Brainscape's Knowledge GenomeTM

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


See full index

Ocular Disease > Conjunctiva > Flashcards

Conjunctiva Flashcards

1
Q

watery (serous exudate) discharge occurs in:

A

acute viral conjunctivitis

acute allergic conjunctivitis

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

mucoid discharge (stringy/ropy filaments) highly indicative of:

A

chronic allergic conjunctivitis

dry eye (bc of less aqueous in aq:mucus tear ratio)

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

mucopurulent discharge is seen in:

A

chlamydia

acute bacterial conjunctivitis

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

purulent discharge is seen in:

A

moderate cases often acute bacterial conjuncitivitis

severe in gonoccocal infections

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

which arteries give rise to the conjunctival vessels?

A

anterior ciliary and palpebral aa.

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

conjunctival injection

A

superficial bright red blood vessels, worse near fornices, move as the conj is manipulated, and are blanched by topical phenylephrine

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

conjunctival hyperemia

A

secondary to dilation of the conjunctival blood vessels, can be caused by environmental factors, or prolonged vasoconstrictor use

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

subconjunctival hemorrhage

A

may be flat or elevated, well-defined, visible, coalesced blood between the bulbar conj and episclera

can be caused by injury, HTN (check bp!), DM, blood disorders, conjunctivitis, or Valsalva maneuver

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

chemosis (edema)

A

an accumulation of fluid within or beneath the conj, severe inflammation, translucent swelling, acute non-traumatic hypersensitivity or chronic orbital outflow restrictions

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

where do papillae form?

A

only form where conj is attached to underlying tissue by anchoring septae (tarsus, or bulbar limbus) flat-topped at tarsus, dome-shaped at limbus

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

signs of papillae

A

red velvety appearance, central elevated tuft of vessels surrounded by a pale base. papillae are a nonspecific sign of conj inflammation, edema, PMN cell infiltration

giant papillary conj. can appear whitened due to fibrosis

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

papillae can be due to:

A

bacterial or allergic conjunctivitis, chlamydia, chronic marginal blepharitis, superior limbic keratoconjunctivitis, floppy eyelid syndrome, CL wear

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

follicles presentation:

A

yellowish-white, discrete, round elevations of conj. produced by a lymphocytic response. difference from papillae is that the center is avascular and the vessels appear on top of the bumps

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

follicles can be due to:

A

viral conjunctivitis, chlamydia, parinaud oculoglandular syndrome, medicamentosa

common with adenovirus or herpes viral infections

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

membranes/pseudomembranes

A

fibrin attached to the epithelial conj surface, true membranes cause bleeding when peeled off and reflect a higher degree of inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common causes for membranous/pseudomembranous conjunctivitis:

A

severe adenoviral conjunctivitis (most common), bacterial infections, gonococcal, stevens johnson syndrome

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

what happens to the conjunctiva as a person ages?

A

conjunctiva becomes thinner, more fragile, less transparent, epithelial layer thickens and subepithelial tissue atrophies, gradual hyaline degeneration and fatty infiltration, loss of elastic fibers, presence of conjunctival chalasis in some pts

18
Q

conjunctivochalasis

A

common, bilateral, characterized by redundant, loose, nonedematous conjunctiva (extra tissue) associated with aging. important to look for in pts with ocular irritation and epiphora, as extra tissue can block punctum

19
Q

pinguecula

A

common, elastotic degeneration of collagen fibers of the conjunctival stroma, due to UV exposure, hot, dusty environments, etc.

looks like a yellowish-white mound on bulbar conj., often bilateral and nasal interpalpebral zone

20
Q

pingueculitis

A

inflammation of a pinguecula, can be treated if symptomatic, with lubricants, corticosteroids, or topical NSAIDs, or sx

21
Q

pterygium

A

common, triangular, winglike mass of fibrovascular tissue extending from the conj to the cornea at the 3 and 9 o’clock locations. highly vascular as opposed to pinguecula

22
Q

concretions

A

common, bilateral, white/yellow spots found on palpebral conj, may become calcified, easily removed if needed

23
Q

conjunctival retention cyst (epithelial inclusion cyst)

A

common, thin-walled fluid-filled cyst on palpebral or bulbar conj.

24
Q

lymphangiectasia

A

irregular, dilated, sausage-shaped channels of lymphatic channels anastomosis 1 mm from limbus. occasionally may be filled with blood

25
Q

conjunctival capillary hemiangioma

A

rapidly developing lesions of the conj., without pre-existing trauma, red and protuberant, may be excised or use cryo

26
Q

scleral hyaline plaque

A

bilateral, oval, dark grey areas located close to insertion of the horizontal rectus muscles

27
Q

conjunctival squamous papilloma

A

uni or bilateral lesions anywhere on conj that are benign and very small risk of conversion. can be associated with HPV when there are lots of lesions present. can be large lesions, pedunculated or sessile, may encroach on cornea or interfere with lid closure

28
Q

squamous papilloma definition

A

presence of central vascular core surrounded by squamous epithelium

29
Q

treating conjunctival squamous papilloma:

A

small lesions may resolve spontaneously, large lesion can be excised or use cryo, for recurrence use mitomycin C, alpha interferon, cimetidine, or CO2 laser

biopsy to make sure benign

30
Q

Ocular Surface Squamous Neoplasia (OSSN)

A

includes non-invasive: CIN (conjunctival intraepithelial neoplasia) and invasive: squamous cell carcinoma

31
Q

conjunctival intraepithelial neoplasia (CIN)

A

non-invasive OSSN/carcinoma in situ/conjunctival dyskeratosis - involving any area of conj or cornea although 95% at limbus, assoc. w/UV exposure, HPV, AIDS, xeroderma pigmentosum, stem cell therapy

32
Q

different CIN presentations

A
  • gelatinous limbal thickening, leukoplakia, mild conj injection around
  • elevated, translucent conj lesion beneath a leukoplakic nodular lesion
  • sessile, papillary appearance - assoc. w/HPV
  • dysplastic squamous lesions can have fine vascular patterns with a hairpin configuration
33
Q

squamous cell carcinoma (invasive OSSN)

A

CIN is often a precursor, becomes invasive when dysplastic epithelial cells penetrate the basement membrane. pink, papillomatous lesion, feeder vessels, diffuse growth, metastasis rare

34
Q

conjunctival nevus

A

common, 1% chance of malignant transformation, usually solitary unilateral discrete mildly elevated intraepithelial lesion with variable pigmentation, may have cystic spaces

35
Q

conjunctival melanosis

A

does not elevate the surface like nevi can, retention of pigment/excessive melanin production

36
Q

Secondary acquired melanosis

A

increased pigmentation is attributed to racially associated genetic, metabolic, or toxic factors. common, usually bilateral but asymmetric, and no malignant potential

37
Q

Primary acquired melanosis (PAM)

A

rare, unilateral, fair-skinned pts >45yrs, flat, usually near limbus, sudden onset of nodules(melanocytic cellular atypia)=strong suspicion of melanoma, 50% chance within 5yrs.

w/o atypia = benign, no risk of malignancy

biopsy to make sure!

38
Q

Malignant melanoma of conj

A

conjunctival melanoma can be pigmented or not, arise from *PAM (74%), a nevus (7%), or de novo. usually >6o yrs old pt, appear as black/grey vascularized nodule anywhere on conj, can also be pink, smooth “fish flesh” appearance with intense vascularity

39
Q

prognosis for conjunctival melanoma

A

mortality of 12% at 5 yrs, 25% at 10 years

main sites of metastasis: lymph nodes, lung, brain, liver

indications of poorer prognosis: multifocal tumors, extralimbal tumors involving fornices or caruncle, tumor thickness >2mm, recurrence, lymphatic or orbital spread

40
Q

what infections can present with preauricular lymphadenopathy?

A

viral conjunctivitis (EKC), chlamydial conjunctivitis, gonococcal conjunctivitis, dacryoadenitis

Parinaud’s oculoglandular syndrome presents with both preauricular and submandibular lymphadenopathy

simple bacterial conjunctivitis does NOT present with preauricular lymphadenopathy

41
Q

scleromalacia perforans

A

necrotizing scleritis without inflammation most commonly occurring in RA

(15% of all cases of scleritis are caused by RA)

Ocular Disease (14 decks)

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