optic neuropathy?
104. What misdiagnosis is often made in dominant optic atrophy?
105. What is the typical disk appearance in dominant optic atrophy?
106. Can hereditary optic atrophies have other neurologic or systemic signs?
107. Are hereditary optic atrophies associated with degenerative or developmental diseases?
108. How is Leber hereditary optic neuropathy (LHON) inherited?
109. What are the clinical findings in Leber hereditary optic neuropathy (LHON)?
110. What can be associated with  Leber hereditary optic neuropathy (LHON?
111. Is there a genetic blood test for Leber hereditary optic neuropathy (LHON)?
112. Does spontaneous vision improvement occur in some patients with Leber hereditary optic neuropathy (LHON)?
113. What test should be done on patients confirmed as having Leber hereditary optic neuropathy (LHON)?
114. Which hereditary optic atrophy often has disk cupping in addition to bilateral temporal disk pallor?
115. What are the characteristics of Autosomal Dominant Optic Atrophy (DOA)?