Ophthalmology

Question 1

What should a primary care provider do for a presumed retinal detachment?

Answer 1

Refer and position patient with head down

Question 2

In what age range do you expect to most commonly find amarousis fugax?

Answer 2

Patients older than fifty

Question 3

What is the #1 cause of retinal artery occlusion?

Answer 3

Carotid athersclerotic disease

Question 4

When treating herpes keratitis should you use topical anti-viral, topical steroid or both?

Answer 4

Dont use steroids. Topical antiviral and refer

Question 5

A patient presents with a painful, red nodule on the eyelid. What diagnosis should you be thinking of? What treatment should you begin with?

Answer 5

Hordeolum (sty). Warm compress and progress to topical abx if necessary

Question 6

A fundal exam shows a cherry red spot. What diagnosis should you be thinking of?

Answer 6

Central retinal artery occlusion

Question 7

A college student with a little purulent drainage from on eye and nontender preauricular lymphadenopathy. What diagnosis and pathogen should you be thinking of?

Answer 7

Chlamydia conjunctivitis

Question 8

What should a primary care provider do for presumed central artery occlusion?

Answer 8

Opthalmic emergency! Refer and intermittent pressure and release of the eye.

Question 9

A patient presents with unilateral blurriness developing over a few days. Fundal exam shows a blood and thunder pattern. What is the most likely diagnosis?

Answer 9

Central vein occlusion

Question 10

What is appropriate treatment for central vein occlusion?

Answer 10

Typically self limited. Treat underlying disease

Question 11

Is glaucoma more prevalent in males or females?

Answer 11

Females (3:1)

Question 12

Give two risk factors for glaucoma

Answer 12

African American descent and diabetes

Question 13

What is the yellow, brown fleshy mass on the conjunctiva which usually does not interfere with vision?

Answer 13

Pinguecula

Question 14

A fundal exam shows a cup to disc ration of >0.5. There are also vessels bending over the disc. What is the most likely diagnosis?

Answer 14

Glaucoma

Question 15

A patient presents saying that he doesn’t seems to need his glasses anymore after 30 yrs. What is the most likely diagnosis?

Answer 15

Macular degeneration

Question 16

What is the most likely quadrant for a retinal detachment?

Answer 16

superior temporal

Question 17

A patients presents with pain in one eye. The cornea is hazy and the pupils are fixed. What is the most likely diagnosis?

Answer 17

Glaucoma

Question 18

What is the most common way of testing for metamorphosia?

Answer 18

Amsler grid

Question 19

You notice drusen deposits on fundal exam. What is the most likely diagnosis?

Answer 19

Macular degernation

Question 20

A patient presents with irritated, burning and tearing eyes. You notice some scurf and scales. Where do you begin treatment?

Answer 20

This is blepharitis. Treatment begins with good hygeine and moves on to topical antibiotics if necessary.

Question 21

A patient has a history of multiple stys. He now has a painless nodule on his eyelid and minor conjunctivitis. What is the most likely diagnosis?

Answer 21

Chalazion

Question 22

What are the most common colors lost in color blindness?

Answer 22

Red and green

Question 23

What is term for eyelids that turn in?

Answer 23

Entropion

Question 24

What is the term for bilateral yellow plaques near the eyes?

Answer 24

Xanthelasma

Question 25

A fundal exam shows an opalescent retina and box-carring of arterioles. What is the most likely occlusion?

Answer 25

Central retinal artery occlusion

Question 26

What is the most common preceding event for orbital cellulitis?

Answer 26

URI

Question 27

Vision loss described as a curtain coming down should make you think of what diagnosis?

Answer 27

Retinal detachment

Question 28

You notice a bowing of the iris on exam. What is the most likely diagnosis?

Answer 28

Glaucoma

Question 29

A CT scan of the head shows broad infiltration of orbital fat. What is the most likely diagnosis?

Answer 29

Orbital cellulitis

Question 30

A patient presents with watery bilateral discharge from the eyes and nontender preauricular adenopathy. What is the most likely diagnosis? What is the most common pathogen?

Answer 30

Viral conjunctivitis, adenovirus?

Question 31

How do you test for color blindness?

Answer 31

Ishihara plates

Question 32

A patient with a history of asthma presents complaining of stringy discharge from both eyes and severe swelling. What is the most likely diagnosis?

Answer 32

Allergic conjunctivitis

Question 33

What is the name for the triangular or wedge shaped growth on the conjunctiva that may interfere with vision.

Answer 33

Pterygium

Question 34

What is the name of the test for dry eyes?

Answer 34

Shirmer test

Question 35

A patient having recently undergone cataracts surgery presents c/o vision loss in the operative eye, what is the most likely diagnosis?

Answer 35

Retinal detachment

Question 36

Patient presents with sudden painless, complete, unilateral vision loss. What is the most likely diagnosis?

Answer 36

Central retinal artery occlusion

Question 37

A dendritic lesion is seen with flouroscein stain, what is the most likely diagnosis?

Answer 37

Herpees keratitis

Question 38

Which nerve is involved in herpes zoster opthalmicus?

Answer 38

CN 5 (trigeminal nerve)

Question 39

Your attending asks you to come and see an excellent example of hutchinsons sign, what diagnosis does the patient have?

Answer 39

Herpes zoster opthalmicus

Question 40

Patient presents with dense corneal infiltrate and an epithelial defect seen with fluoroscein stain, what diagnosis should you be thinking of?

Answer 40

Corneal ulcer

Question 41

A feathery border in an eye exam should make you think of what diagnosis?

Answer 41

Fungal infection

Question 42

A patient in the recover room following foot surgery is complaining of severe photophobia. She feels as though there is something in her eye. What is the most likely diagnosis?

Answer 42

corneal abrasion | patients scratch their eyes before they are completely awake from anesthesia

Question 43

What is the treatment for subconjunctival hemorrhage?

Answer 43

Reassurance

Question 44

19 year old male took an elbow to the face while playing basketball this morning, the whole left side of his face is swollen and he can't look up, whats the most likely diagnosis?

Answer 44

Orbital floor fracture

Question 45

A patient complains of seeing halos and rainbows around lights. She also complains of moderate photophobia, what is the most likely diagnosis?

Answer 45

Glaucoma

Question 46

What is the first thing you should be thinking of if a pediatric patient comes in with blood in the anterior chamber of the eye (hyphema)?

Answer 46

Child abuse until proven otherwise

Question 47

How long after a radiant energy burn do symptoms typically show?

Answer 47

6-12 hours

Question 48

What is the term for eyelids that turn out?

Answer 48

Ectropion

Question 49

What is the initial treatment for a chemical burn to the eyes?

Answer 49

Irrigate, irrigate, irrigate

Question 50

Color blindness is transmitted through what genetic pattern?

Answer 50

``` x-linked recessive (red/green) autosomal recessive (blue/yellow) ```

Question 51

What is the term for being nearsighted? What type of lens do you use to correct it?

Answer 51

Myopia, concave lens

Question 52

A college student presents with copious purulent drainage from one eye, what is the most likely diagnosis?

Answer 52

Neisseria conjunctivitis

Question 53

What is the first line treatment for orbital cellulitis?

Answer 53

IV antibiotics, followed by 2 weeks of PO

Question 54

What is the term for being farsighted? What type of lens do you use to correct it?

Answer 54

Hyperopia, convex lens

Question 55

What is tonometry used for?

Answer 55

Determines Intra-ocular pressure