module 1 conjunctivitis Flashcards

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1
Q

conjunctivitis

A

inflammation of the bulbar or palpebral conjunctiva
- commonly referred to at pink eye
Causes:
- Infectious: viral, bacterial
- Non-infectious: allergy, atopy, exposure to toxins

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2
Q

most common cause of infectious

A

adenovirus

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3
Q

most common cause of non-infectious

A

allergic conjunctivitis

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4
Q

viral conjunctivitis patho

A

spread by direct contact of by proximity to an infected person

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5
Q

acute allergic conjunctivitis patho

A

characterized by an immunoglobulin E mast cell-mediated hypersensitivity

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6
Q

vernal and atopic conjunctivitis patho

A

chronic, mast cell, and lymphocyte-mediated immune processes
- more severe and chronic forms of allergic conjunctivitis

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7
Q

medication conjunctivitis patho

A

typically occurs with long-term use of eye drops
- > 1 month

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8
Q

viral conjunctivitis physical exam

A
  • recent URI or exposure to sick individuals
  • acute onset of red eye with excessive watery discharge
  • begins in one eye then migrates to other
  • follicles, clear bumps ranging in size from pinpoint to 2mm, and overlying injected conjunctival vessels
  • fever
  • Sore throat
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9
Q

adenoviral conjunctivitis 3 forms

A

adenoviral
pharyngoconjunctival fever
epidemic keratoconjunctivitis
- palpate anterior cervical chain

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10
Q

pharyngoconjunctival fever s/s

A

ocular exam similar plus
- fever
- headache
- sore throat

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11
Q

epidemic keratoconjunctivitis

A

bilateral conjunctival hyperemia and chemosis
petechial and larger subconjunctival hemorrhages may be present
- may have corneal involvement

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12
Q

chemosis

A

swelling of bulbar conjunctiva
- looks like a big blister

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13
Q

bacterial conjunctivitis physical exam

A

Thick purulent discharge
both eyes are sticky or glued shut
- worse in the am

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14
Q

bacterial conjunctivitis patho

A

overproliferation of native flora or from direct spread from infected individual

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15
Q

acute conjunctivitis (bacterial) s/s

A

s/s manifest over days, usually last 7-10 days
- hyperemia
- chomsis
- photophobia
- blepharospasm
- tearing
- NO systemic s/s
Children: Hib and stretopcoccus pnue. most common causes
Adults: S. aureus most common cause

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16
Q

hyperacute onset (bacterial) s/s

A

s/s within 12-24 and severe purulent discharge
- consistent with Gonorrhoea
- seen in sexually active adults or neonates via maternal-neonate transmission
Cornea involvement can happen in less than 2 days -> permanent vision loss

17
Q

chronic bacterial conjunctivitis s/s

A

lasting longer than 4 weeks
- chlamydial should be suspected

18
Q

Acute Allergic conjunctivitis s/s

A
  • headache and fatigue along with conjunctivitis
  • occurs simultaneously in both eyes
  • itching
  • discharge: clear or stringy white
  • Conjunctiva: boggy appearance (chemosis)
  • periocular skin shows lid discoloration, thickening, and erythema
  • dark circles under eyes
  • Can lead to corneal ulceration
19
Q

vernal and atopic conjunctivitis s/s

A

more severe s/s of severe itching, burning, and tearing
- blepharospasm
- photophobia
- discharge is white, thick, and ropy
- bilateral
Vernal: giant papillary conjunctivitis is hallmark
- upper lid with cobblestone pattern of large geometric bumps -> droopy eyelid
- corneal involvement
- shield ulcer

20
Q

atopic conjunctivitis patient population

A

> 50
hx: asthma, allergic rhinitis, atopic dermatitis

21
Q

vernal conjunctivitis patient population

A

childhood
primarily male
resolves by 3rd decade

22
Q

medication toxicity s/s

A

contact dermatitis of the lower lids
thickening and scaling of the skin

23
Q

viral tx

A

self-limiting
5-14 days
artificial tears
cool compress
- contagious as long as still tearing or for at least 1 week

24
Q

2 sight threatening consequences of viral

A

corneal involvement -> dec. vision
conjunctival pseudomemebranes -> scarring and chronic dry eye
- follow up in 4 weeks if s/s not fully resolved

25
Q

Bacterial tx

A

topical treatment with antibiotics
MUST be treated:
- H. influenzae
- gonococcal
- chlamydial

26
Q

Acute allergic tx

A

allergens identified and removed
oral antihistamine
artificial tears
cool compress
removal of contact lens

27
Q

vernal tx

A

mast cell stabilizers 2 weeks before the usual time of presentation

28
Q

pericorneal

A

conjunctival disorders near the cornea (inc. redness near cornea)
- rosacea
- corneal lesions
- foreign body
- herpetic keratitis

29
Q

ciliary

A

disorders of deeper tissues and intraocular structures
(red ring around iris)
- episcleritis
- scleritis
- disciform keratitis
- iritis
- cyclitis

30
Q

mixed

A

corneal disorders with intraocular irritation
- corneal ulcerations

31
Q

inclusion conjunctivitis

A

from chlamydial infections
- can occur in neonate or in persons at risk for STI