CC, family history and Ocular medications side effects

Question 1

CC

Answer 1

Main reason for encounter

Chief complain: main reason the pt came in , can be follow up from previous visits or a new complaint. Brief 1 or 2 sentences in the patients own words

Question 2

HPI

Answer 2

History present illness
HPI: story of CC uses descriptives

A full list below

1. Date of onset
2. Location
3. Quality
4. Duration
5. Timing
6. Context
7. Severity
8. Modifying factors
9. Associated signs and Symptoms

History present illness is using the details regarding the chief complaint using the descripted above

Question 3

Sign

Answer 3

Objective

you can actually see on the patient

DONE

Question 4

Symptom

Answer 4

Subjected

That you can’t see on a patient but pt experiences

Question 5

Objective

Answer 5

Sign

Question 6

Subjective

Answer 6

Symptom

Question 7

ROS

Answer 7

Inventory of body systems

Review Of systems- These are not diseases, there the organ systems that there presenting complaints effect example Diabetic eye exam check on endocrine disorder on the box

Question 8

PFSH

Answer 8

Past and present, family, social history

past and present health conditions

Question 9

Name of current physician treating major systemic conditions

Answer 9

Hypertension
Cardiac disorder
Arthritis
Diabetes ( how long diagnosed, last BS, last AIC, stable or unstable, what was the recent, high or low?)

Diabetic retinopathy can occur 10- 15 years for diabetic patient.

Find out last blood sugar reading because the lens becomes diminish when unstable blood sugars, there refractor errors fluctuate.

A1C is important gives an idea of patients blood glucose if its stable or not.

find out their doctor if patient had a recent stroke or cancer or heart attack major systemic disease actively being treated to request medical clearance if patient is going for eye surgery.

Question 10

Family History

Ocular-

General health-

Answer 10

Ocular

Myopia
Strabismus
Glaucoma
Blindness
Cataracts

General health

Diabetes
Heart disease
Cancer
Hypertension

Question 11

Hereditary conditions with ocular significance

Answer 11

Migraine
Retinitis Pigmentosa
Retinoblastoma
Color blindness
Nystagmus
Sickle cell anemia
Keratoconus
Marfans Syndrome
Diabetes
Macula degeneration (Stargadt's disease)

Not a complete list

Question 12

Medications with ocular side effects

Answer 12

Plaquenil
Tomoxifen
viagra
Amiodarone
flomax
corticosteriods
chemotheraphy agents
contraceptives
antihistamines
antidepressants
antibiotics
anticoagulants
saliculates - Aspirin

Question 13

Plaquenil (hydroxychloroquine)

Answer 13

Retinal deposits
Loss of central VA
Night VA

Treats autoimmune diseases it can cause retinal deposits problems with macula and problems with night vision central visual field 10-2 to determine is there a maculopathy

Question 14

Tamoxifen

Answer 14

Decreases VA
Retinophathy,
optic neuritis
Sub- epithelial k deposits

Is used for long term treatment for about 10 years following breast cancer diagnosis treatment to prevent recurrent it can cause decrease VA problems with retina, optic neuritis ( swelling of optic nerve) sub-epithelial K deposits ( corneal deposits)

Question 15

Viagra (Sildenafil)

Answer 15

NA ION (non arteritic Ischemic optic neuropathy)
altered color vision
blurred VA
light sensitivity

Ischemia - lack of blood flow viagra can cause non arteritic Ischemic optic neuropathy

Question 16

Ischemia

Answer 16

lack of blood flood which medication

Viagra

Question 17

Amiodarone

Answer 17

corneal deposits, lenticular opacities, optic neuropathy

Amiodarone is a cardiac medication when it gets to toxic levels in the patients blood the patient can develop corneal deposits, if doctor find corneal deposits patient needs to notify cardiologist to adjust dose medication also cause cataract and optic neuropathy

Question 18

Flomox (tamsulosin)

Answer 18

Floppy iris syndrome

Is used to treat urinary problems in men and cause floppy Iris syndrome the Iris loose muscle tone and is important during surgery because the Iris want maintain the dilation and doctor needs special instrument to handle the problem in surgical room, because the iris cant dialate on its own

Question 19

Corticosteroids

Answer 19

Increased IOP, PSC Cataracts

Can cause only to the group of people with steroids responders can increase IOP and cause posterior sub capsular cataract

Question 20

Chemotheraphy

Answer 20

Conjuctivitis, Dry eye, ocular inflammation and edema

Question 21

Contraceptives

Answer 21

K changes
Retinal Vascular Occlusions, Optic Neuritis and edema
blind spots associated with migranes

Pregnancy similar effects everything gets affected by pregnancy same does contraceptives- a device or drug to prevent pregnancy

Question 22

Antihistamines

Answer 22

Dry eyes, pupil dialation, blurred Vision

Can cause dry eyes and affect accomodation so the patient will have blurry vision up close and pupil dialation

Question 23

Antidepressants

Answer 23

Blurry Vision, pupil dialation

Can affect accomodation, blurry VA at near, and dialated pupils

Question 24

Antibiotics

Answer 24

Keratopathy, conj inflammation, ptosis, optic neuritis, papilledema

Problems with cornea swelling and conjuctiva, ptosis, sweeling optic nerve- papilledema and optic neuritis

Question 25

Anticoagulants

Answer 25

Subcinjuctiva heme, vitreoretinal heme, pre-surgical evaluation

Can cause subconjuctiva hemorrahge need pre surgical evaluation before surgery to make sure their adequate to have surgery depending on what type of anethesia they are schedule for

Question 26

Saliculates (aspirin)

Answer 26

Diplopia

It can disrupt the ocular muscle function

Question 27

After how many years of diabetic retinopathy can occur?

Answer 27

10 to 15 years for diabetic patient