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Anterior Segment > Disorders of the Conjunctiva: General & Bacterial > Flashcards

Disorders of the Conjunctiva: General & Bacterial Flashcards

1
Q

what mucus membrane lines inner surface of eyelids

A

palpebral conjunctiva

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2
Q

what mucus membrane lines the anterior globe

A

bulbar conjunctiva

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3
Q

bulbar conjunctiva is continuous with & where

A

corneal epithelium at the limbus

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4
Q

list the layers of the conjunctiva from most superficial to deep

A

conjunctiva → anterior Tenon’s capsule → episclera → sclera

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5
Q

which conjunctival layer is the protective outer layer

A

epithelium

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6
Q

what does the epithelium contain

A

goblet cells & conjunctival associated lymphoid tissue (CALT)

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7
Q

which conjunctival layer is composed of loose vascularized tissue

A

stroma

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8
Q

what does the stroma contain

A
  • accessory lacrimal glands
  • sensory nerves
  • lymphatic vessels
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9
Q

what is a conjunctival fold that allows the globe to move without stretching the conjunctiva

A

plica semilunaris

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10
Q

what is a small, fleshy nodular prominence

A

caruncle

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11
Q

what does the caruncle contain

A
  • goblet cells
  • sweat glands
  • sebaceous glands
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12
Q

what is dilation of conjunctival vessels that leads to diffuse redness

A

hyperemia

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13
Q

how do hemorrhages appear on an inflamed conjunctiva

A

small “petechial” (pin-point)

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14
Q

what is translucent swelling of the conjunctiva

A

chemosis

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15
Q

which membrane is coagulated exudate that is adherent to inflamed conjunctival epithelium

A

pseudomembrane

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16
Q

which membrane is coagulated exudate & fibrin that is firmly attached to conjunctival epithelium

A

true membrane

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17
Q

do follicles or papillae appear translucent/whitish like “grains of rice”

A

follciles

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18
Q

are follicles or papillae associated with ipsilateral lymphadenopathy

A

follicles

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19
Q

are follicles or papillae caused by formation of a subepithelial lymphoid germinal center with lymphocytes

A

follicles

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20
Q

what are the typical causes of follicles

A
  • viral
  • chlamydial (inclusion)
  • toxic
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21
Q

do follicles or papillae mainly develop in palpebral conjunctiva & potentially bulbar limbal conjunctiva

A

papillae

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22
Q

do follicles or papillae contain a central vascular channel, making it look “red & beefy”

A

papillae

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23
Q

are follicles or papillae composed of folds of hyperplastic epithelium with a fibrovascular core & stromal infiltration with inflammatory cells

A

papillae

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24
Q

what are the typical causes of papillae

A
  • allergy
  • bacteria
  • CL wear
  • floppy eyelid syndrome
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25
what type of discharge would you see in viral & allergic conjunctivitis
serous
26
what type of discharge would you see in VKC or bacterial conjunctivitis
mucoid (stringy/ropy)
27
what type of discharge would you see in bacterial conjunctivitis
mucopurulent (pus-like)
28
what type of discharge would you see in a gonococcal conjunctivitis
severe purulent
29
what is the most common cause of bacterial conjunctivitis
S. aureus
30
what are less common causes of bacterial conjunctivitis
- S. pneumoniae - H. influenzae - Moraxella
31
what are rare causes of bacterial conjunctivitis
- N. meningitidis | - N. gonorrhea
32
these signs are indicative of what type of bacterial conjunctivitis: - eyelid edema & erythema in a severe infection - conjunctival hyperemia/injection & chemosis - white-yellow mucopurulent discharge - SPK - conjunctival papillae - usually bilateral - absent preauricular lymphadenopathy
acute bacterial conjunctivitis
33
which bacterial conjunctivitis will have an acute onset of redness
acute bacterial conjunctivitis
34
what treatment will speed up recovery & prevent reinfection & transmission in acute bacterial conjunctivitis
topical antibiotic QID x 1 wk
35
what are some examples of topical antibiotics to treat acute bacterial conjunctivitis
- G+ ABX - bacitracin - vigamox (if severe)
36
when are systemic antibiotics indicated in acute bacterial conjunctivitis
when N. gonorrhea, N. meningitidis, or H. influenzae suspected
37
in acute bacterial conjunctivitis, does conjunctival hyperemia or injection & chemosis predominate
hyperemia
38
these signs are indicative of which bacterial conjunctivitis: - 12-24hrs onset - copious green-gray mucus discharge - typically unilateral, but can be bilateral - significant eyelid edema & conjunctival hyperemia - lymphadenopathy
hyperacute bacterial conjunctivitis
39
what are the sequelae of hyperacute bacterial conjunctivitis
- corneal ulceration - corneal perforation - panophthalmitis
40
what organisms cause hyperacute bacterial conjunctivitis
- N. gonorrhea | - N. meningitidis
41
when treating hyperacute bacterial conjunctivitis, topical antibiotics are used in conjunction with
oral/IM/IV antibiotics
42
treatments are indicative of which type of bacterial conjunctivitis: - infectious disease consult - hospitalization may be required - topical ABX & oral/IM/IV ABX - continuous irrigation of discharge - must report to government health agency
hyperacute bacterial conjunctivitis
43
which type of bacterial conjunctivitis is conjunctival inflammation that develops within the first month of life through transmission by mother during delivery
neonatal conjunctivitis (ophthalmia neonatorum)
44
these causes cause which type of bacterial conjunctivitis: - chlamydia trachomatis - neisseria gonorrhea - herpes simplex virus 2 - a toxic reaction to silve nitrate prophylaxis (Crede prophylaxis)
neonatal conjunctivitis
45
what is the most common cause of neonatal conjunctivitis
chlamydia trachomatis
46
which cause of neonatal conjunctivitis has an onset within the first few days
toxic reaction
47
which cause of neonatal conjunctivitis has an onset during the 1st week
gonococcal
48
which cause of neonatal conjunctivitis has an onset within 1-2 weeks
HSV
49
which cause of neonatal conjunctivitis has an onset within 1-3 weeks
chlamydia
50
how do you treat neonatal conjunctivitis caused by HSV 2
IV acyclovir
51
how do you treat a chlamydial neonatal conjunctivitis
oral erythromycin
52
how do you treat a gonococcal neonatal conjunctivitis
hospital admission; IM/IV cephalosporin
53
which type of bacterial conjunctivitis is caused by chlamydia trachomatis
chronic bacterial conjunctivitis (inclusion conjunctivitis)
54
asymptomatic urethritis is a systemic symptom of chronic conjunctivitis in males or females
males
55
dysuria & discharge are systemic symptoms in chronic bacterial conjunctivitis in males or females
females
56
urethritis in males with chronic bacterial conjunctivitis can trigger what
Reiter syndrome
57
dysuria & discharge in females with chronic bacterial conjunctivitis can progress to what
pelvic inflammatory disease & risk of infertility
58
these symptoms are indicative of which type of bacterial conjunctivitis: - typically unilateral chronic red eye, can be bilateral - mucopurulent discharge - chronic (3+ weeks)
chronic bacterial conjunctivitis (inclusion conjunctivitis)
59
what sign is characteristic for chronic bacterial conjunctivitis
large follicles in inferior fornix & follicles on bulbar conjunctiva
60
these signs are indicative of which type of bacterial conjunctivitis: - tender preauricular lymphadenopathy - large follicles in inferior fornix - bulbar conjunctiva follicles - SPK - perilimbal subepithelial infiltrates appearing after 2-3 weeks - improves with topical ABX, but returns once discontinued
chronic bacterial conjunctivitis
61
what is the preferred systemic antibiotic therapy for chronic bacterial conjunctivitis
azithromycin 1g PO, single dose
62
what systemic antibiotic therapies are used to manage chronic bacterial conjunctivitis
- azithromycin 1g PO, single dose | - doxycycline 100mg PO BID x 10 days
63
what is the leading cause of preventable blindness in the world that is associated with poverty, overcrowding & poor hygiene
trachoma
64
in trachoma, recurrent infections results in what
chronic immune response (type IV hypersensitivity) to chlamydial antigen
65
which stage of trachoma is most common in preschool children
active inflammatory stage
66
which stage of trachoma is prevalent in middle age
cicatricial chronic stage
67
which stage of trachoma has mixed follicular & papillary conjunctivitis & mucopurulent discharge
active inflammatory stage
68
which stage of trachoma has scarring of superior palpebral conjunctiva (Arlt's line)
cicatricial chronic stage
69
which stage of trachoma has superior epithelial keratitis & pannus formation
active inflammatory stage
70
which stage of trachoma has trichiasis & cicatricial entropion
cicatricial chronic stage
71
which stage of trachoma has corneal opacification from continuous mechanical trauma
cicatricial chronic stage
72
what strategy is used to manage trachoma
SAFE strategy
73
in SAFE strategy, what does the S stand for
surgery for trichiasis
74
in SAFE strategy, what does the A stand for
antibiotics for active diseases
75
in SAFE strategy, what does the F stand for
facial hygiene
76
in SAFE strategy, what does the E stand for
environmental improvement
77
how can you improve the environment to manage trachoma
- access to clean water - sanitation - reduction in fly population
78
what is the vector for trachoma
flies

Anterior Segment (37 decks)

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