Glaucoma + Papilledema Flashcards
A 65-year-old man has progressive peripheral vision loss. Examination shows increased intraocular pressure and optic disc cupping. Which structure is most likely impaired in aqueous humor drainage?
A. Trabecular meshwork
B. Canal of Schlemm
C. Ciliary body
D. Choroid
A
A 72-year-old woman is diagnosed with open-angle glaucoma. Which of the following drugs decreases intraocular pressure by increasing trabecular outflow?
A. Timolol
B. Acetazolamide
C. Latanoprost
D. Atropine
C
A 58-year-old woman presents with sudden severe eye pain, nausea, and vomiting. Her pupil is fixed and mid-dilated. What is the most appropriate next step?
A. Administer mydriatic eye drops
B. Prescribe an oral steroid
C. Urgent intraocular pressure reduction
D. Perform fundoscopy
C
A 55-year-old African American man has gradual, painless vision loss and elevated intraocular pressure. Fundoscopy reveals thinning of the optic disc rim. Which is the most significant risk factor for his condition?
A. Smoking
B. Age
C. Alcohol use
D. Hyperthyroidism
B
A patient with angle-closure glaucoma is given a drug that activates α2 receptors in the eye. What is the expected effect?
A. Decreased aqueous humor production
B. Increased aqueous humor secretion
C. Increased pupillary constriction
D. Ciliary muscle relaxation
A
A 60-year-old man with glaucoma is prescribed a β-blocker. What is its primary mechanism of action?
A. Increase aqueous humor outflow
B. Decrease aqueous humor production
C. Decrease intraocular pressure by vasodilation
D. Reduce intraocular inflammation
B
A 67-year-old man has progressive vision loss and optic nerve atrophy. Trabecular meshwork resistance is increased. Which of the following drugs should be avoided?
A. Timolol
B. Epinephrine
C. Latanoprost
D. Acetazolamide
B
A 50-year-old woman with hypertension presents with headaches and bilateral optic disc edema. What is the most likely explanation?
A. Diabetic retinopathy
B. Impaired axoplasmic flow in the optic nerve
C. Central retinal vein occlusion
D. Acute angle-closure glaucoma
B
A patient with acute angle-closure glaucoma is given a drug that increases aqueous humor outflow by acting on the ciliary muscle. Which receptor does this drug target?
A. Alpha-1
B. Muscarinic (M3)
C. Beta-2
D. H1
B
A 65-year-old woman with a history of diabetes presents with worsening peripheral vision loss. Fundoscopy reveals cupping of the optic disc. What is the likely mechanism?
A. Increased resistance to aqueous humor outflow
B. Decreased aqueous humor production
C. Retinal ganglion cell hypertrophy
D. Choroidal neovascularization
B
A patient with glaucoma is prescribed a drug that decreases aqueous humor production by inhibiting carbonic anhydrase. Which drug was most likely prescribed?
A. Acetazolamide
B. Latanoprost
C. Timolol
D. Pilocarpine
A
A 50-year-old man with chronic open-angle glaucoma is prescribed a prostaglandin analog. Which of the following is a known side effect?
A. Retinal detachment
B. Darkening of the iris
C. Corneal ulceration
D. Optic neuritis
B
A 60-year-old woman presents with sudden severe eye pain, headache, and nausea. Her pupil is mid-dilated and non-reactive to light. What is the pathophysiology?
A. Blocked aqueous humor outflow due to iris displacement
B. Increased aqueous humor production
C. Inflammation of the ciliary body
D. Retinal detachment
A
A woman with acute angle-closure glaucoma is given mannitol IV. What is the drug’s primary mechanism?
A. Inhibition of carbonic anhydrase
B. Osmotic diuresis
C. Beta-adrenergic blockade
D. Prostaglandin-mediated aqueous outflow
B
A patient with severe acute angle-closure glaucoma is given pilocarpine. What is its primary mechanism?
A. M3 receptor activation, leading to miosis and improved aqueous outflow
B. Alpha-1 receptor inhibition, causing decreased aqueous humor production
C. Beta-2 receptor activation, reducing ciliary body secretion
D. Direct inhibition of carbonic anhydrase
A
A 35-year-old man with a brain tumor presents with headache and blurry vision. Fundoscopy reveals optic disc swelling with blurred margins. What is the most likely cause?
A. Optic neuritis
B. Glaucoma
C. Increased intracranial pressure
D. Retinal detachment
C
A patient with papilledema undergoes lumbar puncture, which reveals elevated opening pressure. What is the most appropriate next step?
A. MRI of the brain
B. Prescribe beta-blockers
C.Start topical carbonic anhydrase inhibitors
D. Observe for spontaneous resolution
A
A patient undergoing treatment for glaucoma develops bradycardia and hypotension. Which drug is most likely responsible?
A. Timolol
B. Latanoprost
C. Brimonidine
D. Dorzolamide
A
A 55-year-old man with chronic open-angle glaucoma is given a muscarinic agonist. What is the expected effect?
A. Decrease trabecular meshwork resistance
B. Increase aqueous humor outflow
C. Increase intraocular pressure
D. Block ciliary muscle contraction
B
A patient with a history of glaucoma presents with progressive vision loss despite treatment. Fundoscopy shows optic disc cupping. What is the most likely reason for treatment failure?
A. Increased ciliary muscle contraction
B. Increased choroidal blood flow
C. Poor compliance with therapy
D. Retinal detachment
C
A 68-year-old man with open-angle glaucoma is prescribed a new medication. He later notices darkening of his iris and increased eyelash growth. Which drug was most likely given?
A. Timolol
B. Acetazolamide
C. Latanoprost
D. Brimonidine
C
A 70-year-old woman presents with progressive visual field loss. Tonometry shows increased intraocular pressure. What is the gold standard for confirming her diagnosis?
A. Slit-lamp examination
B. Visual field testing
C. Retinal fluorescein angiography
D. MRI of the orbits
B
A 55-year-old man with chronic open-angle glaucoma is started on a non-selective beta-blocker. What is the primary therapeutic effect of this drug?
A. Decreased aqueous humor production
B. Increased trabecular outflow
C. Increased ciliary muscle contraction
D. Inhibition of prostaglandin synthesis
A
A 66-year-old man with open-angle glaucoma is started on a topical α2-agonist. What is the expected effect?
A. Decreased aqueous humor production
B. Increased aqueous humor secretion
C. Pupillary dilation
D. Ciliary muscle relaxation
A
A 59-year-old man presents with sudden eye pain and vision loss. Examination shows a cloudy cornea and mid-dilated, nonreactive pupil. Which of the following is the next best step?
A. Administer atropine drops
B. Urgent intraocular pressure reduction
C. Prescribe corticosteroids
D. Perform fundoscopy to rule out optic neuritis
B
A 62-year-old woman with chronic glaucoma is started on a prostaglandin analog. What is the most likely effect on intraocular pressure?
A. Decreased production of aqueous humor
B. Increased trabecular and uveoscleral outflow
C. Constriction of ciliary muscles
D. Decreased venous pressure
B
A 50-year-old man with open-angle glaucoma has worsening intraocular pressure despite treatment. Which surgical option is most appropriate?
A. LASIK
B. Scleral buckling
C. Trabeculectomy
D. Cataract extraction
C
A 45-year-old man with a history of angle-closure glaucoma undergoes laser peripheral iridotomy. What is the expected outcome?
A. Increased aqueous humor production
B. Decreased trabecular meshwork resistance
C. Improved aqueous humor drainage
D. Increased pupillary dilation
C
A patient with increased intracranial pressure presents with papilledema. Which of the following best explains the optic disc swelling?
A. Increased aqueous humor production
B. Impaired axoplasmic flow in the optic nerve
C. Direct inflammation of the optic disc
D. Increased episcleral venous pressure
B
A 29-year-old woman with obesity and chronic headaches is diagnosed with idiopathic intracranial hypertension. What is the first-line pharmacologic treatment?
A. Mannitol
B. Acetazolamide
C. Timolol
D. Latanoprost
B
A 45-year-old woman presents with headache and blurry vision. Fundoscopy reveals bilateral optic disc swelling with blurred margins. What is the next step in management?
A. Brain imaging (MRI/CT)
B. Immediate lumbar puncture
C. Optical coherence tomography
D. Visual field testing
A
A patient presents with open-angle glaucoma and is prescribed a drug that reduces aqueous humor production. Which drug class was prescribed?
A. Prostaglandin analogs
B. Cholinergic agonists
C. Beta-blockers
D. Mydriatics
C
A 40-year-old man presents with headache and transient vision loss. Fundoscopy shows papilledema. What is the most likely associated symptom?
A. Diplopia
B. Pulsatile tinnitus
C. Photophobia
D. Dry eyes
B
A patient with papilledema undergoes lumbar puncture. The opening pressure is 30 cm H₂O. What condition is most likely?
A. Idiopathic intracranial hypertension
B. Normal-pressure hydrocephalus
C. Central retinal vein occlusion
D. Angle-closure glaucoma
A
A patient with glaucoma is prescribed a combination therapy that includes timolol and dorzolamide. What is the expected combined effect of these drugs?
A. Decreased aqueous humor production
B. Increased aqueous humor outflow
C. Pupillary dilation
D. Increased intraocular pressure
C
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A 60-year-old woman presents with severe eye pain, nausea, vomiting, and a fixed, mid-dilated pupil. What is the best initial pharmacologic treatment?
A. Atropine
B. Acetazolamide and timolol
C. Phenylephrine
D. Tropicamide
B
A patient with acute angle-closure glaucoma is treated with pilocarpine. What is its effect on intraocular pressure?
A. Decreases production of aqueous humor
B. Increases trabecular outflow by ciliary muscle contraction
C. Causes pupillary dilation to relieve obstruction
D. Increases vitreous humor drainage
B
A woman presents with acute angle-closure glaucoma. Which of the following medications is contraindicated?
A. Acetazolamide
B. Timolol
C. Pilocarpine
D. Atropine
D
A 63-year-old man with angle-closure glaucoma is treated with a drug that acts as an osmotic diuretic. Which of the following is a potential side effect of this treatment?
A. Hyperkalemia
B. Pulmonary edema
C. Hypernatremia
D. Metabolic alkalosis
B
A patient with acute angle-closure glaucoma is given a drug that reduces intraocular pressure by inhibiting carbonic anhydrase. What is the likely adverse effect?
A. Metabolic acidosis
B. Hypokalemia
C. Hyperglycemia
D. Hypertension
A
