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Disease > Conditions > Flashcards

Conditions Flashcards

1
Q

Muscles affected in TED

A

(In order - IM SLO)

Inferior rectus, medial rectus, superior, lateral, oblique?

Often leading first to hypotropia and esotropia.

Treatment: orbital decompression followed by strab surgery.

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2
Q

Orbital Pseudotumour

A
  • unilateral, painful proptosis, chemosis, elevated IOP
  • young to middle aged
  • reduced VA due to ON compression
  • restricted EOMs
  • CT scan will show inflammation of EOM and tendons
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3
Q

Malignant melanomas commonly arise from?

A

Dysplastic nevi or tumour metastasis from the lungs (men) or breasts (women).

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4
Q

Early signs of Keratoconus

A
  • Fleischer’s ring (iron deposit)
  • Scissors reflex
  • irregular mires
  • inferior steepening of the cornea
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5
Q

Late signs of Keratoconus

A
  • Hydrops
  • Munson’s sign
  • Vogt’s striae
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6
Q

What is a corneal ulcer?

A

Epithelial defect with an underlying infiltrate.

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7
Q

Infectious vs Sterile Corneal Ulcer

A
  • size matters! Larger usually infectious.

Infectious ulcers will have epithelial defects bigger than the infiltrate or about the same size.

Sterile will have a smaller epithelial defect than the infiltrate.

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8
Q

Which bacteria can invade an intact corneal epithelium?

A

Canadian National Hockey League!!!!

  • Corynebacterium diphteria
  • Nisseria gonorrhea and meningitidis
  • Haemophilus
  • Listeria
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9
Q

Asides from trauma, what systemic condition is higher risk for hyphema?

A

Sick-cell anemia

Test for: CBC, prothrombin/partial thromboplastin time (PT/PTT).

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10
Q

Treatment/management for hyphemas?

A
  • B-scan ultrasound indicated if hyphema blocks view of fundus/risk of retinal detachment
  • bedrest with head elevated at 30 degrees to decrease risk of corneal blood staining and IOP rise
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11
Q

Problems with corneal blood staining

A

5% of patients and typically develops in late stages of hyphema.

Associated with:

  • large hyphemas
  • elevated IOPs
  • compromised corneal endothelial cells
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12
Q

What SHOULD NOT be performed in a patient with hyphema?

A

Gonioscopy and scleral depression.

  • pressure may increase risk of rebleeding.

Gonio should be done when hyphema has resolved.

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13
Q

Commotio retinae

A

Disruption of the RPE and photoreceptor outer segments due to trauma.

  • gray-white discolouration of the retina
  • Berlin’s edema when located within the macula
  • hyper-reflectivity on OCT photoreceptor outer segment

Typically resolves in 24-48 hours without sequelae. Permanent VA/VF loss may occur.

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14
Q

Sympathetic ophthalmia

A

Immune mediated response in fellow eye after the other eye undergoes penetrating foreign body/surgery.

Characterized by subretinal infiltrates (Dalen Fuchs nodules), vitritis, serous retinal detachments, and papillitis.

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15
Q

Suspected orbital blow-out fracture should be evaluated for?

A
  • EOM restriction
  • crepitus
  • vergences
  • infraorbital hypoesthesia (decreased sensation of the cheek on the affected side due to damage of the infraorbital nerve)
  • step-off
  • exophthalmometry
  • globe ptosis
  • asymmetric monocular PDs
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16
Q

Most common location for an orbital blow-out fracture

A

Maxillary bone in the orbital floor

17
Q

Nerve most susceptible to trauma?

A

CN 4.

Longest course from the brainstem. Can be congenital or acquired palsy:

  • neoplasm/aneurysm (10%)
  • ischemic (20%)
  • undetermined (30%)
  • trauma (40%)
18
Q

Common causes of fungal keratitis

A
  • aspergillus
  • fusarium

Candida albicans often occurs in eyes with chronic corneal disease or immunocompromised

19
Q

Familial adenomatous polyposis (FAP)

A

Autosomal dominant inherited condition that results in hundreds of polyps throughout the colon in post-puberty patients.

If left untreated, 100% of patients will develop colon cancer (usually by the age of 50).

Refer to internal medicine.

20
Q

Gardner’s syndrome

A

Variant of FAP - has multiple CHRPs in the fundus. Triad of multiple intestinal polyps, skeletal hamartomas and soft tissue tumours. 50% of these patients will have dental anomalies.

Refer to internal medicine.

21
Q

Goldenhar syndrome

A

Incomplete development of facial structures. Dermoids appear over face - commonly inferotemporal limbus and may involve entire cornea.

Triad:

  • ocular dermoids
  • preauricular skin tags
  • vertebral dysplasia
22
Q

Crouzan’s syndrome

A

Craniofacial disorder.

  • shallow orbits with PROPTOSIS
  • aniridia
  • blue sclera
  • strabismus
  • optic atrophy
  • hypertelorism
  • congenital cataracts
23
Q

Congenital encephalocele

A

Results in proptosis at birth. Increases in proptosis and becomes pulsatile during crying.

24
Q

Fabry’s disease

A

X-lined autosomal recessive lysosomal storage disease - mostly in males.

  • cornea verticilata
  • posterior spoke-like crystalline lens opacities

Patients often report episodes of excruciating pain in the fingers and toes.
- premature death (ages 40-50) from renal or cardiovascular complications

25
Q

Alcoholism’s effect on optic nerve

A

Temporal pallor of both optic nerves.
- complaints of bilateral, painless, progressive vision loss

(FYI, trauma and medications can lead to pallor too)

26
Q

What kind of vision loss is caused in temporal disc pallor?

A

Central or centrocecal visual field loss.

Macular fibres/papillomacular bundle enter the temporal optic nerve.

27
Q

Marfan’s syndrome

A

Autosomal dominant inherited connective tissue disorder caused by mutation in the fibrillin gene on chromosome 15.

  • lens subluxation (sup temp), myopia, retinal detachments
  • tall stature with disproportionately long arms, legs, and digits (arachnodactyly), joint laxity with disclocation is common
  • cardiovascular abnormalities (eg. aortic aneurysm, mitral valve prolapse)
  • no breakage in zonules, just stretch!
28
Q

Ehlers-Danlos Syndrome

A

Rare inherited autosomal dominant collagen disorder caused by a deficiency in hydroxylysine.

  • lens subluxation, blue sclera, angioid streaks, keratoconus, and megalocornea
  • cardiovascular abnormalities (eg. aortic aneurysm, mitral valve prolapse)
  • joint laxity with dislocation
29
Q

Homocystinuria

A

Autosomal recessive disorder caused by deficiency in enzyme cystathionine synthase.

  • lens subluxation (commonly inferior) and glaucoma (due to pupil block or dislocation of the lens into the anterior chamber)
  • tall stature with features similar to Marfan’s however intelligence is below normal
  • STIFF JOINTS
30
Q

Weill-Marchesani Syndrome

A

Rare inherited (autosomal dominant or recessive) connective tissue disorder.

  • short stature with small, short, stubby appendages
  • lens subluxation (bilateral and inferior), microspherophakia and retinal detachment

Disease (6 decks)

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