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Year 5 MBChB > JB-Opthalmology > Flashcards

JB-Opthalmology Flashcards

1
Q

What is glaucoma

A

Damage to the optic nerve normally by a significant rise in intraocular pressure

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2
Q

Definition of open angle glaucoma

A

Gradual rise in resistance through trabecular meshwork -> increased pressure

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3
Q

Key change on fundoscopy in glaucoma

A

Cupping of optic disc (greater than 0.5) abnormal

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4
Q

4 risk factors for open angle glaucoma

A

Age, FH, black, myopia (nearsightedness)

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5
Q

What is myopia

A

Nearsighted/ short sighted
Cannot see things far away clearly
[shorter word than hypermetropia]

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6
Q

Two ways to measure intraocular pressure

A

Non-contact (puff of air)
Goldmann applanation (gold standard but need slip light)

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7
Q

Visual loss in glaucoma

A

Peripheral -> tunnel vision

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8
Q

Open angle glaucoma first line treatment

A

Prostaglandin analogue eyedrops (lantoprost)
Increase uveoscleral outflow
Eyelash growth, eyelid pigmentation, iris browning

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9
Q

Open angle glaucoma management

A

1:Prostaglandin analogue eyedrops (lantoprost) - increase outflow
2:BB (timolol) - decrease production
3: carbonic anhydrase inhibitor (dorzolamide) - decrease production
4: sympathomimetics (brimonidine) - decrease production
Trabeculectomy

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10
Q

Screening in open angle glaucoma

A

Annual from 40 if 1st line relative

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11
Q

Pathophysiology of closed angle glaucoma

A

Iris bulges forward and seals off trabecular meshwork from anterior chamber -> fluid cannot drain away -> increased pressure

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12
Q

Medications which can precipitate acute angle closure glaucoma

A

Adrenergic (adrenaline), anticholinergic (oxybutynin) and TCAs

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13
Q

4 symptoms of AACG

A

Painful red eye
Blurred vision
Halos around lights
Headaches (nausea and vommiting)

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14
Q

Signs in AACG

A

Red, teary, hazy cornea, fixed and dilated pupil, firm on palpation

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15
Q

3 key management steps in AACG

A

Pilocarpine (mitotic agent to increase room around iris)
Acetazolamide (carbonic anhydrase inhibitor - reduce production)
Lie on back without a pillow

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16
Q

Definitive treatment of AACG

A

Laser iridotomy

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17
Q

Most common cause of blindness in UK

A

Age related macular degeneration

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18
Q

Key finding on fundoscopy in macular degeneration

A

Druseen

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19
Q

2 key symptoms in macular degeneration

A

Worsening central visual loss
Wavy appearance to straight lines

20
Q

Piece of equipment to test for macular degeneration

A

Amsler grid test (distorted straight lines)
Snellen chart

Optical coherence tomography - wet AMD

21
Q

How is wet AMD diagnosed

A

Optical coherence tomography

22
Q

Treatment for dry AMD

A

Stop smoking, control BP
Vitamins (A,C,E and zinc)

23
Q

Treatment for wet AMD

A

Anti-VEGF medications
Need to be started within 3 months to be beneficial

24
Q

Fundoscopy changes in diabetic retinopathy

A

Blot haemorrhages
Hard exudates
Microaneurysms
Cotton wall spots

25
Q

3 management options for diabetic retinopathy

A

Laser photocoagulation
Anti-VGEF medications
Vitreoretinal surgery

26
Q

2 fundoscopy signs in hypertensive retinopathy that are unlikely in diabetic

A

Copper wiring
AV nipping

27
Q

Classification of hypertensive retinopathy

A

Keith-Wagener (1-4)

28
Q

RF for cataracts

A

Age, smoking, alcohol, diabetes, steroids, hypocalcaemia

29
Q

In ophthalmology what causes
Central visual loss?
Peripheral visual loss?
Generalised visual loss?

A

Central = AMD
Peripheral = glaucoma
Generalised = cataracts

30
Q

Key complication of cataracts surgery

A

Endophthalmitis

Inflammation of inner eye
Treated with intravitreal antibiotics

31
Q

Commonly used eye drops for allergic rhinitis

A

Anatazoline (antihistamine)

Sodium cromoglicate (mast cell stabiliser)

32
Q

topical mydriatics

A

Tropicamide (used to examine as short half life)
Atropine

Cocaine and TCAs

33
Q

Drug used to examine for corneal defects

A

Fluroescein

34
Q

Central retinal vein occlusion presenting complaint

A

Sudden painless vision loss

35
Q

Central retinal vein occlusion fundoscopy changes

A

Retinal haemorrhages +++ (sunset appearance)
Widespread hyperaemia (red eye)

36
Q

Central retinal artery occlusion presenting complaint

A

sudden, painless unilateral visual loss

37
Q

Central retinal artery occlusion fundoscopy findings

A

‘cherry red’ spot on a ++ pale retina

RAPD also present

38
Q

Retinitis pigmentosa presenting complaint (2)

A

Tunnel vision and night blindness

39
Q

Retinitis pogmentosa fundoscopy changes

A

Black spicule-shaped pigmentation in the peripheral retina (looks like mottling)

40
Q

Treatment for herpes zoster opthamos

A

Oral aciclovir treatment for 7-10 days

Should start within 72 hrs

41
Q

Cornea changes in Acute angle closure glaucoma

A

Hazy

42
Q

“Cilliary flush” -> dx

A

Anterior uveitis

Blurred vision and photophobia
small, fixed oval pupil, ciliary flush

43
Q

Treatment of anterior uveitis

A

steroid + cycloplegic (mydriatic) drops

44
Q

“irregular pupil” -> dx

A

anterior uveitis

45
Q

Are high or low levels of ca a cause of cataracts

A

Hypocalcaemia causes cataracts

(I have no cataracts)

Year 5 MBChB (17 decks)

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