Final Exam Flashcards
1
Q
Is proptosis bilateral or unilateral?
A
Unilateral
2
Q
What disease is exophthalmos usually associated with?
A
Graves
3
Q
What are the two main differences between Exophthalmos and proptosis?
A
Exo: bilateral, hereditary
Prop: unilateral, not-hereditary
4
Q
What is the definition of Orbital Cellulitis?
A
Infection of the soft tissue behind the orbital septum
5
Q
What is the usual cause of Orbital cellulitis?
A
Spread of infection from sinuses
6
Q
What season is orbital cellulitis more common in?
A
Winter
7
Q
Is orbital cellulitis more common in kids or adults?
A
Kids
8
Q
Is Orbital cellulitis painful?
A
Yes, especially on eye movement
9
Q
What is the treatment for orbital cellulitis?
A
Hospitalization with IV fluids and AB’s
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
11
Q
What are the two different types of exophthalmometers?
A
Hertel and Luedde
12
Q
There’s usually a
A
2
13
Q
What is the definition of Orbital Pseudotumor?
A
Non-specific inflammation of the orbit
14
Q
What are the two tests and results you need to confirm you have a case of orbital pseudo tumor?
A
(-) MRI, (-) biopsy
15
Q
Can you feel a nodule in Pseudotumor?
A
No
16
Q
What is the hallmark sign of pseudo tumor?
A
S-Shaped lid
17
Q
Is Orbital pseudotumor painful?
A
Yes
18
Q
Is there proptosis with pseudo tumor?
A
Yes
19
Q
Is pseudotumor unilateral or bilateral? Be specific
A
Unilateral in adults, 1/3 bilateral in children
20
Q
How do you treat orbital pseudo tumor?
A
Steroids
21
Q
Should you dilate if someone comes in with an eyelid injury?
A
YES
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
23
Q
What is the first thing you need to rule out if you see an eyelid laceration?
A
Globe penetration
24
Q
What makes an eyelid laceration more complicated?
A
When it involves the tear drainage system
25
If a foreign body is lodged in the eyelid that is made out of an inert material, what is the protocol?
Leave it in there
26
What if the foreign body in the eyelid is made out of an organic material, such as wood--what is the protocol?
Remove it because it can cause inflammation
27
How do you image to see what is in the eyelid depending u upon the material?
Usually do MRI, unless it is metal---do a CT
28
What is traumatic ptosis usually due to?
Hemorrhage in the levator
29
Is traumatic ptosis self-limiting?
Yes usually
30
What is the amount of time to wait for a traumatic ptosis to resolve?
6-9 Months
31
What do you do if the traumatic ptosis has not resolved in the 6-9 months?
Surgery for levator resecction
32
What physical sign will you sometimes see with traumatic ptosis patients?
Head tilt
33
What is the main sign/symptom of allergic dermatitis?
ITCH!
34
What are the three methods of treatment for allergic derm?
Cool compresses, removal of offending agent, steroids
35
Why do you want to not initially put the patient on a medication that removes symptoms of contact dermatitis?
Because this will prevent them from figuring the cause!
36
What is the definition of Dacryocystitis
Infection of the lacrimal sac
37
Dacryocycstitis is usually due to?
URTI
38
What is the onset for dacryocystitis?
Acute!
39
What is the reason why we don't see Dacryocystitis as much in the AA population?
Shorter and wider canaliculi
40
What is the hallmark sign of Dacryocystisi?
Epiphora
41
What if the tears are bloody? it is still Dacryocystisis?
No
42
What is the treatment for Dacryocystitis?
oral/IV antibiotics
43
What should you NOT do to patients with Dacryocystisis?
DILATION AND IRRIGATION
44
What if the lacrimal sac bursts?
Need surgery: dacryocystorhinostomy
45
What is the definition of Dacryoadenitis?
Infection of the lacrimal gland
46
what is the main inflammatory cause of Dacryoadenitis?
sarcoid
47
What are the main viral causes of Dacryoadenitis?
mono and mumps
48
If Dacryoadenitis is due to a virus, what sign will be present?
Palpabale node
49
What is the onset like for Dacryoadenitis?
Slow
50
What is the shape of the lid in Dacryoadenitis?
S-shaped
51
What are the three difference in presentation appearance between pseudo tumor and Dacryoadenitis?
no proptosis in Dacryoadenitis, no pain, no decrease in eye movement
52
Which direction would the globe be displaced in Dacryoadenitis?
inferior medial
53
Hordeolum does NOT lead to what two different conditions?
Orbital pseudotumor and Dacryoadenitis
54
What is the definition of Hordeolum
Infection of meibomian, leis, moll gland
55
Will topical meds help hordeolum?
No
56
What CAN a hordeolum lead to?
Preseptal cellulitis
57
What should you educate your patient on immediately with a hordeolum?
DON'T TOUCH IT
58
How do you differentiate hordeolum form perceptual cellulitis?
Discomfort and appearance
59
What else can a hordeolum progress to?
Chalazia
60
What are the two main treatments for hordelum?
WC and Oral antibiotic
61
What part of the eye is affected by perceptual cellulitis?
Anterior to the orbital septum
62
Is perceptual more common in kids or adults?
80% in kids
63
What is perceptual cellulitis treated with?
AB's
64
When should perceptual start responding to AB?
24-48 hours
65
Is a chalazia painful?
No
66
What do you need to rule out if you have a recurring chalazia?
Sebaceous cell carcinoma
67
What is the treatment strategy like for chalazia?
1st try warm compresses for an hour every day for 2 weeks, if still not resolved surgically remove it!
68
What is the prophylactic treatment for chalazia?
Doxycycline
69
Is chalazia an infection?
NO
70
Will AB's help resolve chalazia?
NO
71
What is the discharge like for a viral conjunctivitis?
Watery
72
What may be present on a patient with viral conjunctivitis that you will have to remove?
Pseudomembrane
73
What is the incubation period for viral?
5-10 days
74
How long does it take viral conj to resolve?
2 weeks
75
If you suspect your patient has viral conj. what should you feel for?
Preauricular nodes
76
What seems to be the most effective treatment of viral conj. if caught early enough?
Betadine wash
77
Is bacterial conj as contagious as viral?
No
78
What is the discharge like for bacterial conj?
Mucopurulent
79
All are self limiting bacterial conjunctivitis' except...
Neisseria
80
What is the most common demographic to get bacterial conj?
KIDS
81
How many AB's do you try before culturing?
TWo
82
What is the most frequent neonate conjunctivitis?
Chlamydia
83
What is the most distinct sign of chllamydia?
FOLLICLES
84
Does chlamydial infection have palpable nodes? What about bacterial conj?
Chlam: Yes
Bact: no
85
What is the typical treatment for chlamydial infection?
Z pack -1000 mg
86
What is the main symptom of allergic conjunctivitis?
Itching
87
What are petechial hemes indicative of?
Patient rubbing their eyes too hard
88
What type of allergic conj has the cobblestone papillae?
Vernal
89
What is the looking glass conj?
When it swells because there is an antigen in the eye
90
What is episcleritis usually due to?
Systemic inflammation
91
What are the two types of episcleritis?
Diffuce and nodular
92
What ist he treatment for episcleritis?
Self-limiting
93
How do you diagnose episcleritis?
Phenyl with blanch
94
What can scleritis present as a variant of?
Melanosis
95
What are the three types of scleritis?
Diffuse, nodular, necrotizing
96
What can happen to necrotizing scleritis/
Can spread to other eye
97
Is scleritis painful?
YES VEYR MUCH
98
What is usually used to treat scleritis?
Oral pred
99
What are the three symptoms of ant uveitis?
Pain, redness and photophobia
100
What is pain in ant uveitis usually due to?
Ciliary N involvement
101
What is the decreased IOP caused by in ant uveitis?
Decreased production by CB
102
What sort of uveitis cases should you have worked up?
BILATERAL
103
What are the three main causes of recurrent uveitis?
JRA, TB, and SLE
104
What do we usually use to treat ant. uveitis?
Pred 1% and homatropine 5%
105
What is a plasmid aqueous?
greater than 4+ cells/flare
106
Is traumatic uveitis easy to treat?
Yes! may only need homatropine
107
When tapering Homatropine, which drop do you stop first?
MORNIGN, so they aren't dilated during the day
108
What are the two signs you NEED to diagnose AAC
high IOP and closed gonio
109
What kind AAC patient will have a better prognosis for LPI"
open handle with indentation
110
What is the most common type of AAC?
Pupillary block
111
What type of AAC do you have to avoid dilating meds?
Plateau iris syndrome
112
What is the first med you give to a ACC patient?
topical B-blocker (iopidine)
113
How often do you check IOP in AAC?
15-30 min
114
When can you use Pilo?
when IOP
115
What should you refer your ACC patients for?
LPI
116
Where are the holes from LPI most commonly made?
Temporally
117
Should you be able to see a more open angle after LPI?
YES
118
What are the two causes of CRAO?
Thrombus, embolus
119
What will the FA for a CRAO show?
Delay on filling
120
When should you give treatment a shot for CRAO?
If happened within 24 hours
121
What are the tx options for CRAO
Ocular massage, paracentesis, breathe in paper bag, thrombolytics
122
What are the two main signs of BRAO?
Dilated and trots vessels in all four quadrants and retinal hemes
123
What are the two types of BRAO?
ichemic and non ichemic
124
What are the two worst things with ischemic BRAO
terrible VA and NVI
125
What do you use to treat if the eye is BRVO ischemic? What about the macular edema?
Ichemi: prp
CME: Focal or grid laser
126
If someone is experiencing TMB what should you ordeR?
Carotid doppler
127
What is the demographic for AAION?
older women, caucasian
128
What signs will you see in the eye?
Edematous ON. with or without hemes,
129
What is the essential test to establish GCA?
Temporal biopsy
130
What is treatment for GCA?
Steroids
131
Who do we co manage GCA patients with?
Rheumatologist
132
What is the triad for optic neuritis?
Variable loss of vision, dyschormatopsia, eye pain
133
What is usually the underlying etiology of ON?
MS
134
What med may help ON patients heal fast?
Prednisone
135
Where is the location of the lesion if there is biannual field loss
Tumor at the aneurysm
136
What is the one disease process that can appear as a bi nasal VF loss?
Glaucoma
137
What is the most common cause of a vitreous heme?
Trauma
138
What is the RD you will need to treat the quickest?
Mac on superior detachment
139
Can we diagnose papilledema?
No
140
How long does it take for papilledema to resolve?
6-10 weeks
141
What are the two things you should use to monitor papilledema?
Disc photos and VFs
