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ped exam 1 > eye pedi > Flashcards

eye pedi Flashcards

1
Q

When should a Red Reflex be checked?

A

at birth til age two

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2
Q

What are you looking for in a red reflex?

A

Look for cataracts/pupil opacities

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3
Q

What do we look for when looking in eye?

A

Any abnormality (blunting, absence, white reflex or dark areas must be referred to Ophthalmology

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4
Q

What eye test is used to check red reflex?

A

Bruckners

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5
Q

Who do we refer to pediatric opthamologist regardless of red reflex results?

A

infants and children with a positive family history of:–Cataracts (infant, juvenile or congenital)–Retinoblastoma–Glaucoma–Retinal Abnormalities

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6
Q

Esotropia, Exotropia, hypotropia, hypertropia

A

in, out, down, up

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7
Q

What eye test is used to check for tropias?

A

hirschburg-corneal light reflex

test ocular mobility and alignment

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8
Q

when does normal tearing start in newborn?

A

2 weeks

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9
Q

Sx of blocked tear ducts

A

watery eyes, matting, mucous, tear lakes are noted

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10
Q

how to treat blocked tear duct?

A

massage

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11
Q

what is blocked tear duct called?

A

Dacryostenosis

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12
Q

most common cause of conjunctivitis in newborn?

A

Chlamydial conjunctivitis is the most common: 6.2:1000 live birth

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13
Q

Prophylaxis for gonnorea conjunctivitis

A

Prophylaxis–A single dose of 1% silver nitrate, .5% erythromycin and 1% tetracycline are equally effective for ocular gonorrhea prophylaxis.Silver nitrate may be better in regions where penicillinase producing gonorrhea is prevalent

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14
Q

What medications will reduce incidence of chlaymydia

A

Tetracycline and silver nitrate reduce the incidence of chlamydia, but do not eradicate nasopharyngeal colonization or pneumonia

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15
Q

What are the lab testing for conjunctivitis

A

Lab testing:Conjunctival scraping: Gram stain
, Giemsa stain used for staining protozoan parasites such as Plasmodium and Trypanosoma
-culture on chocolate agar–Chocolate agar is used for growing fastidious respiratory bacteria, such as Haemophilus influenzae and Neisseria meningitidis.
Blood Culture–
HSV Culture

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16
Q

presentation of chlamydia conjunctivitis-how many days?

A

5- 14 days

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17
Q

clinical manifestations of chlamydial conjunctivitis

A

bilateral or bilateral watery discharge which can become purulent and copious–
Hyperemia, eye swelling, chemosis–
Pseudomembranes, thickened conjunctiva, corneal opacification can develop–
Concomitant pneumonitis, OM, pharyngeal and rectal colonization

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18
Q

Tx for chlamydial conjunctivitis

A

Treatment: Oral erythromycin (50mg/kg/day divided qid)
Second course if often required
Topical erythromycin can be beneficial as an adjunctive therapy

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19
Q

When does Gonococcal conjunctivitis appear?

A

presents within 48 hours of birth

20
Q

clinical manifestations of Gonococcal conjunctivitis

A

marked eyelid edema, chemosis and purulent discharge–A conjunctival membrane and/or a corneal ulcer which can lead to perforation of the globe

21
Q

systemic manifestations of Gonococcal conjunctivitis

A

systemic manifestations: septicemia, anorectal infection, arthritis, meningitis, rhinitis, stomatitis.

22
Q

Treatment for Gonococcal conjunctivitis

A

Treatment–Topical erythromycin ointment–Rocephin 30-50mg/kg/day in divided doses or single dose cefotaxime 100mg/kg/IV or IM–Frequent eye irrigation until discharge resolve

23
Q

When does Herpetic Conjunctivitis present

A

within two weeks of life

24
Q

Clinical presentation of Herpetic conjunctivitis

A

Lid edema, injection, serosanguinous discharge–Involves the corneal epithelium or peri-orbital skin vesicles

25
Q

What are the systemic manifestations of herpetic conjunctivitis?

A

Serious systemic issue - encephalitis

26
Q

Treatment for herpetic conjunctivitis

A

Systemic Acyclovir: 30mg/kg/day divided tid x14-21 day

27
Q

What are most common pathogens of Bacterial Conjunctivitis

A

–Staph, strep are the most common pathogens

28
Q

Clinical manifestations of Bacterial conjunctivitis

A

Lid edema, chemosis, drainage, injection

29
Q

Treatment pending lab results for bacterial conjunctivitis

A

Topical e-mycin-

IM/IV third generation cephalosporin

30
Q

causes of conjunctivitis

A 
Bacterial & Viral –
Allergy–
Trauma & Foreign Bodies–
Tumors–
Blepharitis
31
Q

What do you check for when patient has conjunctivitis

A

IARM–Inspection–Acuity–Red Reflex–Motility

32
Q

Tx for conjunctivitis

A

Fluorescein Staining
Treatment – topical abx
Refer if ulcer,
no improvement in 5-7 days

33
Q

Symptoms of allergic conjunctivitis

A

Symptoms–Itchy, watery eyesMay nasal symptoms as wel

34
Q

Tx for allergic conjunctivitis

A

Treatment–Mast Cell Stabilizer/Antihistamine drops–Oral antihistamines–Steroids only for severe case

35
Q

Corneal abrasion clinical symptoms and treatment. referral?

A 
History of trauma to eye
Pain, 
photosensivity, 
tearing
Topical antibiotics
Ophthalmology consultation
36
Q

when is retinoblastoma usually discovered

A

before 4 years of age

37
Q

Sx of retinoblastoma

A

Infants with familial disease-monitoringSymptoms–Leukocoria -Cat eye reflex–
Strabismus–
Pain

38
Q

management of retinoblastoma

A

% no reoccurrence and survival rate–Enucleation, radiation, brachytherapy, cryosurgery, , chemotherapy

39
Q

Definition of sinusitis

A

URI symptoms lasting more than 10 days, but fewer than 30

40
Q

symptoms of sinusitis

A

Cough–Nasal Drainage–Halitosis–Fever–Headache/Facial Pain–Orbital redness/swellingrythema/Swelling of nasal mucosa
Pale, boggy mucosa
Sinus tenderness upon palpation

41
Q

Sinusitis treatment:

A

Treatment–
Antimicrobials–
Antihistamines/Decongestants–
Saline drops/spray

42
Q

What are the systemic manifestations of chlamydial conjunctivitis

A

Concomitant pneumonitis, OM, pharyngeal and rectal colonization

43
Q

hsv-what can you see in eye that you dont see in chlamydia and gonorrhea

A

dendrites

44
Q

sx of chlamydial infection

A

When newborns get a chlamydial infection from their mothers, they may develop eye inflammation (conjunctivitis) with redness, swelling, and discharge, with or without pneumonia. The pneumonia often causes cough and rapid breathing. If illness is present, it typically begins after an incubation period of 1 to 3 weeks.

45
Q

what is the white reflex on retina called

A

leukokoria (white reflex)

46
Q

what is strabismus

A

Defect in ocular alignment, one or both eyes appear crossed, persistent squinting, head tilting. Intermittent extropia normal in kids 6mo-4yr when tired.
Dx: Corneal light reflection, cover-uncover test
Tx: Refer to ophthalmologist if >4months, occlude unaffected eye (2hrs/day), corrective lenses, monitor siblings.

ped exam 1 (8 decks)

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