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DIM Bloc TCP > Ophtalmology > Flashcards

Ophtalmology Flashcards

1
Q

What’s your diagnosis?

A

Trochlear nerve palsy: unopposed inferior oblique due to desabled superior oblique

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2
Q

What’s your diagnosis?

A

Oculomotor palsy

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3
Q

What’s your diagnosis?

A

Abducens nerve palsy: unopposed medical rectus because of disabled lateral rectus

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4
Q

What are the key elements to ask when doing a history taking in ophtalmology?

A
  1. Past medical history (DM2, HTN, thyroid, malignancy…)
  2. History of poor vision (exclude refractory error)
  3. History of trauma
  4. History of surgery
  5. History of contact lens
  6. Family history (blindness, glaucoma, retinal detachment, macular degeneration…)
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5
Q

What are the basic steps of eye examination?

A
  1. Acuity (each eye)
  2. Field (each eye)
  3. Inspection (eyelids, conjunctiva, sclera, cornea, iris)
  4. Extraocular movements
  5. Pupils response
  6. Red reflex
  7. Anterior chamber (depth and clarity)
  8. Ophtalmoscopy
  9. Tonometry (pressure)
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6
Q
  • 14 y/o
  • Difficulty with distance vision
  • Preserved near vision
  • Acuity increases with pinhole

What’s your diagnosis?

A

Myopia

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7
Q
  • 78 y/o
  • Mild progressive loss of vision
  • Painless
  • Dullness red reflex and difficultu seing fundus

What’s your diagnosis?

A

Cataract

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8
Q
  • 8 y/o
  • Asymetric (> 2 lines of difference) acuity
  • Painless, no complaint

What’s your diagnosis?

A

Amblyopia (no need for referral is constant)

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9
Q

How can you use to diagnose corneal abrasions?

A

Fluorescein staining

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10
Q
  • 64 y/o
  • Flashing lights in peripheral vision unilateral
  • Floaters unilateral
  • Dark area in superteporal field unilateral

What’s your diagnosis?

A

Retinal detachment: REFER URGENTLY

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11
Q

What is the most common cause of corneal edema (ground-glass appearance)?

A

Increased IOP

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12
Q
  • 50 y/o
  • Episodes (minutes) of unilateral vision loss

What’s your diagnosis?

A

Amaurosis fugax: arterial insufficiency caused by artherosclerosis or artheroma

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13
Q

What is a Hollenhorst plaque?

A

A cholesterol embolus that lodges at an arterial bifurcation in the eye

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14
Q

What is the urgent treatment of central retinal artery occlusion?

A

Ocular massage and urgent referal to ophtalmologist

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15
Q
  • 90 y/o
  • Right-sided headache
  • Jaw claudication
  • Generalized fatigue and weight loss
  • Unilateral decreased acuity

What’s your diagnosis?

A

Giant cell arteritis

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16
Q

What’s the course of treatment of Giant cell arteritis?

A
  1. Urgent referal to ophtalmologist
  2. High-dose corticosteroids
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17
Q

How does glaucoma present?

A

Gradual decrease in peripheral vision until scotoma (peripheral vision loss of different shapes)

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18
Q

What are the 2 complications of hyphema?

A
  1. Occular pressure
  2. Corneal staining
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19
Q

On average, how much time does a corneal take to heal?

A

48-72 hours

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20
Q

Qu’est-ce qu’un trichiasis?

A

Une inflexion des cils vers l’œil, ce qui provoque une irritation de la cornée.

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21
Q

What is the complication of post-septal cellulitis?

A

Meningitis

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22
Q

How can you differentiate a pre-septal and post-septal (orbital) cellulitis?

A

Pre-septal:

  • Normal eye movements
  • Normal white eye color
  • Normal neuro exam
  • Normal vision
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23
Q

What kind of glaucoma drops often gives contact dermatitis?

A

Alpha-agonist

24
Q

What is the most common side effect of prostaglandin glaucoma eye drops?

A

Hyperpigmentation

25
Q

What is the contraindication of carbonic anhydraase inhibitor glaucoma eye drops?

A

Sulfa allergy

26
Q

What are the side effects of beta-blockers glaucoma eye drops?

A
  • Bronchospasms (do NOT give to asthmatics and COPD)
  • Arythmias
27
Q

How does a viral conjunctivitis present?

A
  • Bilateral
  • Post Upper Respiratory Infection
28
Q

What is Blepharitis?

A

Inflammation, scaling, reddening, and crusting of the eyelid.

29
Q

Dendritic ulcers are pathognomonic for what?

A

HSV

30
Q

Can you give steroids for HSV infection?

A

NO NEVER YOU DUMB ASS BITCH

31
Q
  • 20 y/o
  • Swam with contact lens in a spa
  • Pain (INTENSE)

What’s your diagnosis?

A

Acanthamoeba keratitis

32
Q

How do you diagnose giant cell arthritis?

A
  1. Erythrocyte sedimentation rate
  2. C-reactive protein
  3. Temporal artery biopsy
33
Q

What are the red flags symptoms that warrant an ophtalmo referal for a patient with a red eye?

A
  • Blurred vision
  • Pain
  • Photophobia
  • Colored halos
34
Q

What are the red flags signs that warrant an ophtalmo referal for a patient with a red eye?

A
  • Ciliary flush
  • Corneal opacification
  • Corneal epithelium disruption
  • Pupillary abnormalities
  • Shallow anterior chamber
  • Elevated IOP
  • Proptosis
35
Q

What do you do if someone gets a chemical in his eyes?

A

YOU IRRIGATE ASAP WITH AS MUCH WATER AS YOU CAN

36
Q

When should you refer a child to an ophtalmologist?

A
  • Unusual large eyes (GLAUCOMA!!!)
  • Decreased or no light reflex
  • Strabism
  • Poor visual acuity (ALWAYS SCREEN)
37
Q

What is Argyll Robertson pupils?

A

Small, irregular pupils that show light-near dissociation caused by tertiary syphilis

38
Q

What are the causes of an isolated third nerve palsy?

A
  • Intracranial aneurysm
  • Microvascular infarction of within the nerve (diabetes & hypertension)
  • Trauma
  • Cerebral herniation
  • Brain tumor
39
Q

What do you do if you are a family doctor and have a patient with thrid nerve palsy?

A
  • Order urgent cerebral imagning with angiography
  • Refer to neuro
40
Q

Fourth nerve palsy results in wich type of diplopia?

A

Vertical

41
Q

What is the most common cause of nerve palsy?

A

Microvascular infarcts: resolves spontaneously in 3-4 months in 98% of cases

42
Q

Proptosis in a child should always raise suspicion of what?

A

Rhabdomyosarcoma

43
Q

What condition warrant screening visual problems and/or refering to ophtalmology?

A
  • Diabetes
  • Hypertension
  • Pregnancy
  • Sickle cell anemia
  • Thyroid diseases
  • Sarcoidosis
  • AIDS
  • Syphilis
  • SLE, GPA, EGPA, RA, Sjögren…
44
Q

What is the occular side effect of amiodarone used for arythmias?

A

Optic neurpathy

45
Q

What is the occular side effect of biophosphanates used in osteoporosis?

A

Inflammation of the eye (uveitis, scleritis, etc)

46
Q

What is the occular side effect of choloquines used against malaria?

A

Photophobia and glare

47
Q

What is the occular side effect of corticosteroids?

A

Cataracts

48
Q

What is the occular side effect of diphenylhydantoin used for seizures?

A

Nystagmus

49
Q

What is the occular side effect of statins?

A

Cataracts

50
Q

What is the occular side effect of erectile dysfunction medications?

A

Impairment of color discrimination

51
Q

What is the first thing to do if you suspect globe rupture?

A

Give antiemetic medeication because if the patient vomits, it can cause extrusion of ocular contents and further wound contamination

52
Q

What is Marcus Gunn pupil?

A

Simply an Afferent Pupillary Defect (APD)

53
Q

What is the range of normal IOP?

A

9-21 mmHg

54
Q

What are the steps of cataract surgery?

A
  1. Topical anesthesia
  2. Sideport corneal incision
  3. Viscoelastic to fill anterior chamber (infaltes it)
  4. Main corneal incision
  5. Capsulorhexis
  6. Hydrodissection
  7. Phacoemulsification
  8. Cortical aspiration
  9. Inflate capsule with viscoelastic
  10. Insert intraocular lens
  11. Remove viscoelastic
  12. Hydrate corneal wound
55
Q

What is the myopic correction?

A

Minus to focus farther

56
Q

What is the hyperopic correction?

A

Plus to focus closer

57
Q

What is the presbyopia correction?

A

Plus with reading (focus closer)

DIM Bloc TCP (4 decks)

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