Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Glaucoma > Glaucoma_Test2 > Flashcards

Glaucoma_Test2 Flashcards

1
Q

Secondary glaucoma represents how many of glaucoma cases?

A

2/3rds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Angle Open: Sec glauc……

A

Pigmentary Glaucoma
Exfoliative glaucoma
Steroid induced
Uveitic glaucoma (for the most part)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Angle Open or Closed: Sec glauc………

A

Early and Late Traumatic
Lens Induced
Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Angle closed: Sec glauc………..

A

Neovascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Patient profile for pigmentary glaucoma?

A 
Myopic white male.
Nice deep chamber
Blue Iris
midperipheral TID
San Polesi Line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is the only time you can cure Pigmentary glaucoma?

A

Before the pressure spikes.

You would treat the patient with Iridotomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the minor problem in pigmentary glaucoma?

A

Posterior bowing of mid-peripheral iris: reverse pupil block.
Blcokage of TM and elevation of pressure from pgiment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is there a hereditary component associated with pgimentary glaucoma?

A

Yes

Chromosome 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is pigmentary glaucoma a bilateral condition?

A

Si.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the big problem in pigmentary glaucoma?

A

Continual digestion of pigment that leads to degeneration of TM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Scheie line?

A

Pigment on the lens equator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does pigmentary glaucoma look like in black folks?

A

Rare endothelial pigment
Rare to no TID
Heavy meshwork pigment
These signs are overlooked many times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to treat Pigmentary glaucoma?

A

Tx sim to POAG
1.Drops: beta blocker, CAI, adrenergic agonist, PGAs
Pilocarpine = not well tolerated and risk of RD
2. Argon laser trabeculoplasty: Do within the first year=80% chance of success.
3. Trabeculectomy
4. f/u q3-6 mos for IOP check. Big time variation in IOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Iridotomy and Pigmentary glaucoma?

A

SO there is no closed angle here but there is
reverse pupil block = increased IOP in A/C forces the iris backwards into apposition with the lens zonules.
Iridotomy allows for the shallowing of the ant chamber and flattening of the iris.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Glacomafleccken?

A

Necrotic anterior lens capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you catch exfoliative glacuoma?

A

1.Via dilating the eyes.
The IOP rises big time due to the pigment that being liberated.
2. Radial pigmentation on anterior surface of the lens
3. Peripupillary TID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MOA of exfoliative glaucoma?

A

Deposition of abnormal BM on anteiror lens capsule, iris, and in TM. Abnormal material can come from any structure.
Posterior synechiae can form due to stickiness of material.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In which population does exfoliative glaucoma usually occur in?

A

Northern Europeans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Will lensectomy cure exfoliative glaucoma?

A

Nope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Exfoliative glaucoma associated with?

A

Central retinal vein occlusion.

There is a systemic association here.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Is exfoliative glaucoma unilateral?

A

Yes. U will see it in one eye before you see it in both eyes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which condition is worse? POAG or Exfoliative glaucoma?

A

Exfoliative:
More meds needed
More surgery
More likely to progress to visual disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Trt of pseudoexfoliative glauc?

A

Treat as POAG
1. Drops: beta, PGA, Ad ag, CAIs
ALT
Trabeculectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which two glaucomas are in the spectrum of the same disease process?

A

Pigmentary glaucoma

Pseudoexfoliative glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some examples of early traumatic glaucoma?

A

Hyphema
Inflammation
TM changes
Hours to days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some examples of late traumatic glaucoma?

A

Angle recession
Peripheral anterior synechiae
Weeks to years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a hyphema?

A

A tear in ciliary body (usually longitudinal muscle). Can lead to angle recession(50-90%).
IOP rise related to blood in A/C.
Pupil block secondary to clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Trt of hyphema?

A

Bed reest
Atropine BID
Pred forte q1h
Aq supp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What drugs do we want to avoid in patients with hyphema, an early traumatic glaucoma?

A

PGAs
Miotics
Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What follows traumatic hyphema or vitreous hemorrhage?

A

Ghost cell carcinoma

RBCs lose hemoglobin, can’t bed to get out of TM and gets trapped, CLOGGAGE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How do you treat ghost cell carcinoma?

A

Paracentisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the etiology of angle recession?

A

TM scarring/sclerosis.

Look at fellow eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the percentage of angle recession converting to secondary glaucoma?

A

10-20%

Forever at risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Trt of angle recession

A

Aq supp
Miotics -questionable
PGAs and trabeculectomy work very very well!!!!
ALT/SLT = questionable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the number one cause for unilateral glaucoma?

A

Unilateral glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What three glaucomas should u think to be the cause for unilateral glaucoma?

A

Angle recession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Tidbit on Angle recession

A

Approx 40% of cases of angle recession glaucoma are made by imagination only when a doc can find no other cause for a unilateral or asymmetric case of glaucoma.

38
Q

What does a penetrating injury do to structures in the eye?
A/C?
Iris?
TM?

A

Flattens the A/C(like getting an iridotomy).
PAS and posterior synechiae.
Blockage of TIM due to fibrous connective tissue and epithelial ingrowth

39
Q

IN which glaucoma must glaucoma management be secondary to the open globe injury?

A

Penetrating injury for Traumatic glaucoma

40
Q

MOA of steroid induced glaucoma?

A

Chang ethe TM ability to process aqueous.
Glycoaminoglycan accumulation
Increased difficulty of outflow
Cushing’s syndrome

41
Q

What percentage of population are steroid responders?

A

2/3rds

42
Q

Does genetics play a role in steroid induced glaucoma?

A

Yes

43
Q

Who are at risk for steroid induced glauc?

A

POAG
Children
Myopes

44
Q

Trt for Induced steroid?

A

D/C meds
Aq supp: PGAs (force more aq out of uveoscleral pathway)
Trabeculectomy (cutting an alternate drainage route sucks)
Trabeculoplasty sucks

45
Q

What are the five types of Lens Induced glaucoma?

A 
Phacolytic
Lens particle
Phacoanaphylactic
Phacomorphic
Subluxated lens
46
Q

MOA of phacolytic glaucoma?

A

Uveitis and elevated IOP in association with hypermature cataract.
Lens leak out intrenal proteins. These go into the A/C

47
Q

Trt of Phacolytic glaucoma?

A

Lensectomy

Possible vitrectomy.

48
Q

How to initially treat phacolytic glaucoma?

A

Pred forte q1-2h
Cycloplegia
Beta blockers, alpha agonists, CAI’s
Avoid PGAs, miotics

49
Q

When should we consider phacolytic glaucoma?

A

In patients with
hypermature cataract
Inflammation
Glaucoma

50
Q

What is phacomorphic glaucoma?

A

Unilateral or asymmetric cataract associated with asymmetric shallowing of the anterior chamber not explained by other factors.

  1. Pupil block
  2. Secondary iris bombe
  3. Angle closure with possible PAS formation
51
Q

What is another reason phacomorphic can result from aside from mature cataract?

A

Microspherophakia

52
Q

Trt for phacomorphic glaucoma?

A 
Beta blockers
CAI's
Alpha 2 agonists
PGAs
Pilocarpine
Pred Forte
Iridotomy to relieve pupil block. 
Iridoplasty to retract iris out of the angle. 
Cataract extraction is the best way to go.
53
Q

When do you consider phacomorphic glaucoma?

A

Angle closure
Shallow chamber
Asymmetric advanced cataract

54
Q

What should u keep in mind when the lens is displaced?

A

There is the potential for pupil block and angle closure.

55
Q

With which glaucoma is the 90 day rule applied to?

A

Neovascular

56
Q

MOA of neovascular glaucoma?

A

Secondary angle closure without pupil block.

57
Q

Which is the worst glaucoma a patient can get?

A

Neovascular glaucoma

58
Q

What test do you order for Neovascular glaucoma?

A

ESR and C-reactive protein

59
Q

What does an increase in episcleral venous pressure reflexly increase in…..

A

IOP.

An increase in IOP

60
Q

How to diagnose elevated episcleral venous pressure?

A

Blood in Schlemm’s canal

61
Q

TM outflow can be impeded both by the accumulation of what?

A

Inflammatory cells as well as the inherent outflow infacility of preoteinacious aqueous humor in patients with excessive flare.

62
Q

Cells vs flare; which is a bigger factor in higher IOP in uveitic glaucoma?

A

Flare

63
Q

What are the two common AE of any laser procedure?

A

Inflammation
Potential IOP rise
Related to the amount of laser energy used.

64
Q

Argon is considered to be what laser?

A

Thermal laser

Photocoagulation - long duration at low energy

65
Q

T/F?

ALT will fail over time?

A

True

Surgeons may do just once or twice bcaz they notice that they don’t get the same effects as the first one.

66
Q

T/F?

ALT and SLT works about just the same in decreasing IOP in glaucoma patients?

A

True.

SLT has lower thermal effects; thus no apparent tissue alterations

67
Q

ALT vs SLT?

Which have larger laser burns and makes it impossible to miss?

A

SLT

68
Q

How can an argon laser transfer from photocoagulation to photovaporization?

A

When it goes from long duration at high energy

69
Q

Which laser is least likely to disrupt lens and vitreous?

A

Photocoagulation

70
Q

Which laser is difficult to penetrate the iris?

A

Photocoagulation

71
Q

Describe photodisruption and which laser?

A

Short duration at high energy.

YAG laser

72
Q

Which laser is considered pigment independent?

A

YAG laser.

73
Q

Argon laser iridoplasty is the laser of choice for what?

A

Plateau Iris syndrome

74
Q

What structures are we bypassing in a trabeculectomy?

A

TM and Schlemm’s.

75
Q

What structure does Aqueous flow into and what structure absorbs it?

A

Subconj space

Absorbed by ciliary vessels.

76
Q

What two anti-metabolites are used in trabeculectomy?

A

Mitomycin C

5-FU

77
Q

What are the top two complictations of Trabeculectomy?

A

Cataract

Loss of 3 lines in VA

78
Q

When is anti-metabolite added?

A

When sclerostomy is created.

79
Q

Is there an iridectomy process that happens along with Trabeculectomy?

A

Yes.

80
Q

Which two lasers use photovaporization?

A

Argon and Krypton

81
Q

Which laser is non-pigment dependent and considered non-thermal?

A

Photodisruption

82
Q

T/F?

You can perform argon laser on a blue iris?

A

False.

Remem argon is pigment-dependent

83
Q

What does a vascularized bleb indicated?

A

That the site has become infected (endophthalmitis)

Inflamed = blebitis

84
Q

What is the common cause of failure for trabeculectomy?

A

Scarring of the filtering site.

Need anti-metabolites

85
Q

What does a shallow chamber and low IOP indicate for trabeculectomy?

A

Bleb leakage
Overfiltration
The bleb is either too tight or too loose.

86
Q

What does a shallowing A/C

and high IOP indicate?

A

Malignant glaucoma

87
Q

When are drainage devices used?

A

In ppl who failed trabeculectomy
Indicated for high risk cases.
Also used in uveitis, children

88
Q

What is MIGS

A

New device and procedure that place into hands of cataract surgeons.
Easy to perform.

89
Q

In which procedure is No blem formed?

A

iStent

A glaucoma snorkel

90
Q

What is glaucomatocyclitic crisis attributed to?

A

Herpes virus in the A/C

91
Q

Is there a strong association of POAG with glacumomatocyclitis crisi?

A

Si

92
Q

MOA of glaucomatocyclitic crisi?

A

Trabeculitis

A whole lotta Prostaglandin E

Glaucoma (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions