Day: April 18, 2024

Flashes and floaters

Overview Flashes and floaters are a common ophthalmic presentation. Flashes and floaters are common presenting complaints. They can be caused by both benign and potentially sight-threatening pathologies. For this reason, most patients usually warrant a referral to ophthalmology. Flashes Photopsia, or ‘flashes’, refer to the perception of light without an objective stimulus. They may be described as seeing ‘stars’, ‘lightening streaks’ or ‘flashing lights’. They are essentially visual hallucinations of light with geometric-like structures (e.g. triangles, diamonds). The underlying aetiology of ‘true’ flashes is inappropriate stimulation of the optic nerve or the retina. The main mechanism is retinal traction occurring as

Tremor

Overview A tremor is considered involuntary, rhythmic, oscillatory movements of a body part. A tremor is considered the involuntary shaking of a body part. This is classically associated with the hand but can affect other parts of the body. This shaking may be defined as rhythmic, oscillatory movements (i.e. move back and forth) that occur due to alternating or synchronous contractions of opposing muscle groups. Two key terms when describing tremor are frequency and amplitude: Frequency: this is essentially how quick the tremor is, or in other words, the oscillations (back and forth movement) per second. It is measured in cycles per

Syncope

Overview Syncope is a broad term for transient loss of consciousness. Syncope refers to a transient loss of consciousness. The loss of consciousness is usually due to a brief reduction in cerebral perfusion due to an abrupt fall in blood pressure. The loss of consciousness inevitably leads to a collapse with subsequent recovery as perfusion is restored (~8-10 seconds). There are many different causes of syncope of which the most common is vasovagal syncope. Vasovagal syncope is also known as a ‘common faint’ and typically occurs in the setting of a stressful event (e.g. phlebotomy). It is characterised by prodromal symptoms

Headache

Overview Headache is a very common clinical presentation. Headache refers to pain felt in any region of the head, which also includes behind the eyes and ear or in the upper neck. It is an extremely common presentation and can be broadly divided into primary headaches and secondary headaches. Primary headaches: a headache not caused by or attributed to another disorder. In other words, the headache itself is the primary disorder. Examples include tension-type headache, migraine, and cluster headache Secondary headaches: a headache caused by another underlying disorder. In other words, the headache is a symptom of another pathological process. Examples

Back pain

Overview Back pain refers to pain experienced in a patients’ back that is often in the lower regions. Back pain is an extremely common presentation that is estimated to affect a significant proportion of adults at some point during their life. The majority of back pain is felt in the lower lumbar region (known as low back pain) and is usually self-limiting. There are a variety of causes and it is important to be able to differentiate non-specific back (i.e. in the absence of an underlying disorder) from a sinister cause (e.g. discitis, cancer). Location The location of back pain is usually

Jaundice

Overview Jaundice refers to the yellow complexion that occurs from an elevated bilirubin. Jaundice refers to the characteristic clinical finding of yellow discolouration of body tissue, particularly the skin and sclera. This occurs due to an elevation in bilirubin, which is a breakdown product of red blood cells that are taken to the liver to be modified and excreted in the bile. Any disease process that alters the normal metabolism of bilirubin can lead to elevated levels and jaundice. This may be due to increased production or impaired excretion of bilirubin. Clinically, jaundice is not noticeable until the bilirubin level is