Brainscape's Knowledge GenomeTM

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


See full index

Medical Finals 2020 > Ophthalmology > Flashcards

Ophthalmology Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What do you see on fundoscopy in retinal hypertension?

A
  • AV nipping
  • cotton wool spots
  • blot haemorrhages
  • papilloedema
  • hard exudates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are risk factors for acute closed angle glaucoma?

A
  • Hypermetropia
  • Family history
  • age
  • hypertension
  • diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is acute angle closure glaucoma managed?

A
  • Acetazolamide - reduces aqueous secretions
  • pilocarpine - increases papillary constriction

More definitive - iridotomy (laser to allow aqueous humour draining), trabeculectomy (widening of angle)

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

What do you see on fundoscopy in open angle glaucoma?

A
  • optic disc pallor
  • disc haemorrhage
  • bayonetting of vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is your acute management of anterior uveatis?

A

Atropine or cycopentalate

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

What muscle does cranial nerve IV control?

A

Trochlear
Superior Ocular
so a palsy of it results in the eye looking up and out (normally used to look down the stairs - down and in)

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

A patient is complaining of double vision, their right eye is deviated upwards and rotated outwards. On looking to their left they experience double vision. Which nerve palsy is this?

A

4th nerve of right eye

Superior Oblique - depresses eye and moves it inwards - so eye points up and out

Vertical diplopia

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

What are the features of a 3rd nerve palsy?

A

Fixed dilated pupil
Ptosis
Eye pointing down and out (inability to look inwards)

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

Give some differentials of red eyes

A 
Conjunctivitis
Keratitis, uveatis
Trauma
Acute glaucoma (headache, n+v)
Sub-acute conjunctiva haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some causes of painless visual loss?

A

Retinal detachment, CVA, cataract, CRVO, CRAO (vascular pathologies)

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

What causes loss of colour vision?

A

Optic neuritis
Cataract
Drug toxicity

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

What is the reaction of the pupil in dim light?

A

Dilation, mydriasis

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

What causes pupil constriction?

A

CNIII, ACH + MuSc receptor
Parasympathetic
SPhincter pupillae muscle

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

What causes pupil dilation?

A

CNV (1st branch), NAd + Alpha receptor
Sympathetic
Dilator pupillae muscle

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

Describe the path the signals travel along the nerves of the eye to reach the Edinger-Westphal nucleus

A

Optic nerve - optic chiasm - optic tract - lateral geniculate body of thalamus - optic radiation - visual cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe what happens in a relative afferent pupillary defect?

A

In the swinging light test, when swung to the affect eye there is inappropriate pupil dilation
Occurs in incomplete optic nerve damage

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

What is anisocoria?

A

When the pupil size >2mm different

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

What can cause anisocoria (3)

A 
Physiological
Horner's
Adie's tonic pupil
CN III palsy
Pharmacological
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the features of Horner’s Syndrome?

A

Unilateral miosis on afffected side
Anhidrosis (loss of sweat reflex on affected side)
Partial ptosis
Anisocoria

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

What can cause Horner’s Syndrome?

A

Pancoast’s tumour (Lung cancer)

Brainstem ipsilateral stroke

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

What are 4 key features in a 3rd nerve palsy?

A

Fixed dilated pupil (not always)
Eye: points down and out
Movement: can’t look in
Ptosis (sometimes partial)

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

How does a fourth nerve lesion present?

A

Eye: Eye points in
Movement: can’t look down and out
Double vision

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

What is a Bell’s Palsy and is it ipsilateral or contralateral?

A

Unilateral
LMN lesion
Facial palsy, can be forehead sparing
Drooping mouth, inability to wrinkle the brow

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

What are some complications of cataracts surgery?

A 
Lens rupture
Dropped nucleus
Intraocular haemorrhage
Inflammation
Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Gradual loss of vision with a glare or halos being seen in likely to be…?

A

Cataracts

May be noticed suddenly because the other eye has compensated for decreasing visual acuity

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

What is the typical (but not necessary) presenting triad for glaucoma?

A

Visual field loss
Optic nerve damage
Increased intraocular pressure

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

What is normal intraocular pressure?

A

<21mmHg

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

What is the emergency presentation of glaucoma?

How does this present and what is your management?

A

Acute open angle glaucoma - due to high intraocular pressure
Presents with unilateral red eye, severe pain and visual loss, n+v
Treat with iridotomy

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

What pharmacological medications can be given in glaucoma?

A

BB- timolol

Prostanoids - latanoprost

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

What are drusden?

A

Waste material fro photoreceptors the appear in macular degeneration as small white spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the two types of macular degeneration?

A

Wet - new vessel growth causing retinal detachment and disorted central vision (central scotoma)
Dry - retinal atrophy and loss of central vision, central scotoma, drusden more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What symptoms might someone with retinal detachment describe?

A 
Decrease in vision
Floaters (vitreous haemorrhage), flashes
Visual field loss
Loss of red reflex
Peripheral curtain
Spider webs, dark shadows
Flashing lights in vision
33
Q

What do multiple flame and blot-haemorrhages indicate along with painless loss of vision?

A

Central retinal vein occlusion

34
Q

What are risk factors for a corneal ulcer (microbial keratitis)?

A

Steroid eye drop

Presents with eye pain, photophobia, watering of the eye

35
Q

What is the difference between ectropion and entropion?

A

Ectropion - eyelid droops down

Entropion - out-turning of the eyelids

36
Q

What is amaurosis fugax?

A

Painless, transient loss of vision
like a curtain coming down
TIA association

37
Q

What are some causes of a sudden painless visual loss?

A

Ischaemic/vascular
Vitreous haemorrhage
Retinal detachment
Retinal migraine

38
Q

What should be done in a child presenting with a squint?

A

Opthalmology referral

39
Q

What are the two different kinds of squint?

A

Concomitant and paralytic

40
Q

Does glaucoma have a hereditary involvement and what advice should be given to relatives?

A

Yes

From age 40+ annual screening

41
Q

What are the stages of diabetic retinopathy?

A

Pre-proliferative
Mild - microaneurysms
Moderate - other retinal changes
Severe - widespread microaneurysms, dot and blot haemorrhages, venous beading, IRMA

42
Q

Is crusting of the eyelids normal in newborns?

A

Yes

Unless purulent in which case take a swab for micro investigations

43
Q

What are risk factors in primary open-angle glaucoma?

A 
Hypertension
FH
DMT2
Afro-Carribean ethnicity
Myopia
Long-term steroid use
44
Q

What would you expect to see in someone presenting with a vitreous haemorrhage?

A

Multiple dark spots in vision
Sudden visual loss
RF: diabetes, underlying bleeding disorder, hx of trauma

45
Q

What are the stages in hypertensive retinopathy?

A

1 - arteriolar narrowing + tortuosity, increased light reflex
d2 - AV nipping
3 - cotton wool spots, flame and blot haemorrhages
4 - papilloedema

46
Q

What are the most common causes of bacterial and viral conjunctivitis?

A

Bacterial - staph, strep, morazella

Viral - adenovirus, herpes

47
Q

What is ophthalmia neonatorum?

A

Conjunctivitis that occurs in the first 3 weeks of life - maternally transmitted from birth canal
Common causes include chlamydia, herpes simplex, gonorrhoea or staph aureus

48
Q

What are some symptoms of acute uveatis?

A

Acute, painful red eyes
Unilateral
Photophobia
May be reduced vision, irregular pupil against red reflex

49
Q

What do flame haemorrhages indicate?

A

Hypertensive retinopathy

Retinal vein occlusions

50
Q

What are the grades in diabetic retinopathy?

A

R0: None
R1: Background - Microaneurysms (weakening of blood vessel wall), retinal haemorrhages, retinal exudates, macular oedema
R2: Pre-proliferative - Venous beading, Venous loop or reduplication, Intraretinal microvascular abnormalities (IRMA), Multiple deep, round of blot haemorrhages
R3: Proliferative - New vessels (damaged vessels close off, new vessels are abnormal) haemorrhage or fibrosis

51
Q

What does laser therapy look like in fundoscopy?

A

Lots of little white spots on the back of the eye, regular, multiple

52
Q

What is the difference between a stye and a chalazion?

A

Stye - infection of lash follicle - treat with hot compresses, massages
Chalazion - granuloma/infection of meibomian gland, beneath the eye

53
Q

Blepharitis can occur as a result of which disease?

How can it present and how is it managed?

A

Seborrhoeic dermatitis

Gritty, irritable eyes, watery discharge

Lubricants, lid hygeine, topical antibiotics

54
Q

What does a homonoymous hemianopia refer to?

A

Half the visual fields are lost, it is the same part in both eyes

55
Q

What does arcuate refer to?

A

A scotoma that is shaped like the arc of a circle

56
Q

How can you test visual fields?

A

Humphrey Fields

57
Q

What does a bright red cherry spot on the macula indicate and what symptoms might it present with?

A

Central Retinal Artery Occlusion
Painless, sudden unilateral vision loss
Fundoscopy - pale disc and cherry red spot

58
Q

What is nystagmus a sign of in general terms?

A

Cerebellar disease

Vestibular disease

59
Q

What are the different types of concomitant strabismus?

A

Convergent, Divergent and Vertical

60
Q

What is hypermetropia?

Anisometropia?

A

Long-sighteness

Different prescription in each eye

61
Q

What would you see on fundoscopy in optic neuritis?

A

Pale fundus
Most look normal
Swollen disc

62
Q

Give some differentials of painful visual loss?

A

Anterior uveitis
Acute glaucoma
Optic neuritis – if loss of red vision then retrobulbar neuritis
GCA

63
Q

What do rods and cones functionally do?

A

Cones – colour vision and visual acuity

Rods – peripheral vision

64
Q

What investigations can you do in sudden painless loss of vision?

A

dilated fundoscopy
slit-lamp examination
ultrasound: useful to rule out retinal tear/detachment and if haemorrhage obscures the retina
fluorescein angiography: to identify neovascularization
orbital CT: used if open globe injury

65
Q

What stops an opthalmology patient from driving?

A

Poor visual acuity below 6/12

66
Q

What are signs of acute closed angle glaucoma?

A 
Hazy cornea
Fixed mid-dilated pupil
Red eye
Painful
Non-reactive pupil to light
67
Q

What is your management of acute glaucoma?

A

IV acetazolamide
IV mannitol
Definitive treatment = laser iridotomy

68
Q

What is the key difference between viral and bacterial conjunctivitis?

A

Bacterial has purulent discharge

69
Q

What is the difference between episcleritis and scleritis?

A

Scleritis - more painful and rheumatoid arthritis association, capillaries don’t move

70
Q

What signs do you see on slit lamp for anterior uveatis?

A 
No cloudy cornea (important differential from acute angle glaucoma)
Posterior synechiae (iris sticks to lens)
Anterior chamber cells = signs of inflammation (WCC)
Hypopoyon = inflammation
71
Q

What are the first symptoms patients with cataracts notice?

A

Problem with night vision and glare

Later daytime visual problems

72
Q

What morphological alterations are associated with diabetic retinopathy?

A

Thickening of basement membrane
Loss of inter-endothelial tight junctions
Early and selective loss of pericytes which support the blood vessels
Loss of integrity of retinal vessels
Increased vascular permeability
Neovascularisation

73
Q

What do you get in a VI nerve palsy?

A

Horizontal diplopia worse on left gaze
(lateral rectus - abduction)
Commonly affected by raised ICP

74
Q

What is the significance of a dilated pupil?

A

A compression of the parasympathetic fibres of CNIII

CNIII - 3D - dilated pupil, down and out, drooping lid

75
Q

Which cranial nerves supply which muscles of the eye?

A

III – oculomotor – medial, superior, inferior rectus, inferior oblique (looks up, down and in = elevation, depression, adduction)
IV – trochlear – superior oblique – looks up (elevation)
VI – Abducens – lateral rectus – looks out (abduction)

76
Q

What is the pathophysiology of acute angle glaucoma?

A

Aqueous produced in posterior chamber by ciliary body
Passes through the iris and circulates in the anterior chamber
Drains through the trabecular meshwork
Closure of drainage leads to a sudden increase in intraocular pressure
Pain arises from the pressure on iris

77
Q

What is your immediate management in acute angle glaucoma?

A

Beta blocker

Later => trabeculotomy

78
Q

What is your acute management for anterior uveitis?

A

Pilocarpine - topical eye drop to dilate pupil and relieve pain
Steroid eye drop

79
Q

What are potential infectious causes of anterior uveitis?

A

Herpes simplex

Medical Finals 2020 (25 decks)

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