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PANRE > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

retinal detachment

A 
spontaneous
high risk: post cataract- surgery
"curtain's comes down and stays down"
tx: refer all detachments
positions head, allows gravity to slow the progression
80% get better
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2
Q

amaurosis fugal

A

curtains comes and goes back up in a few minutes
TIA, hx or risk of artheroscleroris
emboli on carotid circulation
tx: endarterectomy

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3
Q

retinal artery occasion

A 
emboli comes into retinal after and does not pass and get ischemia
most are embolic but can be thrombotic 
*painless sudden loss of vision
signs: early--> distal to occlusion ( blood separation - box scarring)
cherry red spot- more ischemia 
infraction
tx: true emergency
place pressure
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4
Q

retinal vein occlusion

A 
older people with lots of plaque
 wake up in am and vision blurry
exam: blood and thunder
neovascularization
tx: resolve on own 
laser tx
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5
Q

optic neuritis

A

inflammation of nerves
happens in chronic disease ( MS, autoimmune, infection)
exam: loss of pupillary reaction to light, loss of color vision, pain with EOM

tx: may resolve on own 2-3 wks
steroids, IV

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6
Q

glaucoma

A

increase in IOP with optic n damage

RF: AA, DM, HTN, Fam hx, Hx eye tumors, retinal detach

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7
Q

what is the pathophys of glaucoma?

A

resistance to drainage of aqueous humor–> pressure on posterior chamber–> pressure on optic nerve

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8
Q

Open angle glaucoma

A 
asymptomatic, rise in IOP
chamber is open
bowing of iris on exam
arcuate scotomata
central vision spread 
tx: prostoglandin- promote drainage
beta blockers
carbonic any drate

tx: iridectomy

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9
Q

angle closure

A 
OCULAR Emergency
sudden complete occlusion
pain, blurred vision
n/v
conjunctive injection, 
fixed mid-dilated pupil

tx: beta blocker
carbonic andydrate
mannitol
laser iridectomy

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10
Q

how to do glaucoma screening

A

check anterior chamber angle-
optic nerve exam- cup/disc ration: > 0.5
IOP> 21 mmHG

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11
Q

cataracts

A

product of age
acquired- sun exposure. inflamm, DM
congenital

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12
Q

macular degneration

A

Drusen- colloid bodies, deposit in Bruch’s membrane–> blocks nutrients in eyes
Dry AMD: only Drusen–> atrophy of retina, more common
Wet AMD–> neovascular, bleed a lot

sxs; blurry vision, central los of vision
sign: atrophy, loss of pigment, macular sccaring, bleeding
tx: laster photo
Lucentis is, Macugen
no cure
eye supplements

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13
Q

retinopathy

A 
DM- T1DM- screen 3-5 years after dx
T2DM- screen right away
-3 types: 
Background: simple ( microaneuryms)
pre-prolferat- cotton wool spots
proliferative- neovascu
HTNive: diffuse arteriolar narrowing, " copper wire" , " silver wire"

tx: rear, laser photocoag, tx underlying dz.

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14
Q

blepharitis

A 
dandruff of eyelids
staph or strep
sx: irrigation, burning, FB sensation 
signs: anterior blepharitis
tx: scrub daily, massage of sections, topical abs, 
oral abx 
oral abs- recurrent
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15
Q

dacryoscysitis

A 
inflammation of lacrimal duct
sxs; pain, swelling,tearing
signs
tx: warm to cool compressed 
oral abs
 I and D
surgery- putting in tubes
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16
Q

hordeolum ( stye)

A

infection of sebaceous glands ( staph)
sxs: subacute onset, mild painful nodule or pustule on lid
signs: pointed, red, tender
tx: warm compress, topical ab ( fluroquino/ polymixin/ trimeth)
I and D

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17
Q

chalazion

A 
occur post hordeolum
painless
signs: grayish discoloration 
local conjunctive erythema
tx; warm compress
triamcinolone injections
cut it out
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18
Q

ectropion- lids turn outward

entropian- likes turn inward

A

causes: scarring of lid, related to age paralytic, mechanics
sx: irrigation, burning, FM sensation
tx: surgical correction

19
Q

xanthelasma

A

idiopathic, hyper lip in DM
all cosmetic
excise

20
Q

epithelial inclusion cyst

A

traumatic implantation of epidermis into dermis or plugged follicle
slow growing, white round firm
ddx: neoplasm
tx: excision

21
Q

orbital cellulitis

A 
more common in kids-  2nd to sinusitis
low grade fever, fatigue, 
signs, red, sluggish pupillary reflex, cannot more their eyes
tx: abs, IV then po 2-3 weeks 
need to do CT 
am-sublac, cephalon, 
monitor closely
22
Q

viral conjunctivitis

A 
adenovirus- most common
acute onset- red, watery d/c
peri-aurical adenopathy-tender
self-limited
cold-warm compressed
23
Q

bacterial conjunctivitis

A

staph aureus, h. f.u. moraxella, pseudomonas ( contact)
- red, irritated, bila, mucopurulent exudate,
niseria- topical abs, systemic ( copious unlit)
tx: broad spectrum absx: fluoroquinolone, polymyxin, sulfa

24
Q

chlamydial conjunctivitis

A

STI
scant mucopurulent d/c
non-tender periauricular adenoma, follicular response
tx; system tetra, topical abx

25
Q

allergic conjunctivitis

A

seasonal
more edema
strongly mucoid d/c
tx: topical anti-histamin

26
Q

Pinguecula

A

fleshy, yellow/brown conjunctival mass

  • nasal side toward cornea
    causes: chronic sun, trauma, dry/ windy conditions
  • no sxs, no tx
27
Q

pterygium

A

triangular wedge- shaped fleshy
grown on the cornea–> vision issues
tx; remove by surgery

28
Q

dry eye

A

idiopathic, aging, contact wears, RA, scleroderma, meds

clinical; irrigation, dryness, redness, FB
dx: artificial tears, ointment
punctual plug
Restates

29
Q

herpes simplex kerastis

A 
ocular EMERGENCY
HSV 1>> HSV 2
very photophobic
exam: dendritic lesions
tx: REFER, topical anti-viral, No steroids
30
Q

herpes zoster

A

HSV in the original nerve

clinical: pain, HA, photophobia, vesicular rash, lesions on tip of nose– ( on cornea)
tx: refer, IV valtrex, topica stenosi
prevention: Zosetavax > 50 y/o

31
Q

cordial ulcer

A 
infection/ inflamma
h/o trauma, contact wearing
- exam: pain, phothophbia, dense cordial infiltrate 
tx: REFER, scraping, Gram stain, 
tx causative agent, avoid contact use
32
Q

corneal abrasion

A

cut to cornea
photophobia, blepharospasm, search for FB
tx: topical anesthetic at first only
cycloplegia, systemic analgesic
abx ointment, pressure patch ( max 24 hours)
f/u daily until gone

33
Q

FB

A 
cornea- more dangerous
sxs: painful, tearing, 
exam: evert lid, fluroscene, 
tx: use forceps, needles, 
lead/rust- 
suspect laceration
34
Q

subconunctival hemorrhage

A

after Valsalva
bening
resolves 2-3 weeks

35
Q

orbital fx

A

trauma to a eye
trapped inferior rectus–> cannot look up

tx: CT scan, REFER
increase in IOP–>retinal detachment
no sneezing, blow your nose

36
Q

hyphema

A 
RBC in the anterior chambers
associated with trauma
call chile protection services
shaken baby syndrome
pain, blurry vision, neoplasm, 
tx: refer
37
Q

radiant energy burn

A

6-12 hours pain the eye, red, tearing, photophobic
tx: cycloplegia, abx ointment,
pressure patch, systemic analgesic
wear sunglasses

38
Q

lid laceration/

A

keep pt sill, avoid pressure

REFER- call surgeon

39
Q

chemical burns

A

water, water,

cycloplegic

40
Q

colon blindness

A

x linked - males
red, green
ishihara plates

41
Q

amblyopia

A

loss of visual acuity not correctable by glasses

  • due to mechanical issue
42
Q

strabismus

A

angle/ degrees of misalignment is equal in all directions of gaze
- more congenial / genetic

  • incomitant- degrees of misalignment differs with direct of gaze - due to neurologic disorder or trauma
43
Q

strabismus test

A

cover/ uncover test:
heterotropia- cover normal eye, affected will move in place
heterophoria- cover suspected eye, uncover and misalignment may become apparent
tx: amblyopia: patch good eye
strabismus: glasses,

PANRE (27 decks)

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