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HOSA PATHOPHYSIOLOGY > Eyes and Ears Diseases and Disorders > Flashcards

Eyes and Ears Diseases and Disorders Flashcards

1
Q

What are the etiologies of refractive disorders (hyperopia, myopia, astigmatism, and presbyopia)?

A

possible genetic link, close work, degeneration

1) Hyperopia: abnormally short eyeball
2) Myopia: abnormally long eye
3) Astigmatism: abnormal cornea
4) Presbyopia: stiff lens

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2
Q

What are the clinical features of refractive disorders (hyperopia, myopia, astigmatism, presbyopia)?

A

S/S:
- blurry vision, eye fatigue, headaches

DIAGNOSTIC TESTS:
- retinoscopy

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3
Q

What’s the treatment and prognosis for refractive disorders?

A

TREATMENT:

  • eyeglasses or contact lenses
  • laser surgery

PROGNOSIS:
- excellent

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4
Q

What are the etiologies of nystagmus?

A
  • congenital factors

- (acquired) alcohol abuse, drug abuse, or neoplasm

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5
Q

What are the clinical features of nystagmus?

A

S/S:
- repetitve or involuntary movement of eyes, blurry vision

DIAGNOSTIC TESTS:
- external examination

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6
Q

What’s the treatment and prognosis for nystagmus?

A

TREATMENT:

  • treat underlying cause (tumor, substance abuse)
  • Kestenbaum procedure

PROGNOSIS:
- varies on underlying cause

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7
Q

What are the etiologies of strabismus?

A
  • (if early onset) associated with amblyopia
  • (if adult onset) diabetes mellitus, hypertension, intracranial lesion, muscular dystrophy, or trauma -> impaired brain, cranial nerves, or orbital muscles
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8
Q

What are the clinical features of strabismus?

A

S/S:
- esotropia (inwards), exotropia, (outwards), and diplopia

DIAGNOSTIC TESTS:

  • abnormal opthalmic examination
  • abnormal radiographic and blood test readings with late onset causes
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9
Q

What’s the treatment and prognosis for strabismus?

A

TREATMENT:
- corrective eyeglasses or surgery

PROGNOSIS:

  • good if early onset
  • variable if late onset
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10
Q

What are the etiologies of blepharitis?

A
  • staphyloccal infection (ulcerative), or hypersensitivity, irritants, or meibomian gland dysfunction (nonulcerative) -> eyelid inflammation
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11
Q

What are the clinical features of blepharitis?

A

S/S:
- erythema and crusting of eyelids, burning sensation, falling out eyelashes

DIAGNOSTIC TESTS:
- collarettes seen with visual examination

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12
Q

What’s the treatment and prognosis of blepharitis?

A

TREATMENT:

  • wash with baby shampoo and water solution
  • bacitracin or erythromycin

PROGNOSIS:
- if untreated, may progress to keratitis and conjunctivitis

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13
Q

What are the etiologies of a hordeolum (or stye)?

A

staphyloccal infection, blepharitis -> abscess of follicule or meibomian gland

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14
Q

What are the clinical features of a hordeolum (or stye)?

A

S/S:
- erythema, swelling, pus, pain

DIAGNOSTIC TESTS:
- signs/symptoms present during examination

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15
Q

What’s the treatment and prognosis for a hordeolum (or stye)?

A

TREATMENT:

  • warm compresses
  • topical antibiotics
  • surgical drainage of abscess

PROGNOSIS:
- usually self-limiting

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16
Q

What’s the etiology of a chalazion?

A

blocked meibomian glands -> subcutaneous nodule

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17
Q

What are the clinical features of a chalazion?

A

S/S:
- small/firm nodule, possible erythema, pain, and swelling

DIAGNOSTIC TESTS:
- signs/symptoms present with examination

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18
Q

What’s the treatment and prognosis of a chalazion?

A

TREATMENT:

  • warm compress
  • gentamicin, tobramycin, azithromycin, or quinolone
  • corticosteroids

PROGNOSIS:
- usually resolves

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19
Q

What are some risk factors and etiologies of keratitis?

A

RISK FACTORS:
- wearing contact lenses

ETIOLOGY:
HSV-1, certain bacteria, certain fungi, corneal trauma, or dry air -> corneal inflammation

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20
Q

What are the clinical features of keratitis?

A

S/S:
- irritation, erythema, tearing, decreased visual acuity, and photophobia

DIAGNOSTIC TESTS:

  • cultures may identify a pathogen
  • slit lamp shows inflamed cornea
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21
Q

What’s the treatment and prognosis of keratitis?

A

TREATMENT:
- broad-spectrum antibiotics or antiviral drugs

PROGNOSIS:
- risk of corneal damage

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22
Q

What’s the etiology of entropion?

A

degeneration of lower eyelids -> eyelids turn inwards and irritate cornea and conjunctiva

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23
Q

What are the clinical features of entropion?

A

S/S:
- redness, itching, tearing, feeling a “foreign body”

DIAGNOSTIC TESTS:
- eyelid inversion present during examination

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24
Q

What’s the treatment and prognosis of entropion?

A

TREATMENT:
- surgical correction

PROGNOSIS:

  • good with surgery
  • risk of corneal damage
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25
Q

What are the etiologies of ectropion?

A

age-related degeneration or scar that pulls eyelid (cicatricial) -> outward bending eyelid

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26
Q

What are the clinical features of ectropion?

A

S/S:
- abnormal tear flow, dry eyes

DIAGNOSTIC TESTS:
- outward bend present during examination

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27
Q

What’s the treatment and prognosis of ectropion?

A

TREATMENT:
- surgical correction

PROGNOSIS:

  • good with surgery
  • risk of corneal damage
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28
Q

What are the etiologies of blepharoptosis?

A

myasthenia gravis, muscular dystrophy -> weakness of CN III or eyelid muscle

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29
Q

What are the clinical features of blepharoptosis?

A

S/S:
- drooping upper eyelid, possible visual obstruction

DIAGNOSTIC TESTS:

  • ptosis present during examination
  • possible abnormal blood tests
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30
Q

What’s the treatment and prognosis for blepharoptosis?

A

TREATMENT:

  • surgical correction
  • systemic medication, depending on cause\

PROGNOSIS:
- good with treatment

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31
Q

What are the etiologies of conjunctivits?

A

viral infection, bacterial infection, chemical irritants OR hypersensitivity (vernal) -> conjunctival inflammation

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32
Q

What are the clinical features of conjunctivitis?

A

S/S:

  • redness, itching, tearing, photophobia, foreign body sensation
  • discharge if infectious
  • coarse eyelid if vernal

DIAGNOSTIC TESTS:

  • conjunctival inflammation present with examination
  • (if infectious) postive viral or bacterial culture
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33
Q

What’s the treatment and prognosis for conjunctivitis?

A

TREATMENT:

  • cool or warm compress
  • antibiotics

PROGNOSIS:
- usually good

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34
Q

What are some risk factors and etiologies of keratoconjunctivitis sicca (or dry eye syndrome)?

A

RISK FACTORS:

  • being female
  • > 50yrs old, wearing contact lenses
  • vitamin A deficiencies

ETIOLOGY:
degeneration, inflammation, Sjrogen’s syndrome, prior radiation therapy, certain drugs -> inadequate tear production

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35
Q

What are the clinical features of keratoconjunctivitis sicca?

A

S/S:
- redness, itching and burning, foreign body sensation, tearing, photophobia

DIAGNOSTIC TESTS:
- dry eyes present during examination

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36
Q

What’s the treatment and prognosis for keratoconjunctivitis sicca?

A

TREATMENT:

  • eye drops
  • cyclosporine and lifitegrast

PROGNOSIS:

  • better with treatment
  • treatment may be lifelong
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37
Q

What are the etiologies of a corneal abrasion? Of a corneal ulcer?

A
  • (corneal abrasion) foreign bodies between eyelid and cornea, direct trauma, and poorly-fitted contacts -> loss of corneal epithelium
  • (corneal ulcer) an untreated or undertreated corneal abrasion -> infection of cornea
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38
Q

What are the clinical features of a corneal abrasion (and ulcer)?

A

S/S:
- redness, tearing, pain, foreign body sensation, and blurry vision

DIAGNOSTIC TESTS:
- positive flourescein eye stain

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39
Q

What’s the treatment and prognosis of a corneal abrasion (and ulcer)?

A

TREATMENT:

  • remove foreign body
  • opthalmic antibiotics
  • eye dressing

PROGNOSIS:
- usually self-limiting, but possible complication of infection and scarring

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40
Q

What are the etiologies of episcleritis and scleritis?

A
  • (episcleritis) currently idiopathic -> superficial sclera inflammation
  • (scleritis) link with autoimmune diseases such as rheumatoid arthritis and chron’s disease/ulcerative colitis -> deep sclera inflammation
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41
Q

What are the clinical features of episcleritis and scleritis?

A

S/S:

  • (epislceritis) redness and irritation
  • (scleritis) intense redness, pain, blurry vision

DIAGNOSTIC TESTS:

  • blood tests may reveal autoimmune/infectious cause
  • ultrasonography, MRI, and/or CT may reveal extent of inflammation
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42
Q

What’s the treatment and prognosis of episcleritis and scleritis?

A

TREATMENT:

  • opthalmic corticosteroids
  • possible immunosupressive drugs
  • scleroplasty

PROGNOSIS:
- good

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43
Q

What are the etiologies of a cataract?

A
  • being older than 40 -> opacification of lens (risk increases each decade)
  • (less commonly) congenital defects, “stamp” trauma, diabetes mellitus, or sunlight -> staining of lens
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44
Q

What are the clinical features of a cataract?

A

S/S:

  • progressively impaired vision
  • white discoloration of pupil

DIAGNOSTIC TESTS:
- opthalmoscopy and slit-lamp examination reveal cataract

45
Q

What’s the treatment and prognosis of a cataract?

A

TREATMENT:

  • phacoemulsification or extracapsular surgery
  • eyeglasses

PROGNOSIS:
- surgery usually successful

46
Q

What are the etiologies of open-angle and closed-angle glaucoma?

A
  • (open-angle) ocular trauma, diabetes mellitus, age-related degeneration -> block WITHIN trabecular meshwork -> increased IOP
  • (closed-angle) iris root or iris-corneal adhesions blocks trabecular meshwork -> increased IOP
47
Q

What are the clinical features of open-angle and closed-angle glaucoma?

A

S/S:

  • (open-angle, chronic) progressive vision loss
  • (closed-angle, acute) eye pain, blurry vision, photophobia, nausea

DIAGNOSTIC TESTS:

  • tonometry reveals increased IOP
  • goniolens identifies if glaucoma is open-angle or closed-angle
48
Q

What’s the treatment and prognosis of open-angle and closed-angle glaucoma?

A

TREATMENT:

  • (open-angle) prostaglandin analogues, laser trabeculoplasty, or trabeculectomy
  • (closed-angle) laser iridotomy

PROGNOSIS:
- if left untreated, may cause irreversible blindness

49
Q

What are the etiologies of macular degeneration?

A

genetic factors, age-related degeneration, and sunlight exposure ->

  • (atrophic) dry degeneration of macula lutea
  • (exudative) abnormal blood vessels grow and rupture -> macula lutea degeneration
50
Q

What are the clinical features of macular degeneration?

A

S/S:
- (affects both eyes) progressive worsening of central vision, semiopaque spots in vision

DIAGNOSTIC TESTS:

  • opthalmosocope reveals pigmentary changes
  • flourescein angiography identifies if atrophic or exudative
51
Q

What’s the treatment and prognosis of macular degeneration?

A

TREATMENT:

  • vitamin supplements to slow degeneration
  • anti-vascular endothelial growth factor (anti-VEGF) if exudative
  • laser photocoagulapathy if exudative

PROGNOSIS:
- no cure is known, central vision may disappear completely

52
Q

What’s the pathogenesis of diabetic retinopathy?

A

(develops around 10 years after diagnosis)

uncontrolled diabetes mellitus -> poor retinal circulation (nonproliferative) -> exudate leakage into vitreous humor -> neovascularization (proliferative) with further leakage

53
Q

What are the clinical features of diabetic retinopathy?

A

S/S:
- progressive worsening of visual acuity

DIAGNOSTIC TESTS:
- complete opthalmoscopic examination reveals neovascularization and macular edema

54
Q

What’s the treatment and the prognosis for diabetic retinopathy?

A

TREATMENT:
- (if proliferative) laser photocoagulation, vitrectomy to draw out vitreous fluid

PROGNOSIS:
- guarded, but controllable with treatment

55
Q

What are the etiologies of retinal detachment?

A

severe proliferative diabetic retinopathy, myopia, or ocular trauma -> tear in retina -> exudative fluid pushes section away

56
Q

What are the clinical feature of retinal detachment?

A

S/S:
- sudden eye floaters, dark “curtain” shadow in vision

DIAGNOSTIC TESTS:
- opthalmoscopy reveals detachment

57
Q

What’s the treatment and prognosis of retinal detachment?

A

TREATMENT:
- photocoagulation

PROGNOSIS:
- resulting blindness is irreversible

58
Q

What are the etiologies of uveitis?

A

autoimmune disorders (including juvenile rheumatoid arthritis and ankylosing spondylitis) or infections -> inflammation of ciliary body, choroid, and iris

59
Q

What are the clinical features of uveitis?

A

S/S:
- pain, redness, blurry vision, photophobia

DIAGNOSTIC TESTS

  • slit lamp shows uveal inflammation
  • blood tests may reveal autoimmune causes
60
Q

What’s the treatment and prognosis for uveitis?

A

TREATMENT:
- opthalmic or systemic steroids

PROGNOSIS
- varies with extent of condition and etiology

61
Q

What’s the most common etiology of exopthalmos?

A

hyperthyroidism -> enlarged extraorbital muscles, increased retrobulbal mass, edema of surrounding tissue -> eyes “pop” out

62
Q

What are the clinical features of exopthalmos?

A

S/S:
- protruding eyes, dryness, possible double vision

DIAGNOSTIC TESTS:
- CT and blood tests may assess thyroid function

63
Q

What’s the treatment and prognosis for exopthalmos?

A

TREATMENT:

  • (if from hyperthroidism) thyroid hormone antagonists or partial thyroidectomy
  • surgical intervention

PROGNOSIS:
- usually good with treatment

64
Q

What are the types of eye tumors and their etiologies?

A

1) Retinoblastoma: usually an inherited mutation on c13
2) Ocular Melanoma: higher prevalence in caucasians
3) Basal Cell Carcinoma: overexposure of sunlight to eyelid
4) Squamous Cell Papilloma: HPV infection

65
Q

What are the clinical features of eye cancer?

A

S/S:

  • possible pain
  • visible lesion on eyelid (if BCC/SCC)
  • growing pigmentatin on iris (if ocular meloma)
  • leukocoria (if retinoblastoma)

DIAGNOSTIC TESTS:

  • ultrasound, opthalmoscopy, CT, and MRI may reveal neoplasms
  • biopsy may reveal histology
66
Q

What’s the treatment and prognosis of eye cancers?

A

TREATMENT:
- eyeball removal or surgical excision, chemotherapy, radiation therapy, and/or laser therapy

PROGNOSIS:

  • 5-year survival rate generally good
  • retinoblastoma associated with future malignancies
67
Q

What’s the etiology and diagnosis of a color vision impairment?

A

ETIOLOGY:
- usually inheritance of X-linked recessive genes

DIAGNOSTIC TESTS:
- multicolored eye charts

68
Q

What are the etiologies of impacted cerumen?

A

abnormally narrow ear canal, excessive hair -> cerumen (earwax) accumulated

69
Q

What are the clinical features of impacted cerumen?

A

S/S:
- muffled hearing, pressure, tinnitus, earache

DIAGNOSTIC TESTS:
- otologic examination reveals excess earwax

70
Q

What’s the treatment and prognosis of impacted cerumen?

A

TREATMENT:
- irrigation of ear

PROGNOSIS:
- great, but recurrence is likely

71
Q

What are the etiologies of infective otitis externa?

A

excessive earwax, frequent use of earphones/earplugs -> bacterial or fungal growth

71
Q

What are the etiologies of infective otitis externa?

A

excessive earwax, frequent use of earphones/earplugs -> bacterial or fungal growth

72
Q

What are the clinical features of infective otitis externa?

A

S/S:
- hearing loss, severe earache, swollen ear canal, pruritis, fever, ear discharge

DIAGNOSTIC TESTS:

  • otoscopy reveals inflammation
  • culture may identify pathogen
73
Q

What’s the treatment and prognosis of infective otitis externa?

A

TREATMENT:

  • antibiotic eardrops
  • steroidal eardrops

PROGNOSIS:
- good with treatment

74
Q

What is the etiology of swimmer’s ear?

A

accumulation of earwax in outer ear canal -> swimming adds water-> serves as medium for bacterial or fungal cultures

75
Q

What are the clinical features of swimmer’s ear

A

S/S:
- severe pain, hearing loss, swollen ear canal, fever, pruritis, discharge

DIAGNOSTIC TESTS:

  • otoscopy reveals inflammation
  • culture may identify pathogen
76
Q

What’s the treatment and prognosis for swimmer’s ear

A

TREATMENT:

  • antibiotic eardrops
  • steroidal eardrops
  • AVOID WATER-RELATED ACTIVITES!!!

PROGNOSIS:
- good with treatment, may recur with swimming

77
Q

What are the etiologies of serous otitis media?

A
  • (if acute) upper respiratory viral infection or hypersensitivity -> inflammation of middle ear
  • (if chronic) untreated acute serous otitis media, enlarged adenoid glands -> recurrent inflammation of middle ear
78
Q

What are the etiologies of suppurative otitis media?

A

dysfunctional estuchian tube, ruptured tympanic membrane -> bacteria breaches middle ear

79
Q

What are the clincial features of otitis media?

A

S/S:

  • (if serous) mild pressure, muffled hearing, watery discharge
  • (if suppurative) severe pain, hearing loss, fever, nausea and vomiting, dizziness

DIAGNOSTIC TESTS:

  • otoscopy reveals discharge and inflammation
  • fluid culture may reveal bacteria and elevated WBCs if suppurative
80
Q

What’s the treatment and prognosis of otitis media?

A

TREATMENT:

  • analgesics
  • antibiotic ear drops (only if confirmed as suppurative)
  • myringotomy

PROGNOSIS:
- good with therapy

81
Q

What are the etiologies of otosclerosis?

A

possible genetic factors, being female -> abnormal growth of spongy bone around stapes

82
Q

What are the clinical features of otosclerosis?

A

S/S:
- (onset begins in young adulthood) diminished hearing and tinnitus

DIAGNOSTIC TESTS:

  • poor audigram results
  • CT scan reveals abnormal bone growth
83
Q

What’s the treatment and prognosis of otosclerosis?

A

TREATMENT:
- stapedectomy with ceramic or plastic prosthesis

PROGNOSIS:
- positive with surgical intervention

84
Q

What are the predisposing factors and physiologic features of Meniere disease?

A

PREDISPOSING FACTORS:
- being >50 years old, otitis media, head trauma, noise pollution, premenstrual edema

PHYSIOLOGY:

  • increased endolymph
  • cilial cell destruction
85
Q

What are the clinical features of Meniere disease?

A

S/S:
recurrent episodes of vertigo (dizziness, nausea, sweating), tinnitus, diminished hearing, and inner ear pressure

DIAGNOSTIC TESTS:

  • poor adiogram results
  • MRI rules out other pathologies
86
Q

What’s the treatment and prognosis of Meniere disease?

A

TREATMENT:

  • salt-free diet with diuretics
  • surgical destruction of labyrinth

PROGNOSIS:

  • controlled by treatment
  • rate of hearing loss greatest during first years of disease, then stablizes afterwards
87
Q

What are the etiologies of benign paroxysmal positional vertigo (or BPPV)?

A

head trauma, otitis media, or free-floating carbonate crystals in labyrinth -> impaired vestibular system (includes the laybrinth and cochlea, vestibular nerve, brainstem and cerebellum)

88
Q

What are the clinical features of benign paroxysmal positional vertigo (or BPPV)

A

S/S:

  • (occurs with changing position) “spinning” sensation, loss of balance, and nausea lasting for 3-10 seconds
  • diminished hearing

DIAGNOSTIC TESTS:

  • signs/symptoms present
  • CT or MRI rules out CNS pathology
89
Q

What’s the treatment and prognosis of benign paroxysmal positional vertigo (or BPPV)?

A

TREATMENT:

  • movement exercises
  • antihistamines or antiemetics if highly disruptive

PROGNOSIS:
- controlled by treatment, may resolve with time

90
Q

What are the etiologies of labyrinthitis?

A

viral/bacterial otitis media or meningitis -> infection of labyrinth

91
Q

What are the clinical features of labyrinthitis?

A

S/S:
- fever, extreme vertigo, nausea, tinnitus

DIAGNOSTIC TESTS:

  • signs/symptoms present
  • poor adiometry results
92
Q

What’s the treatment and prognosis of labyrinthitis?

A

TREATMENT:

  • antihistamines, antiemetics, tranquilizers
  • antibiotics if bacterial
  • possoble corticosteroids if autoimmune

PROGNOSIS:

  • resolves after 1-3 weeks
  • risk of permanent hearing loss or balance problems
93
Q

What are the etiologies of a ruptured tympanic membrane?

A

extremely loud noise, foreign objects, or severe otitis media -> ruptured eardrum

94
Q

What are the clinical features of a ruptured tympanic membrane?

A

S/S:
- slight pain, diminished hearing, possible bleeding from ear

DIAGNOSTIC TESTS:
- otoscopy reveals hole in tympanic membrane

95
Q

What’s the treatment and prognosis of a ruptured eardrum?

A

TREATMENT:

  • tympanoplasty
  • prophylactic antiobiotics and analgesics

PROGNOSIS:
- eardrum usually heals within 1-2 weeks

96
Q

What are the etiologies of a cholesteatoma?

A

chronic otitis media -> inflammed and occluded estuchian tube -> negative middle ear pressure -> skin cells accumulate (cholesteatoma) and become infected

97
Q

What are the clinical features of a cholesteatoma?

A

S/S:
- diminished hearing, earache, headache, possible purulent discharge

DIAGNOSTIC TESTS:

  • otoscopy reveals eardrum retraction
  • radiographic studies show extent of cholesteatoma
  • fluid culture identifies pathogen
98
Q

What’s the treatment and prognosis of a cholesteatoma?

A

TREATMENT:
- surgical destruction of cholesteatoma with estuchian tube inflation

PROGNOSIS:

  • best with early surgical intervention
  • complications may include deafness, labyrinthitis, and Bell’s palsy
99
Q

What are the etiologies of mastoiditis?

A

untreated acute otitis media, extensive cholesteatoma -> Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella cattarhalis infection of mastoid bone

100
Q

What are the clinical features of mastoiditis?

A

S/S:
- pain, headache, diminished hearing, fever, discharge

DIAGNOSTIC TESTS:

  • CT reveals mastoid deformities
  • blood tests reveal elevated WBCs
  • positive culture study
101
Q

What’s the treatment and prognosis of mastoiditis?

A

TREATMENT:

  • antibiotic therapy
  • simple mastoidectomy

PROGNOSIS:

  • varies with extent of infection and response to antibiotics
  • complications may include permanent deafness, facial paralysis, and meningitis or encephalitis
102
Q

What are the etiologies of sensironeural hearing loss?

A

age-related degeneration, loud noises, certain drugs, inner ear infections, or trauma -> damage to basilar membrane or auditory nerve

103
Q

What are the clinical features of sensironeural hearing loss?

A

S/S:
- partial to severe hearing loss, tinnitus

DIAGNOSTIC TESTS:
- audiometry reveals poor hearing

104
Q

What’s the treatment and prognosis of sensironeural hearing loss?

A

TREATMENT:
- prevent further damage through reducing noise

PROGNOSIS:
- sensironeural hearing loss is irreversible

105
Q

What are the types of benign ear tumors?

A
  • (if external) glomus tumor or ceruminal gland neoplasm

- (if inner) acoustic neruoma or facial neuroma

106
Q

What are the types of malignant ear tumors?

A

BCC, SCC, or ceruminal gland neoplasm

*middle ear malignancy uncommon

107
Q

What are the clinical features of ear tumors?

A

S/S:

  • progressive hearing loss, tinnitus, dizziness, discharge
  • (if glomus neoplasm) pulsitate tinnitus

DIAGNOSTIC TESTS:

  • otoscopy may reveal lesion
  • MRI/CT may reveal extent of neoplasm
  • biopsy may reveal histology
108
Q

What’s the treatment and prognosis of ear tumors?

A

TREATMENT:

  • surgical excision
  • nerve graft if CN affected

PROGNOSIS:
- generally good with treatment, but poor if SCC

HOSA PATHOPHYSIOLOGY (13 decks)

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