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Neuro II > Ocular disorders > Flashcards

Ocular disorders Flashcards

1
Q

Chronic lipogranulomatous inflammation of the meibomian gland

A

Chalazion

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2
Q

Acute inflammation of the eyelash follicles

A

Hordeolum

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3
Q

Common infectious agent in hordeolum

A

Mainly by S aureus

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4
Q

Pt presents with conjunctival hyperemia, eye discharge, foreign body sensation, and photophobia

A

Conjunctivitis

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5
Q

Conjunctivitis with thick, purulent discharge

A

Bacterial

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6
Q

Conjunctivitis with watery or mucoid discharge

A

Viral

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7
Q

Small, raised, yellowish-white hyperplasia of lymphatic tissue in the eye

A

Conjunctival follicles, seen in viral conjunctivitis

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8
Q

Often due to silver nitrate exposure within 24 hours after birth

A

Chemical neonatal conjunctivitis

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9
Q

Onset and presentation of gonococcal neonatal conjunctivitis

A

2-7 days after birth with purulent ocular discharge and pronounced eyelid swelling

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10
Q

Onset and presentation of chlamydial neonatal conjunctivitis

A

5-23 days after birth with watery/mucopurulent ocular discharge and mild eyelid swelling

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11
Q

Common causal agent of viral neonatal conjunctivitis

A

HSV II

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12
Q

Onset and presentation of viral neonatal conjunctivitis

A

Within 14 days after birth with nonpurulent ocular discharge, corneal ulceration, and periocular vesicles

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13
Q

Fibrovascular Ct that migrates on to the cornea, associated with chronic sun exposure

A

Pterygium

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14
Q

Small, yellowish, submucosal elevation of protein and lipid deposits in the eye that does not invade the cornea

A

Pinguecula

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15
Q

Fluorescein staining in bacterial keratitis

A

Round corneal infiltrate or ulcer

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16
Q

Keratitis features in shingles

A

Punctate or dendritic lesions on the corneal surface

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17
Q

Fluorescein staining in herpes simplex keratitis

A

Superficial corneal erosions, geographic ulcer

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18
Q

Corneal ring infiltrate, associated with contact lens use

A

Late-stage acanthamoeba keratitis

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19
Q

Inflammation under an intact corneal epithelium

A

Stromal/interstitial keratitis

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20
Q

Infective causes of stromal/interstitial keratitis

A

Syphilis
TB
Leprosy

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21
Q

Pt presents with foreign body sensation, severe ocular pain, photophobia, and blurred vision. They have immigrated from an impoverished country and have had a cough. On exam cornea appears hazy with ground glass/steamy appearance

A

Stromal/interstitial keratitis

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22
Q

Non-inflammatory corneal condition where it becomes thinner and develops a conic shape, bulging outward at the center

A

Keratoconus

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23
Q

Conditions associated with keratoconus

A

Down syndrome
Marfan syndrome

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24
Q

Complication of keratoconus

A

corneal hydrops –> rupture of descemet membrane

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25
Q

Microscopy shows thinning of the cornea with breaks in the Bowman layer

A

Keratoconus

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26
Q

Annular deposits of lipids appear around the corneal margin, associated with normal aging.

A

Arcus senilis/corneal arcus

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27
Q

Green-brown, copper deposits within Descemet’s membrane, associated with Wilson disease

A

Kayser-Gleischer ring

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28
Q

Disease associated with Kayser-Gleischer ring

A

Wilson disease

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29
Q

Earliest manifestation of vit A deficiency

A

Night blindness and impaired vision

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30
Q

Epithelial metaplasia and keratinization of eye with xerophthalmia, Bitot spots, keratomalacia.

A

Vit A deficiency

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31
Q

Characterized by optic disc atrophy with cupping

A

Glaucoma

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32
Q

Progressive visual field loss starting with peripheral vision until tunnel vision

A

Open angle/primary glaucoma

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33
Q

General secondary cause of open angle glaucoma

A

Blocked trabecular meshwork from debris

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34
Q

Primary cause of angle-closure glaucoma in elderly

A

Thickness of lens increases with age

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35
Q

Secondary causes of angle-closure glaucoma

A

Neovascular glaucoma (DM)
Scaring
Lens dislocation
Mydriatic agents

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36
Q

Pt presents with sudden acute loss of vision, unilateral inflamed and painful eye, frontal HA, blurred vision, and halos around light.

A

Closed angle glaucoma

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37
Q

Reduced aqueous outflow leading increase in intraocular pressure that compresses retinal blood supply with optic dis atrophy and cupping

A

Glaucoma

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38
Q

Cholinergic agent for glaucoma

A

Pilocarpine

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39
Q

Acts on M3 receptors to cause contraction of sphincter pupillae and longitudinal ciliary muscle to increases trabecular outflow

A

Pilocarpine

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40
Q

Adverse effects of Pilocarpine

A

Superficial punctate keratitis
Brow ache
Induced myopia
Increased risk of retinal detachment
Iritis

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41
Q

Most widely used ocular hypotensive agent

A

Timolol

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42
Q

Conditions that contraindicate use of Timolol in glaucoma

A

COPD
Asthma
HF

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43
Q

Selective beta-1-blocker used for glaucoma

A

Betaxolol

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44
Q

Beta-blocker used in glaucoma with an additional neuroprotective effect

A

Betaxolol

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45
Q

Mechanism of beta-blockers in treating glaucoma

A

Decreases aqueous humor production by blocking beta receptors on ciliary epithelium

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46
Q

Nonselective adrenergic agents used in treating glaucoma

A

Epinephrine
Dipvefrin

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47
Q

Prodrug of epinephrine with an increased penetration to the anterior chamber of the eye

A

Dipivefrin

48
Q

Mechanism of Dipivefrin

A

Increased uveoscleral outflow

49
Q

Selective alpha-2 agonists used in glaucoma

A

Brimonidine
Apraclonidine

50
Q

Drug used short term for post op rise in intraocular pressure

A

Apraclonidine

51
Q

Selective alpha-2 agonist with an additional neuroprotective effect

A

Brimonidine

52
Q

Drug used for glaucoma in pts with contraindications to beta blockers

A

Brimonidine

53
Q

Mechanism of alpha-2 agonists for glaucoma

A

Decrease aqueous humor production by alpha-2 action on ciliary epithelium

54
Q

Prostaglandin analogues used to treat glaucoma

A

Latanoprost
Unoprostone
Bimatoprost
Travoprost

55
Q

Adverse effects of latanoprost

A

Conjunctival hyperemia
Iris pigmentation
cystoid macular edema

56
Q

Prostaglandin analogue with an additional neuroprotective effect by increasing microcirculation in optic nerve head

A

Unoprostone

57
Q

First line drug class for open angle glaucoma

A

Prostaglandin analogue

58
Q

Mechanism of prostaglandin analogues in glaucoma

A

Decrease IOP by increasing uveoscleral outflow

59
Q

Systemic carbonic anhydrase inhibitors used in glaucoma

A

Acetazolamide
Methazolamide

60
Q

Drug class that blocks CA enzyme reversibly in ciliary body, limits generation of bicarbonate ion, and reduces aqueous humor production. Used to treat glaucoma.

A

Systemic carbonic anhydrase inhibitors

61
Q

Topical carbonic anhydrase inhibitors used to treat glaucoma

A

Dorzolamide
Brinzolamide

62
Q

Advantage of dorzolamide

A

Not absorbed systemically

63
Q

Adverse effects of dorzolamide

A

Corneal edema
Allergic reaction
Burning and stinging sensations

64
Q

Osmotic agents used to treat glaucoma

A

Glycerine
Mannitol

65
Q

Mechanism of osmotic agents in glaucoma

A

Increases shift of water into the intravascular space to decrease IOP

66
Q

Types of optic neuritis

A

Retrobulbar
Intrabulbar neuritis/papillitis

67
Q

Most common cause of optic neuritis

A

MS

68
Q

Infections associated with optic neuritis

A

Lyme disease
Syphilis

69
Q

Toxin associated with optic neuritis

A

Methanol

70
Q

Pt presents with blurry vision, sudden vision loss, central scotoma, and retrobulbar pain.

A

Optic neuritis

71
Q

Inherited optic neuritis

A

Leber hereditary optic neuropathy

72
Q

Inflammatory disorders associated with anterior uveitis

A

Sarcoidosis
RA
Juvenile idiopathic arthritis

73
Q

Slit-lamp examination shows hypopyon

A

Non-granulomatous uveitis

74
Q

Hypopyon

A

Collection of pus in anterior chamber of eye

75
Q

Findings in granulomatous uveitis

A

Large keratic precipitates

76
Q

Bilateral granulomatous panuveitis after penetrating injury or surgery beginning several weeks to a year after trauma

A

Sympathetic ophthalmia

77
Q

Patient presents with floating spots, reduced vision, pain in both eyes, and increased sensitivity to light. Eye trauma occurred several months ago.

A

Sympathetic ophthalmia

78
Q

Complication of sympathetic ophthalmia

A

Bilateral blindmess

79
Q

T cell mediated autoimmune response to retinal antigens

A

Sympathetic ophthalmia

80
Q

Treatment for sympathetic ophthalmia

A

Systemic immunosuppressant

81
Q

Lens of eye becomes cloudy and opaque, most often with increasing age

A

Senile cataract

82
Q

Key sign in senile cataract

A

Loss of red reflex

83
Q

Leading cause of blindness in those <65 yo in developed countries

A

Macular degeneration

84
Q

Elderly pt present with gradual, painless, bilateral vision loss

A

Macular degeneration

85
Q

Accumulation of EC deposits (drusen) underneath the retinal pigment epithelium due to oxidative damage

A

Dry/non-exudative macular degeneration

86
Q

Growth of neovascular vessels from choroid that proliferate underneath the retinal pigment epithelium and defects in Bruch’s membrane. Leakage produces elevation of retina causing metamorphopsia and blurring.

A

Wet/exudative macular degeneration

87
Q

Early sign of wet AMD

A

Scotoms

88
Q

Late-sign of wet AMD

A

Straight lines appear wavy

89
Q

General treatment for wet AMD

A

Intraocular injection of VEGF antagonists

90
Q

VEGF antagonists used in AMD

A

Bevacizumab
Ranibizumab
Aflibercep

91
Q

Sudden and painless loss of vision in one eye

A

Vessel occlusion

92
Q

Fundoscopy findings in central retinal A occlusion

A

Cherry-red spot at fovea centralis

93
Q

Fundoscopy findings in central retinal V occlusion

A

Flame-shaped hemorrhages
Tortuous veins
Papilledema

94
Q

Pt presents with asymptomatic gradual reduction in vision with normal lens and cornea

A

Retinopathy

95
Q

Retinopathy grade with focal narrowing or arterioles and mild A-V nicking

A

Grade 1

96
Q

Retinopathy grade with arteriole narrowing, copper wiring, and more accentuated A-V nicking

A

Grade 2

97
Q

Retinopathy grade with arteriole narrowing, silver wiring, flame-shaped and dot-blot hemorrhages, soft cotton wool spots, hard exudates, and normal disc.

A

Grade 3

98
Q

Retinopathy grade with fine, fibrous arterioles, silver wiring, flame-shaped and dot-blot hemorrhages, soft cotton wool spots, hard exudates, normal disc, and papilledema.

A

Grade 4

99
Q

Two types of diabetic retinopathy

A

Non-proliferative/early
Proliferative/late

100
Q

Wet retinopathy is associated with this underlying condition

A

Diabetes

101
Q

Risk factor for developing retinopathy of prematurity

A

Treatment with hyperbaric oxygen therapy in premature infants with hyaline membrane disease

102
Q

Retinal ischemia, upregulation of VEGF-retinal angiogenesis, formation of fibrovascular membranes, and retinal detachment

A

Retinopathy of prematurity

103
Q

Most common primary intraocular malignancy in adults

A

Uveal melanoma

104
Q

Risk factors for uveal melanoma

A

Uveal nevus
Light skin color
Light color of iris

105
Q

Fundoscopy findings in uveal melanoma

A

Pigmented lesion near temporal margin of the optic disc

106
Q

Histology of ocular lesion shows large cells, vesicular nucleus, prominent nucleolus, with cytoplasmic melanin pigment

A

Uveal melanoma

107
Q

Most common primary intraocular malignancy of children

A

Retinoblastoma

108
Q

Mutation associated with retinoblastoma

A

RB on chromosome 13

109
Q

Other cancers associated with retinoblastoma

A

Osteosarcoma
Pinealoma

110
Q

Child presents with leukocoria and progressive or sudden loss of vision

A

Retinoblastoma

111
Q

Features of leukocoria

A

Cat’s eye pupil
White pupillary reflex
Strabismus

112
Q

Cause of progressive loss of vision in retinoblastoma

A

Due to tumor infiltration into the macula or vitreous humor

113
Q

Cause of sudden loss of vision in retinoblastoma

A

Retinal detachment

114
Q

Histology shows small, round, blue cells with hyperchromatic nuclei and scanty cytoplasm. With rosettes and fleurettes, necrosis, and dystrophic calcification

A

Retinoblastoma

115
Q

Generalized reduction of visual acuity with starburst around lights

A

Cataract

116
Q
A

Neuro II (21 decks)

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