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ocular disease > iris napier > Flashcards

iris napier Flashcards

1
Q

The long ciliary nerve branches of the trigeminal are _____ and innervate the _____ muscle

A) parasympathetic, dilator
B) parasympathetic, sphincter
C) sympathetic, dilator
D) sympathetic, sphincter

A

C) sympathetic, dilator (long/sympathetic/dilator, think LSD)

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2
Q

The short ciliary nerves from the ciliary ganglion of the Edinger-Westphal are _____ and innervate the ____ muscle

A) parasympathetic, dilator
B) parasympathetic, sphincter
C) sympathetic, dilator
D) sympathetic, sphincter

A

B) parasympathetic, sphincter (short/parasympathetic/sphincter, think SPS)

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3
Q

Which is closer to the pupil, the sphincter muscle or the dilator muscle?

A

the sphincter muscle

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4
Q

neovascularization of the iris can lead to neovascularization of the_____ which can lead to _______ ______

A

angle, neovascular glaucoma

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5
Q

(T or F) neovascular glaucoma clogs Schlemms canal and is harder to control than angle closure glaucoma

A

true

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6
Q

define ischemia

A) oxygen deprivation
B) restriction of blood flow
C) vascular dilation
D) tumor necrosis

A

B) restriction of blood flow

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7
Q

define hypoxia

A) oxygen deprivation
B) restriction of blood flow
C) vascular dilation
D) tumor necrosis

A

A) oxygen deprivation

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8
Q

8% of all uveal melanomas are found in the:

A) choroid
B) ciliary body
C) sclera
D) iris

A

D) iris. Iris melanoma is the most rare

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9
Q

iris melanoma is composed of ______ ____

A

spindle cells

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10
Q

The uvea is comprised of the parts. Which of the following is not part of the uvea?

A) choroid
B) ciliary body
C) sclera
D) iris

A

C) sclera

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11
Q

An iris nevus is a benign neoplasm composed of ______.

A

melanocytes (be sure to monitor for growth over time to rule out iris melanoma)

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12
Q

why do you not find a nevus in the cornea?

A

The cornea is non-pigmented and a nevus is made of melanoctes.

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13
Q

(T or F) iris melanoma in 3 times more common in darker pigmented irises

A

false, it is 3 times more common in light eyes

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14
Q

iris melanoma ______ ciliary body/choroidal melanoma

A) occurs around the same time as
B) is another name for
C) occurs 1 decade earlier than
D) occurs shortly after

A

C) occurs 1 decade earlier than

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15
Q

Iris melanoma is at least ____mm in diameter and ____mm thick

A

3mm, 1mm (which is usually much bigger than a nevus) (also usually found in inferior portion of the iris)

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16
Q

what diagnostic testing method is appropriate in diagnosing iris melanoma?

A

b-scan ultrasound

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17
Q

The following is a description of which condition? Patient presents with cafe au lait spots and pigmented nodules on skin, lisch nodules on iris, retinal astrocytoma, affected first-degree relative, and optic nerve glioma.

A) albinism
B) neurofibromatosis 1
C) neurofibromatosis 2
D) nothing, all these are normal

A

B) neurofibromatosis 1 (more common than type 2)

18
Q

The following is a description of which condition? patient presents with bilateral acoustic nerve masses OR unilateral acoustic nerve masses, an affected first-degree relative, and at least 2 of the following: neurofibroma, meningioma, schwannoma, juvenile posterior cataract

A) albinism
B) neurofibromatosis 1
C) neurofibromatosis 2
D) nothing, all these are normal

A

C) neurofibromatosis 2

19
Q

which hereditary disorder is also called Von Recklinhausen disease?

A) albinism
B) neurofibramatosis 1
C) floppy iris
D) aniridia

A

B) neurofibramatosis 1

20
Q

where do you find lisch nodules?

A) on the skin
B) on the skin near sweat glands only
C) on the iris
D) on the cornea

A

C) on the iris

21
Q

What disorder is caused from a deficiency in the tyosinase enzyme?

A) Albinism
B) Neurofibromatosis 2
C) Von Recklinhausen disease
D) Coloboma

A

A) Albinism – these patients lack the ability to convert tyrosine to melanin

22
Q

In neurofibromatosis 2, what portion of patients have cataracts?

A) 1/3
B) 1/2
C) 2/3
D) 3/4

A

C) 2/3

23
Q

With Albinism, patients usually have:

A) a dark fundus
B) nystagmus
C) many pigmented spots on their iris
D) an iris nevus

A

B) nystagmus (not A,C, and D…duh! they have no pigment!)

24
Q

What is the term for an iris that has a lack of closure in utero (also occurs in lens, fundus, and optic nerve)?

A) coloboma
B) aniridia
C) floppy iris
D) heterochromia

A

A) coloboma

25
Q

In patients with aniridia, what portion of patients have glaucoma?

A) 1/3
B) 1/2
C) 2/3
D) 3/4

A

D) 3/4 (aniridia is to be without an iris)

26
Q

conditions secondary to aniridia are NOT which one of the following:

A) nystagmus
B) lens and/or cornea opacity
C) foveal and/or disc hyperplasia
D) chorodial coloboma

A

C) foveal and/or disc hyperplasia (they can have foveal and/or disc hypoplasia)

27
Q

Floppy iris is secondary to what?

A) treatment of benign prostate hyperplasia with alpha-1-blockers
B) glaucoma treatment with beta-blockers
C) cataract surgery where new lens does not properly fit to iris
D) old age

A

A) benign prostate hyperplasia with alpha-1-blockers

28
Q

Which of the following describes Iridodialysis?

A) sequela of blunt ocular trauma
B) loss of pigment in the iris
C) disinsertion of the iris from the scleral spur
D) gradual degeneration of the iris collarette

A

C) disinsertion of the iris from the scleral spur (pt can have monocular diplopia)

29
Q

in “Pigment Dispersion” there is a liberation of pigment from what structure?

A) trabecular meshwork
B) corneal endothelium
C) retinal pigmented epithelium
D) iris pigmented epithelium

A

D) iris pigmented epithelium (it can clog trabecular meshwork and cause glaucoma)

30
Q

what is the cause “pigment dispersion”?

A) idopathic
B) iris rubbing against lens zonules
C) increase in acidity of aqueous humor
D) an iris nevus that has metastasized

A

B) iris rubbing against lens zonules

31
Q

What is a key symptom of pigment dispersion syndrome?

A) hyperopic shift
B) rock hard eyeballs after exercise
C) retinal detachment
D) constant flashes of light

A

B) rock hard eyeballs after exercise

32
Q

(T or F) Iridocorneal endothelial syndrome (ICE) is when abnormal corneal endothelial cells migrate to the surface of the iris

A

true

33
Q

What is the difference between primary and secondary angle closure?

A

in primary angle closure, obstruction of aqueous outflow by blockage of the TM by the iris. In secondary angle closure, obstruction of aqueous outflow by blockage of the TM by other structures such as neovascular network, peripheral anterior synechiae, ICE, and others

34
Q

in primary angle closure, the TM is blocked by:

A) posterior placement of the iris
B) anterior placement of the iris
C) posterior placement of NVI
D) anterior placement of NVI

A

B) anterior placement of the iris

35
Q

Can corneal edema be a sign of angle closure, why/why not?

A

yes, aqueous is trying to drain thru the TM but can not. As pressure builds, the aqueous tries to escape thru the cornea but cannot, causing painful swelling.

36
Q

(T or F) a common cause of primary angle closure is “pupillary block”

A

TRUE-pupillary block is an attachment of the iris to the lens, usually from synechiae, and aqueous pushes iris forward to block angle.

37
Q

does angle closure happen more often in hyperopes or myopes?

A

hyperopes, because they have shorter eyes

38
Q

A diffuse iris nevus is a sign of what?

A) Cogan-Resse ICE
B) progressive iris atrophy-ICE
C) Chandler-ICE

A

A) Cogan-Resse ICE (can look almost like heterochromia, also may have pigmented nodules on iris)

39
Q

Between Cogan-Resse-ICE, progressive iris atrophy-ICE, and Chandler-ICE which one has a good, poor, and variable prognosis?

A

Cogan-Resse ICE=poor
progressive iris atrophy-ICE=good
Chandler-ICE=variable

40
Q

50% of ICE cases are:

A) Cogan-Resse ICE
B) progressive iris atrophy-ICE
C) Chandler-ICE

A

C) Chandler-ICE (also has the most corneal changes of all the ICE’s)

41
Q

Which condition has a management option of PRP (pan-retinal-photocoagulation)?

A

NVI

ocular disease (3 decks)

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