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Step 2 CK > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Unilateral

Purulent, thick discharge

Poorly transmissible

Normal vision

Not itchy

No adenopathy

A

Bacterial conjunctivitis

Treat with topical abx

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2
Q

Bilateral

Water discharge

Easily transmissible

Normal vision

Itchy

Preauricular adenopathy

A

Viral conjunctivitis

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3
Q

The red eye (emergencies)

Diabetic retinopathy

Artery and vein occlusion

Retinal detachment

A

The “must know” subjects in ophthalmology

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4
Q

Red eye with:

Itchy eyes, discharge

Normal pupils

A

Conjunctivitis

Clinical diagnosis

Treat with topical abx

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5
Q

Red eye with:

Autoimmune diseases

Photophobia

A

Uveitis

Most accurate test = slit lamp exam

Treat with topical steroids

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6
Q

Red eye with:

Pain

Fixed midpoint pupil

A

Glaucoma

Most accurate test = tonometry (elevated pressure)

Treat with acetazolamide, mannitol, pilocarpine, and laser trabeculoplasty as a last resort

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7
Q

Red eye with:

Feels like sand in eyes

H/o trauma

A

Abrasion

Most accurate test = fluorescein stain

No specific therapy; patch not clearly beneficial

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8
Q

How does chronic glaucoma present?

A

Most often asymptomatic and is diagnosed on routine screening

Confirm with tonometry indicating extremely elevated intraocular pressure

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9
Q

Treatment for chronic glaucoma

A

Prostaglandin analogues: latanoprost, travoprost, bimatoprost

Topical beta blockers: timolol, carteolol, metipranolol, betaxolol, or levobunolol

Topical carbonic anhydrase inhibitors: dorzolamide, brinzolamide

Alpha-2 agonists: apraclonidine

Pilocarpine

Laser trabeculoplasty if medical therarpy is inadequate

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10
Q

Sudden onset of an extremely painful, red eye that is hard to palpation

A

Acute Angle-Closure Glaucoma

Walking into a dark room can precipitate pain (pupilary dilation); cornea is described as “steamy” and the pupil does not react to light because it is stuck; the cup-to-disc ratio is > 0.3

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11
Q

Treatment for acute angle-closure glaucoma

A

IV acetazolamide

IV mannitol (osmotic)

Pilocarpine, beta blockers, and apraclonidine (constric the pupil to enhance drainage)

Laser iridotomy

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12
Q

What is keratitis

A

Infection of the cornea

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13
Q

Testing and treatment for herpes keratitis

A

Confirm with fluorescein staining (dendritic pattern)

Treat with oral acyclovir, famciclovir, or valacyclovir

DO NOT use steroids because they markedly increase the production of the virus

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14
Q

Treatment for cataracts

A

Surgically remove the lens (no medical therapy)

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15
Q

Most accurate test for diabetic retinopathy

A

Fluorescein angiography

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16
Q

Treatment for diabetic retinopathy

A

Nonproliferative or “background” is managed by controlling glucose level

Proliferative retinopathy is treated with laser photocoagulation (VEGF inhibitors are injected in some patients to control neovascularization)

17
Q

Sudden onset of monocular visual loss with a pale retina and dark macula (aka “cherry red” macula)

A

Retinal artery occlusion

18
Q

Sudden onset of monocular visual loss with extravasation of blood into the retina

A

Retinal vein occlusion

19
Q

Treatment of retinal artery vs retinal vein occlusion

A

Artery = 100% O2, ocular massage, acetazolamide, or anterior chamber paracentesis, and thrombolytics

Vein = ranibizumab (VEGF inhibitor)

20
Q

Sudden onset of painless, unilateral loss of vision (“curtain coming down”)

A

Retinal detachment

21
Q

Treament for retinal detachment

A

Mechanical methods (surgery, laser, cryotherapy, and injection of gas) to push the retina back up against the globe of the eye

22
Q

Most common cause of blindness in older persons in the US

A

Macular degeneration

The cause is unknown; there is an atrophic (dry) and a neovascular (wet) type

23
Q

Difference between wet and dry macular degeneration

A

Wet is more rapid/severe and causes 90% of cases of permanent blindness

24
Q

Treatment for wet macular degeneration

A

VEGF inhibitor: ranibizumab, bevacizumab, or aflibercept

Injected directly into the viterous chamber every 4-8 weeks

25
Q

Herpes zoster ophthalmicus

A

Dendriform corneal ulcers and a vesicular rash in the trigeminal distribution

Step 2 CK (18 decks)

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