Ophtho

Question 1

Rb imaging and cause and death?

Answer 1

inactivation tumor suppressor Rb and U/S or CT shows calcification. death from liver or brain metastases

Question 2

External hordeolum name?

Answer 2

stye

Question 3

tx open angle (chronic) glaucoma

Answer 3

b-blocker (timolol) reduces aqueous humor production from epithelium. prostaglandin analogue, topical CA inhibitors, pilocarpine

Question 4

dacrocystitis tx

Answer 4

broad spectrum abx

Question 5

keratitis cause and tx?

Answer 5

commonly from left contact lens over time. pseudomonas and serratia. topical broad spectrum abx to tx

Question 6

presentation of CMV vs HSV/VZV retinitis

Answer 6

CMV-painless with fluffy or granular lesion near retinal vessels. No keratitis or conjunctivitis
HSV or VZV-painful retinitis with necrosis bilaterally. Yes keratitis and conjunctivitis

Question 7

2 types of diabetic retinopathy and tx?

Answer 7

non prolif-damage to capillaries leads to leakage with hemorrhage and macular edema. tx blood sugar control
prolif-chronic hypoxia with new blood vessel formation with traction on retina. tx with argon laser or anti-VEGF

Question 8

mcc vitreous hemorrhage?

Answer 8

diabetic retinopathy

Question 9

tx viral vs allergic vs bacterial conjunctivitis?

Answer 9

viral-warm or cold compress with or without antihistamine/decongestant drops
allergic-antihistamine or degonestant for intermittent or olopatadine or azelastine (mast cell or antihistamine for persistent)
bacterial-erythromycin/azithromycin/or trimethoprim drops

Question 10

best test and tx uveitis?

Answer 10

slit lamp. topical steroids

Question 11

best initial and gold standard and tx closed angle glaucoma?

Answer 11

tonometry/gonioscopy to visualize angle. acetazolamide, mannitol, pilocarbine (opens canal of schlemm)

Question 12

what drug to avoid in acute angle closure?

Answer 12

sympathomimetic or anticholinergic or atropine because they all dilate pupils!!

Question 13

dendritic pattern fluorscein tx and what to avoid?

Answer 13

herpes keratitis. use oral acyclovir, famciclovir or valacylclovir. AVOID STEROIDS AT ALL COST AS IT MAKES IT WORSE

Question 14

painless monoocular visual loss causes and tx?

Answer 14

retinal artery occulsion (pale retina and dark macula with cherry red spot)-100% o2, ocular massage, anterior chamber paracentesis to decrease pressure
retinal vein occlusion (blood and thunder appearance) -ranibizumab
retinal detachment (curtain coming down)-flashes of light and floaters. reattachement with mechanical methods

Question 15

macular degeneration type description and tx?

Answer 15

progressive loss of central vision
dry-drusen with yellowish material and loss in vision (antioxidant and vitamins prevent)
wet-neovascularization (tx with ranibizumab injected into vitreous chamber every 4-8 wks)

Question 16

what is amaurosis fugax and next best step?

Answer 16

transient painless monocular vision loss from retinal emboli as curtain falling down and return of vision when clots break. Next best step is duplex US of neck b/c sign of impending stroke

Question 17

pediatric condition associated with uveitis?

Answer 17

JRA

Question 18

cataracts in neonate?

Answer 18

TORCH or other inherited metabolic disorder (galactosemia)

Question 19

top cause blindness less than 55 older than 55 and blac?

Answer 19

diabetes, senile macular degeneration, glaucoma

Question 20

orbital vs preorbital cellulitis?

Answer 20

orbital with proptosis, severe eye pain, decreased visual acuity

Question 21

mcc of isolated palsies of III, IV, VI

Answer 21

hypertension and diabetes

Question 22

corneal blink reflex involvement?

Answer 22

cn V (afferent is sensory) and cn VII (efferent is motor)

Question 23

herpes simplex keratitis vs herpes zoster ophthalmicus?

Answer 23

herpes zoster-skin and eye infection (dendridofrom corneal ulcers) in distribution of ophthalmic branch of trigeminal with vesicles near corner of eye and forehead
herpes simplex-just eye infection
both can show dendritic branching (dendritic ulcers and vesicles) with fluoroscein examination

Question 24

tx herpes keratitis?

Answer 24

oral acyclovir and topical antiherpetic trifluridine and idoxiuridine

Question 25

monocular vision loss with pain with eye movement and changes in color perception

Answer 25

optic neuritis