Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Posterior Segment Disease - OD4 > 7 - Age Macular Degeneration > Flashcards

7 - Age Macular Degeneration Flashcards

1
Q

What are the two genes explaining AMD?

A

Tyr402His(5 fold) and Ala69Ser(7 fold) Note: Both are complement of the H gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the risk of a Smoker getting AMD?

A

Twice Note: Reduces chorodial blood flow, decreases pigment in RPE, depresses antioxidants levels and imune system activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the biggest factor for AMD?

A

Age Note: Risk increases with advancing age Race: Caucasian is another demographic Gender: Female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the hallmark for Dry AMD?

A

Drusen RPE Hyperpigmentation RPE atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the hallmark findings for WET AMD?

A

Choroidal NV Subretinal/SUB RPE fluid or blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common type of AMD?

A

Dry AMD Note: Non exudative, Atrophic, non bleeding and is about 85 to 90% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which layer of the retina will have lipid deposits?

A

Bruch’s membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What vasculature is effected in AMD?

A

Choriocapillaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the balance molecules for Bruch’s membrane?

A

Collagen (Type 1 Increase with aging and Type 4 decrease as one ages) Laminin (Decrease as aging occurs) Fibronectin (Decrease as aging occurs) GAG’s (Increase with aging) Matrix Metalloproteinases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a distinction of the Pathophysiology of DRY AMD?

A

Photoreceptor function is decreased Note: Usually due to OXIDATIVE STRESS (RPE) and INFLAMMATION (Choriocapillaris)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oxidative stress produces what type of product which impacts the RPE?

A

Free radicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Injury of endothelial cells of the choriocapillaris and RPE results from inflammation. What is happening?

A

Activation of complement cycle which results in the formation of the Membrane Attack Complex (MAC) –> Lyses pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is damaged first in the inflammation?

A

Choriocapillaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What specific protein is damaged in the RPE?

A

Matric metalloproteins (MMP’s) Note: Products are backed up in the basal lamina of the RPE and Bruch’s membrane and get stuck on the RPE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the two types of Drusen deposits?

A
  1. Basal Laminar deposits (Lipid and Collagen) 2. Basal Linear deposits (phosopholipid vesicles and granules)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the size criteria for Drusen?

A

small (usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the boundary criteria for Drusen?

A
  1. hard (discrete and well demarcated) 2. soft (amorphous and poorly demarcated) 3.confluent (contiguous boundaries between drusen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the two main materials Drusen is made of?

A

Lipid and Hyalin Material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the predisposing formation from hydrophillic drusen?

A

Chorodial Neovascularization will occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

NV occurs during WET AMD and what product does the new vessels contain to create a membrane (network)?

A

Fibroblasts

21
Q

What is the most common VGF?

A

Vascular Endothelial Growth Factor

22
Q

True or False. Pt will not exhibit vision loss?

A

True

23
Q

What are the two types of CNV?

A
  1. Classic - Uniform lesion with typical IVFA pattern 2. Occult - Irregular lesion with typical IVFA
24
Q

What is a Disciform scar?

A

Fibrous tissue proliferation (Hemorrhage or Hyperplasia of the RPE)

25
Q

What is the classification of AMD Criteria?

A
26
Q

Since IVFA use to the be Gold standard, what mechanism or machine which deminished the usage of IVFA?

A

OCT

27
Q

What is the benefit of using ICG FA?

A

Finding Occult CNVM

28
Q

What type of defect will you notice on the OCT if there is an RPE Atrophy?

A

Window Defect

29
Q

True or False. With RPE Atrophy, the image of the Dry AMD can be seen upto the choroid?

A

True.

30
Q

An OCT image shows complete irregularity in the the macula area. What is usually directly correlated to Wet AMD and this irregularity?

A

CNVM

31
Q

True or False. Hard exudates will stain later in stage compared to soft exudates?

A

False. Hard will immediatly Fluoresce and Soft will copulate over time. Leakage will occur in soft exudates

32
Q

What is the follow up protocol for Dry AMD?

A
  • 6-12 months, Depends on appearance
  • Early hard drusen only-about 12 months
  • Some soft drusen-about 9 months
  • Extensive soft drusen-about 6 months
  • Geographic atrophy-6-12 months
33
Q

What is the protocol for follow up of a WET AMD?

A
  • Confirm fundoscopic findings with ancillary tests
  • Any new area of CNVM, bleeding, fluid, etc MUST be referred to OMD for treatment

–Treatment of Wet AMD is outside of scope of OD in all 50 states

  • OMD will proceed with treatment
  • OMD will follow-up every 1-3 months until CNVM inactive
34
Q

What is follow up protocol for Disciform Scar?

A
  • If scarring extensive, new treatment won’t be very effective
  • Monitor based on risk of more visual impairment
  • Usually every 12 months
  • If extensive scarring, extensive VI
35
Q

What is the most common testing conducted on AMD pts?

A

Amsler Grid

36
Q

What is the benefit of PHP; in regards to photoreceptors?

A

Sensitivity to photoreceptors

37
Q

What is the treatment of Dry and Wet AMD?

A

•Dry

–Oral vitamins

–Experimental treatments

•Wet

–Oral vitamins

–Intravitreal injections

–(laser, PDT)

38
Q

What was the most effective measure for individuals with Int. AMD or Advanced AMD in 1 eye?

A

High levels of antioxidants and zinc

Formula: AREDS 1 Formula

  • 500 milligrams of vitamin C
  • 400 international units of vitamin E
  • 15 milligrams of beta-carotene (concern in smokers developing lung cancer)
  • 80 milligrams of zinc as zinc oxide
  • 2 milligrams of copper as cupric oxide

–Prevent copper deficiency, which may be associated with high levels of zinc

•OK to take multivitamin in addition

39
Q

What is the formula in AREDS 2?

A
  • 500 milligrams of vitamin C
  • 400 international units of vitamin E
  • 80 milligrams of zinc as zinc oxide
  • 2 milligrams of copper as cupric oxide

–Prevent copper deficiency, which may be associated with high levels of zinc

  • 10 milligrams lutein
  • 2 miligrams zeaxanthin
40
Q

What is the protocol of IV injections in AMD pts?

A
  1. Upon sign of CNVM, injection monthly for 3-6 months, then as needed after
  2. “Treat and extend”-after initial treatment and stabilization, intervals are adjusted based on clinical signs: extended 2 weeks if no bleeding, shortened by 2 weeks if bleeding
41
Q
A
42
Q

What is Purtscher retinopathy?

A

Loss of vision after acute compression injuries to the thorax or head

Presentation: CWS, Heme and retinal edema

FA: Arteriolar obstruction and leakage

May occur: APD and disc edema

43
Q

What is Valsalva or Venous retinopathy?

A

IO Venous pressure increases. Around macula, you will see a hemes. Located on the NFL,

Ex: Large amount of blood right infront of the macula (fundus photo).

44
Q

What is hyperviscosity syndrome?

A

Vascular occlusion, therefore a flow decrease damage vessels with leakage and ischemia; usually due to high protein (hyperglobulinemia)

45
Q

What is HIV retinopathy?

A

Many hemes; CWS; decreased VA and advanced pts will have it. This will tell you that you will have an asymptomatic issues.

46
Q

What is the presentation of interferon retinopathy?

A

CWS, hemes, block FA but after discontinuation will stop all the symptoms.

Note: Monitor monthly if there is retinopathy and if not 3 months RTC

47
Q

What is Talc Retinopathy?

A

Talc is inert filler in methylphenidate hydrochloride tablets: crushed for IV drug use

IV to lungs: Infarcts to right to left and CRVO will occur

48
Q

What is Terson syndrome?

A

Vitresous and sub-ILM or subhyaloid hemorrhage (sub ILM)

Usually occurs due to trauma

1/3 subarachnoid or subdural heme

49
Q

What is child abuse syndrome?

A

Due to trauma; you will see blood in the back of eye and this is the only sign that you could find.

Heme’s and 80% of shaken baby syndrome you will see this.

Posterior Segment Disease - OD4 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions