High Yield Diseases Block 3 Flashcards
Defects in deep retinal layers. Degeneration of macula. Causes central vision loss (scotomas) that is rapid due to neovascularization, edema, and hemorrhage. Eye exam = neovascularization, edema, hemorrhage, and eventual scarring and vision loss. Age Related if after 50; usually over 70 Rx: quit smoking, nutritional recommendations, AREDS (High amounts of zinc and antioxidants) supplements, manage systemic diseases. And conventional laser, photodynamic therapy, anti-vegf drugs.
Wet (exudative) Macular Degeneration
Degeneration of RPE leading to blurry vision and loss of central vision first
Macular degeneration
Conjunctivitis
Infection of the thin conjunctiva. Symptoms: Discharge, red eye, irritation, and sensitivity to palpitation; caused by dilation and congestion of sub epithelial vessels. DDX: Bacterial vs Viral vs Allergic (Other include Rhinoconjunctivitis, chemical reaction, meds, neoplasm, foreign body) Bacterial: 50 to 74% bilateral, mucopurulent discharge, 32-39% acute otitis media. Viral: 35% bilateral, mild watery discharge, redness, 10% acute otitis media Allergic: Usually bilateral, discharge is rare, usually red, no otitis media, MAJOR PRURITIC *AdenoPlus Test to test for viral vs. bacterial.
Infection of the thin conjunctiva. Symptoms: Discharge, red eye, irritation, and sensitivity to palpitation; caused by dilation and congestion of sub epithelial vessels. DDX: Bacterial vs Viral vs Allergic (Other include Rhinoconjunctivitis, chemical reaction, meds, neoplasm, foreign body) Bacterial: 50 to 74% bilateral, mucopurulent discharge, 32-39% acute otitis media. Viral: 35% bilateral, mild watery discharge, redness, 10% acute otitis media Allergic: Usually bilateral, discharge is rare, usually red, no otitis media, MAJOR PRURITIC *AdenoPlus Test to test for viral vs. bacterial.
Conjunctivitis
Macular degeneration
Degeneration of RPE leading to blurry vision and loss of central vision first
Shearing forces applied to anterior auricle which separates from underlying cartilage. Tears auricular blood vessels creating a hematoma and then stimulates new cartilage growth. Rx: Excise, drain, and bolster
Cauliflower Ear
Degeneration of macula. Causes central vision loss (scotomas) that is slow, due to fat deposits and causes gradual decrease in vision. Age Related if after 50; usually over 70 Eye exam = Drusen around macula and atrophy of retina Rx: quit smoking, nutritional recommendations, AREDS (antioxidants and zinc in high levels) supplements, manage systemic diseases
Dry Macular Degeneration
Cauliflower Ear
Shearing forces applied to anterior auricle which separates from underlying cartilage. Tears auricular blood vessels creating a hematoma and then stimulates new cartilage growth. Rx: Excise, drain, and bolster
Viral conjunctivitis
Neonatal - HSV Neonatal - HSV Post natal - Adenovirus (most common) Coxsackie, HSV, VZV (pain before redness), EBV, rubella, mumps, influenze
Sensorineuronal hearing loss
Increase in thresholds and/or loss of ability to transduce specific freq. due to damage to cochlea, auditory nerve, or cochlear nucleus. More commonly due to hair cell damage due to noise (brief high sounds most potential to damage, but all are important) Exposure/toxic drugs (aminoglycosides cause sterocilia damage and furosemide blocks NKCC in stria vascularis) Genetic problems w/ endolymph changes possible too (commonly due to connexin genes regualting gap junctions) Weber lateralizes to normal ear. Normal or absent rinne.
Otitis media
Acute middle ear space infection. Tubes often blocked. fluid, inflammation under TM Most or Second most common reason that children visit MD Risk factors: Day care attendence, smoke exposure, bottle feeding (lack of maternal Anitibodies) Common etiologic agents: Strep pneumo 25-50%, Haem infl. 15-30%, Moraxella catarrhalis 3-20%, Viral (RSV, rhinovirus) 5-22%, No pathogen identified May cause tympanic membrane rupture Sx: Otalgia, Aural fullness, hearing loss, tinnitus. Hearing loss temporary which can cause significant impact on speech development for kids. Tubes are shorter and less slanted in children Low freq sounds (speech) affected first – threshold elevations High freq sounds not affected until mass of middle ear bones is increased –> both low and high frequency sounds are reduced = conductive hearing loss Complications: Perforated TM, Acute mastoiditis, Abcess, labyrinthe fistula, facial nerve paralysis, meningitis, and more
Dry Macular Degeneration
Degeneration of macula. Causes central vision loss (scotomas) that is slow, due to fat deposits and causes gradual decrease in vision. Age Related if after 50; usually over 70 Eye exam = Drusen around macula and atrophy of retina Rx: quit smoking, nutritional recommendations, AREDS (antioxidants and zinc in high levels) supplements, manage systemic diseases
Acute bacterial conjunctivitis
Mucopurulent Children - Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae Adults - Staphylococcus aureus Self-limited, but decreased morbidity and transmission with treatment. Empiric w/ gram pos and negative coverage. Trimethoprim and polymixin opthalmic drops (Polytrim) or more expensive moxifloxacin drops
Causative agent: Neisseria gonorrhea Symptoms: Copious yellow-green discharge (purulent), preauricular adenopathy Gram negative intracellular diplococci that grows on chocolate agar. Treat promptly with systemic ceftriaxone.
Hyperacute bacterial conjunctivitis
Detached retina
Failure of retinal layers to fuse and obliterate intraretinal space between neural retinal layer and retinal pigmented epithelium. Presents as sudden partial vision loss in one eye. Painless, progressive, and often floaters. Can occur congenitally (linked with Marfans and Down Syndrome), or later in life secondary to trauma or type II DM. Linked with myopia. Surgical emergency = lasar demarcation of retinal tear, or scleral buckling procedure.
