HEENT

Question 1

wet AMD pathogenesis vs sxs vs tx

Answer 1

photoreceptors & pig epith send VEGF & cytok to choroid capillaries –> neovasc under macula –> leaky vessels –> Bruschen breaks down, scarring macula & fibrosis vs metamorphosia, central vision blind spots vs anti-angio/VEGF drugs, photodynamic therapy (photosensitizer + cold laser), laser photocoag, surg

Question 2

dry AMD pathogenesis vs sxs vs tx

Answer 2

insuff O2 & nutrients to photoreceptors –> inc metabolic wastes –> drusen/hyaline vs blurry vision, incipient/geographic atrophy vs ARED2 formula

Question 3

how to dx AMD?

Answer 3

visual acuity, Amsler grid test, ophthalmoscope, fluorescein & ICG angio, optical adherence tomography

Question 4

retinal detach cause vs sxs vs tx

Answer 4

ctx vitreous vs flashes, floaters, periph retinal tears, scotoma vs retinal laser (ablate, adhere retinal tear down}

Question 5

risk factors vs genetics of macular degen

Answer 5

age, smoke, HTN/CVD, fhx, gender vs auto dom, complement factor H

Question 6

3 types of ectopia lentis

Answer 6

marfans –> dislocates upward
homocysteinuria –> dislocates downward
more spherical lens –> inc myopia

Question 7

5 common retinal eye surg

Answer 7

macular hole repair, retinal detach repair, DM hem removal, remove IOFB, remove dropped artificial lens

Question 8

AMD rehab

Answer 8

low vision aids, closed circuit TV, simple magnifiers/reading glasses

Question 9

TED clinical findings

Answer 9

lymphocytes, mastocytes, plasmocytes. collagen & GAG deposits in muscle –> fibrosis. lipogenesis from preadipocytes & fibroblasts

Question 10

TED pathogenesis vs tx

Answer 10

TsHR = ag on orbital fat & connective tissue vs teprotummab = IGF1R inhibitor

Question 11

TED clinical signs

Answer 11

eyelid retraction, lid lag on infraduction, globe lag on supraduction, lagophthalmos

Question 12

HTN retinopathy sxs vs complications

Answer 12

HA, blurry; macular star, inc arteriovenous pressure/swell, microaneurysm, optic disc swelling vs central retinal v occlusion, blown out capillaries, prolif retinopathy –> PRP, heart/kid complications

Question 13

4 signs vs 4 txs of retinoblastoma

Answer 13

leukocoria, strab, pseudohypophon, hyphemia vs enucleation, irrad, laser, cryo/chemo

Question 14

when to do screening for ROP vs retinal exam

Answer 14

<30 wks, <1500g, >30 wks if cardiopulm support vs 4-6wks, 31-32wks post conception

Question 15

3 signs of retinitis pigmentosa vs 3 zones of ROP w/ assoc of ea?

Answer 15

loss night -> periph -> central vision. usher syndrome (+ hearing loss) vs post/inner 30 degrees, middle ora ser nasally, outer ora ser temporally. plus dz

Question 16

strabismus tx. should not be dxed earlier than what age?

Answer 16

patch good eye, glasses, atropine eye drops, surgical reposition/resection of extraocular muscle. 6wks old

Question 17

Pierre Robin syndrome sxs vs complications vs tx

Answer 17

mandibular hypoplasia vs resp distress, feeding difficulties, dec hearing, ear infxn vs resp/nutritional support, prone –> tongue falls forward, intub +/- tracheostomy

Question 18

stickler syndrome sxsx

Answer 18

auto dom. flat facies, inner canthal folds, midfacial hypoplasia

Question 19

TCs sxs vs complications vs tx

Answer 19

malar hypoplasia, slanted palp fissures, cleft palate, lower lid coloboma vs resp distress, feeding probs, conductive hearing loss, visual deficits vs facial reconstruction

Question 20

hemifacial microsomia sxs vs complications vs tx

Answer 20

R>L lower side of face, malformed ear & mandible vs hearing, preauricular tags vs resp support, reconstruct

Question 21

fetal alc syndrome sxs vs tx

Answer 21

flat nose, thin lips, microcephaly, IUGR/short, short palp fissures vs multidiscip, support nurturing environ, avoid violence/freq change, counseling

Question 22

aniridia. Wilm’s tumor?

Answer 22

auto dom del 11q13 –> iris hypoplasia. del chrm 11 –> anridia, abd mass, retard mental, GU abnlities

Question 23

RPE vs Bruch’s membrane

Answer 23

maintain photoreceptors, absorb stray light, form outer retinal barrier, phag + regen visual pig vs give O2 & nutrients from choroid to RPE, prevent overheat

Question 24

how to dx vs tx uveitis

Answer 24

visual exam; skin tests for TB, toxocar, histo; blood test vs tx underlying cause, cycloplegics & steroids to eye

Question 25

UV keratitis cause vs sxs vs dx vs tx

Answer 25

UV 6-10h before dmg vs FB sensation, red eye, photophobia vs diffuse punctate lesion on fluorescein, conjunctival erythema vs cycloplegic drops, topical abx ointment, cool compress

Question 26

congenital glaucoma pathogenesis vs sxs vs tx

Answer 26

no ant angle structures –> disrupt Descement’s membrane/Haab’s striae vs buphthalmos, epiphoria, photophobia, Axenfield ( thin iris, micro/oligodontia, hypertelorism vs goniotomy

Question 27

how to tx dacryostenosis vs cystitis vs cele

Answer 27

nasolacrimal massage, clean w/ warm water, topical abx vs systemic abx, surg vs nasolacrimal massage, warm compress, systemic abx

Question 28

coloboma iris cause vs assoc

Answer 28

auto dom failure of closing embryonic fissure of optic cup –> affects iris, ciliary body, retina, lens optic n vs CHARGE syndrome

Question 29

How to tx blepharitis?

Answer 29

Eye scrub/mild shampoo, warm compress, erithromycin if severe