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NMSP > Eye Dr. Martin > Flashcards

Eye Dr. Martin Flashcards

1
Q

proptosis

A

increased orbital contents displaces eye

= eyelid cant cover all of it —-> ulcers and infection

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2
Q

cause for inferior + medial proptosis

A

Lacrima gland problem (sarcoidosis, lymphoma, pleomeorphic adenoma, adenoid cystic carcinoma

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3
Q

causes for axial proptosis

A

optic nerve problem (glioma, meningioma)

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4
Q

graves disease causes what kind of orbitopathy

A
  1. extraocular muscles are non-granulamatous inflammed
  2. HIGH Glycosaminoglycans
  3. NOT ADIPOSE OR TENDONS inflammation
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5
Q

graves disease orbitopathy complications

A
  1. visual loss

2. cornea complications

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6
Q

Idiopathic orbital inflammation is what and causes and what needs to be excluded

A

= psudotumor

  1. eosinophils in fat and tendons —-> inflammation and fibrosis
  2. only in lacrimal gland
  3. IgG related disease can look like this and needs to be excluded
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7
Q

other orbital inflammation diseases besides psudotumor and graves

A
  1. Wagner
  2. Sinus infection
  3. sarcoid —> granulomatous uveitis + Mutton Fat + Candle wax dippling
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8
Q

sarcoid causing orbital inflammation gives what 2 PE findings

A
  1. Mutton fat = keratic debri on cornea

2. Candle wax dripping : privascular inflammation of retina

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9
Q

most common neoplasm of the eye

A
  1. capillary hemangioma = children , infants
  2. cavernous hemangioma = adults
  3. non-hodkins lymphoma (B-cell lymphomas only)
  4. lacrimal gland adenoma
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10
Q

Blepharitis

A

eyelid inflammation , chronic

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11
Q

chalazion is what and can look just like what

A

lipid into the tissue —> granulamatous response = lipogranuloma

= Sebaceous carcinom**

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12
Q

neoplams to look for on eyelid in AIDS and can look like what

A

Karposi sarcoma can be in conjunctiva also, purple lesion in dermis

= can look like subconjunctival hemorrhage due to redness

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13
Q

most common tumor of all on eyelid and looks like

A

BCC (lower eyelid, inner canthus, upperlid)
= pearly nodules, telengiectasia vessels, **
= central rodent ulcer , rolled edges **
= can eat away anything
= peripheral palisading ***

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14
Q

BCC looks like what color on histology that is important to see

A

BLUE

1. peripheral palisading = nucleus stand up vertically (like a flower)

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15
Q

SCC looks like what and histologic things to see

A

PINK

1. keratin pearls

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16
Q

Sebaceous Carcinoma can be found how, spreads how, and histology + stain needed

A
  1. reoccuring chalazion that is removed and comes back
  2. Pagetoid spread : intraperipheral spread (through epidermis)
  3. Vacuolization of cytoplasm **, Oil Red O STAIN ** only stain that works
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17
Q

Sebaceous Carcinoma metastasizes first where and is associated with what syndrome

A
  1. parotid + subandibular LN, lung, liver, brain, skull

2. Muir- Torre Syndrome (lynch syndrome where internal tumors cause sebaceous gland skin tumors)

18
Q

you see many goblet cells with nonkeratinizing squamous epithelium what area is this

A

conjunctiva

19
Q

conjunctiva

  1. palpebral
  2. fornix
  3. bulbar
  4. limbus
A
  1. palpebral = allergies and bacterial infection
  2. fornix = lacrimal gland + LN is here
  3. bulbar = non-K SS Epi covers the eye
  4. limbus = transition from sclera to cornea
20
Q

what can cause conjunctiva scarring

A
  1. chlamydia trachomatis or autoimmune ocular cicatrical pemphigoid
  2. can cause a type of dry eye
21
Q

what happens in the conjunctiva scarring that causes dry eye

A

goblet cells decrease = less mucin made = needed for adherence of aqueous part in tears (so even if you give artificial tears it will not adhere to the cornea)

22
Q

Pinguecula vs pterygium

A

Pinguecula : limbus, small yellow elevation from sun exposure + CAN become SCC OR MELANOMA fragmented collagen (elastase stain VVG)
Pterygium : can impair vision, winging onto cornea

23
Q

freckle vs lentigo

A 
freckle = melanin is higher due to enlarges melanocytes 
lentigo = melanin increases due to linear melanocyte hyperplasia
24
Q

nevus vs melanoma seen how

A

NEVUS : melanocytes grow round and grow in aggregates of nests (LARGE to small as you go down vertically)
MELANOMA : stays LARGE all the layers down

25
Q

conjunctival melanoma what happens and gene

A
  1. primary acquired melanosis not tx completely
  2. BRAF V600
    = 25% fatal
26
Q

blue scleral means what and due to what 3 things can this happen

A

from thinning of sclera

  1. increased intraocular P = staphyloma
  2. osteogenesis imperfecta
  3. congenital melanosis oculi
27
Q

normal cornea layers

A
  1. Bowman layer : prevent cancer, and injuries
  2. stroma = NO BVs, Lymph, hard to repair
  3. ednothelium : no vasculature
  4. Decemet membrane : increase thickness with age (gets Kayser-Fleischer Wilson ring = copper deposits)
28
Q

Cornea Transplant of stroma is done how

A

LOW rejection due to low BVs and lymph

as long as there is no cornea vascularization

29
Q

what can prevent cornea vascularization

A

VEGF antagonist

30
Q

corneal infections

  1. hypopyon:
  2. bacteria most common
A
  1. exudate that layes on bottom of cornea like a boat

2. staph Aureus, strep pneumo, psudo aeruginosa, enterobacteriaceae

31
Q

acanthamoeba can do what and how and most common way of getting this

A

blindness, parasite
= acanthamoebic keratitis —> cornea ulcer –> blindess
= contact lenses (wash hands)

32
Q

Acanthamoeba tx and what can happen in immunocompromised pts

A

transplant cornea

GAE (Granulomatous amoebic encephalitis) = enters by open wound and goes to brain

33
Q

Herpes Simplex Virus Keratitis

A
  1. chronic stromal keratits = ulcer and scarring**

2. granulamtous reaction at Descemets membrane

34
Q

corneal degeneration vs dystrophy

A

Degeneration : unilateral , asymmetric, peripheral caused inflammation
Dystrophy : familial, several corneal layers, NO inflammation, deposition of abnormal material

35
Q

Calcific Band Keratopahty what happens and what usually causes this and looks like

A

Bowman Membrane CALCIUM depostis
from
1. chronic uveitis (juvenile rheumatoid arthritis)
2. white/grey band across cornea

36
Q

Actinic Band Keratopathy (climatic droplet keratopathy)

is what and caused by what and looks like

A
  1. high UV light (solar elastosis in superficial cornea= horizontal band)
  2. yellow oil droplet keratopathy on the cornea (from damaged collagen)
37
Q

Keratoconus is what and risk of getting

A
  1. BILATERAL thinning of cornea + Bowman breaks causing edema = anterior protrusion of cornea when looking down (RIGID CONTACTS CAN HELP)**
  2. infantile glaucoma = HIGH Intraoccular P
38
Q

Keratoconus is associated with what dzs and PE sig nto test for this

A
  1. Marfans, Downs, Atopic Disorders, forcepts used at birth

2. MUNSON SIGN (look down and lower lids bulge out

39
Q

Fuchs Dystrophy is what and how does a pt get this and can cause what risk

A
  1. Descemets membrane thickened + ANVIL SHAPED excrescents of BM (GUTTATA*) material in it
  2. more in women, inherited
  3. Psudophakic bullous Keratopathy
40
Q

Fuchs Dystrophy looks like what on PE

A

cornea is hazy and like bluish ground glass, distorted light reflex,
= blurred vision
= beaten metal appearance in fundus reflex

NMSP (5 decks)

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