Eye / Abdomen Flashcards
1
Q
Acute onset, painful red eye - hx questions
A
- Change in visual acuity
- Photophobia
- Recent viral URTI
- Contact with anyone with conjunctivitis
- Recent trauma
- FB sensation in eye
- Contact lense wearer
- Hyperopia
- Discharge or tearing from the eye
- Pruritis
- Exposure to UV or chemicals
- Headaches / vomiting
- FMHx glaucome
2
Q
DDx acute red eye
A
- Acute angle closure glaucoma
- Iritis / uveitis
- Keratitis
- Scleritis / episcleritis
- Foreign body
- Chemical keratitis
- UV keratitis
- FB
3
Q
Emergency mx acute angle closure glaucoma
A
- Urgent referral to Ophthalmologist
- Position patient supine
- Analgesia - morphine
- Anti-emetic
- Do not patch the eye
- (consider timolol / pilocarpine / acetazolamide?)
4
Q
Mx of mild, intermittent GORD symptoms
A
- Weight loss if overweight
- Eating smaller meals
- Drinking fluids between meals rather than with meas
- Avoiding lying down after eating
- Avoiding eating or drinking 2-3 hours prior to bed or vigorous exercise
- Elevate head of bed
- Smoking cessation
5
Q
Physical examination of the eye - important steps
A
- Visual acuity
- Inspection of eye surface, cornea and sclera
- Evert eyelid for foreign body
- Stain with fluorescein for corneal abrasion
- Assess red reflexes
- Assess pupil shape and light reflex
- Slit lamp examination
6
Q
DDx for presentation of Amaurosis Fugax (transient monocular or binocular visual loss)
A
- Giant cell arteritis
- Carotid artery disease
- Retinal vein occlusion
- Optic neuropathy
- Retinal vasospasm
- Optic nerve compression by a lesion
- Idiopathic amaurosis fugax
7
Q
DDx for progressive peripheral visual loss
A
- pituitary adenoma
- craniopharyngioma
- meningioma
- malignant sellar tumour
8
Q
Physical signs of chronic liver disease
A
- spider naevi
- palmar erythema
- leukonychia
- gynaecomastia
- hepatosplenomegaly
- signs of portal hypertension (collateral vessels on anterior abdominal wall, caput medusa)
- ascites
- varices
9
Q
Mx for patients with chronic hepatitis and cirrhosis
A
- hepatocellular carcinoma surveillance 6 monthly
- medication monitoring for adherence to antivirals
- appropriate vaccinations: Hep A, influenza, pneuomoccoal
- lifestyle modification, smoking cessation, minimise alcohol
- weight loss advice
10
Q
Signs of haemochromatosis
A
- arthralgia
- loss of libido
- skin pigmentation
- hepatomegaly
- hypogonadism
- gynaecomastia
- symmetrical small joint arthropathy MCP + PIPs
11
Q
DDx for hyperferritinaemia
A
- acute inflammation (infection)
- chronic inflammation (systemic lupus erythematosus)
- malignancy
- haemophagocytic lymphohistiocytosis
- hereditary hyperferritinaemia-cataract syndrome
- iron overload syndromes (haemochromatosis)
- secondary iron overload (
12
Q
DDx for hepatitis on bloods
A
- Viral hepatitis
- Non-alcoholic fatty liver disease
- Alcoholic liver disease
- Drug-induced hepatitis (paracetamol)
- Hereditary conditions (haemochromatosis)
- Autoimmune hepatitis
13
Q
DDx for presentation of dyspepsia
A
- GORD
- NSAID induced gastritis
- Oesophageal carcinoma
- H.pylori induced gastritis
- Functional dyspepsia
- Angina
- Biliary colic
14
Q
Basic eye examination in pt with unilateral red eye
A
- Visual acuity
- General inspection of cornea, sclera, lids
- Evert eye lids to look for FB
- Pre-auricular LN
- Examine pupils with light reflex
- Examine cornea with fluorescein 1% drops and cobalt blue light
15
Q
Examination findings in suspected acute angle closure glaucoma
A
- mid dilated pupil
- poor pupillary reactivity to light
- cloudy cornea
- injected / red conjunctiva
- increased IOP
- decreased visual acuity
