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Opthalmology > Jack's Opth > Flashcards

Jack's Opth Flashcards

1
Q

An infection of the eyelid with loss of eyelashes, scaling, and itchy eye?

A

-Blepharitis

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2
Q

An external Hordeolum

A

-Sty, a staph abscess in the eyelid on the margin of the eyelid

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3
Q

An infection of the meibomian gland and abscess

A

-Hordeolum (internal)

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4
Q

Tx of Sty (external Hordeolum) or internal Hordeolum

A
  • bacitracin or erythromycin q 3 hrs

- I&D if necessary

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5
Q

A cyst of a clogged meibomian gland.

A

-Chalazion

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6
Q

Sx and sx of a Chalazion?

A
  • painless bump

- often secondary to a sty

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7
Q

Tx of a Chalazion

A

-steroid injection or surgical excision

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8
Q

Folding in of the eyelid is what and what is the etiology?

A

-Entropion, due to weakening of the eyelid muscle/skin

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9
Q

Folding out of the eyelid is what and what causes it?

A

-Ectropion, lossening of the eyelid muscle and skin

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10
Q

Teardrop sign on facial/orbit xray? Tx

A
  • blowout fx
  • antibiotics because fx extends into the sinus
  • monitor vs surgery
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11
Q

-Rust ring on corneal exam

A

-foreign body, steel causes the rust ring

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12
Q

Do you apply an eye patch to a patient with a foreign body?

A

-no, contraindicated

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13
Q

To identify a corneal abrasion you do what?

A

-fluorescein stain and abrasion will be darker than the rest of the cornea

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14
Q

Inflammation/infection of the nasolacrimal sac?

A
  • Dacryocystitis
  • usually newborns
  • tx, probing or surgical procedure
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15
Q

Lab test for Chlamydia conjunctivitis?

A

-Giemsa stain for chlamydia

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16
Q

Lab test for Neisseria conjunctivitis?

A

-culture on Chocolate agar

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17
Q

Common bugs that cause Orbital Cellutitis?

A

-Strep pneumo and Staph aureus

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18
Q

This bug can cause an orbital cellulitis secondary to a chronic sinus infection or dental infection?

A
  • H. flu

- vaccination for H. flu now so this isn’t seen often any more

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19
Q

Sx of Orbital cellulitis?

A
  • Sick/ill person
  • fever
  • painful swelling around the eye
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20
Q

Tx of Orbital cellulitis

A

-admit for IV antibiotics, Vanc, Clindamycin, Doxy

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21
Q

Opacification of the eye lens obstructing the flow of light to the retina

A

-Cataract

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22
Q

Some causes of cataracts

A
  • age, proteins denature over time
  • sunlight and radiation
  • smoking
  • secondary to diabetes
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23
Q

Sx of cataracts

A
  • difficulty seeing at night

- slow progressing cloudy vision

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24
Q

Cataract prevention

A

-sunglasses with UV filtering

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25
Q

Tx of cataracts

A
  • glasses with proper prescription (prevent falls in elderly)
  • better lighting
  • use of magnifying glasses
  • surgery
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26
Q

Increased intraocular pressure leading to damage to the optic nerve

A

-Glaucoma

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27
Q

Chronic angle glaucoma

A

-open angle glaucoma

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28
Q

Eye c/o of gradual loss of peripheral vision or no sx at all

A

-open angle glaucoma

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29
Q

Eye c/o pain, N/V, blurred vision, halos around lights and photophobia

A

-Acute closed angle glaucoma

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30
Q

A fixed mid dilated pupil that does not change when you shine light on the pupil

A

-closed angle chronic glaucoma

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31
Q

Bowing of the iris

A

-open angle glaucoma

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32
Q

N Tonometry and cup:disc ratio on eye exam

A
  • IOC > 21 is abnormal

- cup:disc of > 0.5

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33
Q

Visual field shows decreased peripheral vision and bowing of the iris

A

-open angle glaucoma

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34
Q

red or hazy eye and IOP >21

A

-closed angle glaucoma

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35
Q

Glaucoma tx to promote drainage

A
  • Prostoglandins
    • Latanoprost (Xalatan)
    • Bimatoprost (Lumigan)
36
Q

Glaucoma tx to decrease production of aqueous humor

A
  • Beta Blockers
    • Timolol
    • Betaxolol
37
Q

Glaucoma tx to decrease production of aqueous humor and to promote drainage

A
  • Alph Adrenergic agonists
    • Apraclonidine (iopidine)
    • Brimonidine (Alphagan)
38
Q

Sx of Papilledema

A
  • Headache
  • noticeable blindspot
  • blurred vision
  • total vision loss
39
Q

Optic disc swelling secondary to intracranial pressure

A

-Papilledema

40
Q

Fundal exam for Papilledema

A
  • venous engorgement
  • hemorrhages near the optic disc
  • blurring of optic disc margins
41
Q

What further study is needed to treat Papilledema?

A

-CT or MRI of the head to find the intracranial pressure

42
Q

Tx for Papilledema

A
  • Tx the underlying cause of intracranial pressure
  • diuretics to decrease pressure (Furosemide)
  • keep head of bed elevated
43
Q

Blood in the anterior chamber of the eye

A

-Hyphema

44
Q

Sx for Hyphema

A
  • vision abnormalities
  • pain
  • photophobia
45
Q

Tx for Hyphema

A
  • sleep with head of bed at 45 degree angle
  • no reading or TV for 3 days
  • eye patch
46
Q

Wedge shaped growth of conjunctiva which grows from the nasal side towards the cornea, is starting to grow over the cornea

A
  • Pterygium

- surgery it disrupts vision

47
Q

Yellowish deposit on the conjunctiva which does not grow over the cornea

A

-Pinguecula

48
Q

Risk factors for Pterygium and Pinguecula

A
  • wind
  • sun exposure
  • sand
49
Q

72 y.o. male presents with loss of central vision (scotoma), wavy vision (metamorphopsia), and a decrease in visual acuity? What is the likely Dx?

A

-Macular Degeneration

50
Q

PE findings for macular degeneration

A
  • decreased visual acuity
  • Amsler grid test shows wavy vision (metamopohopia)
  • loss of central vision
51
Q

Metamorphopis

A

-wavy vision

52
Q

Funal exam findings for Macular Degeneration

A
  • Drusen deposits

- atrophy of the retina–pigment loss

53
Q

What dietary supplements help Macular Degeneration?

A
  • Vit A, C, E, B6, B12
  • zinc
  • copper
  • lutein
  • omega 3 fatty acids
54
Q

What is the tx for wet Macular Degeneration?

A

-Vascular endothelial growth inhibitors given by intravitreal injection

55
Q

What surgical procedure is for Macular Degeneration?

A

-Laser photocoagulation

56
Q

If really concerned about nystagmus what test would you get?

A

-CT or MRI to check for mass effect

57
Q

Tx for nystagmas

A
  • observation
  • glasses
  • surgery for brain mass
58
Q

Misalignment of both eyes, eyes don’t move together

A

-Strabismus

59
Q

PE for Strabismus

A
  • Cover/uncover test

- Hirshberg corneal reflex test

60
Q

Why tx Strabismus as a child?

A

-so it doesn’t lead to Amblyopia (blindness in the affected eye)

61
Q

A loss of vision in the otherwise normal eye

A

-Amblyopia

62
Q

Patient presents with acute vision loss (or blurred vision), loss of color vision, pain before the visual symptoms began, and pain with eye movement? Dx and Tx

A
  • Optic Neuritis
  • vision test, color vision test and MRI of the brain
  • tx treat underlying cause (infection)
    • ? IV steroids
    • usually resolved in 2-3 mo
63
Q

What causes Optic Neuritis?

A
  • Autoimmune– MS #1 cause
  • fungal infection
  • bacteria infection–lyme, TB, syphilis
  • viral infection-herpes zoster, mumps, rubella
  • Vitamin B deficiency
64
Q

What are the 2 ways people get a detached retina?

A

-trauma, older pts have a spontaneous detachment

65
Q

62 y.o. male presents with painless vision loss and feels like “the curtain coming down”. What is the likely Dx and Tx?

A

-Dx is torn retina

  • Refer to Ophth
  • surgery
66
Q

PE findings for detached retina?

A
  • Retina may appear to be hanging down

- asymmetric red reflex

67
Q

5 causes of Retinopathy (damage to the retina)

A
  • HTN
  • DM-DM type 1 screen annually, DM type 2 screen 3-5 yrs
  • Premature birth
  • Radiation/sun damage (pain 6-12 hrs after sunburn)
  • Sickle Cell
68
Q

Fundus exam shows hemorrhages, and Cotton Wool Spots

A
  • DM (Preproliferative changes)

- Dx is diabetic retinopathy

69
Q

Fundus exam shows copper wire, silver wire sclerosis and AV nicking

A
  • HTN (arteriolar narrowing)

- Dx is HTN retinopathy

70
Q

Who gets Reinal Artery Occlusion

A
  • Atrial Fib
  • Temporal arteritis
  • DM
  • HTN
  • Sclerosis
  • Clot
71
Q

DM patient presents with Acute vision loss and no pain. Fundal exam shows Boxcarring, Cherry Red Spot, optic atrophy and a pale disc. What is the likely Dx and how do you tx?

A

-Retinal artery occlusion

  • TX, emergency get to Opth.
    • intermittent pressure
    • tPA
72
Q

HTN or sickle cell patient presents with vision loss and/or blurred vision. Fundal exam shows blood under the fundus, dilated veins, exudates and neovascularization.

A

Central vein occlusion

tx underlying cause – DM, Sickle Cell, HTN, Glaucoma

73
Q

Who gets Amaurosis Fugas (TIA of the eyeball)?

A
  • people with Carotid plaques

- people with atrial fibrilation

74
Q

A patient known to have A Fib (or would have carotid plaques) presents with transient ACUTE vision loss, sees the Curtain descend and then goes back up in just one eye. Dx and tx

A

-Amaurosis Fugas

Tx, tx the A fib or carotid plaques
-heparin

75
Q

Retinal lines that have the appearance of a “ripple on a pond” or a “billowing sail” are fundascopic findings consistent with what Dx?

A

-Retinal Detachment

76
Q

A fundal exam that shows a pale or milky retina with a cherry-red fovea is consistent with what Dx?

A
  • central retinal artery occlusion as a result of small emboli breaking loose from sclerotic plaque and lodging in the retinal arterioles.
  • transient visual loss (amaurosis fugax) often occurs
77
Q

A swollen disc with blurred margins, and physiologic cup is not visible on fundal exam is consistent with what Dx?

A

-Papilledema–get a head CT

78
Q

An enlarged physiologic cup, occupying more than half of the disc’s diameter is consistent with what Dx?

A

-Glaucoma

79
Q

Yellowish-orange to creamy-pink disc with sharp margins and a centrally located physiologic cup on fundal exam is consistent with what Dx?

A

-Normal Exam

80
Q

Symptoms of difficulty keeping eyelids (often only one eyelid) open but improves with a nap are consistent with what Dx?

A
  • myasthenia gravis

- get a Tensilon (edrophonium test)

81
Q

Describe the Tensilon test (endrophonium) for myasthenia graves.

A

-adult dose is 0.2 cm3 endophonium chloride IV and eyelids are then assessed for improvement of function. Additional dosing is provided in 0.2 cm3 increments to a total of 1.0 com3.

82
Q

Who gets myasthenia graves?

A

-young adults, 20-40 yrs of age and often after an illness, stress, injury or pregnancy

83
Q

What is the pathology for myasthenia graves?

A

-cholinesterase destroying acetylcholine at the myoneural junction.

84
Q

26 y.o. male presents with bilateral conjunctivitis, dysuria, and low back and achilles tendinitis? What is the probable Dx?

A

-Reiter Syndrome (Reactive Arthritis)

triad of arthritis, conjunctivitis, urinary tract sx

85
Q

When is Seidel test performed on the eye?

A

-when a perforated globe is suspected

86
Q

How do you perform the Seidel test for a possible perforated globe?

A

-a moistened fluorescein dye strip is gently applied to the site of injury. Slit-lamp exam is performed with cobalt blue light. If a perforation or leak is present, the flourescein stain dye will be diluted by aqueous fluid from the injured site. It will appear as a dark (diluted) stream with a pool of bright green (concentrated) dye.

Opthalmology (3 decks)

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