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Misc. Notes Year 2 > Ophthalmology notes > Flashcards

Ophthalmology notes Flashcards

1
Q

Name 4 ocular adnexa

A

Eyelids
Lacrimal glands
Naso-lacrimal duct
Lacrimal sac

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2
Q

What is emmetropia

A

Normal vision

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3
Q

What is the medical term for long sightedness

A

Hypermetropia

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4
Q

What is presbyopia and what causes it

A

Long-sightedness due to loss of elasticity of lens over time

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5
Q

Name a gram positive and gram negative coccus species

A

Gram + -> Staph/Strep

Gram - -> Neisseria

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6
Q

What is keratitis

A

Inflammation of the cornea

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7
Q

What is orbital cellulitis

A

Inflammation behind orbital septum

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8
Q

What is the most common cause of bacterial conjunctivitis

A

Staph Aureus

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9
Q

What investigation and treatment is done for suspected bacterial conjunctivitis

A

Swab -> topical chloramphenicol

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10
Q

When should chloramphenicol not be given

A

History of aplastic anaemia or allergy

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11
Q

What are 3 common causes of viral conjunctivitis

A

Herpes zoster
Adenovirus
Herpes Simplex

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12
Q

What kind of conjunctivitis shows sub tarsal scarring and follicle development

A

Chlamydial Conjunctivitis

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13
Q

What kind of keratitis can present with hypopyon

A

Bacterial

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14
Q

What kind of keratitis can present with a dendritic ulcer

A

Herpetic keratitis

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15
Q

Which steroid is given as treatment for herpetic keratitis

A

DONT GIVE STEROIDS

can cause corneal melt

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16
Q

What kind of keratitis presents with bilateral sub-epithelial infiltrates

A

Adenoviral Keratitis

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17
Q

Name 2 common causes of fungal keratitis

A

Pseudomonas

Acanthamoeba

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18
Q

Who tends to get fungal keratitis

A

Contact lens wearers

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19
Q

Which ENT pathology can lead to orbital cellulitis

A

Sinusitis

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20
Q

Which scan must be done in suspected orbital cellulitis

A

CT scan

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21
Q

What is CMV chorioretinitis

A

CMV infection of choroid and retina

Seen in HIV patients

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22
Q

Investigation for Bacterial Keratitis

A

Corneal scrape

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23
Q

Investigation for endophthalmitis

A

Aqueous/Vitreous culture

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24
Q

Mechanism of action of Chloramphenicol

A

Inhibits protein synthesis

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25
Q

Mechanism of action of Penicillin & Cephalosporin

A

Inhibit cell wall synthesis

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26
Q

Mechanism of action of Quinolones

A

Inhibits nucleic acid synthesis

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27
Q

What specifically does Chloramphenicol inhibit

A

Peptidyl Transferase

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28
Q

Name some side effects of Chloramphenicol

A

Irreversible aplastic anaemia

Grey-baby syndrome

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29
Q

Mechanism of action of Aciclovir

A

Base Analogue (mimics guanine)

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30
Q

Treatment for Chlamydial conjunctivitis

A

Topical oxytetracycline

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31
Q

Treatment for genital chlamydia

A

Oral Azithromycin

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32
Q

Treatment for bacterial keratitis

A

Gentamicin + Cefuroxime

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33
Q

Which ventricles contain the choroid plexus

A

3rd and 4th

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34
Q

Compare the chemical makeup of CSF to water with regards to NaCl, K+, Glucose & proteins

A

CSF has higher concentrations of NaCl

Water has higher concentrations of K+, glucose & protein

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35
Q

How does CSF return to venous blood

A

Via Arachnoid granulations in the Superior Sagittal Sinus

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36
Q

Where does CSF predominantly circulate

A

Subarachnoid space

Between pia and dura mater

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37
Q

What is pseudotumour cerebri

A

Idiopathic inter-cranial hypertension

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38
Q

Where does aqueous humour drain

A

To the scleral venous sinus via the trabecular meshwork and the canal of Schlemm

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39
Q

Which cells are responsible for lateral connections in the retina

A

Amacrine cells

Horizontal cells

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40
Q

What is the resting membrane potential in photoreceptor cells and why

A

-20mV due to a constant influx of Na+ in the dark

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41
Q

What is the dark current

A

cGMP gated Na+ channel open in the dark but closed in light

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42
Q

Which chemical conversion modulates the dark current

A

The conversion of 11-cis-retinal to all-trans-retinal

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43
Q

What are the three main immune cells in the eye

A

Mast cells
Macrophages
Neutrophils

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44
Q

What is the only part of the eye with lymphatic drainage

A

Conjunctiva

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45
Q

Are there Langerhans cells in the cornea or sclera

A

Langerhans cells are in the peripheral cornea

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46
Q

What is ACAID (Anterior Chamber Associated Immune Deviation)

A

Peripheral tolerance to ocular antigens

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47
Q

What can be described as bilateral granulomatous uveitis

A

Sympathetic Ophthalmia

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48
Q

Which eye is the exciting eye in Sympathetic Ophthalmia

A

The injured eye

the fellow eye is the sympathising eye

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49
Q

What is a Dalen-Fuchs nodule

A

An epithelial cell cluster in the retinal layers

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50
Q

Give an example of a Type 1 hypersensitivity of the eye

A

Acute allergic conjunctivitis

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51
Q

Give an example of a Type 2 hypersensitivity of the eye

A

Ocular cicatricial pemphigoid

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52
Q

Give an example of a Type 3 hypersensitivity of the eye

A

Autoimmune corneal melting

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53
Q

Give an example of a Type 4 hypersensitivity of the eye

A

Corneal graft rejection

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54
Q

What is the sensory supply to the Dura Mater

A

CN V

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55
Q

Which meningeal layer are the dural venous sinuses in

A

Dura Mater

56
Q

Which meningeal layer are the arachnoid granulations in

A

Arachnoid mater

57
Q

Where does the subarachnoid space stop with regards to the spinal cord

A

S2

58
Q

Where is the 3rd ventricle

A

In midline with the diencephalon

59
Q

Where is the 4th ventricle

A

Between the cerebellum and pons

60
Q

What will the eye look like in a patient with 3rd nerve palsy

A 
Ptosis (loss of eyelid muscle)
Dilated pupil (loss of sphincter of the pupil) 
Eye down and out (LR & SO functioning)
61
Q

When will a patient with 4th nerve palsy get diplopia

A

When looking down

eye can’t move inferomedially

62
Q

What should you always do for suspected Intra-Ocular-Foreign-Body

A

X-ray orbits

63
Q

Is an alkali or acid burn worse and why

A

Alkali is worse because it easily and rapidly penetrates

Acid coagulases protein so has little penetration

64
Q

What does intracameral mean

A

Into the anterior chamber of the eye

65
Q

What is the structure of the cornea in terms of lipid and water

A

lipid: water: lipid
epithelium: stroma: endothelium

66
Q

What can be added to drugs to make them more hydrophobic

A

Alcohol or Acetate

67
Q

What can be added to drugs to make them more hydrophilic

A

Phosphate

68
Q

What kind of disease would Prednisolone Phosphate be used for and why

A 
Corneal disease 
(phosphate makes it more hydrophilic so the drug does not penetrate and remains on cornea)
69
Q

Name a preservative that is used and how it enhances corneal penetration

A

Benzalkonium

disrupts lipid layer of tear film

70
Q

When is the intra-vitreal mode of administration used

A

To administer antibiotics in endophthalmitis

To administer anti-VEGF

71
Q

What is the mechanism of action of anaesthetics used in tonometry/ corneal scrape

A

Block Na+ channels

impede nerve conduction

72
Q

How do mydriatic drugs work

A

Cause pupil dilation by blocking parasympathetic supply to the iris

73
Q

What visual field side effect can Vigabatrin have

A

Constriction of the visual field

74
Q

What visual field side effect can Ethambutol have

A

Optic neuropathy

75
Q

What visual field side effect can Chloroquine have

A

Maculopathy

76
Q

What is the pathogenesis of diabetic retinopathy

A

Glycosylation of basement membranes

leads to loss of basement pericytes

77
Q

What are the 3 classifications of new vessel growth in the eye

A

Growth on disc (NVD)
Growth in the periphery (NVE)
Growth on iris (Rubeosis iridis)

78
Q

The central retinal artery supplies the inner 2/3rd’s of the retina, what supplies the outer 1/3rd

A

Choroid

79
Q

Management of Central Retinal Artery Occlusion

A

If in 24 hours - Ocular massage to try and convert it to BRAO

80
Q

Management of Central Retinal Vein Occlusion

A

Anti-VEGF

81
Q

Which arteries, that supply the optic nerve head, become occluded in Ischaemic Optic Neuropathy

A

Posterior Ciliary Arteries

82
Q

Ischaemic Optic Neuropathy can be arteritic or non-arteritic - Name a cause of each type

A

Arteritic - Giant Cell Arteritis

Non- Arteritic - Atherosclerosis

83
Q

What could a loss of the red reflex suggest

A

Retinoblastoma
Vitreous haemorrhage
Retinal detachment
Cataract

84
Q

What do flashes and floaters suggest

A

Retinal Detachment

85
Q

What do haloes around lights suggest

A

Acute Angle Closure Glaucoma

86
Q

Treatment of dry ARMD

A

Low vision aids (magnifiers)

87
Q

What kind of visual field defect does open-angle glaucoma cause

A

Arcuate field defect

88
Q

What should you assume is causing bilateral papilloedema until proven otherwise

A

Space-occupying lesion in the brain

89
Q

What is the Monroe-Kellie hypothesis

A

States that if one component of inter-cranial pressure changes, the others must also change to compensate

90
Q

What are the two causes of anterior blepharitis

A

Seborrhoeic (on eyelashes)

Staphylococcal (on hair follicle)

91
Q

What is usually the cause of posterior blepharitis

A

Meibomian gland dysfunction

92
Q

What derm condition is posterior blepharitis associated with

A

Acne Rosacea

93
Q

Which derm condition can follicular conjunctivitis be secondary to

A

Molluscum Contagisoum

94
Q

How can you differentiate between infective and autoimmune corneal ulcers

A

Infective ulcers tend to be central

Autoimmune ulcers tend to be peripheral

95
Q

Treatment for bacterial corneal ulcers

A

Ofloxacin hourly

96
Q

Which MSK pathologies are Episcleritis and Scleritis associated with

A

Episcleritis - Gout

Scleritis - Rheumatoid Arthritis

97
Q

Which test is done for Scleritis

A

Phenylephrine test

98
Q

What kind of vision puts you at a higher risk of retinal detachment

A

Myopia

short-sighted

99
Q

What kind of vision puts you at a higher risk of Acute Angle Closure Glaucoma

A

Hypermetropia

long-sighted

100
Q

What disease are Brushfield spots seen in

A

Down Syndrome

101
Q

What disease are Kayser Fleischer rings seen in

A

Wilson’s disease

102
Q

What disease are blue sclera seen in

A

Osteogenesis Imperfecta

103
Q

CRVO can present with a relative afferent pupillary defect true or false

A

True

104
Q

What is the normal range of intraocular pressure

A

10-21mmHg

105
Q

Name a risk factor for ARMD

A

Smoking

106
Q

If a patient presents complaining that straight lines are appearing wavy/curvy, what should you think of

A

ARMD

107
Q

Which endocrine disease can cause vitreous haemorrhages

A

Diabetes

108
Q

Flashes and Floaters suggest what pathology

A

Retinal detachment

109
Q

When can contact lenses be worn in a patient with conjunctivitis

A

Should not be worn

110
Q

What is the next course of action in a patient with ARMD and neovascularization

A

Fluorescein angiography

111
Q

What is another name for a Marcus-Gunn pupil and what are the two possible causes

A

RAPD

Damage to optic nerve/ retina

112
Q

What is a retinal cause of a relative afferent pupillary defect

A

Retinal detachment

113
Q

What is an optic nerve cause of a relative afferent pupillary defect

A

Optic neuritis

114
Q

Which biochemical abnormality can predispose to cataract formation

A

Hypocalcaemia

115
Q

60 year old asthmatic presents with symptoms consistent with open-angle glaucoma. Tonometry confirms this with an intraocular pressure of 29mmHg. What is the management

A

Latanoprost (prostaglandin analogue)

b-blocker contraindicated due to asthma

116
Q

A fractured zygoma tends to rotate in which direction and what can this disrupt

A

Medially

can disrupt suspensory eye ligament

117
Q

Which tendon is attached to the superior tarsus

A

Levator Palpebrae Superioris

118
Q

What is another name for Muller’s muscle

A

Superior tarsal muscle

119
Q

What is the innervation of the lacrimal gland

A

CN VII (parasympathetic)

120
Q

Where do all rectus muscles originate

A

Common Tendinous ring

121
Q

Which nerve is responsible for conduction of afferent action potentials from the cornea in the blink reflex

A

CN V1 (long ciliary branch)

122
Q

Which three things are being tested in the accommodation reflex and which structures are involved

A

Bilateral pupillary constriction (Spinchter pupillae)
Bilateral midline convergence (Medial rectus)
Bilateral lens relaxation (Ciliary muscle constriction)

123
Q

Bilateral conjunctivitis in young adults can indicate what

A

Chlamydial Conjunctivitis

124
Q

What kind of eye disease can result in sub tarsal scarring

A

Chlamydial Conjunctivitis

125
Q

What is the most common cause of endophthalmitis and what is the treatment

A

Staph Epidermidis

Ceftazidime/ Vancomycin/ Intra-vitreal Amikacin

126
Q

What do quinolones inhibit

A

DNA gyrase

thus inhibiting nucleic acid synthesis

127
Q

What enzyme does chloramphenicol inhibit

A

Peptidyl transferase

128
Q

Where on the cornea are Langerhan’s cells NOT found

A

Absent from central 1/3rd

129
Q

Which two eye structures are known as the tough collagen coat and have no lymphatics or vasculature

A

Cornea + Sclera

130
Q

Describe an Epidural Haematoma

A

Arterial bleed between skull and dura mater

131
Q

Describe a Subdural Haematoma

A

Venous bleed between dura mater and arachnoid mater

132
Q

What are the lateral and medial apertures of the 4th ventricle also known as and what space do they open to

A

Subarachnoid space
Lateral -> Foramen of Luschka
Medial -> Foramen of Magendie

133
Q

What is the foramen of Monro

A

Connects 3rd and lateral ventricles

134
Q

Define visual acuity

A

The ability to distinguish between 2 points

135
Q

What colour of light do short medium and long wavelength cones allow us to see

A

Short -> Blue
Medium -> Green
Long -> Red

Misc. Notes Year 2 (30 decks)

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