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HEENT > Eyes > Flashcards

Eyes Flashcards

1
Q

Hemianopia

A

Loss of half the visual field. This relates to the brain’s impaired ability to receive the information transmitted to it through both eyes

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2
Q

Visual field loss on the same side in both eyes

A

Homonymous hemianopia

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3
Q

The visual field loss is on the same side that the lesion is on

A

Ipsilateral

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4
Q

The visual field loss is on the opposite side that the lesion is on

A

Contralateral

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5
Q

An area of reduced or absent vision within an otherwise intact visual field (an aura or blind spot that obstructs vision)

A

Scotoma

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6
Q

unequal size of the pupils

A

Anisocoria

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7
Q

etiology & #1 trmnt

“Pink Eye” Viral conjunctivitis

A

Adenovirus
#1 Cold Compress

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8
Q

Allergic Conjunctivitis Mild trmnt

A

Artificial tears

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9
Q

etiology & trmnt

Bacterial conjunctivitis

A

-S. aureus, S. pneumoniae, H. Flu, M. Catarrhalis
- Polymyxin B/Trimethorprim (polytrim), Bleph-10, Erythromycin ointmnet

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10
Q

What is this benign variant called?

A

Conjunctival Nevus = mole on eye

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11
Q

is Pinguecula or Pterygium harmful to your vision?

A

Pterygium

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12
Q

____ vs _____

A

Pinguecula - yellow-white, flat or slightly raised growth on the bublar conjunctiva
Pterygium - wing shaped fold of fibrovascular tissue. invades the cornea

both: degeneration of the deep conjunctival layers 2ndary to sunlight and chronic irritation

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13
Q

What & Trmnt?

A
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14
Q

what and trmnt?

mild pain, foreign body sensation, conjunctival and subconjunctival hemorrhages present. No changes in V/A exam. Hx of BB gun fights

A

Conjunctival Laceration
Fluorescein stain
CT or XR to r/o foreign body
- <1cm in length: erythromycin ointment
- >1cm in length: sx closure

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15
Q

trmnt?

A
  • ABX ointment
  • temporary taping
  • Sx often req
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16
Q

what & trmnt?

obese male with sleep apnea has chronically red irritated eye that is worse in the morning

A

Floppy Eyelid Syndrome
Trmnt: Lubricants, topical ABX, eyelid taping during sleep, Sx

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17
Q

what & trmnt

A

Xanthelasma

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18
Q

Most common eyelid tumor

an asymptomatic or mildly irritated eyelid lump

A

BCC

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19
Q

what & trmnt

painless lump inside the lid

A

internal chalazion
- warm compress, ophthalm ref

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20
Q

what & trmnt

tender nodule on the lid

A

Hordeolum
- Warm compress
- topical ABX: bacitracin, erythromycin ointment, polymyxin B
- refer if no imprvmnt ~2 weeks for Sx I&D

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21
Q

What & trmnt

eyelid margin itchy, burning, crusting, foreign body sensation

A

Blepharitis
- warm compress
- baby shampoo wash
- erythromycin or bacitracin if severe

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22
Q

Hordeolum vs Chalazion

A

Hordeolum is ON THE LID and caused by S. aureus

Chalazion is INSIDE THE LID and caused by noninfectious meibomian gland occlusion

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23
Q

what & trmnt

A

hyphema

bleeding into anterior chamber -> permanent vision loss
- Cycloplegia - Atropine sulfate (mydriatics)
- Analgesia, anti-emetics as needed

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24
Q

what

A

blowout frx

rule out globe fracture
augmentin

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25
Q

what & trmnt

A

globe rupture

vision test, slit-lamp exam, CT scan, eye shield

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26
Q

trmnt?

A

rule out globe fracture, eval lacrimal system, CT scan, eval ptosis, suture repair, refer to specialist, tetanus shot

eval ptosis for levator muscle injury

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27
Q

pathogens for preseptal (periorbital) & orbital cellulitis?

A
  • S. aureus & strep most common
  • **H. Flu **in unimmunized children (Hib)
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28
Q

what & trmnt?

inflamed lacrimal gland

A

Dacryoadenitis

most commonly idiopathic -> oral steroids
if infx -> Augmentin, Keflex

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29
Q

what, path, trmnt

Pain, redness, and swelling over the lacrimal sac

A

Dacryocystitis

staph, strep

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30
Q

orbital cellulitis trmnt

A
  • CT scan
  • IV ABX: unasyn, vanco, zosyn
  • CBC w/diff
  • Blood cultures
  • LP if meningitis suspected
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31
Q

preseptal cellulitis trmnt

A
  • CT to r/o cellulitis
  • Mild Cases: ABX (polytrim, Augmentin, Bactrim)
  • Severe: Hosp, Ampicillin/subactam (unasyn) IV
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32
Q

Pt’s with early symptoms of Myasthenia Gravis frequently present with ____

A

Eyelid Ptosis

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33
Q

Vertical nystagmus is a concern for?

A

CNS tumor

34
Q

Trmnt for chronically blocked tear duct that fails to respond to topical ABX

A

if not improved by 1 yo old, perform lacrimal probe

35
Q

what & trmnt

Acute onset of localized inflammation of the episcleral vessels. Mild pain, norm V/A exam, no discharge. Manipulation of the conjunctiva demonstrates vessel dilation beneath the conjunctiva affecting the sclera.

A

Episcleritis
Mild: cold compress, artifical tears
Mod-Severe: topical steroids, NSAIDs

36
Q

This dendritic or branching fluorescein stain pattern is a classic findings for _____

Copeland may call them “dendritic lesions”

A

Herpes simplex virus keratits

Aka herpetic corneal ucer,

37
Q

Most common risk factors for Iritis(Uveitis)

A

Taxoplasmosis, HSV(herpes simplex), VZV(varicella-zoster)

50% idiopathic

38
Q
A
39
Q
A
40
Q

Pinguecula & Pterygium trmnt

A

artificial tears
topical steroid drops if symp severe.
Severe cases require sx rmvl if you cant see

41
Q

Corneal abrasion trmnt

A

Non-contacts -> Erythromycin, bacitracin, polysporin ointment, polytrim drops
Fingernail injury -> Fluoroquinolone drops
Contact lens wearers need pseudomonas coverage -> Ciprofloxacin, Tobramycin

42
Q

Corneal abrasion trmnt for pt who scraped their eye with their dirty fingernails while taking out their contacts.

A

Ciprofloxacin drops

fingernails need fluoroquinolones
Contact-lens needs ciprofloxacin or tobramycin

43
Q

A small piece of metal fell into pts eye while they were working under their car. Very superficial and no globe penetration. Trmnt?

A

Rmvl under topical anesthesia
+ Topical ABX: Polytrim (polymyxin B/Trimethoprim)

44
Q

After you rmv metal from the cornea, you see it left a rust stain. Wdyd?

A

Diamond** burr** polishing is performed in office using anesthetic drops. The surface layer of the cornea is removed with a surgical sponge and blade. The diamond-dusted burr is then used to smooth the corneal surface

45
Q

Why are cycloplegics beneficial for intraocular foreign bodies?

A

Cycloplegics block ACH binding. If there’s something deeper in your eye, you want to paralyze the eye to avoid further trauma

a piece of metal deep in the eye may be held in place by any layers (ex. cornea). You don’t want your pupils to constantly constrict and dilate and cut your iris even further.

46
Q

How to tell if a foreign body is superficially within the cornea or deeper (intraocular)?

A

Corneal: milder symptoms, foreign body sensation, irritation, and pain
Intraocular: irregular pupil, asniscoric, viteous hemorrhage

You only have to paralyze the pupil if its deeper (intraocular)l

47
Q

Thing grayish white circle near cornea is concern for

A

hyperlipoproteinuria

48
Q

red, brown ring, sometimes shades green or blue. Concern for?

A

Wilson’s disease - build up of copper in the body

49
Q

What causes myopia?

A

point of focus is in front of retina due to cornea being TOO curvy or axial length TOO long

50
Q

What causes hyperopia

A

Farsightedness is due to flatter cornea or short axial length

51
Q

What causes presbyopia?

A

with age, the lens becomes more rigid and cant move to focus on objects up close very well

52
Q

Anisometropia

A

a significant difference b/w the refractive errors of the 2 eyes

53
Q

Emmetropia

A

normal vision

54
Q

Laser sx opts for refractive errors

A

Photorefractive keratotomy (PRK)
Laser in situ keratomileusis (Lasik)

PRK corrects the cornea

55
Q

4 month old child (+) for strabismus on PE. Trmnt?

A

nothing, normal visual axis alignment is achieved by 6 months

56
Q

Strabismus

A

misaligned eyes

57
Q

Concomitant Strabismus

A

Nonparalytic (naturally occurring)
misalignment EQUAL in all directions of gaze

58
Q

Incomitant strabismus

A

paralytic strabismus (not naturally occuring). Misalignment VARIES with direction of gaze

nerve dysfunction of mechanical restriction

59
Q

Amblyopia

A

“lazy eye” defective vision w/o identifiable organic cause. what the PATIENT SEES. Starts off as double vision (diplopia). Eventually, the brain compensates and only chooses one eye to look at

60
Q

Anisometropia

A

condition that occurs when your eyes have varying refractive powers, which can cause your eyes to focus unevenly

61
Q

How does chronic HTN affect your eyes?

A

as your arteries constrict more, it increases your risk for atherosclerosis. The build up of plaque looks like silver wire. The arteries look like they’re “nicking” the veins. A/V ratio change from 2:3 -> 1:3 or 1:4.

Other exam findings: exudates, hemorrhages, cotton-wool spots

62
Q

The most frequent cause of preventable blindness in the world

A

Cataract

63
Q

Cataract trmnt

A

Glasses (early dz)
Sx lens replacement (late dz)

64
Q

retinopathy is present in ___% of DM pts at initial dx

A

20

65
Q

Most common cause of adult blindness in USA

A

Diabetic retinopathy

most pts <65yo

66
Q

Proptosis

A

eyes bulging out

67
Q

a wing shaped fold of fibrovascular tissue that extends and invades the cornea resulting in impairment of vision

A

Pterygium

68
Q

a yellowish elevation extending from the medial canthus to the nasal cornea

A

Pinguecula

69
Q

Which CNs help you open and close your eyelids?

A

CN 3: Open
CN 7: Close

70
Q

ptosis relates to CN ___

A

CN III Occulomotor

71
Q

Contact lens wearers need pseudomonas coverage when treating bacterial infx. What classes are your go tos?

A

Topical aminoglycosides or fluoroquinolones

Aminoglycosides: gentamycin, tobramycin
Fluoroquinolones: ciprofloxacin

72
Q

tear-drop pupil + abnormal red light reflex

A

globe rupture

73
Q

what, WU, trmnt?

Sudden unilateral vision loss with scalp tenderness and headache

A

Temporal Arteritis
Labs: ESR>50
temporal artery biopsy
IV Methylprednisolone

74
Q

What does a high ESR mean?

A

measures how fast your RBCs sink. if you sink faster than normal, it may mean you have a medical condition causing inflammation.

75
Q

Hypopyon

A

collection of pus in anterior chamber of eye

76
Q

Cherry red spot

A

retinal artery occlusion

77
Q

Pale white spot

A

Retinoblastoma

78
Q

Cotton wool spots

A

Hypertensive Retinopathy or Diabetic Retinopathy

caused by lack of blood flow to small retinal arteries

79
Q

most common cause of blindness in ppl >65yo

A

Macular degeneration

80
Q

Meds that make glaucoma worse

A

Metoclopramide, Atropine

81
Q

what, etiology, trmnt

painful red eye with ircumcorneal conjunctival injection, blurry vision, light sensitivity,

A

Acute (anterior) Uveitis

toxoplasmosis, HSV, VZV
Cycloplegic paralytics (scopalamine, atropine), topical steroid (predisone)

HEENT (9 decks)

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