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JG Year 1 > 130 Sudden visual disturbance > Flashcards

130 Sudden visual disturbance Flashcards

1
Q

Where in the retina are cone cells predominantly found?

A

Centrallly - highest at the fovea

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2
Q

Where in the retina are rod cells predominantly found?

A

In the periphery

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3
Q

Which cells of the retina are responsible for the ‘sensor surround effect’?

A

Horizontal cells

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4
Q

Where in the brain do ganglion cells project to?

A

Suprachiasmatic nuclei

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5
Q

Which cells contain melanopsin?

A

Retinal ganglion cells

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6
Q

Which photopigment is involved with the regulation of circadian rhythm?

A

Melanopsin

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7
Q

Explain the phototransduction pathway

A
  • light hits rhodopsin and 11-cis-retinal in the disc of rod cell
  • change in conformation –> all-trans-retinal
  • transducin detaches –> α subunit binds to phosphodiesterase
  • phosphodiesterase changes cGMP –> GMP
  • Na+ channels close as cGMP no longer bound
  • no Na+ means hyperpolarisation = off –> which turns bopolar cells on
  • signal transduction
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8
Q

What is RAPD?

A

Relative afferent pupil defect - lesions anterior to the chiasm eg in neuritis and MS

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9
Q

What is protanopia?

A

Red visual weakness

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10
Q

What is deutranopia?

A

Green visual weakness

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11
Q

What is tritanopia?

A

Blue visual weakness

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12
Q

Which nucleus in the mibrain is involved in the visual pathway?

A

Edinger-Westphal

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13
Q

Where do the oculomotor efferents synapse with short ciliary nerves?

A

Ciliary ganglion

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14
Q

Loss of vision in the right eye - where in the visual pathway is the defect?

What could cause this?

A

Right optic nerve

  • compressive tumour
  • optic neuritis
  • anterior ischaemic optic neuropathy
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15
Q

Loss of peripheral vision - where in the visual pathway is the defect?

What could cause this?

A

Defect in the optic chiasm

  • Parasellar mass
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16
Q

Loss of nasal vision in the R eye and loss of temporal vision in the L eye - where in the visual pathway is the defect?

What could cause this?

A

Defect in the right optic tract

  • neoplasm
  • inflammatory process
  • arteriovenous malformation
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17
Q

Loss of vision in the upper left quadrant of L and R eyes - where in the visual pathway is the defect?

What could cause this?

A

Lesion in the upper right optic radiations

  • neoplasm
  • inflammatory process
  • ischaemia
  • infection
18
Q

What protective molecules/cells are in tears?

(7 listed)

A
  1. Lactoferrin
  2. lysozyme
  3. β-lysin
  4. IgA
  5. IgG
  6. complement
  7. leukocytes
19
Q

What causes primary open angle glaucoma?

A

Decreased outflow of aqueous humour through tebecular meshwork

20
Q

What is timolol and what is it used to treat?

A

β- blocker used to treat primary open angle glaucoma

21
Q

Where is the vision loss in age related macula degeneration?

A

Central

22
Q

What are drusen and in which condition are they found?

A

Lipfuscin deposits - found in dry macula degeneration

23
Q

What is the cause of wet macula degeneration?

A

Neovascularisation from the choroid layer which has severe impact on central vision

24
Q

How does lucentis work in macular degeneration?

A

Binds to VEGF-A which prevents it from binding to its receptor. Normally involved with neovascularisation and angiogenesis

25
Q

Which receptors does phenylephrin act on?

A

α1 receptors

26
Q

What is the effect of topical application of phenylephrin on the eye?

A

Myadriasis - dilation of the pupil

27
Q

Why is phenylephrin less effective in:

  • diabetes
  • dark irises
  • elderly
A
  • increased glucose makes the pupillary muscles less flexible
  • lots of melanin which phenylephrin binds to
  • lots of wear and tear
28
Q

What are the SE of phenylephrin?

(5 listed)

A
  • photophobia and blurred vision
  • stinging
  • acute glaucoma
  • HTN
  • arrhythmias
29
Q

Name 3 antimuscarinics which causes myadriasis

A
  1. Atropine
  2. Cyclopentolate
  3. Tropicamide
30
Q

What are the benefits of using tropicamide to cauase myadriasis?

A

Quick and short-acting

31
Q

What are the systemic effects of tropicamide, atropine and cyclopentolate? Action on which receptors cause this?

A
  • Dry mouth
  • Flushing
  • Confusion

Act to block ACh at muscarinic receptors

32
Q

Which eye drugs can raise IOP?

A

Antimuscarinics, sympathomimetics

33
Q

What drug is used in the treatment for glaucoma?

MOA?

A

Pilocarpine - mimics ACh on muscarinic receptors which causes miosis and opens up the drainage of the trabecular network. Reverses myadriasis in 30-60mins

34
Q

Which parasympathomimetic eye drug inhibits the production of aqueous humor?

A

Timolol

35
Q

What is the MOA of the sympathomimetic eye drug acetazolamide?

A

Inhibits carbonic anhydrase which is needed for the production of bicarbonate in aqueous humor

36
Q

What is hypromellose the 1st line treatment for?

A

Artificial tears

37
Q

What are the red flag symptoms suggestive of acute closed angle glaucoma?

A
  • red, painful eye
  • N&V
  • blurred vision
  • headache
38
Q

Which antibiotic can cause orange tears?

A

Rifampicin

39
Q

Which is the most appropriate abx for the treatment of a Pseudomonas infection of the eye + corneal ulcer?

  • chloramphenicol
  • gentamycin
  • ciprofloxacin
A

Ciprofloxacin

40
Q

Which is the most appropriate abx for the treatment of a *Pseudomonas *infection of the eye?

  • chloramphenicol
  • gentamycin
  • ciprofloxacin
A

Gentamycin

41
Q

Which is the most appropriate abx for the treatment of a Staphylococcus infection of the eye.

  • chloramophenicol
  • gentamycin
  • ciprofloxacin
A

Chloramphenicol

JG Year 1 (27 decks)

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