Opthal: Mydriasis: Free MSRA Podcast скачать в хорошем качестве

Opthal: Mydriasis: Free MSRA Podcast

🎧 MSRA Deep Dive: Mydriasis – Dilated Pupils, Big Clues Today we unravel mydriasis — abnormally dilated pupils, often a sign of deeper neurological or systemic pathology. Whether it signals brain injury, drug effects, or benign causes, this is a must-know MSRA topic. 👁️ Definition • Mydriasis = dilated, poorly reactive pupils • Can be unilateral or bilateral • Not a diagnosis but a clue to underlying pathology 🧠 Mnemonic: "MAD NURSES TAKE SOME SUBSTANCES" • Medications (atropine, SSRIs, TCAs) • Anticholinergics, sympathomimetics (amphetamines, cocaine) • Drug misuse • Neurological: 3rd nerve palsy, Adie’s, Holmes-Adie • Underlying trauma (head/orbital) • Reflex/reactive causes • Systemic disease (diabetes, pheochromocytoma) • Surgical or iatrogenic 🔍 Differentials • Pharmacological: Meds or recreational drugs • 3rd nerve palsy: Mydriasis + ptosis + eye movement abnormality • Adie’s tonic pupil: Unilateral, slow light response, normal accommodation • Ocular trauma, iridoplegia • Horner’s syndrome: Usually miosis but worth remembering 👁️ Clinical Features • Dilated pupil(s), slow/no light reaction • Photophobia, glare, blurred vision • Ptosis/diplopia if cranial nerves affected • Associated systemic or neuro symptoms 🩺 Investigations • History: meds, trauma, substance use • Light and accommodation reflex testing • Full neuro exam • Imaging (CT/MRI) if suspect lesion or trauma • Toxicology screen if drug-related cause likely 💊 Management • No direct treatment — manage the cause:  – Stop culprit drugs  – Neuro causes → urgent referral  – Adie’s → pilocarpine (for symptoms)  – Trauma/surgery → ophthalmology input 📈 Prognosis & Complications • Often reversible (e.g., drugs) • May be permanent if due to nerve damage or trauma • Complications:  – Light sensitivity  – Blurred vision  – Missed diagnosis (e.g. 3rd nerve palsy or brain herniation) 📚 MSRA Quick Summary • Always check for medication use and neuro signs • Don’t miss 3rd nerve palsy: dilated pupil + ptosis + eye deviation • Adie’s = benign but requires recognition • Mydriasis = sign, not disease — think broadly and investigate 🧠 Quiz Tips • SSRIs + dilated pupils? → Think anticholinergic tox • Ptosis + dilated pupil + eye deviation → 3rd nerve palsy • Unilateral slow-reactive pupil + intact accommodation in young woman? → Adie’s 🧩 Reflection Prompt If dilated pupils signal major pathology, what subtle signs are you missing in daily exams? 📚 Mydriasis MSRA Resources: 📝 Notes: https://www.passthemsra.com/topic/myd... 🃏 Flashcards: https://www.passthemsra.com/topic/myd... 📖 Accordion Q&A: https://www.passthemsra.com/topic/myd... 🎯 Rapid Quiz: https://www.passthemsra.com/topic/myd... 🧠 Full Quiz: https://www.passthemsra.com/quizzes/m... 🌐 More: https://www.passthemsra.com | https://www.freemsra.com #MSRA #Mydriasis #Ophthalmology #MSRARevision #3rdNervePalsy #AdiesPupil #DilatedPupil #PassTheMSRA #FreeMSRA #GPTraining #Photophobia #MedicalEducation #NeuroRedFlags