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5 Things you Must do when Patients Present with Syncope

By Dr Peter Kas | 18/11/2020

Patients who present to the emergency department following a syncopal episode can be a diagnostic challenge to us....

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

Can you diagnose the cause of DIPLOPIA? Take the test.

By Dr Peter Kas | 07/11/2020

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Created by

Dr Peter Kas

Can you Diagnose the Cause of DIPLOPIA?

A 58 yo male presents to the emergency department with a complaint of "Doc I'm seeing double"
Try these 8 questions.

1 / 8

If you think that the patient has MONOCULAR DIPLOPIA

The diplopia resolves when one eye is closed or covered.

It is due to Ocular Misalignment

It is most commonly due to a refraction error

It requires investigation with a non-contrast CT scan

All of the above are true

2 / 8

In terms of BINOCULAR DIPLOPIA, which of the following is correct?

It resolves when one eye is closed or covered

It indicates ocular misalignment

It may be due to Thyroid Orbitopathy

It may be due to neuromuscular junction pathology, such as myasthenia graves

All of the above are true

3 / 8

Which cranial nerve is affected here?

Source: October 2011Case Reports in Neurology 3(3):248-51

Left CN III

Right CN III

Right CN IV

Left CN VI

CN VII

4 / 8

Which cranial nerve is affected here?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

CN II

CN III

CN IV

CN VI

CN VII

5 / 8

Look at the following image. Which Cranial Nerve is involved?

Source: Oman J Ophthalmol. 2014 May-Aug; 7(2): 103–104

CN III

CN IV

CN VI

CN VII

CN II

6 / 8

In the following image, when would you expect diplopia to occur?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

When the patient's looks to his right

When the patient looks to his left

When the patient looks upward

When the patient looks downward

When the patient looks in any direction

7 / 8

Multiple cranial nerve abnormalities and any headache require an urgent CT brain looking for:( 2 correct answers)

Cavernous Sinus Lesion

Orbital Apex Lesion

Extradural Heamorrhage

Subdural Haemorrhage

Subarachnoid Haemorrhage

8 / 8

Cranial Nerve III paralysis can be complete or incomplete.
In terms of clinical findings in CN III paralysis, which of the following is true?(3 correct answers)

There is Mydriasis

There is Ptosis

Anisocoria is isolated

The pupil is down and out

There is Exophthalmos

Your score is

The average score is 49%

0%

Read the Blog on Diplopia.

Cardioversion in Pregnancy: Is it Safe?

By Dr Peter Kas | 21/10/2020

Is cardioversion safe in the pregnant patient? A CASE A 24 yo female patient presents with palpitations and...

Paediatric Resuscitation

By Dr Peter Kas | 08/10/2020

Paediatric Resuscitation is stressful. However if we remember a few small points, it makes it so much easier....

Shock Dose When Defibrillating Children

By Dr Peter Kas | 08/10/2020

Cardiac arrest in children is certainly less frequent than in adults. However most paediatric in-hospital cardiac arrests do...

Am I ready to sit the ACEM Fellowship Exam?

By Dr Peter Kas | 06/10/2020

This is for those Emergency Medicine registrars about to sit the ACEM Written Fellowship Exam. It's 4 weeks...

Bell’s Palsy

By Dr Peter Kas | 17/09/2020

What is Bell's Palsy? It is an ipsilateral Cranial Nerve VII (lower motor neurone) palsy. There is usually a...

Facial Nerve Palsy examination

By Dr Peter Kas | 17/09/2020

When examining a patient with a facial nerve palsy and we wish to determine if the lesion is...

Trigeminal Neuralgia

By Dr Peter Kas | 12/09/2020

An excellent review article on Trigeminal Neuralgia, has just come out in the NEJM(1). Here is a quick...

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5 Things you Must do when Patients Present with Syncope

Can you diagnose the cause of DIPLOPIA? Take the test.

Cardioversion in Pregnancy: Is it Safe?

Paediatric Resuscitation

Shock Dose When Defibrillating Children

Am I ready to sit the ACEM Fellowship Exam?

Bell’s Palsy

Facial Nerve Palsy examination

Trigeminal Neuralgia

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