II Exam 2 Flashcards
What are the 5 parts of the Eye Exam?
distant, neuro-ophthalmic, dx testing, pupillary dilation, orbital/ocular/intraocular assessment
Distant Exam: Assessments
navigation, ocular symmetry, globe position, ocular motility
Neuro-Ophthalmic Exam: Tests (CN assessed)
menace (II, VII), Dazzle (II, VII), PLR (II, III), palpebral (V, VII)
Eye Dx Testing: Tests
1) schirmer,
2) fluorescein stain,
3) tonometry
What drug is used to dilate the pupil?
0.5-1% tropicamide
Buphthalmos: Definition
enlarged globe caused by inc. IOP
Exophthalmos: Definition
normal sized globe protruding forward
Exophthalmos: Etiologies
extension from orbit associated structures, primary orbital dz
Exophthalmos: Dx
PE
Exophthalmos: Tx
enucleation
Orbital Cellulitis: Etiologies
puncture, foreign body, infectious, idiopathic inflammation
Orbital Cellulitis: Signs
uni-/bilateral exophthalmos, hyperemia, conjuctivitis, acute onset
Orbital Cellulitis: Dx
PE, U/S
Orbital Cellulitis: Tx
topical/systemic antibiotics, anti-inflammatories, analgesia
Extraocular Polymyositis: Signs
intermittent “surprised” look, non-painful/hyperemic
Extraocular Polymositis: Dx
PE, muscle biopsy
Extraocular Polymositis: Tx
corticosteroids
Orbital Neoplaisa: Signs
progressive exophthalmia
Orbital Neoplasia: Dx
U/S, DI, biopsy
Orbital Neoplasia: Tx
chemo +/- radiation
Proptosis: Definition
Eye pops out of socket
Proptosis: Signs
inability to/incomplete blink, keratitis
Proptosis: Tx
reduce (lateral canthotomy)
Glaucoma: Etiology
dec. outflow of aqueous humor
Acute Glaucoma: Signs
unilateral, hyperemia, painful, mydriasis, retinal edema
Chronic Glaucoma: Signs
blind, buphthalmic, hyperemia
Secondary Glaucoma: Etiologies
uveitis, lens dzs, trauma
Glaucoma: Dx
tonometry (>25mmHg)
Acute Glaucoma: Tx
diuretics, moisis induction
Chronic Glaucoma: Tx
enucleation
What are the 5 layers of the eyelid?
skin, muscle, tarsal plate, glands, conjunctiva
Dermoid: Appearance
haired skin on the eye
Ankyloblepharon: Appearance
fused eyelids
Symblepharon: Appearance
adhesion of conjunctiva to itself/cornea
Trichiasis: Appearance
normal hairs contacting cornea
Distichiasis: Appearance
ectopic cilia erupt from meibomian gland
Blepharitis: Signs
red, discharge, pruritus
Blepharitis: Tx
antibiotics, anti-inflammatories (if fluorescein neg.)
Chalazion: Appearance
obstruction of Meibomian duct => non-painful swelling in lid
Hordeolum (stye): Appearance
meibomian gland infection => red, painful swelling in lid
How much tear production is the nictitans responsible for?
40%
Cherry Eye: Appearance
prolapse of nictitans gland
Cherry Eye: Tx
replace gland via sx
Conjunctivitis: Signs
hyperemia, chmosis, discharge, pruritus
Lymphoreticular Conjunctivitis: Appearance
enlarged follicles/blisters
Ligneous/Membranous Conjunctivitis: Appearance
thickened, proliferative conjunctiva
Plasmoma Conjunctivitis: Appearance
thick, depigmentated nictitans
Nodular Granulomatous Episcleritis: Appearance
proliferation of episclera and conjunctiva
Medial Canthal Pocket Syndrome: Conditions
deep orbits, enophthalmos, inadequate drainage
Medial Canthal Pocket Syndrome: Tx
cleaning regimen
What are the 3 layers of tear film?
inner mucin, middle aqueous, outer lipid
KCS: Signs
progressive, inflammation, desication, pain, corneal dz,vision loss
KCS: Etiologies
Congenital - aciar hypoplasia
Acquired - immune mediated, non-immune mediated
KCS: Dx
schirmer tear test
KCS: Management
lacrimostimulant (cyclosporine A), anti-inflammatories, lube -or- parotid duct transposition
Epiphora: Signs
impaired tear drainage (tear stains)
Epiphora: Tx
flush cannulate punctum/nasolacrimal duct
What are the 5 layers of the Cornea?
tear film, epithelium, stroma, descemet’s membrane, endothelium
Ulcerative Keratitis: Etiologies
trauma, anatomical abnormalities, infection, degeneration, nerve damage, KCS
Corneal Ulcers: Causes of Delayed Healing
infection, excess leukocyte enzymes, excess steroid, underlying dz
Superficial Corneal Ulcer: Depth
loss of corneal epithelium
Superficial Corneal Ulcer: Tx
topical antibiotics, mydriatic, recheck 1-4d
Indolent Ulcer: Definition
epithelium fails to attach in healing superficial ulcer
Indolent Ulcer: Tx
debride, grid/punctate kerototomy
Deep Ulcers: Depth
extends into stroma
Deep Ulcer: Tx
antibiotic drops, atropine, systemic NSAIDs, sx closure, conjunctival grafts
Superficial Punctate Keratitis: Signs
diffuse punctate ulcers across cornea
Superficial Punctate Keratitis: Etiology
qualitative tear film deficiency
Superficial Punctate Keratitis: Tx
immunosuppresion
Bullous Keratopathy: Appearance
stromal vesicles
Bullous Keratopathy: Tx
topical NaCl ointment, thermokeatoplasty
Pigmentary Keratitis: Etiology
inflammatory non-ulcerative dz => pigmented cornea
Chronic Superficial Keratitis: Signs
progressive, bilateral, inflammatory, non-ulcerative
Chronic Superficial Keratits: Tx
immunosuppresion, min UV exposure
Florida Keratopathy: Appearance
multifocal cotton-like opacities in corneal stroma
Florida Keratopathy: Tx
bengin neglect
Feline Eosinophilic Keratoconjunctivitis: Appearance
proliferative pink lesion from lateral conjunctiva
Feline Sequestrum: Appearance
focal cornea necrosis
Feline Sequestrum: Tx
remove irritant
Nuclear Sclerosis: Etiology
normal aging of lens
Cataract: Classification
incipient - less than 15% of lens affected
Immature - 15-99%
Mature - 100%
Hypermature - 100% w/ shrinking of lens
Cataract: Etiologies
hereditary, concurrent ocular dz, systemic dz (DM), trauma
Cataract: Tx
phacoemulsification
Lens Luxation: Etiology
zonule breakdown => luxation
Persistant Hyaloid Artery: Signs
cataract, hyphema, extends from optic nerve
What are the 3 parts of the Uvea?
iris, ciliary body, choroid
What produces aqueous humor?
ciliary body
Persistant Pupillary Membrane: Etiology
failure of complete regression of embryonic pupillary membrane
Colobomas: Appearance
holes/defects in iris/choroid
Iris Atrophy: Appearance
holes in iris
Uveal Cysts: Tx
benign neglect, aspirate/laser
Feline Diffuse Melanoma: Appearance
iris color change
Uveitis: Signs
aqueous flare (cloudiness), blepharospasm, corneal edema, miosis, hypopyon, hyphema
Uveitis: Tx
steroids, atropine
How many layers are in the retina?
10
Sudden Acquired Retinal Degeneration Syndrome: Signs
acute blindness, mydriasis
SARDS: Dx
ERG
Retinal Detachment: Etiologies
infection, drugs, hypertension, neoplasia
Chorioretinitis: Signs
Active - poorly demarcated retinal lesions
Inactive: well demarcated, hypereflexive retinal lesion
IRIS: Subgrading
Grade I - less than 1.6mg/dL creatinine Grade II - 1.7-2.5mg/dL Grade III - 2.6-5mg/dL Grade IV - 5.1-10mg/dL Grade V - >10mg/dL
What are the Phases of Renal Failure?
initial -> extension -> maintenance -> recovery
Initial Phase: Presentation
no signs, inc. in Cre
Extension Phase: Presentation
signs start
Maintenance Phase:
Presentation
urine is ultrafiltrate, 1-3wk duration
Acute Tubular Necrosis: Etiologies
intra-renal vasoconstriction, tubular dysfunction
Acute Tubular Necrosis: Dx
UA (casts)
Acute Tubular Necrosis: Tx
fluid/electrolyte management
How much urine is produced when the patient is Oliguric?
less than 0.5ml/kg/hr
Oliguria: Therapy
mannitol, furosemide
Supportive Care: Hyperkalemia
insulin and dextrose
Supportive Care: Hyercalcemia
diuresis, steroids
Supportive Care: Hyperphosphatemia
Al Carbonate
Supportive Care: Hypertension
amlodapine, hydralazine
What UP/C value is considered proteinuric?
> 0.4
Chronic Kidney Dz: Signs
PU/PD, GI signs, lethargy, dehydration, underweight
Chronic Kidney Dz: Lab
azotemia, low SG, Chem (hyperphosphatemia, hypokalemia)
Chronic Kidney Dz: Dx
UA (proteinuria), culture, DI
Chronic Kidney Dz: Tx
treat underlying dz, supportive, diet (stage II)
Proteinuria: Etiologies
Physiological - Stress
Prerenal - inc. protein
Renal - inflammation/insuficiency
Postrenal - inflammation
Proteinuria: Dx
CBC, chem, UA, DI
Glomerulonephritis: Etiologies
immune complexes deposited in the glomeruli
Glomerulonephritis: Dx
BP, CBC, chem, biopsy
Glomerulonephritis: Signs
abdominal/pleural effusion, pitting edema
Glomerulonephritis: Tx
immunosuppresion (mycophenolate)
Ureteral Obstruction: Signs
acute uremia, big kidney little kidney
Ureteral Obstruction: Dx
DI, U/S
Ureteral Obstruction: Tx
stabalize, lithotripsy, ureteral stent
Urethral Obstruction: Signs
enlarged bladder, dysuria
Urethral Obstruction: Dx
U/S, DI
Urethral Obstruction: Tx
catheterize, cystotomy
Lower Urinary Tract Dz: Signs
dysuria, pollakiuria, stranguria, pigmenturia, incomplete voiding, incontinence
Lower Urinary Tract Dz: Dx
UA, rads, U/S, biopsy
What’s the difference between Reinfection and Relapse UTI?
reinfection - different organism
relapse - same organism
Urolithiasis: Types
struvite, calcium oxalate, cystine, urate, silicate, mixed
Urolithiasis: Struvite - Therapy
diet, treat concurrent infection
Urolithiasis: CaOx - Therapy
cystotomy
Urolithiasis: Urate - Therapy
diet
Feline Idiopathic Cystitis: Dx
rule out
FIC: Tx
client edu, environment (reduce stress, inc. litter boxes, water sources, activity)
UMN Bladder: Signs
small bladder, small volumes of urine, difficulte to expressing
LMN Bladder: Signs
large bladder, easily expressed, constantly leaks
Reflex Dyssynergia: Pathophysiology
urethral sphincter spasms when detrusor contracts
Reflex Dyssynergia: Tx
a-adrenergic blockers
Urinary Incontinence: Etiology
urinary sphincter mechanism incompetence
Urinary Incontinence: Dx
contrast rads, urethral pressure profilometry
Urinary Incontinence: Tx
bovine collagen injection, colposuspension and urethropexy
Ectopic Ureter: Sings
wet coat, inflammed perineum
Ectopic Ureter: Dx
contrast DI
Ectopic Ureter: Tx
cystoscopic laser ablation