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KHIO 1 VIVA > extre > Flashcards

extre Flashcards

1
Q

RA ocular involvement

A

Autoimmune disease:
DED
Keratoconjuntivitis
Precursor to Sjrogrens
Peripheral corneal ulceration

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2
Q

Sterile corneal ulceration causes:

A

DED
SS/RA
GPC

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3
Q

Confluent drusen in one eye treatment:

A

Treated as AMD
OCT (severity)
VA + Amsler
“confluent” > recheck 3-6m
Return if vision changes/amser

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4
Q

DDX Red/sore eye

A

Keratitis
CLARE
Foreign body/Pterygium flare

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5
Q

DDX gritty/burning eyes:

A

DED (CL/Meds/SLE)
Allergic conjuntivitis
Bacterial conjuntivitis

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6
Q

Idiopathic macula oedema testing:

A

OCT (AMD)
Fundoscopy (uveitis/RP)
Medical history (HT)
Drug use (Lanaprost>Glauc)

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7
Q

Chlamydial infection presentation

A

Unilateral > bilateral, Mucopurulent discharge, hyperaemia, lid chemosis
Trachoma: repeated infection, Large papillae + follicles, conj. scarring, entropion
Acute inclusion: large follicles
Bacterial culture is recomended
Both with oral doxycycline 100mg BID 4 weeks

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8
Q

Patho nuclear cataract:

A

Age> Barrier before cortex, prevents glutathione transport
Post translational modifation> Glycation/calpain/tryptophan addition

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9
Q

Patho PSC:

A

Age, stress, DM > GF alterations
Loss of growth factors impede epithelial differentiation to lens fibers
Undifferentiated cells with organelles micrate to posterior pole
Abnormal pump function>swelling> vacuole formation > disruption of lens organisation

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10
Q

Risk factors of hypertension:

A

Family history
Smoking/alcohol
Obesity
Age

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11
Q

Distinct features of retinal BV in HT:

A

Lack sympathetic nerve supply
Autoregulation of flow
Blood retinal barrier

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12
Q

HT pathophysiology:

A

BP > stress induced vasospasm > arteriole narrowing
Sustained BP > vessel hyperplasia/wall degeneration > AV nipping, vein tortuisity, copper wiring
Loss of BBB > fluid leakage/ischemia > hemorrhage (dot/blot), hard exudate, CWS
Intracranial HT > optic nerve ischemia/swelling/pallor

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13
Q

Thickening of arteries:

A

Vasospasms > compensatory hypertrophy of smooth muscle > loss of transparency (copper wiring) / AV nipping

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14
Q

AV nipping:

A

Artery hyperplasia > thickening > increased pressure on venules
Ususally veins under artery is visible (transparent arteries), hyperplasia > decreased transparency
Leads to vein tortuisity

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15
Q

Retinal haemorrgahes:

A

Dot/Blot: bleed within retina
Flame: bleed in NFL (wont occur in DR)

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16
Q

Exudates:

A

Hard: lipid deposit on retina
Soft: CWS (NFL swelling)
Macula star: radial hard exudates around macula

17
Q

HT related conditions:

A

CRAO/CRVO
BRAO/BRVO
AMD
CSR

18
Q

Diabetic retinopathy patho:

A

Hyperglycemia > damaged vessel pericytes > weakening capiliary walls/increased permeability > microanerysms/hard exudates (lipid leaks) > ischemia > VEGF production > CNV > vit. Bleed / RD

19
Q

TED presentation:

A

Exopthalmos
DED > corneal erosion
Lid retraction
Optic neuropathy

20
Q

TED causes/risks:

A

Graves disease
RA
DM
Smoking

21
Q

Assessment of lacrimal drainage:

A

NaFL drops > cleared in 5m > present in sneeze
Assessment of the tear film meniscus (should be >0.1mm)

22
Q

Vernal vs Atopic keratoconjunctivitis:

A

Vernal: 20y, mucoid discharge, cobblestone papillae, trantas dots, seasonal, type 1 IgE

23
Q

Presentation of trachoma from chlamydia:

A

Follicles, Pannus (corneal infiltrate), hyperaemia, mucopurulent discharge
Later forms entropion (inward lid turn), corneal scar

24
Q

Prevention of HSV recurrence

A

Acyclovir 400mg bid

25
Q

Scleritis/episcleritis assessment:

A

Phenelephrine 2.5% (vessels remain)
Episcleritis is painless, scleritis is painful
Episcleritis self resolves 2w
Scleritis needs oral prednisolone

26
Q

Macula hole:

A

Unilateral, painless loss of central vision (metamorphopsia if pucker)
Related to PVD
Requires gas and face down.

27
Q

Optic neuritis:

A

Inflammation of optic nerve, commonly from MS
Unilateral loss of vision over days
Swollen optic disc

28
Q

Anterior ischaemic optic neuropathy:

A

Ischaemia of ON, commonly from HT/BV inflammation
Sudden painless loss of vision
Optic disc oedema / crowding

29
Q

Common cause of CN3 palsy:

A

Compressive lesion from communicating artery anerysm

30
Q

Clinical testing for keratitis/conjuntivitis:

A

Slit lamp w/NaFL (ulcer analysis)
Pain (scale/Q-tip)
Pressure lacrimal duct/maibomian (lacrimal infection, meibum)
Corneal scrape (lab assessment)

31
Q

DDX for Macula oedema:

A

AMD (look for drusen)
Uveitis (several RDs, pain)
DR (haemorrhages)
CSR (stress, corticosteroids, male)

32
Q

HT pathophysiology:

A

BP > stress induced vasospasm (autoregulation) > arteriole narrowing
Sustained BP > vessel arteriosclerosis (hyperplasia)/wall lumen degeneration > AV nipping, vein tortuosity, copper wiring
Loss of BBB > fluid leakage/ischemia > hemorrhage (dot/blot), hard exudate, CWS
Intracranial HT > optic nerve ischemia/swelling/pallor

33
Q

Non pharmacologic treatment of allergic conjuntivitis:

A

Avoid allergen
Lubricants (wash away allergen)
Cold compress (vasoconstriction)

34
Q

Pharmacologic treatment of allergic conjuntivitis:

A

Antihistamine levocabastine drop 0.05% bid
Mast cell stabiliser: Loxamide
NSAID: Ketorolac
Topical corticosteroids: Fluromethalone 0.1% qid

35
Q

PSC history:

A

Age (usually young)
Glare at day
Steroid use/inflammation (uveitis)

36
Q

PSC patho:

A

Corticosteroid, trauma, inflammation > altered GF expression
Abberrant lens cell migration from germinative zone to visual axis at posterior pole

37
Q

DM on cataract:

A

Post translational modification (glycation) of proteins > conformation change
Gucose influx > sorbitol influx > water influx > RI increase

KHIO 1 VIVA (5 decks)

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