Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSRA > ophthalmology > Flashcards

ophthalmology Flashcards

1
Q

optic neuritis causes (3)

A

MS
DM
syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

optic neuritis features: (5)

A

unilateral decrease in visual acuity over hours or days
poor discrimination of colours, ‘red desaturation’
pain worse on eye movement
relative afferent pupillary defect
central scotoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

optic neuritis mgt

A

high dose steroids
(usually resolved in 4-6 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

sinister cause of chronic unilateral conjunctivitis

A

orbital lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

bacterial conjunctivitis features:

A

Purulent discharge
Eyes may be ‘stuck together’ in the morning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

viral conjunctivitis features:

A

Serous discharge
Recent URTI
Preauricular lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bacterial conjunctivitis mgt:

A

chloramphenicol
fusidic acid in pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

sudden loss of vision causes: (4)

A

ischaemic/vascular
vitreous haemorrhage
retinal detachment
retinal migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

HSV keratitis presentation: (5)

A

DENDRITIC CORNEAL ULCER

red, painful eye
photophobia
epiphora (watery eyes)
visual acuity may be decreased
fluorescein staining may show an epithelial ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HSV keratitis mgt

A

topical aciclovir
immediate ophthalmology r/v

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

rheumatoid arthritis ocular manifestations (5)

A

keratoconjunctivitis sicca (= dry eyes, most common)
episcleritis (erythema)
scleritis (erythema and pain)
corneal ulceration
keratitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acute angle closure glaucoma

what happens?

A

rise in IOP secondary to an impairment of aqueous outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acute angle closure glaucoma predisposing factors: (3)

A

hypermetropia (long-sightedness)
pupillary dilatation
lens growth associated with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

acute angle closure glaucoma

features: (7)

A

severe pain: may be ocular or headache
decreased visual acuity
symptoms worse with mydriasis (e.g. watching TV in a dark room)
hard, red-eye
haloes around lights
semi-dilated non-reacting pupil
corneal oedema results in dull or hazy cornea
systemic upset may be seen, such as nausea and vomiting and even abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

acute angle closure glaucoma mgt

A
  1. offer 360° selective laser trabeculoplasty (SLT) first-line to people with an IOP of ≥ 24 mmHg
  2. prostaglandin analogue (PGA) eyedrops should be used next-line
  3. BB eye drops
    carbonic anhydrase inhibitor eye drops
    sympathomimetic eye drops
  4. surgery in the form of a trabeculectomy may be considered in refractory cases.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

prostaglandin analogues
mode of action

A

Increases uveoscleral outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

prostaglandin analogues
example:

A

lantoprost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

prostaglandin analogues
SE:

A

brown pigmentation of the iris
increased eyelash length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

BB
examples:

A

timolol
betaxolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

BB mode of action

A

Reduces aqueous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

groups to avoid BB in:

A

asthmatics
heart block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sympathomimetics
examples:

A

e.g. brimonidine, an alpha2-adrenoceptor agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sympathomimetics
mode of action:

A

reduces aqueous production and increases outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sympathomimetics
who should avoid:

A

Avoid if taking MAOI or tricyclic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Carbonic anhydrase inhibitors

example:

A

Dorzolamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Carbonic anhydrase inhibitors
mode of action:

A

Reduces aqueous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Carbonic anhydrase inhibitors
SE:

A

Systemic absorption may cause sulphonamide-like reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

miotics
e.g.

A

ilocarpine, a muscarinic receptor agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

miotics mechanism:

A

Increases uveoscleral outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

miotics adverse effects:

A

constricted pupil
headacheblurred vision

31
Q

Sympathomimetics
adverse effect:

A

hyperaemia

32
Q

age related macular degeneration presentation (5)

A

a reduction in visual acuity, particularly for near field objects
- gradual in dry ARMD
- subacute in wet ARMD

poor night vision/ dark adaptation
fluctuations in visual disturbance
Charles Bonnet syndrome
‘flickering’

33
Q

age related macular degeneration signs

A

distortion of line perception may be noted on Amsler grid testing
drusen (yellow areas of pigment deposition in the macular area) which may become confluent in late disease to form a macular scar.
in wet ARMD well demarcated red patches (intra-retinal or sub-retinal fluid leakage or haemorrhage)

34
Q

wet macular degeneration mgt:

A

anti-VEGF

35
Q

anterior uveitis (aka irisitis)

associations

A

HLA-B27 associated conditions:
-ankylosing spondylitis
-reactive arthritis
-ulcerative colitis, Crohn’s disease
-Behcet’s disease
-sarcoidosis: bilateral disease may be seen

36
Q

anterior uveitis

features

A

acute onset
ocular discomfort & pain (may increase with use)
pupil may be small +/- irregular due to sphincter muscle contraction
photophobia (often intense)
blurred vision
red eye
lacrimation
ciliary flush: a ring of red spreading outwards
hypopyon; describes pus and inflammatory cells in the anterior chamber, often resulting in a visible fluid level
visual acuity initially normal → impaired

37
Q

anterior uveitis mgt (3)

A

urgent review by ophthalmology
cycloplegics (dilates the pupil which helps to relieve pain and photophobia) e.g. Atropine, cyclopentolate
steroid eye drops

38
Q

Argyll-Roberston pupil (who is she?)

A

ARP (Argyll Robertson pupil)

Accommodation Reflex Present (ARP) but Pupillary Reflex Absent (PRA)

i.e.
small, irregular pupils
no response to light but there is a response to accommodate

39
Q

ARP (Argyll Robertson pupil)
causes: (2)

A

DM
syphilis

40
Q

cataracts causes:

A

normal ageing

Smoking
Increased alcohol consumption
Trauma
Diabetes mellitus
Long-term corticosteroids
Radiation exposure
Myotonic dystrophy
Metabolic disorders: hypocalcaemia

41
Q

cataracts presentation: (5)

A

Reduced vision
Faded colour vision: making it more difficult to distinguish different colours
Glare: lights appear brighter than usual
Halos around lights

ABSENT RED REFLEX

42
Q

cataract surgery cx: (4)

A

Posterior capsule opacification: thickening of the lens capsule
Retinal detachment
Posterior capsule rupture
Endophthalmitis: inflammation of aqueous and/or vitreous humour

43
Q

central retinal a. occlusion

features: (3)

A

sudden, painless unilateral visual loss
relative afferent pupillary defect
‘cherry red’ spot on a pale retina

44
Q

central retinal a. occlusion causes: (2)

A

thromboembolism (from atherosclerosis)
arteritis (e.g. temporal arteritis)

45
Q

central retinal vein occlusion
RF (5)

A

age
HTN
CVD
glaucoma
polycythaemia

46
Q

central retinal vein occlusion
features (3)

A

sudden, painless reduction or loss of visual acuity, usually unilaterally

fundoscopy:
- widespread hyperaemia
- severe retinal haemorrhages - ‘stormy sunset’

47
Q

central retinal vein occlusion key ddx:

A

branch retinal vein occlusion (BRVO)

  • when a vein in the distal retinal venous system is occluded and is thought to occur due to blockage of retinal veins at arteriovenous crossings.
  • results in a more limited area of the fundus being affected.
48
Q

central retinal vein occlusion
mgt (3):

A

conservative

if macular oedema: aanti-VEGF
if retinal neovascularisation - laser photocoagulation

49
Q

chorioretinitis features:

A

patients with chorioretinitis often present with unilateral vision changes
blurred vision
scotomas (blind spots)
floaters
ophthalmoscopic finding
- focal or diffuse areas of retinal whitening
‘- pizza pie’ fundus: retinal spots (superficial retinal infarction + flame-shaped haemorrhages

50
Q

chorioretinitis mgt:

A

if infectious:
- pyrimethamine and sulfadiazine for toxoplasmosis
- ganciclovir or valganciclovir for CMV
if autoimmune:
steroids

51
Q

how to differentiate episcleritis/ scleritis:

A

phenylephrine drops

  • if eye redness improves following drops = episcleritis
52
Q

scleritis mgt

A

PO NSAIDs

53
Q

scleritis RF

A

rheumatoid arthritis: the most commonly associated condition
systemic lupus erythematosus
sarcoidosis
granulomatosis with polyangiitis

54
Q

herpes zoster opthalmicus features:

A

vesicular rash around the eye
Hutchinson’s sign:
= rash on the tip or side of the nose. Indicates nasociliary involvement, strong RF for ocular involvement

55
Q

Homes-Adie pupil

A

benign
- dilated pupil
- once the pupil has constricted it remains small for an abnormally long time
- slowly reactive to accommodation but very poorly (if at all) to light
- associated with absent knee/ ankle reflex

56
Q

Horner’s syndrome
features:

A

miosis (small pupil)
ptosis
enophthalmos* (sunken eye)
anhidrosis (loss of sweating one side)

57
Q

hypertensive retinopathy signs:

A

I silver wiring of the arterioles

II AV nipping

III cotton-wool exudates, flame and blot haemorrhages (collect round fovea to make “macular star”

IV papilloedema

58
Q

keratitis
what is it?

A

inflammation of the cornea

(unlike conjunctivitis can be potenitially sight threatening so needs rx)

59
Q

keratitis causes:

A

bacterial
- s. aureus most commonly
- pseudomonas aeruginosa in contact lens wearers
fungal
amoebic
- acanthamoebic keratitis (typically pain is out of proportion with findings)
parasitic
- onchoceral keratitis (river blindness)
viral
- HSV keratitis

60
Q

keratitis features:

A

red eye + pain
photophobia
foreign body, gritty sensation
+/- hypopyon (white milky fluid layer)

61
Q

bacterial keratitis mgt

A

topical abx
- usually quinolones

+cycloplegic for pain relief e.g. cyclopentolate

62
Q

keratitis cx

A
  • corneal scarring
  • perforation
  • endophthalmitis
  • visual loss
63
Q

lens dislocation causes:

A

Marfan’s syndrome: upwards
homocystinuria: downwards
Ehlers-Danlos syndrome
trauma
uveal tumours
autosomal recessive ectopia lentis

64
Q

lens discolation
direction in Marfans

A

upwards

65
Q

lens dislocation: direction in homocystinuria

A

downwards

66
Q

causes of mydriasis

A

(large pupil)

CN III palsy
Holmes-Adie pupil
traumatic iridoplegia
phaeochromocytoma
congenital

67
Q

drug causes of mydriasis

A

topical mydriatics: tropicamide, atropine
sympathomimetic drugs: amphetamines, cocaine
anticholinergic drugs: tricyclic antidepressants

68
Q

orbital compartment syndrome
features:

A

eye pain/swelling
proptosis
‘rock hard’ eyelids
relevant afferent pupillary defect

69
Q

orbital compartment syndrome

mgt

A

urgent lateral canthotomy (before diagnostic imaging) to decompress the orbit

70
Q

Marcus Gunn pupil
what is it?

A

relative afferent pupillary defect

caused by lesion of anterior optic chiasm i.e. optic n/ retina

71
Q

Marcus Gunn pupil causes:

A

retinal detachment
optic neuritis

72
Q

retinitis pigmentosa

features:

A

initial sign = night blindness
tunnel vision (as primarily affects peripheral retina)
black bone spicule-shaped pigmentation in the peripheral retina, mottling of the retinal pigment epithelium

73
Q

occular manifestations of RA:

A

keratoconjunctivitis sicca (most common)
episcleritis (erythema)
scleritis (erythema and pain)
corneal ulceration
keratitis

Iatrogenic
steroid-induced cataracts
chloroquine retinopathy

74
Q

tunnel vision causes

A

papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy secondary to tabes dorsalis
hysteria

MSRA (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions