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Opthalmology > New Ophthalmalogy > Flashcards

New Ophthalmalogy Flashcards

1
Q

Blepharitis is associated with what two other medical conditions?

A

-Rosacea and Seborhea

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2
Q

Inflamed lid without palpable bump and no pain

A

-blepharitis

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3
Q

painless nodular lesion of the eyelid

A

-chalazion

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4
Q

an obstruction o meibomian or Zeis tear glands causing a painless bump on the eyelid, TX?

A
  • chalazion

- Tx is warm compresses, if persistent I & D or steroid injection

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5
Q

painful nodular lesion of the eyelid

A

-Hordeolum, staph infection of either internal meibomian gland or external follicle of eyelash

Tx is warm compress, oral antibiotic if local cellulitis

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6
Q

this eye lid disorder causes excess air to the eye lid causing dryness

A

ectropion

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7
Q

this eyelid disorder causes irritation of the cornea by rubbing against it

A

entropion

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8
Q

infection of the orbital muscles and fat

A

-orbital cellulitis, spread behind the eye

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9
Q

infection of the skin of the eyelid and surrounding area

A

-periorbital cellulitis

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10
Q

decreased eye movement, pain with eye movement, and proptosis (forward movement of the eyeball)

A

-signs and DX for orbital cellulitis

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11
Q

most common bug for orbital cellulitis

A

staph/strep

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12
Q

Tx for orbital cellulitis

A

IV vanc plus ceftriaxone, cefotaxime, ampicillin-sbuactam or piperacillin-tazobactam

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13
Q

If you need to confirm orbital cellulitis order what

A

CT scan

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14
Q

Tx for periorbital cellulitis

A

-oral ABX

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15
Q

predisposing factors for orbital cellulitis

A 
paranasal sinusitis
eye surgery
orbital trauma
dacryoscystitis
mucocele
inner ear infection
tooth infection
facial infections
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16
Q

orbital cellulitis can lead to what

A

Cavernous sinus thrombosis and intracranial extension of orbital cellulitis lead to poor prognosis and may be life threatening

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17
Q

peripheral to central vision loss

A

Glucoma

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18
Q

central to peripheral vision loss

A

macular degeneration

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19
Q

begin glucoma screening at what age

A

40

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20
Q

think open angle glaucoma when cup to disk ratio is what

A

> 0.5

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21
Q

Schiotz tonometry positive for open angle glaucoma

A

> 21 mmHg

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22
Q

What in office PE do you do for glaucoma

A

peripheral field testing to confirm

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23
Q

Drugs to tx open angle guaucoma

A

topical carbonic anhydrase inhibitors, acetazolamide, dorzolamid

prostaglandins, latonoprost, bimatoprost

beta blockers, timolol, betaxolol

alpha antagonists, brimonidine

laser Tx , trabeculoplasty, or open surgery

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24
Q

Hallmark findings of acute angle closure glaucoma

A
  • injected conjunctiva
  • cloudy or “steamy” cornea
  • fixed, dilated pupil
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25
Q

first line drugs for tx of acute angle closure glaucoma

A
  • acetazolamide (Diamox)

- Methazolamied (Neptazane)

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26
Q

2nd line drugs for tx of acute angle closure glaucoma

A

timolol

pilocarpine

27
Q

most common cause of bacterial conjunctivitis

A

staph aureus, strep pnuemo, H flu, M cat

28
Q

causes of cobblestoning of palpebral conjunctiva

A

viral or allergic conjunctivitis

29
Q

most common cause of viral conjunctivitis

A

adenovirus

30
Q

the 3 causes of acute monocular vision loss (amaurogis fugal)

A
  • retinal artery occlusion
  • optic neuritis
  • temporal artery neuritis/temporal arteritis
31
Q

cherry red spot on macula and amaursosis fugal ( acute loss of vision in one eye)

A

retinal artery occlusion

32
Q

most common cause of retinal artery occlusion

A

ruptured carotid plaque from ipsilateral carotid artery

33
Q

other causes of retinal artery occlusion

A 
a fib
endocarditis
valvular heart disease
sickle cell anemia
hypercoaguable states
focal aterial disease/trauma
autoimune vasculitis
34
Q

how to you tx retinal artery occlusion

A

just like a stroke

35
Q

Sx of retinal vein occlusion

A

often asymptomatic or loss or blurring of vision in one eye, seen with Branch retinal vein occlusion (BRVO)

36
Q

Tx for retinal vein occlusion

A

Ranibizumab (Lucentis)
intravitreal steroids
thrombolytics
surgical intervention including vitrectomy

37
Q

Funduscopy finding findings of “blood and thunder retina”

A

superficial retinal hemorrhages–central retineal vein occlusuion (CRVO)

38
Q

guy with diabetic retinopathy now has floaters or small moving flashes of light

A

think retinal detachment as diabetic retinopathy causes degregation of the retina and can lead to detachment or small tears

39
Q

tx of small tear of retina

A

ophthalmology referral

40
Q

tx of retinal detachment

A

repair

41
Q

PE of retinal detachment shows what

A
  • visual field loss

- line of tear/detachment on fudus exam

42
Q

fudul exam shows yellow retinal deposits

A

macular degeneration

43
Q

what PE test is necessary for macular degeneration

A

Amsler grid

44
Q

risk factors for macular degeneration

A

age
smoking
CAD
family HX

45
Q

Slow visual loss, Drusen (yellow retinal deposits)

A

Dry macular degeneration

46
Q

Tx for Dry Macular Degeneration

A

Supportive, supplements

47
Q

Rapid vision loss with macular degeneration, neovasculariztion

A

Wet macular degeneration

48
Q

Tx of wet macular degeneration

A

Inravitreal ranibizumab (Lucentis) and anti-VEGF TX, laser TX

49
Q

Acute inflammation and demyelinaion of the optic nerve

A

optic neuritits

50
Q

What causes optic neuritis

A

multiple sclerosi most often (MS)

51
Q

Guy has acute monocular vision loss, pain in affected eye, and sluggish pupillary response

A

optic neuritis–think MS

MRI for confirmation

52
Q

Tx for optic neuritis

A

methylprdnisolone (Solu-Medrol) IV

neurology evaluation for eye and MS eval

53
Q

retinopathy in an HIV patient is likely caused by what infectious agent

A

CMV, next toxoplasmosis

54
Q

a blowout fx involves what ocular muscle

A

inferior rectus muscle entrapment

55
Q

What nerve can be involved with a blowout fx and how would you recognize it?

A

-paresthesia in the gums, upper lip, and cheek

56
Q

What direction would the globe be displaced in a blowout fx?

A

posterior displacement of the globe

57
Q

What PE findings would you have in a blowout fx?

A

loss of EOM, paresthesia, diplopia (double vision), warrant CTto confirm orbital floor fx

58
Q

swelling of the optic disk

A

Papilledema

59
Q

swelling of the optic disk from intracranial pressure

A

Papiledema

60
Q

What conditions could lead to intracranial pressure and Papiledema?

A
  • tumor or bleed
  • cerebral edema
  • CSF outflow obstruction or overproduction
61
Q

What tests do you need to do when you recognize Papiledema?

A

CT imaging and Lumbar puncture

62
Q

What finding is diagnostic for intracranial pressure being increased?

A

increase opening pressure on lumbar puncture

63
Q

What is the danger of increased intracranial pressure and not quickly treating when we see Papiledema?

A

blindness

64
Q

If you see a hyphema in the absence of trauma what would you suspect?

A
  • blood dyscrasia
  • coagulopathy

look for hypo coagulable state or hemoglobinopathy

Opthalmology (3 decks)

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