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Opthamology > Clinical Pathology > Flashcards

Clinical Pathology Flashcards

1
Q

what is cataracts?

A

blurring of the lens

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2
Q

maincauses of cataracts?

A 
sun damage
diabetes
genetic
hypertension
smoking
post-op and trauma
metabolic disorders
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3
Q

what is glaucoma?

A

abnormal increase in pressure in the eye

- related to the amount of vitreous fluid and anteriorly aqueous humour

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4
Q

where does the aqueous fluid usually drain?

A

trabecular meshwork/canal of schlemm into scleral venous sinus
blockage of this can cause increased pressure and lead to glaucoma

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5
Q

what is the consequence of increased pressure in the eye?

A

mainly causes problems at the back of the eye (optic nerve etc)
structures at the front can be compressed

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6
Q

what is the most common type of glaucoma?

A

primary open angled glaucoma
drainage of aqueous humour is blocked
secretion of aqueous humour is clear

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7
Q

what is angle closure glaucoma?

A

where drainage through the meshwork is patent
iris is essentially opposed to anterior eye and fluid cant get passed to the meshwork
(iridocorneal angle?)

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8
Q

open glaucoma?

A

slow onset
often asymptomatic and now screened for
many people don’t know they have it
pharmacological therapy aimed at slowing it down by widening canal etc

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9
Q

closed glaucoma?

A

1/3 are a medical emergency

can lose sight v quickly

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10
Q

how does closed glaucoma present?

A

acute red eye
visual loss
headache nausea and vomiting

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11
Q

how is closed glaucoma managed?

A

zap a hole in iris with a laser

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12
Q

what is cupping?

A

raised intraocular pressure which damages the optic disc and nerve
essentially the edges of the disc become rolled up and the centre becomes depressed
sign of raised intraocular pressure

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13
Q

what is papilloedema?

A

swelling of the optic nerve/disc

non-specific finding related to raised intracranial pressure

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14
Q

what is conjunctivitis?

A

inflammation of the conjunctiva

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15
Q

how does conjunctivitis present?

A

swelling
redness
pain
heat

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16
Q

causes of conjunctivitis?

A

usually viral
occasionally bacterial
sometimes allergic

17
Q

what is scleritis?

A

inflammation of sclera

18
Q

how does scleritis rpesent?

A

pain onmovement

19
Q

what underlying pathology can be associated with scleritis?

A

can have an underlying autoimmune aetiology

  • SLE
  • HLA B27
20
Q

what is episcleritis?

A

superficial inflammation of sclera
less severe than scleritis
self limiting

21
Q

causes of episcleritis?

A

usually no real cause

22
Q

what is ARMD and what 2 types exist?

A 
ARMD = age related macular degeneration
dry = no vascular proliferation
wet = vascular proliferation (worse than dry)
23
Q

what causes ARMD?

A

unclear
age-related and underlying inflammatory process
accumulation of by-products (drusen)

24
Q

what is drusen?

A

proteins and lipids and inflammatory mediatory
by-product of inflammatory process
present in macular degeneration
shows as yellow bits in retina

25
Q

what causes wet ARMD?

A

neovascularisation in choroid
new vessels are small and fragile and therefore leaky
more lkely to result in visual loss

26
Q

how is wet ARMD managed?

A

monoclonal antibodies to VEGF

27
Q

what mediated wet ARMD?

A

VEGF

28
Q

how can diabetes affect the eye?

A

cataract
hyperglycaemia (changes osmotic pressure in anterior chamber)
blurred vision (often presenting complaint in T1DM)
pupils - Argyll Robertson pupil, peripheral neuropathy

29
Q

what is Argyll Robertson pupil?

A

accommodation reflex intact

light reflex not intact

30
Q

how does diabetes cause cataracts?

A

increased sugar content in lens
conversion of glucose to sorbitol
altered gradients - swelling and fibre disruption
scarring

31
Q

what is diabetic glaucoma known as?

A

rubeotic glaucoma

32
Q

how does diabetes cause glaucoma?

A

new vessel formation obstructing angle

33
Q

how does diabetic retinopathy occur?

A

complex mechanisms leading to poor function of vessels
leaky vessels and small aneurysms forming
if severe - new vessel formation
oedema
if macula affected, visual loss is worse

34
Q

name 2 vascular diseases of the eye

A

central retinal artery occlusion (CRAO)

central retinal vein occlusion (CRVO)

35
Q

causes of CRAO?

A 
thromboembolic disease (often originating in carotids)
same pathogenesis as arterial occlusion anywhere else in the body
36
Q

causes of CRVO?

A

thrombosis

vasculitis

37
Q

what vasculitis is most likely to affect the eye?

A

giant cell

38
Q

what cutaneous cancers can occur in the eye?

A

BCC
SCC
melanoma
retinal melanoma

Opthamology (18 decks)

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