Brainscape's Knowledge GenomeTM

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


See full index

Mandatory Selectives > Ophthamology > Flashcards

Ophthamology Flashcards

1
Q

Name the 6 important aspects of the ophthalmic physical exam

A

Visual Acuity - 20/##, pinhole, ischihara colour fields
Pupils - PEERLA
Confrontational visual fields and eye movements
Intra-ocular pressure - normal is 10-21mmHg
Fundoscopy - Cup to disc, macula, periphery
Slit Lamp - LLL, S/C, K, A/C, I, L

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

Describe the principle of pinhole occulusion

A

By using a pinhole it focuses the light at the centre of the lens removing any affects of refraction error.
If improves mean there is a refractive error (myopic, peripheral cataract)
If does not improve means there is conclusions (retina or optic nerve lesion)

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

List red flags for vision loss

A

Haloes
Sudden loss of vision
Severe eye pain

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

List conditions that are associated with vision loss

A

Trauma: Lid laceration, globe perforation, foreign body
Infection: bacterial conjunctivitis, corneal ulcer, hypopyon
Inflammatory: Acute iritis
Vascular: central retinal artery occlusion
Other: acute angle closure glaucoma, retinal detachment

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

Name the two types of cyclopegic eye drops

A

Anti-cholinergics (Tropicamide)
- Act by decreasing the parasympathetic stimulation causing myodriasis and ciliary muscle paralysis
Alpha Agonists (phenylpherine)
- Act by increasing the sympathetic stimulation to cause myodriasis

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

List the mechanism of action of the Glaucoma eye drops

A

Non-selective alpha agonist (phrine)
- decrease aqueous production and increase flow through the trabecular meshwork
Selective alpha2 agonist (onidine)
- decrease aqueous production and increase uveoscleral outflow
Beta-Blockers
- decrease production of aqueous
Carbonic anhydrase inhibitors (zolamide)
- decrease production of aqueous production
Prostaglandin analogues (Prost)
- increase uveoscleral outflow

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

List the differential for ocular trauma

A 
External: eyelid laceration, ethmoidal bone fracture, blowout fracture
Internal:
Globe: rupture, foreign body
Cornea: abrasion, ulcer
A/C: angle closure glaucoma, hyphema, hypopyon
Iris: iritis
Lens: cataract, dislocation
Vitreous: hemorrhage
Retina: tear, detachment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Discuss the management of a globe rupture

A

1) Prevent further damage: limit examination, keep covered, provide anti-emetics, analgesia
2) CT of head and globe
3) Antibiotics
4) Urgent ophthalmic surgery

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

List the findings for foreign body in the eye

A

Symptoms: foreign body, tearing, redness, pain, photophobia
Signs: vizualization, rust ring, Seidel sign (extrusion of fluorescein dye due to perforation)
Management: remove foreign body, begin antibiotic eye drops (moxifloxacin)

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

List the findings for vitreous hemorrhage and compare to retinal detachment

A

Symptoms: floaters, flashes, loss of vision
Signs: loss of red reflex, possible RAPD (detachment), hemorrhage seen on fundoscopy
Management: resorb within 3-6 months, must figure out reason for hemorrhage though. Retinal detachment require surgery (scleral buckle or retinal pneumopexy)

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

List some concerns with contact lens wearers

A
  • Greater likelihood of red eye being infectious keratitis

- Risk of pseudomonas infection following abrasion (must not patch eye)

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

List the Differential Diagnosis for Red Eye

A

Adnexa: entropian, extropian, holozeulom, chalazian, blepharitis, dacroadenitis, dacrocystitis, dry eyes, pre-septal cellulitis, post-septal cellulitis
S/C: conjunctivitis: viral, bacterial, allergic, medicamentosa, scleritis, episcleritis, pytergium, pingeucula
K: Cornal abrasion or ulcer
A/C: acute angle closure glaucoma, hypopyon
I: Anterior uveitis

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

Differentiate between the different forms of conjunctivitis

A

Viral:
- caused by adenovirus and have history of infectious contact and upper respiratory tract infection
- Symptoms: tearing, burning, pain
- Signs: diffuse conjunctival injection, mucoid discharge, chemosis, follicles on lower lid, pre-auricular lymphadenopathy
- Treatment: infection control, cool compresses
Bacterial
- Caused by strep, staph, H flu, gonorrheae and chlamydia (neonates and sexual active)
- Symptoms: acute onset of tearing, burning, pain, photophobia
- Signs: diffuse conjunctival injection, chemosis, purulent discharge papillae on lower lid (chlamydia have follicles, lid crusting, and mucoid discharge), STI
- Treatment: require antibiotic eye drops (moxifloxacin, gentamicin) or gonorrheae require IV ceftriaxone and irrigation
Allergic
- have history of atopy and seasonal allergies
- Symptoms: itchy eyes, rhinitis
- Signs: mild diffuse conjunctival injection, watery discharge
- Treatment: anti-histamine eye drops
Medicamentosa
- have history of using eye drops

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

Discuss the diagnosis and management of corneal ulcer

A
  • bacterial causes: strep, staph, h flu in children
  • Symptoms: eye pain, redness, photophobia, tearing
  • Signs: exudate in anterior chamber, hypopyon, positive fluorescein stain (green showing epithelial defect)
  • Treatment: Antibiotic eye drops, cycloplegics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What stain is used to identify dry eyes

A

Rose bengal stain

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

Which of the following can grow over cornea? Pytergieum or pinguecula

A

Pytergieum

17
Q

Which gland is blocked in hordeolum and chalazian?

A

Meibomian glands

18
Q

Discuss the diagnosis and management of corneal abrasion

A

It is an epithelial defect from trauma on the eye

  • Symptoms: pain, redness, photophobia, tearing
  • Signs: fluorescein uptake
  • Treatment: antibiotic drops, cover eye (unless CL wearer or organic material)
19
Q

Differentiate between Scleritis and Episcleritis

A

Scleritis:

  • Autoimmune and infectious and neoplastic causes
  • more diffuse and deep blood vessel injection
  • More deep, severe pain
  • Decreased visual acuity
20
Q

Differentiate between Orbital and Pre-orbital cellulitis

A

Orbital
- both caused by staph aureus or strep pneumonia
- more likely to be caused by sinusitis, tooth infection or skin infection, vs trauma or skin infection in pre
- Symptoms: severe eye pain with decreased visual acuity in orbital
- Signs: tender, swollen and erythematous eyelids in both
Ophthomalplegia, pain with eye movements, proptosis, RAPD in orbital
- Treatment: IV antibiotics, admission to hospital, and ENT or Ophtho consult vs antibiotics only in pre

21
Q

List the different strabismus conditions

A

Tropia:
- alternating (switch eyes) or non-alternating (always same eye)
- concomitant (does not change with gaze) vs non-concomitant (changes with gaze)
Phoria:
- only detected with cover-uncover test, so should be done between 6 months and 5 years

22
Q

Differentiate Between the Cover Tests

A

Cover Test:
Alternating
- in alternating when the fixating eye is covered the tropic eye will become fixating and the other will become malaligned
- in non-alternating when the fixating eye is covered the malaligned eye will fixate, but the other eye will be aligned as well and will return to fixating eye when cover is removed
Cover-Uncover test:
- in phoria when the one eye is covered it will move into the tropic position. When it is uncovered you will see it move to centre to pick up fixation

23
Q

List the different causes of strabismus

A

Paralytic:
- Muscular: grave’s disease, myasthenia gravis
- Cranial Nerves: ischemic, tumour, multiple sclerosis, brain trauma
Non-paralytic:
Vision: accommodative due to refractive error
Structural: anisometropia, cataract, retinoblastoma

24
Q

When can you no longer treat amblyopia?

A

After 9-10 years old

25
Q

List the differential for Anterior Uveitis

A

Infectious: herpes zoster, herpes simplex, cytomegalovirus
Inflammatory: PAIR (psoriatic, ankylosing spondylitis, inflammatory bowel disease, reactive), SLE

26
Q

Discuss the diagnosis and management of anterior uveitis

A

Symptoms: pain, redness, photophobia
Signs: Ciliary flush, miosis, posterior syncheciae, cells and flare, keratin precipitates
Treatment: underlying cause (anti-virals, systemic steroids), prednisolone eye drops

27
Q

List complications of anterior uveitis

A 
Band keritanopathy
Angle closure glaucoma
Cataract
Macular edema 
Posterior synechiae
28
Q

List the normal flow of aqueous fluid from the ciliary body to episcleral veins

A

Produced by ciliary body -> through pupil -> through trabecular meshwork -> through canal of Schlemm -> into episcleral veins

29
Q

Discuss the diagnosis and management of open angle glaucoma

A

Symptoms: asymptomatic peripheral (arcuate) vision loss
Signs: high intra-ocular pressure, increased cup to disc ratio
Treatment: glaucoma eye drops, selective laser trabeculoplasty, trabeculotomy

30
Q

Discuss the diagnosis and management of acute angle closure glaucoma

A

Symptoms: acute onset and progression, severe eye pain, haloes, redness, photophobia, decreased visual acuity
Signs: high intraocular pressure, white-hazy cornea, fixed mid-dilated pupil
Treatment: Reduce pressure with azetazolamide, glycerine (hyperosmotic) and mannitol (hypertonic solution). Peripheral iridotomy

31
Q

Compare the risk factors of open angle and closed angle glaucoma

A 
Open Angle:
- Increased age
- African-American
- Increased intra-ocular pressure
- Family History
Closed angle
- Increase age
- Female
- Hyperopia
- Chines, Inuit

Mandatory Selectives (9 decks)

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