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NBEO Review-AA > Disease > Flashcards

Disease Flashcards

1
Q

Ectropion common with

A
  • Involutional due to loss of muscle tone within orbicularis oculi
  • paralytic
  • Mechanical
  • Cicatricial
  • Congenital
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2
Q

What are optic disc drusens?

A

They are hyalin bodies located within the optic disc. Can be hereditary ( AD).
Gradually move anterior as pt ages.
Diagnosed with B-scan, appear hyperreflective

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3
Q

Common collagen vascular disorders that can cause optic disc edema

A

Rheumatoid arthritis
Systemic lupus erythematosus
Polyarteritis nodosa
Wegeners granulomatosis

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4
Q

What is Papillitis

A

Secondary to inflammation of the anterior optic nerve and will present with disc edema. Occurs 1/3 cases of optic neuritis.

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5
Q

What are signs of TRO

A

Unilateral optic disc edema
APD
Unilateral or bilateral proptosis, upper eyelid retraction
inferior and medial rectus effected first
Reduced color vision
Variable VA loss
Elevated IOP

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6
Q

Papilledema signs

A 
Elevated optic nerve rim tissue
Elevated or opaque NFL
Paton's folds
Hyperemia of optic disc 
CWS
Exudates 
Splinter hemorrhage 
Absent SVP
VF shows "Large Blind Spot"
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7
Q

IIH signs

A

Enlarged Blind Spot on VF
Diplopia due to CN VI palsy
Papilledema
Optic Atrophy ( late signs)

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8
Q

Reverse APD

A

Constriction of good eye during swinging flash light test when fellow eye has APD
Direct response of good eye is stronger than consensual response

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9
Q

In which cases of optic nerve abnormality, optic nerve appears normal

A

Retrobulbar Optic Neuritis.

Posterior ischemic optic neuropathy.

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10
Q

CN 3 palsy pathophysiology

A
  • Lesion along the pathway of CN III
  • Micro vascular infarcts from DM and hypertension.
  • Trauma
  • Aneurysm ( posterior communicating artery)
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11
Q

CN IV palsy common cause and symptoms

A

Trauma
Vertical Diplopia
Compensatory head tilt away from the side of the lesion

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12
Q

CN VI palsy cause/symptoms

A 
Cause:
Pseudotumor cerebri
Horner's syndrome
DM/HTN
Trauma
Tumor
Symptoms:
Head turn toward the affected side
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13
Q

Viral Conjunctivitis

A 
Common cause is adenovirus.
Patient highly contagious for 12-14 days
Classic syndrome:
1-Acute non-specific follicular conjunctivitis 
2-pharyngoconjunctival fever
3- EKC
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14
Q

Bacterial conjunctivitis

A

Signs;
Mucopurulent discharge.
Treatment:
Erythromycin ointment

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15
Q

Allergic conjunctivitis

A

Signs;
Watery, itchy , chemosis, allergic shiners.
Treatment:
Patanol

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16
Q

Follicles

A
  • Blister like, more common in viral conjunctivitis.
  • Avascular, white-gray nodules typically found in tarsal and fornix conjunctiva.
  • Associates with Chlamydia, toxic or viral infections
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17
Q

Papilla

A

inflamed areas of elevated conj that have central vessel.
Can be small to very large ( as in GPC and VKC).
Non-specific but common in allergic or bacterial conjunctivitis.

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18
Q

psudomembrane

A

appears with severe conjunctivitis.

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19
Q

Blepharitis Treatment

A

Treatment:
warm compresses, lid scrubs, and artificial tears.
Erythromycine at bed time
Doxycycline can help by changing oil viscosity.(anti inflammatory and stops MMPs)

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20
Q

Chalazions

A

backed up lipids cause of blocked MGs

  • non-infections (sterile) inflammations of the meibomian glands.
  • painless and immobile
  • recurrent, warrants possible malignancies ( sebaceous gland carcinoma)
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21
Q

Pre-septal cellulitis

A

Treatment:

Keflex, Augmentin

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22
Q

HSV infections

A

NO steroids..

Acyclovir, viroptic

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23
Q

Endophthalmitis is a.

A

serious infection inside the eye. Hypopon

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24
Q

Removal of acoustic neuroma may result in damage to the ……

A

Parotid gland and CN VII, causing facial paralysis on affected side

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25
Q

Neurotrophic keratitis is

A

Poor corneal sensitivity and wound healing. Secondary damage to V1

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26
Q

Congenital Gaucoma

A

Haab’s stria( folds in descemet’s membrane)

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27
Q

Band Keratopathy is associated with

A 
Hypercalcimia
Gout
JIA
Uveitis 
Dry Eye
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28
Q

Blue sclera is associated with what diseases?

A

Osteogenesis imperfecta or Ehler’s Danlos syndrome

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29
Q

What is Commotio Retinae

A
  • Disruption of the RPE and photoreceptors outer segments causes of Trauma.
  • Usually resolves without sequelae within 24-48 hours.
  • known as Berlin’s edema
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30
Q

Purtscher’s Retinopathy

A

Associated with acute chest-compressing trauma

  • diffuse retinal hemorrhage
  • exudate
  • cws
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31
Q

Perseptal Cellulitis

A

-ocular infection-( acute hordeolum, dacryocystitis)
-Systemic infection
-skin trauma
Signs:
Eyelid edema, Erythema, Ptosis, warmth, bump on eyelid

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32
Q

Orbital Cellulitis

A

1-Sinus Infection( Ethmoid sinusitis)
2-Orbital Infection ( dacryoaddentits, dacryocyctitis, progression of preseptal cellulitis)
3-Orbital Fracture
4-Dental Infection
Signs:
Red Eye, pain, Fever, Decreased vision, APD, proptosis, diplopia, pain on eye movement, EOM restriction

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33
Q

Diabetic and immunocompromised patients with orbital cellulitis may develop what

A

Mucormycosis (aggressive fungal infection)

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34
Q

Strongest risk factor for developing Thyroid eye disease

A

cigarette smoking

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35
Q

Thyroid eye disease occurs in

A
  • 30-70% of patients with Graves thyroid disease

- most common cause of u or b proptosis in middle-aged patients

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36
Q

Thyroid eye disease signs

A
  • inflammation and thickening of the EOMs resulting Optic nerve compression
  • U or B proptosis
  • upper eyelid retraction resulting in Dalrymple’s sign
  • APD
  • conj injection
  • decreased color vision
  • EOM involvement ( Im So Lazy) [ no muscle tendons]
  • Corneal involvement ( SLK)
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37
Q

Von Graefe’s sign

A

upper eyelid lag during downgaze

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38
Q

Kocher’s sign

A

globe lag compared to lid movement when looking up

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39
Q

Orbital Psudotumor

A

-Affects young to middle aged patients
-idiopathic inflammatory process
-Acute onset of unilateral pain
-proptosis, EOM restrictions ( involved tendons), chemosis, hyperopic shift, optic nerve swelling (if posterior), increased IOP, reduced corneal sensation.
Testing: CT or MRI

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40
Q

Bilateral Orbital Pseudotumor in adults raises suspicion of which systemic diseases

A

systemic vasculitis:
Wegener’s granulomatosis
Polyarteritis nodosa
Lymphoma

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41
Q

Evisceration

A

Removal of the inner contents of the eye, sclera and other orbital content

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42
Q

Exenteration

A

removal of ALL contents of the orbit. including EOMs and orbital fat

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43
Q

Ocular Rosacea

A

Affects Sebaceous Glands ( Meibomian glands)

  • chronic eyelid disease ( MGD, Blepharitis, recurrent hordeola/chalaza) resulting in ocular surface disease:
  • Telangiectasia
  • phyctenules
  • staph marginal keratitis.
  • SPK
  • prelimbal corneal infiltrates.
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44
Q

Steven Johnson Syndrome

A

Type 3 hypersensitivity
-most commonly drug induced ( sufonamide,…)
-from infectious agents ( HSV, staph, adenovirus, pneumoonrpelbmnia)
Chronic signs: corneal scars, ulcers and NV, symblepharon.

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45
Q

Symblepharon associated with

A

Mucous membrane disorders:

  • Ocular cicatricial pemphygoid (OCP)
  • SJS
  • severe AKC
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46
Q

Hordeolum

A

acute staph infection

  • Internal
  • External
  • painfull
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47
Q

Trachoma signs

A

Entropion and Trichiasis ( causes corneal ulceration)

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48
Q

Meige’s syndrome is characterized by

A

BEB and lower facial abnormalities

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49
Q

The two prognostic factors for malignant melanoma

A
  • depth of invasion

- lesion size

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50
Q

rodent ulcer is associated with

A

BCC

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51
Q

Causative agents for Dacryocystitis

A
  • staphylococcus aurerus
  • staphylococcus epidermidis
  • Pseudomonas
  • H. influenza in children
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52
Q

Dacryocystitis symptoms

A

Pain
Epiphora
Crusting
Occasional fever

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53
Q

Dacryocystitis signs

A

Edema and tenderness of the lacrimal sac below the medial canthal tendon

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54
Q

Primary Acquired Melanosis can progress to

A

Conjunctival Melanoma

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55
Q

Conjunctival intraepithelial Neoplasia

A
  • known as Bowen’s disease or conjunctival squamous dysplasia
  • can progress to sq cell carcinoma
56
Q

Gonococcal conjunctivitis

A
  • causative agent is Neisseria gonorrhea
  • Thayer-Martin agar for diagnosis
  • severe purulent discharge
  • preauricular lymphadenopathy
  • psudomembranes
57
Q 
Dennie's lines
Atopy Shiners
bilateral itching
Inferior Papillae
Corneal neovascularization, keratoconus, cataract
common with Wilson disease
Keratoconus is more common
most common in young to middle aged adults ( teens to 40s)
A

Atopic Keratoconjunctivitis (AKC)

58
Q 
Shield ulcers
bilateral prominent papillae
Cobblestone papillae (upper palp conj)
Trantas dots.
intense itching, photophobia, thick mucus discharge
common with young males
A

Vernal Keratoconjunctivitis (VKC)

59
Q

VKC has strong association to

A

Atopic conditions
Asthma, eczema, seasonal allergic rhinitis.
40-75% of patients have eczema or asthma.
40-60% of patients have family history of atopy.

60
Q

Trantas dots

A

Collection of epithelial cells and eosinophils near the limbus

61
Q

Toxicity to topical mediation or CL solutions can result in

A

Allergic Conjunctivitis that is characterized by a Follicular reaction

62
Q

GPC can results from

A
  • Extended CL wear ( common with SH)
  • Exposed sutures
  • Glaucoma filtering bleb
  • Scleral Buckles
  • Ocular prosthetics
  • classic signs; papillae > 0.3mm of upper tarsal conjunctiva, giant papillae > 1mm
63
Q

Patient reports clear vision with CL and blurry with glasses, ghost images and diplopia.
topography shows irregular astigmatism.
what can you suspect

A

Corneal warpage

High riding CL

64
Q

3 and 9 o clock staining is common complication with what type of CLs

A

Low-riding GP lenses.

65
Q

Chlamydial-Adult Inclusion Conjunctivitis

A
  • Caused by chlamydia serotypes D-K
  • Acute Follicular conjunctivitis that becomes Chronic
  • unilateral giant follicles in inferior fornices.
  • preauricular lymphadenopathy and mucopurulent discharge possible.
  • report chronic red eye started several weeks to months
  • persist 3-12 months if left untreated and become bilateral.
66
Q

Chlamydial- Trachoma Conjunctivitis

A
  • Prevalent btw ages 1-5
  • Caused by chlamydia serotypes A-C
  • Follicular and papillary conjunctivitis
  • preauricular lymphadenopathy
  • mild superior pannus
  • Arlt lines
  • Herbert’s pits
67
Q

Ophthalmia neonatorum

A
  • acute conjunctivitis in newborns

- Chlamydia is the leading cause

68
Q

Pterygium

A
  • Fibrovascular growth of bulbar conjunctiva on to cornea
  • destroys Bowman’s membrane
  • leading to WTR
  • Present Stocker’s line
69
Q

Scleritis vs Episcleritis injection

A

bilateral and diffuse injection with Scleritis

unilateral and sectoral injection with episcleritis

70
Q

Axenfeld’s nerve loop

A

Posterior ciliary nerve loop visible in sclera

71
Q

Fine Keratic Precipitates (KPs)

Koeppe nodules

A

characteristics of non-grannulomatous etiology

72
Q

Mutton-fat KPs

Iris stromal nodules ( Koeppe, Busacca)

A

characteristics of grannulomatous etiology

73
Q

Stellate KPs are observed in

A
  • Fuch’s heterochromic iritis

- Herpatic Uveitis

74
Q

Congenital Syphilis Triad

A
  • Hutchinson’s teeth
  • deafness
  • interestitial keratitis
  • saddle nose deformity
  • frontal bossing
75
Q

Pars Planitis

A
  • Chronic intermediate Uveitis

- characterized by inflammation over pars plana (snow banking)

76
Q

Iris Malignancy

A
  • From Iris Nevi
  • located within iris STROMA tissue in the inf quadrant 80%
  • diameter >3mm
77
Q

Neurotrophic Keratopathy cause and symptoms

A 
Herpes simplex
Herpes zoster
Diabetes 
LASIK 
Corneal findings worse than symptoms
78
Q

Confluent SPK

Associated with what disease

A

UV Keratopathy

Symptoms are typically worse 6-12 hours

79
Q

1 cause of aq deficient dry eye

A

Primary Non-sjogrens and secondary

80
Q

Number one cause of dry eye

A

Intrinsic MGD

Extrinsic cause > vitamin A deficiency

81
Q

Which layer of cornea does Keratoconus originate in?

A

Bowman ‘s layer

82
Q

Hydrops on cornea

A

Tears in DESCEMET’s membrane that results in edema and rupture of epithelium

83
Q

Posterior corneal dystrophies

A

Fuch’s

Posterior Polymorphous Dystrophy

84
Q

Posterior Polymorphous Dystrophy is

A

20-30 yo patients
Metaplasia of endothelial cells
patches of vesicles is the hallmark sign

85
Q

painfull Bullae and scarring

A

caused from stromal edema in Fuch’s

86
Q

two conditio that have Corneal findings worse than symptoms

A 
Neurotrophic Keratopathy
Acanthamoeba Keratitis (early signs), (ring ulcer, late sign)
87
Q

Chocolate agar for

A

N. Gonorrhea.

Haemophilus

88
Q

heat-killed E.Coli agar

A

Acanthamoeba

89
Q

Sabaroud’s agar

A

test for fungi

90
Q

interestitial keratitis are

A

WBC in endothelium with diffuse newovascularization

91
Q

most common cause of endothelitis

A

Disciform endothelitis

92
Q

what are the common corneal sign in active HZ

A

Pseudodendritic keratitis

93
Q

Bank Keratopathy associated with

A 
Uveitis
after trauma
Gout
hypercalcemia
>>>calcium deposit at 3 and 9 oclock position
94
Q

Krachmer’s spots

A

stromal corneal graft rejection associated with sub epi infiltrates

95
Q

Kodadoust line

A

endothelium corneal graft rejection line characterized by WBCs on endothelium line.

96
Q

Hyperopic shift

A

Radial Keratotomy
cortical cataract
CNVM

97
Q

how much residual cornea is required after PRK

A

400nm

98
Q

how much corneal thickness is required for LASIK

A

250um

99
Q

myopic shift

A 
Nuclear Sclerosis
Scleral buckle surgery
Diamox
NSAIDs 
Topamax
Oral Sulfonamides
100
Q

Elsching pearls

A

type of posterior capsular opacification common in children who undergo cataract extraction.

101
Q

common post-operative complication

A

PCO

CME ( Irvine-Gass syndrome, 6-10 weeks following surgery)

102
Q

Bull’s eye maculopathy differential diagnosis

A
  • Stargard’s disease
  • cone dystrophy
  • Chloroquine toxicity
  • hydroxychloroquine toxicity
  • thioridazine toxicity
103
Q

Retinoschisis

A

splitting of OPL and INL resulting in elevation of the inner retina

104
Q

common ocular finding of Behcet’s Disease is

A

Acute recurrent Hypopyon

105
Q

Cluster headaches can cause

A

transient or permanent ipsilateral Horner’s syndrome

106
Q

Early cataract

A

M A D
Myotonic dystrophy
Atopic dermatitis
Diabetes

107
Q

Moore’s Lightning streaks

A

Lightning streaks which are Vertical Flashes of light seen in the peripheral visual field.
Occurs because of vitreous syneresis, traction on peripheral retina.0

108
Q

What test are considered for foreign body diagnosis?

A

CT scan
B-scan
NO MRI

109
Q

Canaliculitis presentation

A 
Inflammation or infection of the canaliculi caused by bacterial, fungal or viral.
Unilateral smoldering red eye
Epiphora 
Mild tenderness/pain on nasal portion
Swollen puncta ( pouting puncta)
Mucopurulent discharge
110
Q

Canaliculitis etiologies

A 
Actinomyces israelii ( strep tothrix)- expression of yellow sulfur granules.
Staphylococcus aureus 
Candida albicans 
Aspergillus 
Nocardia asteroides 
Herpes simplex
Herpes zoster
Surgery, trauma, neoplastic disorders
111
Q

Allergic conjunctivitis presentation

A

Moderate or severe Ocular itching,hyperemia and tearing.

May also complain of associated rhinitis and sneezing.

112
Q

GPC avrg length time for development secondary to CL

A

8 months
May occur early as 3 weeks.
Risk Factors:
-Extended wear hydrogel CL. High water ionic CL, High modulus of elasticity, poor replacement compliance.

113
Q

Cause of decreased vision in AKC

A

Superficial punctuate keratitis.

114
Q

Superior limbic keratoconjunctivitis

A

Chronic inflammatory reaction.
Associated with thyroid disease, Keratoconjunctivitis sicca, CL wear ( hypersensitivity reaction to preservative in CL solution or poor CL fit).
Symptoms: redness, foreign body sensation,frequent blinking

115
Q

Corneal signs of HZO

A 
Occurs in 65% pt with acute HZO;
Punctate epithelial keratitis 
Pseudodendrtitic keratitis 
Anterior stromal keratitis 
Keratouveitis
Endothelitis
Neurotrophic keratopathy 
Less common signs;
Exposure keratopathy, disciform keratitis, IK
116
Q

Acanthamoeba corneal signs

A 
Punctuate defect
Whorl-like defect
Pseudodendrtitic lesions
Late signs: patchy, anterior stromal infiltrate becoming confluent over 2-3 months forming Ring ulcer. 
Also presenting radial keratoneuritis
117
Q

Marginal keratitis

A

caused by a hypersensitivity reaction against staphylococcal exotoxins and cell wall proteins with deposition of antigen-antibody complexes in the peripheral cornea (antigen diffusing from the tear film, antibody from the blood vessels) with a secondary lymphocytic infiltration. The lesions are culture negative but S. aureus can frequently be isolated from the lid margins.

118
Q

Phlyctenulosis

A

delayed hypersensitivity reaction to staphylococcal antigen; the most common systemic association is rosacea.
-Presentation is usually in children or young adults with photophobia, lacrimation and blepharospasm.

119
Q

Thygeson superficial punctate keratitis

A

Symptoms :consist of recurrent attacks of irritation, photophobia, blurred vision and watering.
Signs • Mainly central, coarse, distinct, granular, greyish, slightly elevated epithelial lesions that stain with fluorescein. -A mild subepithelial haze may be present especially if topical antivirals have been used. •The conjunctiva is uninvolved and the eye is not hyperaemic.

120
Q

Art lines

A

White scarring of the superior tarsal conjunctiva

121
Q

Herbet’s pits

A

Depression of the limbal conjunctiva after resolution of limbal follicles

122
Q

Chrysiasis

A

occurs secondary to the deposition of gold in the skin, lens, and cornea, causing a gray discoloration of the skin and brown/gold deposits in the deep stroma of the cornea.

123
Q

Conditions that cause corneal blindness in the US

A

1-Trauma

2-HSV

124
Q

Thygeson’s SPK signs

A

Bilateral
Small multiple asymmetric, gray white clusters of superficial intraepithelial raised “crumb like” central corneal lesions.

125
Q

Aberrant regeneration of CN 3

A

Evaluation for trauma and tumor
-signs are lid -gaze and pupil-gaze dyskinesia
( patient will have upper eye lid retraction with downgaze and pupil construction with down gaze and addiction )

126
Q

Ocular signs of Myotonic Dystrophy

A 
Miotic pupil
Ptosis
External ophthalmoplegia
"Christmas tree " cataract 
Pigmentary retinopathy
127
Q

Type of cataract with Diabetic

A

Cortical cataract

  • bilateral, multiple, gray white cortical crystalline lens opacities described as “snow flake opacities’”
  • earlier and faster progression of senile NS and cortical cataract.
128
Q

Cataract with Wilson disease

A

Green- brown opacities “ sun flower cataract”

129
Q

Positive Seidel’s sign

A

Early post op period due to trauma
Suture failure
Valsalva maneuver

130
Q

Hopotony

A

Loss of aq humor
IOP < 6
Causing anatomical and physiological changes

131
Q

Common cause of elevated IOP in post op cataract patients

A

Retained viscoelastic materials

132
Q

Potential cause of elevated IOP in post op patients

A 
Retained viscoelastic 
Steroid response
Pseudoexfoliation material
Pupillary block
Red blood cells in TM
133
Q

PCO

A

41-51% of patients over 5 year old
Occurs within 2-6 months
Elsching pearls common in children

134
Q

signs and symptoms of neovascularization

A

vary with the stage of the disease.
Early symptoms usually consist of decreased visual acuity from the underlying retinal condition, and, occasionally, from corneal epithelial edema and anterior chamber inflammation if retinal function is normal.
Later symptoms include ocular discomfort, brow ache, and nausea from inflammation and elevated IOP.

135
Q

orbital bruit

A

represents increased blood flow through the collateral arterial system and intracranial arterial supply. In the correct clinical context, the presence of an orbital bruit should make the examiner suspect either a severe stenosis or occlusion of either the ipsilateral or the contralateral internal carotid artery (ICA).

136
Q

Growth factors are found in

A

Glial cells
RPE cells
Vascular Endothelial cells

137
Q

What improves macular capillary blood velocity in CME patients occurring after central retinal vein occlusion.

A

Systemic carbonic anhydrase inhibitors or corticosteroids, but not nonsteroidal anti-inflammatory drugs

NBEO Review-AA (15 decks)

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