Lecture 3.1 picture descriptions (incl. in 3%)

Question 1

1) What is ptosis?
2) List potential causes
3) What can cause senile ptosis?

Answer 1

1) Drooping upper eyelid
2) Myasthenia gravis, damage to CN3, and Horner’s syndrome, congenital
3) A weakened muscle, relaxed tissues, and the weight of herniated fat

Question 2

1) Define entropion. Who is it common in?
2) What does this cause?
3) How do you check for less obvious entropion?

Answer 2

1) An inward turning of the eyelid margin, more common in the elderly
2) Lower lashes are often invisible when turned inward and irritate the conjunctiva and lower cornea.
3) Have pt squeeze eyelids together, then open them

Question 3

1) What is ectropion and who it’s most common in
2) What does this cause?

Answer 3

1) Outward turning of the lower eyelid margin exposing palpebral conjunctiva; common in older ppl
2) When punctum is outward, eye no longer drains well, causes tearing.

Question 4

1) What is exophthalmos?
2) What is it a sign of?

Answer 4

1) When eyes protrude from the socket (often due to lid retraction)
2) Grave’s (usually bilateral, can be unilateral)

Question 5

1) What is a pinguecula? What is it seen in?
2) What is episcleritis? What is it seen in?

Answer 5

1) A harmless yellow triangular node in the bulbar conjunctiva on the side of the iris
-Common in aging, usually starts on nasal side
2) Localized ocular inflammation of the episcleral vessels; may appear movable and may be nodular (or just may be red).
-Seen in RA, Sjorgen syndrome, and Herpes zoster

Question 6

1) What is a stye? What usually causes it?
2) What is its cause at the inner margin?
3) What about at the outer margin?

Answer 6

1) A painful, tender, red infection at the inner or outer margin of the eyelid, usually from Staphylococcus aureus 2) From an obstructed meibomian gland
3) From an obstructed eyelash follicle or tear gland)

Question 7

1) What is a chalazion?
2) How is it different from a stye?

Answer 7

1) A subacute nontender, usually painless, nodule caused by a blocked meibomian gland.
2) May become acutely inflamed but, unlike a stye, usually points inside the lid rather than on the lid margin.

Question 8

What is xanthelasma?

Answer 8

Yellow plaques along lower eyelids

Question 9

1) Define blepharitis and its cause
2) What variant exists?

Answer 9

1) A chronic inflammation of the eyelids at the base of the hair follicles, often from S. aureus.
2) A scaling seborrheic variant

Question 10

1) What is a corneal arcus?
2) Who is it seen in?
3) What does it suggest?

Answer 10

1) A thin grayish white arc or circle not quite at the edge of the cornea.
2) Accompanies normal aging but also seen in younger adults, especially African Americans.
3) In young adults, suggests possible hyperlipoproteinemia. Usually benign

Question 11

1) What is a Kayser-Fleischer Ring?
2) What do pts with this condition often present with?

Answer 11

1) A golden to red brown ring, sometimes shading to green or blue, from copper deposition in the periphery of the cornea found in Wilson disease.
2) Patients present with liver disease, renal failure, and neurologic symptoms of tremor, dystonia, etc

Question 12

1) What is a pterygium?
2) What may occur? Can pterygium affect vision?

Answer 12

1) A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side.
(visually, it appears as if sclera was growing onto cornea, even if that’s not what’s happening)
2) Reddening may occur. May interfere with vision as it encroaches on the pupil

Question 13

1) What are cataracts?
2) What are risk factors for cataracts?
3) What are nuclear cataracts?
4) What are peripheral cataracts?

Answer 13

1) Opacity of the lenses visible through the pupal
2) Older age, smoking, diabetes, corticosteroid use.
3) A nuclear cataract looks gray when seen by a flashlight. If the pupil is widely dilated, the gray opacity is surrounded by a black rim.
4) Produces spoke-like shadows that point- gray against black, as seen with a flashlight, or black against red an ophthalmoscope. A dilated pupil facilitates this observation.

Question 14

What is the triad of Horner’s syndrome symptoms? What causes Horner’s?

Answer 14

1) Ptsosis
2) Miosis
3) Anhidrosis
-Sympathetic pathway disruption

Question 15

1) What is the pattern of redness in conjunctivitis?
2) Is it painful?

Answer 15

1) Conjunctival injection, diffuse dilatation of conjunctival vessels with redness that tends to be maximal peripherally
2) Mild discomfort rather than pain

Question 16

1) What is the pattern of redness in subconjunctival hemorrhage?
2) Is it painful?

Answer 16

1) Leakage of blood outside of the vessels, producing a homogeneous, sharply demarcated, red area that resolves over 2 weeks
2) No pain at all

Question 17

1) What is the dark spot on a retinal image?
2) What is the bright spot?

Answer 17

1) Fovea
2) Optic nerve

Question 18

How does an image of the retina look different when a pt has papilledema?

Answer 18

The margin of the optic disc is blurred, soft, or indistinct

Question 19

What do red blotches on a retinal image indicate?

Answer 19

Hemorrhage

Question 20

“Copper wiring” is pathognomonic for what?

Answer 20

Hypertensive retinopathy.

Question 21

1) What are drusen?
2) What two things are they seen in?

Answer 21

1) Yellowish round spots on the retina
2) Aging and macular degeneration

Question 22

What 3 things can cause facial swelling?

Answer 22

1) Cushing syndrome (excess cortisol)
2) Nephrotic syndrome (hypovolemia)
3) Myxedema (severe hypothyroidism)

Question 23

Parotid gland swelling is associated with what?

Answer 23

Mumps

Question 24

Large bones in face and hands may be due to what?

Answer 24

Acromegaly

Question 25

What is a characteristic of Parkinson’s?

Answer 25

“Masked facies”

Question 26

Describe what a normal eardrum looks like

Answer 26

-Grayish pinkish
-Handle of malleus can be seen on upper part
-Cone of light is anterior
-NOT bulging, red, or containing purulence behind it

Question 27

What does a perforated eardrum look like?

Answer 27

Literally just a hole in it. Pretty obvious

Question 28

What does tympanosclerosis (eardrum scarring) look like?

Answer 28

White, chalky looking lines and hyaline deposits

Question 29

What is serous effusion?

Answer 29

Clear, thin fluid is visible outside eardrum
(usually caused by upper RI or sudden changes in pressure)

Question 30

Red, bulging, purulent eardrum is indicative of what?

Answer 30

Otitis media

Question 31

Define cheilitis

Answer 31

Irritation and fissures at mouth corners.

Question 32

Vesicular rash around the lips is indicative of?

Answer 32

Herpes

Question 33

Define angioedema

Answer 33

-Localized subcutaneous or submucosal swelling (of lips or mouth).
-Leaking of intravascular fluid into interstitial fluid.

Question 34

White stuff on tonsils is usually?

Answer 34

Exudate

Question 35

Pharyngitis causes what?

Answer 35

Visible redness and vascularity of tonsillar pillars.

Question 36

Diphtheria can cause what?

Answer 36

Grey exudate (pseudo membrane) on oral mucosa
important to know b/c it’s an acute illness that needs quick treatment

Question 37

Describe thrush on the palate (candidiasis)

Answer 37

White plaques that scrape off and often leave punctate bleeding beneath.

Question 38

1) What are kolpik spots?
2) What are they an early sign of? How quick do the spots appear?
3) Where do they usually occur?

Answer 38

1) Small white specks that resemble grains of salt on a red background.
2) Measles (rubeola); within a day
3) On the buccal mucosa near the first and second molars

Question 39

What are petechiae of the mouth?

Answer 39

Small red spots on buccal mucosa

Question 40

1) What is leukoplakia? What can it lead to?
2) How is it different from candida?
3) What can cause it?

Answer 40

1) A thickened white patch; cancer
2) It doesn’t scrape off
3) Chewing tobacco, human papillomavirus infection

Question 41

1) What is marginal gingivitis?
2) Describe symptoms
3) When is it common?

Answer 41

1) Gingival margins are reddened and swollen, and the interdental papillac are blunted, swollen, and red.
2) Brushing the teeth often makes the gums bleed. Plaque (which leads to gingivitis) is not readily visible.
2) Adolescence, early adulthood, and pregnancy.

Question 42

Enlarged masses of the gums are called what?

Answer 42

Gingival hyperplasia