Week 4 SBL Learning Issues

Question 1

What causes a bovine cough?

Answer 1

• Unable to close glottis (e.g. vagus damage)
• Leads to weak sounding coughs

Question 2

What are the lumbar puncture findings of multiple sclerosis?

Answer 2

• Raised white blood cells
• Neurofilaments
• Oligoclonal bands: two or more bands of IgG antibodies shown on electrophoresis

Question 3

Describe the pathophysiology of open angle glaucoma

Answer 3

• Usually, aqueous humour drains from the anterior segment of the eye through the trabecular meshwork (at the join between the iris and cornea)
• In open angle glaucoma, this happens to slowly,. causing pressure buildup in the eye that damages the optic nerve

Question 4

List some painless causes of vision loss

Answer 4

• Diabetic retinopathy
• Retinal detachment
• Central retinal artery/vein occlusion
• Cataracts
• Vitreous haemorrhage

Question 5

List some painful causes of vision loss

Answer 5

• Optic neuritis
• Conjunctivitis
• Migraine
• Glaucoma

Question 6

Outline the McDonald criteria for MS diagnosis

Answer 6

• Two or more lesions, disseminated in space and time
• Corresponding signs and symptoms
• Can be diagnosed in one go if MRI shows multiple lesions at different stages of progression
• Oligoclonal bands on LP

Question 7

What investigations are indicated for MS?

Answer 7

• MRI of brain and spinal cord
• Lumbar puncture (oligoconal bands)
• Blood test

Question 8

How, specifically, are acute relapses of MS usually treated?

Answer 8

• Corticosteroids
• IV methylprednisolone
• ACTH can be used instead (why?)