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PANCE Subjects > EENT- Eye > Flashcards

EENT- Eye Flashcards

1
Q

34 y/o F presents with acute left sided eye pain. It is worse with movements, especially lateral and medial. Her vision in decreased in the left. Exam shows a afferent pupillary defect and some mild optic disc swelling.
dx
tx

A

presentation of optic neuritis
would likely get MRI brain/orbits
IV methylprednisone transition to PO pred
should return to normal

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2
Q

How would you diagnose a suspected corneal abrasion?

A

Fluorescein drops

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3
Q

FP with rust ring present, tx

A

25g needle or drill with burr
abx, anesthetic eye drop
f/u ophth 1-2 days

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4
Q

Contact users who sustain corneal abrasion that is superficial and FB easily removed with cotton tip. Tx

A

Contact uses require
Ciprofloxacin
Keep contacts out for 7 days/until healed

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5
Q

When can you patch for treatment for corneal abrasion?

A

DONT

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6
Q

Corneal ulcers most commonly due to

A

infection

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7
Q

RF for corneal ulcer

A 
contact lens use
dry eye states/ ocular surface dis
HIV
trauma, ocular sx
smoking
low SEC status
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8
Q

Common bacteria seen in corneal ulcer

A

staphylococcus, pseudomonas

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9
Q

How would you diagnose a suspected ulcer

A

fluorescein eye drop

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10
Q

Pt presents with right eye pain, photophobia, tearing and FB sensation. There is erythema of the conjunctiva and corneal injection. Fluorescein stain demonstrates a dendritic lesion. Dx and Tx

A

HSV Keratitis/Ulceration
Tx with Acyclovir PO (sometimes drops)

Cycloplegic drops (cyclopentolate 1%) for pain

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11
Q

Tx chalazion

A

warm compress and lid scrubs

refractory >1m I&D

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12
Q

Hard, non-tender swelling on lid with redness and swelling of adjacent conjunctiva

A

Chalazion

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13
Q

Patho of chalazion

A

granulmatous inflamm of meibomian gland likely following internal hordeolum

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14
Q

MCC conjunctivitis

A

Adenovirus

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15
Q

Anterior Blepharitis involves what location?

Pathophysiology?

A

eyelid skin, eyelashes, glands

ulcerative secondary to staph infec or from seborrhea

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16
Q

Posterior Blepharitis involves what location?

Pathophysiology?

A

inflamm of meibomian from primary glandular dysfx
-strong association with acne rosacea
or bacterial infect

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17
Q

18 y/o male presents with bilat eye that are red rimmed. He complains of itching and a FB sensation. On exam you note scales clinging to the lashes.
Dx
Tx

A

Anterior Blepharitis- likely seborrheic
warm compresses BID followed by eyelid scrubs

abx only if sxs secondary infection

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18
Q

24 y/o female presents with c/o bilat itching eyes and irritation. It has been bothering her for 1 1/2 weeks. On exam you see hyperemic lid margins with telangiectasis. Palpation of meimobian glands causes mild expectorant of a clear oily substance.
Dx
Tx

A

Posterior Blepharitis
warm compresses BID followed by eyelid scrubs

if sxs rosacea then PO doxy

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19
Q

Patho for hordeolum

A

staphylococcal abscess on upper or lower lid
internal = meibomian gland abscess
external (aka sty) = Zeis/Moll abscess

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20
Q

14 y/o F with R eye tearing and itching. Lower lid has internal bump that is acutely painful. There is mild erythema and swelling.
Tx and recommendations

A

Hordeolum
warm compresses several times a per day x48hrs
I&D if no improvement in 2days

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21
Q

7 y/o M presents with unilat mild eye irritation and copious purulent DC. In the morning his eye was crusted over. He reports his friend at school recently had “pink eye”.

A

Likely bacterial conjunctivitis

topical sulfonamide or PO abx

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22
Q

Unilat lacrimal sac swollen, red, tender
dx
tx

A

Dacryocystitis
PO Augmentin, Cephalexin
warm compress

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23
Q

inward turning of the eyelid

A

entropion

24
Q

Treatment for Ectropion

A

tape eyelid in place temporarily until sx

artificial tears/lubricants

25
Q

Treatment for Entropion

A

Artificial tears/lubricants

A few stitches in the office, hold in place until sx

26
Q

fleshy overgrowth of conjunctiva onto cornea

“wing shaped” vascular overgrowth

A

Pterygium

27
Q

yellow elevated conjunctival node on nasal side

A

Pinguecula

28
Q

MCC of cataract

A

Aging

29
Q

Patho of cataract

A

change in lens protein lead to opacification

30
Q

Leading cause of blindness worldwide

A

Cataract

31
Q

64 y/o M with a PMH of CAD and HTN (now controlled) presents with c/o bilat progressive bluring of vision. He says he has increased glare and driving at night is extremely bothersome. On exam his retina is difficult to visualize and he has an absent red reflex bilat.
Dx
Tx

A

Cataracts

Surgery

32
Q

45 y/o AAM hx of DM presents with insidious loss of peripheral vision and c/o “halos around lights”. Exam reveals IOP of 24 and slightly enlarged disk/cup ratio
Dx
Tx

A 
Open Angle Glaucoma
Referral- 
    B adrenergic drops
          Timolol, Levobunolol
    Alpha Adrenergic Agonist drops
           Apraclonidine
~Laser trabeculectomy
33
Q

Drugs that can cause acute angle closure glaucoma

A

SULFA
anticholinergics
sympathomimetics
+ others, sometimes even acetazolamide….

34
Q

Beta adrenergic drops like Timolol and Levobunolol are contraindicated in what other disease states

A

Asthma

Cardiac conduction disorders

35
Q

Normal IOP

A

10-20mmHg

36
Q

37 y/o Asian man presents to PCP with acute onset unilat HA and aching brow pain. He c/o of halos around lights. On exam you note a red eye and steamy cornea with a fixed mid-dilated pupil.
w/o
tx

A

Check IOP- likely in 40s and up
Examine cornea- likely CORNEAL EDEMA

Angle Closure Glaucoma

Tx- IV acetazolamide
topical Badrenergic, alpha agonist

Definitive tx- laser iridotomy

37
Q

Exam findings classic for HTN retinopathy

A

AV nicking, arteriolar narrowing

~retinal hemorrhages, microanuerysms, optic nerve swelling

38
Q

DBP of ______ causes retinal vessels to narrow and straighten

A

90-110mmHg

39
Q

DBP of _______ causes leakage of plasma proteins and blood products

A

110-115mmHg

40
Q

DBP of ______ causes optic nerve swelling

A

130-140mmHg

41
Q

Patho of cotton-wool spots

A

ischemia to nerve fiber

42
Q

Neovascularization and vitreous body hemorrhage classic for what dx?

A

Proliferative DM Retinopathy

43
Q

Microaneurysms, venous dilation, and hard exudates seen in what dx?

A

Non-prolif DM Retinopathy

44
Q

Unilat swelling with redness of lid with proptosis, fever, and restricted EOM recent hx sinusistis

A

Orbital Cellulitis

Nafcillin

45
Q

Tx hyphema

A

Elevate HOB, limit activity
~eye shield (not a patch)
Avoid ASA, NSAID- acetaminophen only
referral to ophthalmologist

46
Q

24 y/o M presents to ED following bar fight for skin lac to medial nose. It is grossly swollen. On exam you not a 4 cm lac and orbital crepitus. He reports some facial numbness on his upper lip on that side and has double vision when looking up

A

Blow out fracture with nerve entrapment/injury

47
Q

tear drop sign

A

orbital fat herniated into maxillary sinus

blow out fx

48
Q

45 y/o F with hx of near-sighteness and DM presents to ED with 2 day hx of increasing floaters and flashes of light and 1 hr hx of curtain moving over her field of vision.
Dx

A

Retinal Detachment presentation

49
Q

Acute PAINLESS vision loss
pyknosis-whitened retina
Cherry Red dot of fovea

A

Retinal Artery Occlusion

50
Q

PAINFUL unilat vision loss

exam with dilated tortuous retinal veins

A

Retinal Vein Occlusion

51
Q

Drusen are characteristic of what disease process

A

macular degeneration

52
Q

Hard drusen
pigment changes
amsler grid changes

A

Non-exudative/Dry Macular Degeneratoin

53
Q

Soft drusen
neovascularization
scarring

A

Exudative/Wet Macular Degeneration

54
Q

infantile esotropia treatment

A

surgery

55
Q

crossed eyed

A

esotropia

PANCE Subjects (12 decks)

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