Onco & Ocular

Question 1

*Superior Vena Cava Syndrome usu caused by?

Sxs?

Answer 1

• obstruction by maligN (mc is Bronchogenic Carcinoma)

- facial/neck swelling, HA, SOB!, JVD, enlargement of veins, Horner’s Syn. (anhidrosis, ptosis, myosis), cough

Question 2

*if older (30’s, 40’s, 50’s) and new onset of seizure, must rule out?

Answer 2

space occupying lesion

Question 3

Tumor Lysis Syndrome results in imbalances of electrolytes.

• Electrolytes?
• Eti?

Answer 3

Tumor dies off dramatically

• increase in: uric acid, phosphate, potassium
• decrease in: Ca
• hematologic maligN, CA w rapidly growing tumors, particularly acute leukemias and high-grade lymphomas

Question 4

• SIADH … what is it?
• Eti? MC?
• Sxs
• hallmark blood work marker

Answer 4

Syndrome of Inappropriate Antidiuretic Hormone release

• Bronchogenic carcinoma … small cell carcinoma
• Fatigue, alterned mental status, anorexia, nausea, vomiting, constipation, muscle weakness, myalgia, polyuria, polydipsia, seizures, coma
• *Hyponatremia … renal sodium loss

Question 5

• Hypercalcemia of malignancy
• what malignancies cause this?
• Sxs

Answer 5

• mets of CA or prostate causing bone lysis and resorption
• cytokine production dt MM
• *paraneoplastic syndrome… PTHrP … see elevated Ca and low PTH
• Fatigue, anorexia, nausea, vomiting, constipation, mental decline, renal failure, coma, myalgia, headache, altered mental status

Question 6

Febrile neutropenia

• Eti
• how many neutrophils
• sxs

Answer 6

Chemotherapy-associated bacterial or fungal infections

• absolute neutrophil count less than 500 per mm3
• Temp. greater than 101º F

Question 7

Eti’s of Rapidly Developing Visual Loss vs Progressive

Answer 7

• Acute Vascular Occlusion (central A or V)
• Vitreous Hemorrhage
• Acute Glaucome
  (Progressive: retinal detachment, wet macular degeneration)

Question 8

• Temporal Arteritis

- Sxs

Answer 8

HA, scalp T, jaw claudication, reduced visual acuity, fatigue, malaise, fever

Question 9

Cataract Sxs

Answer 9

• can’t see in part or entire visual field… esp at night… difficulty w glare from bright lights
• diabetics more prone

Question 10

• Central Retinal A Occlusion
• characteristic finding
• sxs

Answer 10

cherry red spot over macula

- SUDDEN LOV

Question 11

• Central Retinal Vein occlusion
• characteristic finding
• sxs

Answer 11

blood and thunder!

• retinal hemorrhages extending outward from optic disk
• asx, painless, GRADUAL marked decrease in vision usu in discovered upon waking or more pronounced in the morning

Question 12

Retinal Detachment

- sxs

Answer 12

• flashes of light, FLOATERS, curtain or shadow, peripheral or central vision loss; usu painless, afferent pupillary defect

Question 13

Vitreous Hemorrhage

- sxs

Answer 13

• hazy vision, photophobia, shadows, floaters, smoke signals, cobwebs; usu painless, decreased red reflex, mb afferent pupillary defect, blood in vitreous gel

Question 14

Herpes Simplex

• sxs
• characteristic finding

Answer 14

• pain

- dendritic figure on cornea

Question 15

Chronic Open-Angle Glaucoma assoc. w ____

- sxs

Answer 15

MYOPIA

• mc form
• gradual onset, progresses slowly, w age, diabetes, myopia

Question 16

• Acute Angle-Closure Glaucoma
• *sxs
• risk factors

Answer 16

elevated IOP.. optic N damage

• acute onset
• severe PAIN
• HA, N/V
• blurred vision w halos around lights, LOV, conjunctival injection, corneal edema, mid-dilated non-reactive pupil
• RISK FACTORS: HYPEROPIA, chinese, small drainage angle

Question 17

how are Chalazions different from Hordeolums?

Answer 17

• Chalazions contain granulation tissue, nontender nodules, mc on upper lid