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PPO4 > #14 Red Eye assessment > Flashcards

#14 Red Eye assessment Flashcards

1
Q

What are the lymph nodes of the head and neck?

A

Preauricular, Tonsillar nodes (at the angle of the mandible), submandibular

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2
Q

Which of the lymph nodes will have a tenderness to it when palpating patients with Herpes Simplex and Zoster?

A

Submandibular

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3
Q

Which lymph nodes has an infections of the skin at back of head and frequently enlarged during upper respiratory infections such as Monoucleosis and German Measles?

A

Posterior cervical lymph nodes

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4
Q

How do the lymph nodes feel with palpation when the body is fighting an infection?

A

Firm, Tender, Enlarged, Warm (not always)

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5
Q

How do the lymph nodes feel with palpation when the body is having a maglignant disease?

A

Firm, Non-tender, Fixed, increase in size over time

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6
Q

In what condition would the supraclavicular lymph node swollen?

A

Chest/abdomen disease such as TB and cancers(lymphoma)

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7
Q

When would you check for lymphadenopathy?

A

In all cases of red eye

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8
Q

What are the vital signs of optometry?

A

VA, EOM, pupil

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9
Q

What should you check before slit lamp in a problem focused situation in the case of red eye?

A
  1. History
  2. VA
  3. Gross observation (gross inspection of injection, check lymphadenopathy, check sinuses)
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10
Q

What are the symptoms that patients have with allergies or sinus infections?

A

congestion, post-nasal drip, headaches/facial pain over brow, under eyes, or behind eyes.

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11
Q

Percussion is to tap directly over both brows using the ______ finger. Then repeat for each maxillary using the _____ finger to check for pain or tenderness.

A

middle, index

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12
Q

Which sinus is not accessible to palpation or transillumination?

A

ethmoid and sphenoid

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13
Q

When using the transillumination method to check for sinuses obstruction, + glow means ______, and - glow means ______.

A

open, blocked or thickened sinus

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14
Q

Where do you position the transilluminator when observing the frontal sinus?

a. above the supraorbital rim
b. under the supraorbital rim

A

b

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15
Q

Where do you position the transilluminator when observing the maxillary sinus and what do you ask the patient to do for you?

A

place light directly on the infraorbital rim and ask the patient to open their mouth.

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16
Q

Do you need to do Gonioscopy with red eye patients?

A

Yes, check if the angle are close due to cells or flare

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17
Q

What anterior structures you have to check with red eye patients?

A
  1. Lid and lashes looking for crusting and MGD
  2. Palpebral and bulbar conjunctiva
  3. Cornea - direct, indirect, retro and stain cornea with Fluorescent
  4. Anterior chamber
  5. Tono
  6. Gonio
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18
Q

What dye do you have to use with red eye patient when looking at their cornea when scanning for epithelial defects?

A

fluorescent dye

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19
Q

T/F Epidermic keratoconjunctivitis (EKC) is not contagious.

A

False, EKC is very contagious. Make sure to wash hands and clean slit lamp.

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20
Q

What is Keratic Precipitates?

A

They are inflammatory WBC deposits on the corneal endothelium

21
Q

How does acute KP looks like?

A

white and round

22
Q

How do old KP look like?

A

irregular, faded and/or pitmented

23
Q

What does it mean if you see KP and cells?

A

sign of uveitis

24
Q

What are the intraocular inflammations associated with KP?

A

Iritis, Uveitis, post-opt cataract or laser peripheral iridotomy (LPI) surgery

25
Q

What is the most useful or common method of illumination when viewing KP?

A

parallelepiped with direct beam

26
Q

What is the 2nd most useful or common method of illumination when viewing KP?

A

Indirect

27
Q

What are the signs of angle closure glaucoma?

A
  1. elevated IOP (50)
  2. angle closed with gonio
  3. deep conunctival and episcleral injection greatest at limbus
  4. mid-dilated pupil
  5. corneal edema (steamy cornea)
28
Q

Glaucoma screening includes measurement of ____, stereoscopic assessment of _________, and screening of __________.

A

IOP, optic nerve head, central visual field.

29
Q

___% of patients develop glaucoma despite apparently normal eye pressure.

A

~50

30
Q

What is Primary Open Angle Glaucoma (POAG)?

A

The anterior chamber angle is open and there are NO secondary causes to increase the IOP

31
Q

T/F Open angle Glaucoma is the most common glaucoma in the US.

A

True

32
Q

How is the optic nerve damage due to primary open angle glaucoma?

A

optic neuropathy that is chronic and progressive with a characteristic acquired loss of optic nerve fibers

33
Q

What is IOP difference between the two eyes when you do suspect primary open angle glaucoma?

A

more than or equal to 3mmHg

34
Q

What are you thinking about if the patient’s IOP is more than of equal to 3 between the two eyes?

A

it can be glaucoma, retinal detachments or uveitis/iritis

35
Q

What is the abnormal diurnal variation of IOP measurement over the course of an 8 hr clinic day?

a. 3mmHg
b. 5mmHg
c. 8mmHg
d. 4mmHg

A

c. greater than 5mmHg is abnormal

36
Q

How to calculate Ocular Perfusion pressure?

A

Diastolic BP - IOP

37
Q

Peak IOP pressure occurs during when?

A

sleep

38
Q

In obese patients, valsalva movement when measuring IOP using GAT can cause an increase in _________.

A

episcleral venous pressure

39
Q

_________ is most often associated with higher than average central corneal thickness?

A

ocular hypertension

40
Q

Based on the ocular hypertension treatment study, what cause the greater risk of developing primary open angle glaucoma?

A

thin cornea (under 545microns)

41
Q

Is race a factor for developing glaucoma?

A

Yes

42
Q

What is the average cornea thickness?

A

540 to 545 microns

43
Q

Pachymetry is use to measure the _______.

A

central corneal thickness

44
Q

Pachymetry is now standard of care for ________ and _______ in optometry.

A

glaucoma, LASIK Co-management

45
Q

What is the PASCAL Dynamic Contour Tonometer (DCT)?

A

It’s a new alternative to GAT. It uses the contour matching that includes the influence of corneal thickness, rigidity, curvature and elastic properties

46
Q

In PASCAL Dynamic contour Tonometer, a complete measurement cycle requires about ___ seconds of contact time.

A

8

47
Q

GAT remains the _____ Standard.

A

Gold

48
Q

Where do LPI usually perform at on the iris?

A

at 10 and 2 O’clock position

49
Q

How do you check if the LPI is open?

A

use transilluminator

PPO4 (4 decks)

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