Brainscape's Knowledge GenomeTM

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


See full index

3b specialties > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q 
Which 2 of the following play a role in upper eyelid elevation: 
Facial (seventh/VII) cranial nerve
Oculomotor (third/III) cranial nerve
Parasympathetic nervous system
Sympathetic nervous system
Trochlear (fourth/IV) cranial nerve
A

Elevation of upper eyelid controlled by levator palpebrae suprioris, supplied by oculomotor CN, and Muller’s muscle, supplied by sympathetic nervous system.

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

The eyelids are closed by the action of which muscle, supplied by which nerve?

A

Orbicularis oculi supplied by facial (VII) CN.

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

Give 3 causes of ptosis?

A 
Myasthenia gravis
Horner's syndrome
Third nerve palsy, 
Age
Myopathy e.g. chronic progressive external ophthalmoplegia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A 25 year woman has three days of mild pain in the right eye, worse on eye movements. In her right eye, her vision is blurred and colours also appear faded. Her vision gradually worsens in her right eye over one week. She has no systemic symptoms.
This is a typical history of?

A

Optic neuritis

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

Pain on eye movement can occur in optic neuritis and scleritis. What are two differences to differentiate scleritis?

A

Scleritis more severe pain and not associated with reduction of colour vision.

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

An afferent pupillary defect implies a defect in the contralateral or ipsilateral optic nerve?

A

Ipsilateral

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

What are the 3 most common causes of an abnormally large pupil?

A

Pharmacological, third nerve palsy and acute glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
What treatment would you offer a patient with optic neuritis:
Aspirin
Beta Interferon
IVIG (intravenous immunoglobulin)
No pharmacological treatment
Steroids?
A

No pharmacological treatment

Steroids will speed up recovery, but have no impact on the final vision, and do not modify the disease process.

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

Which nerve is involved in herpes zoster ophthalmicus? (Specific branch)

A

V1= ophthalmic branch of trigeminal nerve

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

Name 3 ophthalmic complications of herpes zoster ophthalmicus

A 
Conjunctivitis
Keratitis
Uveitis
Extraocular muscle palsy 
Corneal ulcer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient presents after their partner noticed their eye had turned red. On examination, you find a confluent redness of the white of the right eye. The patient has reported no pain.
What is the most likely diagnosis?
Investigations and management?

A

Subconjunctival haemorrhage

No investigations necessary (unless it’s recurrent or there are signs of bruising/bleeding elsewhere)
Management= none required, it will settle like a bruise.

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

True/false: hypermetropia is a risk factor for acute angle closure glaucoma.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
The following signs: 
Mydriasis
General corneal haze 
Eye feels rock hard when (gently) palpated
are seen in what condition?
A

Acute angle closure glaucoma

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

Name 3 agents given to lower IOP in acute ACG?

A
  • IV acetozolamide
  • Topical prostaglandin analogues
  • Topical beta blockers
  • Sometimes IV mannitol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other than IOP lowering therapies, what are 3 other components involved in managing acute angle closure glaucoma?

A
  • Pilocarpine drops to cause miosis
  • Topical steroids for inflammation
  • Laser peripheral iridotomy to prevent recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give 3 causes of an acute red eye

A 
Bacterial keratitis
Acute angle closure glaucoma
Endophthalmitis
Conjunctivitis
Iritis
17
Q

As a general rule, if there is a hypopyon, what is the diagnosis?

A

Endophthalmitis- urgent treatment needed, until proven otherwise

18
Q

What investigation is required in bacterial keratitis?

A

Urgent ophthalmology review in order to do a corneal scrape for Gram stain and cultures + sensitivities

19
Q

What is the management of bacterial keratitis?

A
  • Intensive antimicrobial eye drops (start before results of cultures come back)
  • May need admission to ensure drops are given hourly
  • Analgesia
20
Q

What are the 2 most common causes of infected corneal ulcers?

A

Contact lenses and trauma

21
Q 
Which of the following microorganisms is not recognised as a causitive organism of bacterial keratitis?
Acanthamoeba
Clostridium perfringens
Gonococcus
Pseudomonas aeruginosa
Staph. Aureus
A

Clostridium perfringens (commonly causes food poisoning)

22
Q

What is the most common cause of unilateral or bilateral proptosis?

A

Thyroid eye disease

23
Q

Chemosis and pulsatile proptosis with an audible bruit point towards what diagnosis?

A

Caroticocavernous fistula

24
Q

A patient has a smaller pupil on the same side as a ptosis. Which investigations would be appropriate, and describe why?

  • Abdominal CT
  • Angiography of the head and neck (MRI or CT)
  • Chest x-ray
  • Intraocular pressure
  • Orbital x-ray
A

Angiography of head and neck, and CXR

Horner’s syndrome is due to an interruption of the sympathetic supply to the eye. The sympathetic supply to the eye starts in the brainstem and takes a long scenic route to the eye, descending as far as the apex of the lung, then ascending with the carotid artery. Any lesion along this course can potentially cause a Horners syndrome. Two causes are particularly worth remembering:

Pancoast’s tumour, i.e. a lung tumour in the lung apex, which chest imaging (chest x-ray or CT) may demonstrate
Carotid artery dissection, occurring for example after severe whiplash injuries of the neck or after prolonged neck extension. Angiography (MRA or CTA) is the gold standard test to exclude or detect carotid artery dissection.

25
Q

A cherry red spot on the retina is seen 2 to 3 weeks following what type of occlusion?

A

Central retinal artery occlusion

26
Q

Following a retinal vein occlusion, macular oedema can occur. The treatment is the same as for diabetic macular oedema and wet age-related macular degeneration. What is that treatment?

  • Intravitreal injections of anti-VEGFs
  • Oral steroids
  • Panretinal laser photocoagulation
  • Phacoemulsification
  • Topical prostaglandin analogues
A

Intravitreal injections of anti-VEGFs

27
Q

How is a central retinal artery occlusion followed up?

A

Same as stroke or TIA e.g. cardiovascular workup including finding source of the clot. Most commonly this will be a carotid atherosclerosis, so Carotid doppler scan.

Also history seeking symptoms of GCA and do ESR and CRP

28
Q

Which three of the following signs are suggestive of a pigmented yndal lesion being a choroidal melanoma rather than a benign naevus?

  • Change in size of lesion
  • Flat lesion
  • Orange pigment on surface
  • Overlying retinal detachment
  • Width <3mm
A

Change in size of lesion
Orange pigment on surface
Overlying retinal detachment

29
Q

In a patient with suspected malignant melanoma under the retina, suggested 3 follow up investigations to do.

A

Chest x-ray
Liver function tests
Ocular ultrasound examination

Melanomas are highly malignant and can metastasise haematogenously to the lungs and liver

30
Q

What is the appropriate management for a choroidal naevus?

A

Fundal photograph and follow up

31
Q

Give 4 risk factors for progression of diabetic retinopathy

A 
Lack of exercise
Poor glycaemic control
Poor BP control
Not attending annual eye check up 
Pregnancy
32
Q

What are the 4 main causes of optic disk swelling?

A

Papilloedema, severely raised BP, optic neuritis, anterior ischaemic optic neuropathy

33
Q

T/F: Papilloedema is usually associated with normal visual acuities.

A

True

34
Q 
Which of the following is a common symptom of papilloedema:
Difficulties reading
Floaters
Metamorphopsia (distortion)
Photopsia (flashing lights)
Transient visual obscurations
A

Transient visual obscurations

35
Q

Give 3 causes of poor fundal view.

A

Cataracts, corneal scar, vitreous haemorrhage

36
Q

Name 2 conditions associated with cataracts.

A

Diabetes, Down syndrome, retinitis pigmentosa, steroids

37
Q 
What 3 features of retinitis pigmentosa might a patient have out of: 
Diplopia
Family history
Night blindness
Retinoblastoma
Visual field defect
A

FH, night blindness and visual field defect (loss of peripheral vision)

38
Q

What are the 3 forms of inheritance of retinitis pigmentosa?

A

AR, AD and X-linked recessive

3b specialties (15 decks)

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