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OD2 - Applied Clinical Training & Research Studies in Vision and Optometry > AED - Lumps and Bumps IV - Week 4 > Flashcards

AED - Lumps and Bumps IV - Week 4 Flashcards

1
Q

Briefly describe the anatomy of the following glands:
Zeis
Moll
Meibomian
Wolfring
Krause
Describe each of them in terms of where they are found in the eyelid and, in order of anterior to posterior, where their openings are.

A

Zeis - sits at the base of the eyelash, most anterior
Moll - small gland whose opening is found between Zeis and Meibomian
Meibomian - opening found in the middle of the eyelid margin base, the gland extends superiorly throughout the tarsal plate in a line
Wolfring - the gland is found superior to the Meibomian gland, and opens onto the superior bulbar conjunctiva from inside the eyelid
Krause - gland and opening found at the fold between the tarsal and bulbar conjunctiva deep within the eyelid

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2
Q

Is the gland of Moll a hair follicle?

A

Yes

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3
Q

What is an inclusion cyst? Is it hard or soft? Is it translucent or not?

A

An entrapment of epithelial cells that secrete

Harder than fluid filled and not translucent

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4
Q

Can inclusion cysts be conjunctival?

A

Yesd

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5
Q

How does a cyst of moll appear? Is the fluid clear and is the cyst itself translucent or not?

A

It is a swelling at the lid margin, with clear fluid inside, and appears like a translucent balloon

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6
Q

Describe what milia look like and why they appear.

A

They are keratin cysts that appear as multiple hard pimples

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7
Q

Can sweat glands be blocked and form cysts?

A

Yes, multiple flat lesions or a very large balloon about the eye with milky fluid

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8
Q

Are cysts of Zeis and Moll tender?

A

No

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9
Q

What do Zeis cysts contain? What colour?

A

Contains fat, slightly yellow/white

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10
Q

Are Zeis cysts painful?

A

No

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11
Q

Are Zeis cysts opaque or translucent? What about Moll cysts?

A

Zeis are opaque, Moll are translucent

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12
Q

Do Zeis cysts contain a lash?

A

Yesd

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13
Q

Is a stye or hordeolum tender/painful?

A

Yes

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14
Q

What is a stye/hordeolum?

A

Infection of the gland of Zeis

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15
Q

How are styes and hordeolums managed? What about if they dont go away?

A

Warm compresses, most resolve within 2-3 days

Topical broad spectrum antibiotics can be used if persistent

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16
Q

How does a chalazion form?

A

Chronic bacterial activity at the opening of a meibomian gland results in blockage and buildup of meibomian secretion, which appears as a bump in the eyelid.

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17
Q

Are chalazions painful?

A

No

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18
Q

Are chalazions typically uni- or bilateral?

A

Unilateral

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19
Q

Are chalazions typically recurrent?

A

Yesd

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20
Q

Over what period of time do chalazions develop?

A

Several weeks

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21
Q

Are chalazions firm or soft?

A

Firm

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22
Q

In what three conditions are chalazions common?

A

Blepharitis
Acne rosacea
Seborrhoeic dermatitis

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23
Q

What kind of inflammation occurs in chalazions?

A

Chronic granulomatous inflammation

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24
Q

What are the four main cell types seen in the inflammation occuring ith chalazions?

A

Plasma cells
Neutrophils
Lymphocytes
MN giant cells

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25
Q

How would you rule out a sinister lesion with a case of chalazion?

A

Check for blood vessel feeders

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26
Q

What happens to chalazions eventually?

A

Spontaneous resolution in a few months when fluid is resorbed

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27
Q

What are two general treatment options for chalazion treatment? What about if it is recurrent?

A

Heat compresses and lid massages

Tetracycline if recurrent

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28
Q

What is a treatment option for long-lasting chalazions?

A

Incision with currettage

Steroid injection

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29
Q

In which gender and age group is sebaceous gland carcinoma more common in?

A

Elderly females, upper eyelid

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30
Q

List 4 signs of sebaceous gland carcinoma.

A

Chronic non-healing blepharitis
Multi-lobed, red/irritated, recurrent mass for months to years
Loss of lashes and eyelid structure

31
Q

What does a sebaceous gland carcinoma resemble?

A

Long lasting chalazion

32
Q

What is a verruca?

A

Viral wart

33
Q

What are the two forms of verruca?

A

Small papule with a lumpy surface and broad base

Elongated filiform

34
Q

What virus is responsible for causing molluscum contagiosum? What appearance does this infection have?

A

Viral infection caused by pox virus

A wart-like lesion but less prominent - dome shaped papule

35
Q

List 4 symptoms of molluscum contagiosum. Can it be asymptomatic?

A 
Mild photophobia
Lacrimation
VA drop
Hyperaemia
Can be asymptomatic
36
Q

How is molluscum contagiosum managed (2)?

A

Counsel goo hygiene

Refer large lesions for excision

37
Q

What appearance does a keratoacathoma have?

A

A raised nodule with a central crater, resembling a volcano

38
Q

Do keratoacanthoma have a halo?

A

No

39
Q

In what age population is a keratoacantoma more likely?

A

Middle aged/eldery

40
Q

What is a risk factor for keratoacanthoma?

A

Sun-damaged skin

41
Q

What is found at the centre of a keratoacanthoma?

A

Keratin core

42
Q

How does a keratoacanthoma grow?

A

Grows rapidly initially over 2-6 weeks

43
Q

What is the management for keratoacanthoma?

A

Refer for excision and biopsy

44
Q

How would SCC be excluded for a suspected case of keratoacanthoma (2)?

A

Crater and halo

Find the keratin core with biopsy

45
Q

What is a xanthelasma?

A

Benign, lipid filled tumour

46
Q

How does xanthelasma appear?

A

Soft yellowish plaques

47
Q

Are xanthelasma uni- or bilateral? Are they found medially on the eyelid or temporally?

A

Often bilateral, on the medial aspect

48
Q

What do xanthelasma follow?

A

The folds of skin

49
Q

Are xanthelasma permanent? Do they grow rapidly?

A

Often permanent and grow slowly

50
Q

What age group is more likely to get xanthelasma?

A

Middle aged / elderly

51
Q

In what two conditions may xanthelasma occur?

A

Hypercholesterolaemia and lipoprotein disorders

52
Q

How are xanthelasma managed (2)?

A

Refer to GP for systematic lipid profile

Consider referral for excision for cosmesis if recurrent and biopsy

53
Q

What is seborrhoeic keratosis?

A

A benign epithelial tumour

54
Q

Are seborrhoeic keratoses symptomatic or aymptomatic?

A

Usually asyptomatic

55
Q

What are seborrheic keratoses caused by?

A

UV damage

56
Q

How long are seborrheic keratoses present for?

A

Months to years

57
Q

Can seborrheic keratoses grow larger?

A

They may slowly

58
Q

Are seborrheic keratoses common or rare before 30yo?

A

Rare

59
Q

How does seborrheic keratosis appear?

A

Small hard lesion above the skin surface which may be rough

60
Q

What happens with seborrheic keratosis histologically (2)?

A

Proliferation of basal epidermal cells

Keratin filled cysts

61
Q

What is the management for seborrheic keratosis?

A

Referral for excision, biopsy if suspicious

62
Q

What is solar or actinic keratosis?

A

Benign skin tumour

63
Q

How do solar/actinic keratoses appear?

A

Rough/scaly elevated lesion

64
Q

Can solar/actinic keratoses be malignant?

A

Yes there is poetential

65
Q

How are solar/actinic keratoses managed?

A

Refer for excision or biopsy as needed

66
Q

What is the histopathological difference between skin naevus and moles?

A

Same, but moles are small, naevus are larger

67
Q

Are skin naevus colourations even or uneven?

A

Even

68
Q

Are skin naevus flat or elevated?

A

Can be either

69
Q

Are skin naevus pigmented or unpigmented?

A

Can be either

70
Q

Which layer of skin are skin naevus typically found (3)?

A

Epidermis, dermis, rarely deeper (appears blue)

71
Q

What is the most common type of skin naevus?

A

Intradermal

72
Q

When do skin naevus appear?

A

Appears at puberty

73
Q

How can a skin naevus be distinguished from a malignant melanoma (9)?

A 
Melanoma are:
Raised nodule or plaque
Has an active halo and variable in colour
Increased size/thickness
Irregular edges
Inflammation
Bleeding
Satellite lesions
Growth and rapid change
74
Q

How can a suspected malignant melanoma be managed?

A

Take yearly photos and watch closely

Refer for biopsy/excision if at all suspicious

OD2 - Applied Clinical Training & Research Studies in Vision and Optometry (174 decks)

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