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Gen. + ocular emergencies > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Is proptosis bilateral or unilateral?

A

Unilateral

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2
Q

What disease is exophthalmos usually associated with?

A

Graves

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3
Q

What are the two main differences between Exophthalmos and proptosis?

A

Exo: bilateral, hereditary
Prop: unilateral, not-hereditary

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4
Q

What is the definition of Orbital Cellulitis?

A

Infection of the soft tissue behind the orbital septum

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5
Q

What is the usual cause of Orbital cellulitis?

A

Spread of infection from sinuses

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6
Q

What season is orbital cellulitis more common in?

A

Winter

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7
Q

Is orbital cellulitis more common in kids or adults?

A

Kids

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8
Q

Is Orbital cellulitis painful?

A

Yes, especially on eye movement

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9
Q

What is the treatment for orbital cellulitis?

A

Hospitalization with IV fluids and AB’s

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10
Q

If you can’t tell if you have a perceptual or orbital cellulitis, how do you proceed?

A

Er’ on side of caution always treat with AB’s

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11
Q

What are the two different types of exophthalmometers?

A

Hertel and Luedde

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12
Q

There’s usually a

A

2

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13
Q

What is the definition of Orbital Pseudotumor?

A

Non-specific inflammation of the orbit

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14
Q

What are the two tests and results you need to confirm you have a case of orbital pseudo tumor?

A

(-) MRI, (-) biopsy

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15
Q

Can you feel a nodule in Pseudotumor?

A

No

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16
Q

What is the hallmark sign of pseudo tumor?

A

S-Shaped lid

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17
Q

Is Orbital pseudotumor painful?

A

Yes

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18
Q

Is there proptosis with pseudo tumor?

A

Yes

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19
Q

Is pseudotumor unilateral or bilateral? Be specific

A

Unilateral in adults, 1/3 bilateral in children

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20
Q

How do you treat orbital pseudo tumor?

A

Steroids

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21
Q

Should you dilate if someone comes in with an eyelid injury?

A

YES

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22
Q

What are you going to recommend for your patient to do concerning their eyelid injury?

A

Cold compresses for 24hours and then warm

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23
Q

What is the first thing you need to rule out if you see an eyelid laceration?

A

Globe penetration

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24
Q

What makes an eyelid laceration more complicated?

A

When it involves the tear drainage system

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25
Q

If a foreign body is lodged in the eyelid that is made out of an inert material, what is the protocol?

A

Leave it in there

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26
Q

What if the foreign body in the eyelid is made out of an organic material, such as wood–what is the protocol?

A

Remove it because it can cause inflammation

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27
Q

How do you image to see what is in the eyelid depending u upon the material?

A

Usually do MRI, unless it is metal—do a CT

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28
Q

What is traumatic ptosis usually due to?

A

Hemorrhage in the levator

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29
Q

Is traumatic ptosis self-limiting?

A

Yes usually

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30
Q

What is the amount of time to wait for a traumatic ptosis to resolve?

A

6-9 Months

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31
Q

What do you do if the traumatic ptosis has not resolved in the 6-9 months?

A

Surgery for levator resecction

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32
Q

What physical sign will you sometimes see with traumatic ptosis patients?

A

Head tilt

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33
Q

What is the main sign/symptom of allergic dermatitis?

A

ITCH!

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34
Q

What are the three methods of treatment for allergic derm?

A

Cool compresses, removal of offending agent, steroids

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35
Q

Why do you want to not initially put the patient on a medication that removes symptoms of contact dermatitis?

A

Because this will prevent them from figuring the cause!

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36
Q

What is the definition of Dacryocystitis

A

Infection of the lacrimal sac

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37
Q

Dacryocycstitis is usually due to?

A

URTI

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38
Q

What is the onset for dacryocystitis?

A

Acute!

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39
Q

What is the reason why we don’t see Dacryocystitis as much in the AA population?

A

Shorter and wider canaliculi

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40
Q

What is the hallmark sign of Dacryocystisi?

A

Epiphora

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41
Q

What if the tears are bloody? it is still Dacryocystisis?

A

No

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42
Q

What is the treatment for Dacryocystitis?

A

oral/IV antibiotics

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43
Q

What should you NOT do to patients with Dacryocystisis?

A

DILATION AND IRRIGATION

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44
Q

What if the lacrimal sac bursts?

A

Need surgery: dacryocystorhinostomy

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45
Q

What is the definition of Dacryoadenitis?

A

Infection of the lacrimal gland

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46
Q

what is the main inflammatory cause of Dacryoadenitis?

A

sarcoid

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47
Q

What are the main viral causes of Dacryoadenitis?

A

mono and mumps

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48
Q

If Dacryoadenitis is due to a virus, what sign will be present?

A

Palpabale node

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49
Q

What is the onset like for Dacryoadenitis?

A

Slow

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50
Q

What is the shape of the lid in Dacryoadenitis?

A

S-shaped

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51
Q

What are the three difference in presentation appearance between pseudo tumor and Dacryoadenitis?

A

no proptosis in Dacryoadenitis, no pain, no decrease in eye movement

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52
Q

Which direction would the globe be displaced in Dacryoadenitis?

A

inferior medial

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53
Q

Hordeolum does NOT lead to what two different conditions?

A

Orbital pseudotumor and Dacryoadenitis

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54
Q

What is the definition of Hordeolum

A

Infection of meibomian, leis, moll gland

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55
Q

Will topical meds help hordeolum?

A

No

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56
Q

What CAN a hordeolum lead to?

A

Preseptal cellulitis

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57
Q

What should you educate your patient on immediately with a hordeolum?

A

DON’T TOUCH IT

58
Q

How do you differentiate hordeolum form perceptual cellulitis?

A

Discomfort and appearance

59
Q

What else can a hordeolum progress to?

A

Chalazia

60
Q

What are the two main treatments for hordelum?

A

WC and Oral antibiotic

61
Q

What part of the eye is affected by perceptual cellulitis?

A

Anterior to the orbital septum

62
Q

Is perceptual more common in kids or adults?

A

80% in kids

63
Q

What is perceptual cellulitis treated with?

A

AB’s

64
Q

When should perceptual start responding to AB?

A

24-48 hours

65
Q

Is a chalazia painful?

A

No

66
Q

What do you need to rule out if you have a recurring chalazia?

A

Sebaceous cell carcinoma

67
Q

What is the treatment strategy like for chalazia?

A

1st try warm compresses for an hour every day for 2 weeks, if still not resolved surgically remove it!

68
Q

What is the prophylactic treatment for chalazia?

A

Doxycycline

69
Q

Is chalazia an infection?

A

NO

70
Q

Will AB’s help resolve chalazia?

A

NO

71
Q

What is the discharge like for a viral conjunctivitis?

A

Watery

72
Q

What may be present on a patient with viral conjunctivitis that you will have to remove?

A

Pseudomembrane

73
Q

What is the incubation period for viral?

A

5-10 days

74
Q

How long does it take viral conj to resolve?

A

2 weeks

75
Q

If you suspect your patient has viral conj. what should you feel for?

A

Preauricular nodes

76
Q

What seems to be the most effective treatment of viral conj. if caught early enough?

A

Betadine wash

77
Q

Is bacterial conj as contagious as viral?

A

No

78
Q

What is the discharge like for bacterial conj?

A

Mucopurulent

79
Q

All are self limiting bacterial conjunctivitis’ except…

A

Neisseria

80
Q

What is the most common demographic to get bacterial conj?

A

KIDS

81
Q

How many AB’s do you try before culturing?

A

TWo

82
Q

What is the most frequent neonate conjunctivitis?

A

Chlamydia

83
Q

What is the most distinct sign of chllamydia?

A

FOLLICLES

84
Q

Does chlamydial infection have palpable nodes? What about bacterial conj?

A

Chlam: Yes
Bact: no

85
Q

What is the typical treatment for chlamydial infection?

A

Z pack -1000 mg

86
Q

What is the main symptom of allergic conjunctivitis?

A

Itching

87
Q

What are petechial hemes indicative of?

A

Patient rubbing their eyes too hard

88
Q

What type of allergic conj has the cobblestone papillae?

A

Vernal

89
Q

What is the looking glass conj?

A

When it swells because there is an antigen in the eye

90
Q

What is episcleritis usually due to?

A

Systemic inflammation

91
Q

What are the two types of episcleritis?

A

Diffuce and nodular

92
Q

What ist he treatment for episcleritis?

A

Self-limiting

93
Q

How do you diagnose episcleritis?

A

Phenyl with blanch

94
Q

What can scleritis present as a variant of?

A

Melanosis

95
Q

What are the three types of scleritis?

A

Diffuse, nodular, necrotizing

96
Q

What can happen to necrotizing scleritis/

A

Can spread to other eye

97
Q

Is scleritis painful?

A

YES VEYR MUCH

98
Q

What is usually used to treat scleritis?

A

Oral pred

99
Q

What are the three symptoms of ant uveitis?

A

Pain, redness and photophobia

100
Q

What is pain in ant uveitis usually due to?

A

Ciliary N involvement

101
Q

What is the decreased IOP caused by in ant uveitis?

A

Decreased production by CB

102
Q

What sort of uveitis cases should you have worked up?

A

BILATERAL

103
Q

What are the three main causes of recurrent uveitis?

A

JRA, TB, and SLE

104
Q

What do we usually use to treat ant. uveitis?

A

Pred 1% and homatropine 5%

105
Q

What is a plasmid aqueous?

A

greater than 4+ cells/flare

106
Q

Is traumatic uveitis easy to treat?

A

Yes! may only need homatropine

107
Q

When tapering Homatropine, which drop do you stop first?

A

MORNIGN, so they aren’t dilated during the day

108
Q

What are the two signs you NEED to diagnose AAC

A

high IOP and closed gonio

109
Q

What kind AAC patient will have a better prognosis for LPI”

A

open handle with indentation

110
Q

What is the most common type of AAC?

A

Pupillary block

111
Q

What type of AAC do you have to avoid dilating meds?

A

Plateau iris syndrome

112
Q

What is the first med you give to a ACC patient?

A

topical B-blocker (iopidine)

113
Q

How often do you check IOP in AAC?

A

15-30 min

114
Q

When can you use Pilo?

A

when IOP

115
Q

What should you refer your ACC patients for?

A

LPI

116
Q

Where are the holes from LPI most commonly made?

A

Temporally

117
Q

Should you be able to see a more open angle after LPI?

A

YES

118
Q

What are the two causes of CRAO?

A

Thrombus, embolus

119
Q

What will the FA for a CRAO show?

A

Delay on filling

120
Q

When should you give treatment a shot for CRAO?

A

If happened within 24 hours

121
Q

What are the tx options for CRAO

A

Ocular massage, paracentesis, breathe in paper bag, thrombolytics

122
Q

What are the two main signs of BRAO?

A

Dilated and trots vessels in all four quadrants and retinal hemes

123
Q

What are the two types of BRAO?

A

ichemic and non ichemic

124
Q

What are the two worst things with ischemic BRAO

A

terrible VA and NVI

125
Q

What do you use to treat if the eye is BRVO ischemic? What about the macular edema?

A

Ichemi: prp
CME: Focal or grid laser

126
Q

If someone is experiencing TMB what should you ordeR?

A

Carotid doppler

127
Q

What is the demographic for AAION?

A

older women, caucasian

128
Q

What signs will you see in the eye?

A

Edematous ON. with or without hemes,

129
Q

What is the essential test to establish GCA?

A

Temporal biopsy

130
Q

What is treatment for GCA?

A

Steroids

131
Q

Who do we co manage GCA patients with?

A

Rheumatologist

132
Q

What is the triad for optic neuritis?

A

Variable loss of vision, dyschormatopsia, eye pain

133
Q

What is usually the underlying etiology of ON?

A

MS

134
Q

What med may help ON patients heal fast?

A

Prednisone

135
Q

Where is the location of the lesion if there is biannual field loss

A

Tumor at the aneurysm

136
Q

What is the one disease process that can appear as a bi nasal VF loss?

A

Glaucoma

137
Q

What is the most common cause of a vitreous heme?

A

Trauma

138
Q

What is the RD you will need to treat the quickest?

A

Mac on superior detachment

139
Q

Can we diagnose papilledema?

A

No

140
Q

How long does it take for papilledema to resolve?

A

6-10 weeks

141
Q

What are the two things you should use to monitor papilledema?

A

Disc photos and VFs

Gen. + ocular emergencies (2 decks)

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