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IPA Exam 2 Flashcards

1
Q

What are refractive errors?

A

The most common cause of blurred vision, including myopia, hyperopia, astigmatism, and presbyopia.

Refractive errors occur when the shape of the eye prevents light from focusing directly on the retina.

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2
Q

Define myopia.

A

Nearsightedness; difficulty seeing distant objects clearly because light focuses in front of the retina.

Myopia is characterized by clear near vision and blurry distant vision.

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3
Q

What does HYPER-opia stand for?

A

Farsightedness; difficulty seeing near objects clearly because light focuses behind the retina.

Hyperopia means ‘high vision’ indicating that far vision is better.

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4
Q

What is astigmatism?

A

Blurred vision at all distances due to light not being uniformly focused, often caused by an irregularly shaped cornea.

Astigmatism can cause distortion in vision.

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5
Q

What is presbyopia?

A

Age-related decline in near vision due to decreased lens flexibility, typically occurring after age 40.

Presbyopia affects the ability to focus on close objects.

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6
Q

What is amaurosis fugax?

A

Transient vision loss in one or both eyes due to inadequate blood flow to the retina, usually lasting up to 3 minutes.

It is often described as a momentary blackout.

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7
Q

Describe open-angle glaucoma.

A

Characterized by gradual peripheral vision loss and is a leading cause of visual impairment and blindness in the United States.

Examination reveals optic disc pallor and an enlarged optic cup.

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8
Q

What are the symptoms of narrow-angle glaucoma?

A

Pain, seeing halos, and poor vision due to intermittent obstruction of aqueous humor drainage.

Untreated narrow-angle glaucoma can lead to total blindness.

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9
Q

Define age-related macular degeneration (AMD).

A

A leading cause of vision loss in older adults.

AMD affects the central part of the retina, leading to a loss of central vision.

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10
Q

What are retinal tears and detachments?

A

Conditions that can lead to vision reduction and a shadow or curtain in the peripheral vision.

These conditions require urgent medical attention to prevent permanent vision loss.

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11
Q

What is amblyopia?

A

Loss of visual acuity in childhood due to strabismus, where the eyes are misaligned.

Amblyopia is reversible until around age 7.

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12
Q

What are cataracts?

A

Opacification of the lens, most commonly due to aging, leading to slow, gradual vision loss.

Cataracts can significantly affect vision clarity.

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13
Q

What is scotoma?

A

A blind spot that can be physiologic or pathologic, with pathologic scotomata detectable on visual field testing.

Scotomas may result from primary ocular disease or CNS lesions.

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14
Q

Explain tunnel vision.

A

Loss of peripheral vision while retaining central vision.

Tunnel vision can occur in advanced glaucoma.

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15
Q

What is diplopia?

A

Seeing double; can be caused by conditions affecting the extraocular muscles or nerves.

Strabismus can lead to diplopia, confusion, and subsequently amblyopia.

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16
Q

What are floaters and flashes?

A

Visual disturbances that can indicate retinal tears, potentially progressing to detachments if untreated.

Patients often describe these as small dots or streaks in their vision.

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17
Q

Define corneal abrasion.

A

Pain, photophobia, and blurred vision due to a scratch on the cornea, usually caused by trauma.

Fluorescein staining reveals defects in the corneal epithelium.

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18
Q

What is acute angle-closure glaucoma?

A

Sudden onset of severe eye pain, headache, nausea, and blurred vision, often with a sluggish, mid-dilated pupil.

This is a medical emergency requiring immediate attention.

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19
Q

What is iritis or iridocyclitis?

A

Inflammation of the iris, causing severe pain, photophobia, tearing, decreased vision, and circumcorneal congestion.

Ciliary flush is characterized by injection of deep episcleral vessels.

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20
Q

What is a stye?

A

Localized abscess in an eyelash follicle caused by a staphylococcal infection, presenting as a painful, red bump.

Also known as an acute external hordeolum.

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21
Q

What is conjunctivitis?

A

Inflammation of the conjunctiva, the membrane lining the inner eyelid and covering the white part of the eye.

It is the most common eye disease in the Western Hemisphere.

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22
Q

What are the common symptoms of nasal disease?

A

Obstruction, nasal discharge, epistaxis (nosebleeds) and loss of smell (anosmia).

These symptoms can be caused by various conditions including infections and allergies.

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23
Q

What is rhinitis?

A

Inflammation of the nasal mucosa, which can be triggered by allergens or other factors.

Symptoms may include nasal obstruction and discharge.

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24
Q

What are the types of nasal discharge?

A
  • Thin and watery: Viral infection or allergies
  • Thick and purulent: Bacterial infection
  • Bloody: Neoplasm, trauma, or infection
  • Foul-smelling: Foreign bodies or chronic sinusitis
  • Clear watery: Suggests cerebrospinal fluid leakage

The characteristics of nasal discharge can help in diagnosing the underlying condition.

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25
Q

What causes conductive hearing loss?

A
  • Cerumen (earwax)
  • Foreign bodies in the ear
  • Infection
  • Congenital abnormalities
  • Middle ear effusions
  • Otosclerosis

Conductive hearing loss occurs when sound transmission is blocked from the outer ear to the inner ear.

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26
Q

What is the Weber test?

A

A hearing test using a vibrating tuning fork to assess conductive hearing loss by placing it in the middle of the forehead.

Lateralization indicates which ear may have a conductive hearing loss.

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27
Q

What are signs of acute otitis media?

A
  • Diffusely red tympanic membrane
  • Loss of light reflex
  • Less prominent malleus
  • Bulging tympanic membrane due to effusion

Pneumatic otoscopy is used to assess the mobility of the tympanic membrane.

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28
Q

What is blepharoptosis?

A

Drooping of the eyelid, which can be symmetrical or affect only one eyelid.

It can be caused by various conditions including genetic disorders.

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29
Q

What is lagophthalmos?

A

Inability to close the eyelids completely, caused by conditions such as thyroid disease or ocular surgery.

This can lead to exposure keratitis.

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30
Q

What is entropion?

A

A turning inward of the lid margin causing eyelashes to rub against the cornea.

This condition can lead to irritation and corneal damage.

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31
Q

What is ectropion?

A

A turning outward of the eyelid margin, which can also be caused by age-related changes.

Ectropion may result in dryness and irritation of the eye.

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32
Q

What are raccoon eyes?

A

Orbital pigmentation indicating a basilar skull fracture.

This sign suggests serious intracranial injury.

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33
Q

What is entropion?

A

A turning inward of the lid margin that causes the eyelashes to rub against the cornea and globe.

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34
Q

What can cause entropion?

A

Age-related changes and dry eye syndrome.

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35
Q

What is ectropion?

A

A turning outward of the eyelid margin.

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36
Q

What can cause ectropion?

A

Age-related changes and dry eye syndrome.

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37
Q

What are raccoon eyes?

A

Orbital pigmentation that is a sign of a basilar skull fracture.

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38
Q

What is xanthelasma?

A

Sharply demarcated yellowish papules and plaques commonly found near the inner corner of the eyelid.

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39
Q

What causes xanthelasma?

A

Lipid deposits in the periorbital skin and is associated with hyperlipidemia in about half of cases.

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40
Q

What is a chalazion?

A

A granulomatous reaction to thickened secretions of the meibomian glands in the eyelid caused by a blocked duct.

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41
Q

What is a stye?

A

A painful, red, localized abscess in an eyelash follicle caused by a staphylococcal infection.

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42
Q

What is blepharitis?

A

Chronic inflammation of the eyelid margins.

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43
Q

What are common symptoms of blepharitis?

A

Itching, tearing, and redness.

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44
Q

What types of carcinoma can affect the eyelid?

A
  • Basal cell carcinoma (BCC) * Squamous cell carcinoma (SCC) * Malignant melanoma.
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45
Q

What are sublingual varices?

A

Varicose veins that appear under the tongue.

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46
Q

What is geographic tongue?

A

Irregular, map-like patterns on the tongue caused by areas where the papillae are missing.

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47
Q

What is black hairy tongue?

A

A harmless condition causing the tongue to look black and hairy due to overgrowth of bacteria and yeast.

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48
Q

What is scrotal tongue?

A

A benign condition that causes deep grooves or fissures on the surface of the tongue.

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49
Q

What is oral candidiasis?

A

A fungal infection of the mouth that can cause white patches on the tongue.

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50
Q

What is oral hairy leukoplakia?

A

A white, hairy-looking lesion on the sides of the tongue caused by the Epstein-Barr virus.

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51
Q

What is angular cheilitis?

A

Dry, cracked corners of the mouth.

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52
Q

What is the most significant risk factor for oral cancer?

A

Tobacco use.

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53
Q

What are the primary causes of oral cancer?

A
  • Tobacco use * Alcohol consumption.
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54
Q

What is the role of HPV in oral cancer?

A

Human Papillomavirus, especially HPV-16, is an important modern risk factor.

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55
Q

What is conjunctivitis?

A

The most common eye disease in the Western Hemisphere, caused by various factors.

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56
Q

What is Acute Hemorrhagic Conjunctivitis (AHC)?

A

A highly contagious viral eye infection characterized by sudden onset of painful, swollen eyes with subconjunctival hemorrhages.

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57
Q

What is giant papillary conjunctivitis (GPC)?

A

An inflammatory condition with large papillae under the upper eyelid, usually as an allergic reaction.

VERY COMMON IN CONTACT LENS USERS

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58
Q

What is subconjunctival hemorrhage?

A

A condition occurring when a blood vessel breaks just beneath the conjunctiva.

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59
Q

What is episcleritis?

A

Inflammation of the episclera, usually benign and self-limiting.

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60
Q

What is scleritis?

A

A more serious condition involving inflammation of the sclera itself, often associated with autoimmune disorders.

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61
Q

What is a corneal abrasion?

A

A scratch on the cornea that is often painful.

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62
Q

What is a corneal ulceration?

A

An open sore on the cornea that can be very painful and may cause vision loss.

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63
Q

What is herpes simplex virus-related keratitis?

A

A viral infection of the cornea caused by the herpes simplex virus.

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64
Q

What is acute iritis?

A

Inflammation of the iris, which can cause pain and light sensitivity.

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65
Q

What is uveitis?

A

Inflammation of the uvea, which includes the iris, ciliary body, and choroid.

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66
Q

What is hyphema?

A

Bleeding into the anterior chamber of the eye.

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67
Q

What is globe rupture?

A

A serious injury where the sclera is torn.

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68
Q

What is papilledema?

A

Swelling of the optic disc caused by increased intracranial pressure.

69
Q

What is open-angle glaucoma?

A

A leading cause of vision impairment due to gradual loss of peripheral vision.

70
Q

What are risk factors for open-angle glaucoma?

A
  • Age over 65 * African American ethnicity * Diabetes * Myopia * Ocular hypertension.
71
Q

What is narrow-angle glaucoma?

A

A condition arising from obstruction in the drainage of aqueous humor, leading to acute increases in intraocular pressure.

72
Q

What is diabetic retinopathy?

A

A complication of diabetes that can damage small blood vessels in the retina.

73
Q

What is the first step in conducting an otoscopic exam?

A

Turn on the light source of the otoscope.

74
Q

What is the importance of patient positioning during an otoscopic exam?

A

Ensures the patient’s head is stabilized for optimal visualization.

75
Q

What should be visually inspected before inserting the otoscope?

A

The external ear anatomy, ear canal patency, erythema, swelling, and lesions.

76
Q

What is the purpose of the ‘tug test’ during an otoscopic exam?

A

To assess for pain in the ear.

77
Q

What maneuver helps facilitate easier passage of the otoscope?

A

Gently grasping the top of the ear and pulling upward and backward.

78
Q

What should be checked using fluorescein staining?

A

Identify any corneal damage.

79
Q

What is the first step in speculum insertion?

A

Place the tip of the speculum into the opening of the external canal under direct vision

Do not insert while looking through the otoscope.

80
Q

What maneuver helps to straighten the ear canal?

A

Gently grasp the top of the ear and pull upward and backward

This facilitates easier passage of the otoscope.

81
Q

How should the otoscope be advanced during an examination?

A

Slowly advance the otoscope towards the patient’s nose, avoiding upward or downward angulation

Hold the otoscope steady to minimize discomfort.

82
Q

What should be observed during ear canal examination?

A

Look for abnormalities such as redness, swelling, discharge, or foreign bodies

Note the appearance of the external canal.

83
Q

What is a healthy tympanic membrane’s appearance?

A

Grayish and translucent

The malleus should be visible and touching the membrane.

84
Q

What is assessed using pneumatic otoscopy?

A

The mobility of the tympanic membrane

A normal membrane will move; effusions will prevent movement.

85
Q

What is the significance of documenting findings during an ear examination?

A

To record observations including appearance and any abnormalities

Important for clinical assessments.

86
Q

What condition is characterized by large papillae under the upper eyelid?

A

Giant Papillary Conjunctivitis (GPC)

It is a common complication of contact lens wear.

87
Q

What is the normal cup-to-disc ratio in a fundoscopic exam?

A

Ranges from 0.1 to 0.5

Asymmetry or increased ratios may suggest glaucoma.

88
Q

What does papilledema indicate?

A

Swelling of the optic disc due to increased intracranial pressure

Often caused by a space-occupying lesion in the brain.

89
Q

What is arteriovenous nicking?

A

Compression of a vein by a hardened artery crossing it

This is a sign of hypertension.

90
Q

What are the characteristics of nonproliferative diabetic retinopathy?

A

Microaneurysms, hemorrhages, and exudates

This is an early stage of diabetic retinopathy.

91
Q

What is the primary symptom of epiglottitis?

A

Drooling

Other symptoms include fever, dysphonia, and stridor.

92
Q

Which condition involves a sudden increase in intraocular pressure?

A

Acute Angle-Closure Glaucoma

Characterized by severe eye pain and blurred vision.

93
Q

What distinguishes otitis externa from otitis media?

A

OE is an infection of the external auditory canal; OM is an infection of the middle ear

Symptoms and examination findings differ between the two.

94
Q

What are common symptoms of allergic rhinitis?

A
  • Itching in the nose, eyes, and throat
  • Sneezing in bursts
  • Clear, watery discharge
  • Nasal congestion
  • Conjunctivitis

Symptoms are triggered by allergens.

95
Q

What are the main causes of decreased visual acuity?

A
  • Refractive errors
  • Cataracts
  • Glaucoma
  • Macular degeneration
  • Retinal tears and detachments
  • Diabetic retinopathy
  • Corneal abrasions
  • Amaurosis fugax

Each condition affects vision in different ways.

96
Q

What is the typical presentation of a corneal abrasion?

A

Pain, photophobia, and blurred vision

Fluorescein staining can help diagnose it.

97
Q

What is the significance of the red reflex in an eye exam?

A

Absence or dimming may indicate opacity in the lens or vitreous humor

This can suggest cataracts or other ocular issues.

98
Q

What is the definition of amaurosis fugax?

A

Transient vision loss in one or both eyes due to temporary interruption of blood flow to the retina

It is often a warning sign of vascular issues.

99
Q

What is diabetic retinopathy?

A

A leading cause of blindness in Americans aged 20 to 75 years old.

100
Q

What are corneal abrasions?

A

Scratches on the cornea causing pain, photophobia, and blurred vision.

101
Q

Define Amaurosis Fugax.

A

Transient vision loss in one or both eyes due to temporary interruption of blood flow to the retina.

102
Q

What is Central Retinal Artery Occlusion (CRAO)?

A

A serious condition where the central retinal artery becomes blocked, leading to sudden and often permanent vision loss.

103
Q

What is Amblyopia?

A

Reduced vision in one eye due to abnormal visual development in childhood, often associated with strabismus.

104
Q

What can cause optic nerve damage?

A

Conditions like optic neuritis or tumors.

105
Q

What are common causes of visual loss in elderly patients?

A

Age-related changes, ocular disease, vascular issues affecting the eye.

106
Q

What is presbyopia?

A

A natural age-related decline in the eye’s ability to focus on near objects due to decreased lens flexibility.

107
Q

What are cataracts?

A

Opacification of the lens causing gradual vision loss.

108
Q

What is glaucoma?

A

A group of conditions that damage the optic nerve, often due to increased intraocular pressure.

109
Q

What is Age-Related Macular Degeneration (AMD)?

A

Deterioration of the macula, affecting sharp, detailed vision.

110
Q

How does hypertension affect the eye?

A

It can lead to narrowing, copper wiring, and arteriovenous nicking of retinal blood vessels.

111
Q

What is the significance of visual acuity testing?

A

Crucial for detecting and quantifying vision loss.

112
Q

What is a fundoscopic examination?

A

An ophthalmoscopic exam for visualizing the retina and its blood vessels.

113
Q

What characterizes acute angle-closure glaucoma?

A

A sudden and severe increase in intraocular pressure causing intense eye pain.

114
Q

What is tinnitus?

A

A sensation of hearing sounds without an external source.

115
Q

What are common causes of tinnitus?

A
  • Sensorineural hearing loss
  • Conductive hearing loss
  • Noise exposure
  • Meniere’s disease
  • Ototoxic medications
  • Head and neck injuries
  • TMJ disorders
116
Q

What are the symptoms of acute bacterial sinusitis?

A
  • Persistent symptoms >10 days
  • Facial pain/pressure
  • Purulent nasal discharge
  • Fever
117
Q

What is the first step in examining the thyroid gland?

A

Inspection for visibility and enlargement.

118
Q

What does diffuse enlargement of the thyroid indicate?

A

Conditions like Graves’ disease and Hashimoto’s thyroiditis.

119
Q

What is a bruit?

A

A soft, whooshing sound indicating increased blood flow, often associated with hyperthyroidism.

120
Q

What is the significance of a detailed fundoscopic examination?

A

It can reveal signs of conditions affecting vision, such as diabetic retinopathy.

121
Q

What are red flags suggesting complications in sinusitis?

A

“HOMS”

  • Severe headache
  • Orbital involvement
  • Mental status changes
  • High fever
122
Q

What is a bruit in relation to the thyroid gland?

A

A soft, whooshing sound indicating increased blood flow, often associated with hyperthyroidism

Bruits can be detected using the bell of a stethoscope over the lateral lobes of the thyroid.

123
Q

What landmarks are used to palpate the thyroid gland?

A

Thyroid cartilage, cricoid cartilage, sternal notch

The thyroid gland lies between the cricoid cartilage and the sternal notch.

124
Q

What is the significance of a tender thyroid gland during palpation?

A

Suggests thyroiditis (inflammation of the thyroid)

Tenderness can indicate various underlying conditions affecting the thyroid.

125
Q

What are the characteristics of lymph nodes that could indicate malignancy?

A

Fixed, firm, hard, nontender

These characteristics often raise concern for possible cancer involvement.

126
Q

What is the normal range for jugular venous pressure (JVP)?

A

Typically less than or equal to 9 cm

JVP is an important indicator of intravascular volume status and cardiac function.

127
Q

Fill in the blank: A _______ thyroid gland may indicate Graves’ disease.

A

soft

Graves’ disease is an autoimmune disorder characterized by an overactive thyroid.

128
Q

What does a firm thyroid gland suggest?

A

May indicate Hashimoto’s thyroiditis, malignancy, or benign and malignant nodules

The consistency of the thyroid gland provides valuable diagnostic insights.

129
Q

What is the primary concern with enlarged supraclavicular lymph nodes?

A

Possible malignancy originating in the thorax or abdomen

Enlarged nodes in this area are significant and warrant further investigation.

130
Q

True or False: Hyperthyroidism can present with symptoms such as weight loss and excessive sweating.

A

True

Symptoms of hyperthyroidism include nervousness, heat intolerance, and tachycardia.

131
Q

What conditions are associated with thyroid abnormalities?

A
  • Graves’ Disease
  • Hashimoto’s Thyroiditis
  • Endemic Goiter
  • Thyroid Cancer
  • Thyroiditis
  • Multinodular Goiter
  • Hypothyroidism
  • Hyperthyroidism

Each condition presents with distinct clinical features and requires specific assessments.

132
Q

What does the presence of a bruit over the thyroid suggest?

A

Increased blood flow, often associated with hyperthyroidism

Bruits can be indicative of various thyroid dysfunctions.

133
Q

What should be assessed when a thyroid nodule is detected?

A

Risk factors for malignancy

Important factors include radiation exposure, nodule hardness, and rapid growth.

134
Q

What are the signs of inflammation in lymph nodes?

A

Tenderness and potential enlargement

Tender nodes often indicate an inflammatory process, which can arise from infections or other causes.

135
Q

What is the procedure for measuring JVP?

A
  1. Position patient at 30-45 degrees
  2. Identify sternal angle
  3. Visualize IJ pulsations
  4. Measure vertical distance to sternal angle
  5. Add 5 cm to calculate JVP

This method assesses the pressure in the right atrium of the heart.

136
Q

What can elevated JVP indicate?

A

Heart failure, fluid overload, or constrictive pericarditis

Elevated JVP is a significant clinical finding in assessing cardiac function.

137
Q

What is the role of lymph nodes in the immune system?

A

Filter fluid and trap foreign substances like bacteria and cancer cells

They play a crucial role in the body’s immune response.

138
Q

What does a rubbery consistency of lymph nodes suggest?

A

May indicate lymphoma

The texture of lymph nodes can provide important diagnostic clues.

139
Q

What anatomical areas do the anterior cervical lymph nodes drain?

A

Throat, tonsils, oropharynx, thyroid, and tongue

The location of enlarged lymph nodes can indicate underlying health issues.

140
Q

What is the significance of palpating the thyroid isthmus while the patient swallows?

A

Feel for the isthmus as it slides upward beneath your fingers

This technique helps assess the size and consistency of the thyroid gland.

141
Q

What does Anterior Auricular drain?

A

Ear, scalp, skin

142
Q

What does Anterior Cervical drain?

A

Throat, tonsils, oropharynx, thyroid, tongue

143
Q

What does Posterior Cervical drain?

A

Back of skull, scalp, neck

144
Q

What does Sub-Mandibular drain?

A

Floor of mouth

145
Q

What does Sub-Mental drain?

A

Teeth

146
Q

What does Supra-Clavicular drain?

A

Thorax

147
Q

What does Tonsillar drain?

A

Tonsils, posterior pharynx

148
Q

What does the Weber Test assess?

A

It assesses hearing loss types and lateralization.

149
Q

In the presence of a conductive hearing loss, where is the sound heard?

A

On the side of the conductive loss.

150
Q

In the presence of a sensorineural loss, where is the sound heard better?

A

On the opposite (unaffected) side.

151
Q

True or False: The Weber Test can determine if hearing loss is conductive or sensorineural.

A

True.

152
Q

The head acts as a _______ during the Weber Test.

A

receiver of sound.

153
Q

What happens to the head when sound is heard during the Weber Test?

A

The whole head vibrates.

154
Q

What does OD mean?

A

OD means Right eye.

155
Q

What does OS mean?

A

OS means Left eye.

156
Q

What does OU mean?

A

OU means both eyes.

157
Q

What is an absence of refractive error known as?

A

Emmetropia

Good vision - no nearsightedness or farsightedness.

158
Q

What does emmetropia indicate?

A

Good vision with no nearsightedness or farsightedness.

159
Q

Which nerve tests visual fields (i.e. peripheral vision)?

A

CN 2 (optic)

160
Q

What does CN 2 (optic) nerve test?

A

Peripheral

161
Q

What is it called when pupils are >6mm?

A

Mydriasis (dilated)

162
Q

Which cranial nerves innervate the extra ocular muscles?

A

CN 3, 4, 6

163
Q

What is another term for eye alignment?

A

esotropia

164
Q

What is disconjugate gaze?

A

Disconjugate gaze refers to a condition where the eyes do not move together in the same direction.

165
Q

What is exotropia?

A

Exotropia is a type of strabismus where one or both eyes turn outward.

166
Q

What is the eye motion going internally and upwards?

A

Intorsion

167
Q

What is the eye motion going internally and upwards?

A

Intorsion

168
Q

What is it called when the pupils are less than 2mm?

A

Miosis (Constricted)

169
Q

What is it called when the pupils are less than 2mm?

A

Miosis (Constricted)

me. IPA (8 decks)

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