Ophtho Part 2 Flashcards

(69 cards)

1
Q

name the muscles of mastication

A

pterygoid
masseter
temporalis

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2
Q

what is exophthalmos?

A

Abnormal protrusion of normal sized globe from the orbit

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3
Q

what is a classic sign you see with exophthalmos?

A

Third eyelid protrusion

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4
Q

what are the two most common causes of exophthalmos

A
  1. orbital/retrobulbar neoplasia
  2. orbital cellulitis/abscess
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5
Q

Exophthalmos
Elevated third eyelid
NO pain on mouth opening
Globe deviation (dorsolateral strabismus)

what would you think?

A

retrobulbar neoplasia

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6
Q

Rapid onset, painful
Elevated 3rd eyelid
Conjunctivitis
Pain on opening mouth

what would you think?

A

orbital cellulitis/abscess

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7
Q

common sign of masticatory muscle myositis

A

inflam = exophthalmos
atrophy = enophthalmos
googly eyes

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8
Q

diagnostics for exophthalmos

A

look above or straight on
retropulse globe (limited retropulsion)
nictitans protrusion (present)

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9
Q

orbital neoplasia treatment

A

globe sparing (radiation, surgical explore, chemotherapy)
globe removal (enucleation or exenteration)

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10
Q

orbital cellulitis/abscess treatment

A

medical (NSAID, steroid, abx)
surgical exploration + drainage

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11
Q

what is an example of enophthalmos due to passive globe retraction

A

horner’s syndrome (sympathetic denervation)

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12
Q

symptoms of horner’s syndrome

A

ptosis
enophthalmos
miosis
third eyelid elevation

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13
Q

what do you call an enlarged globe

A

bupthalmos

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14
Q

what is the difference between bupthalmos and exophthalmos

A

bupthalmos has NO 3rd eyelid protrusion

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15
Q

what do you call anterior displacement of the globe such that eyelids are caught behind the quarter of the globe? who are they common in?

A

proptosis

brachycephalics

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16
Q

what is a common complication from surgery for proptosis

A

lateral strabismus

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17
Q

name the tear film layers in order from inner to outer

A

inner: mucin layer by conjunctiva

middle: aqueous layer by lacrimal and gland of third eyelid

outer: lipid layer by meibomian glands

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18
Q

normal Schirmer tear test in dog? cat? horse?

A

dog > 15mm/min
cat > 5 mm/min
equine > 10mm/min

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19
Q

what does the Schirmer tear test measure?

A

tear quantity

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20
Q

what is the most common form of KCS

A

quantitative - deficiency of aqueous layer

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21
Q

what is the most common cause of KCS? other causes?

A

immune-mediated

metabolic dz - Cushings or DM
drug induced - sulfa, NSAID, atropine
infectious - distemper or FHV1

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22
Q

treatment for KCS in dogs…
which lacrostimulants? include dosage
which abx?
which anti-inflam?
tear replacement?

A

topical cyclosporine 0.2% or topical tacolimus 0.01-0.02% TID
oral pilocarpine
abx if conjunctivitis or ulcer is present - tobramycin/terramycin or neopolybac
anti-inflam (use if keratitis, no ulcer): diclofenac or neopolydex
gel or ointment

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23
Q

what is the most common cause of feline conjunctivitis and feline keratitis

A

FHV-1

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24
Q

FHV-1
age group?
pathogenesis?
what triggers it?
unilateral or bilateral?

A

young cats
acute lysis, latent in trigeminal ganglion, active with stress (spontaneous, enviornmental, corticosteroids, co-infection) + epithelial tropism = surface dz
stress or chronic steroids
unilateral

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25
conjunctivitis + keratitis +/- URT signs in cat what is your number one differential?
FHV-1
26
what is pathognomonic for FHV-1
dendritic ulcer
27
what test can you do for FHV1?
none - no definitive test
28
treatment for FHV-1
reduce stress supportive care - erythromycin L-lysine 500mg BID (adults), SID (kittens) cidofovir 0.5% BID famcliclovir 40mg/kg TID`
29
most common signs of chlamydia felis
chemosis bilateral no ulceration
30
treatment for chlamydia felis
topical ax - tetracycline (oxytet) BID/TID - macrolide (erythromycin) BID/TID
31
calicivirus clinical signs
conjunctival & oral ulceration (pathognomonic)
32
diffuse episcleral injection not painful no intraocular abnormalities perilimbal corneal edema what disease process?
diffuse episcleritis "red eye"
33
what are the 5 layers of the cornea in dogs/cats
tear film epithelium stroma descemet's membrane endothelium
34
criteria of simple ulcers
- superficial - not infected - heals in 5-7 days - no complicating factors
35
what is the goal of treating simple ulcers?
prevent infection NOT to accelerate healing
36
what is the treatment for a simple ulcer? include dosage
erythromycin/tobramycin TID (triple abx ideal) oral NSAID oral GABA topical atropine e-collar
37
when do you want to recheck a simple ulcer in normal dogs? brachycephalics?
5-7 days in normal dogs 2-3 days in brachycephalics
38
criteria of a complicated ulcer
deep loss of stroma infected/melting delayed wound healing complicating factors
39
if there is <50% stromal loss/melting/infection how would you want to rule out infection?
cytology (rapid) culture and Se (slower) use microbrush or cytobrush
40
how to control secondary uveitis with a complicated ulcer?
topical atropine 1% q 8-24hrs oral NSAIDs
41
4-5 A’s of complicated corneal ulcer therapy in dogs & cats antibiotic topical? anti-collagenase? atropine antibiotic oral? anti-inflam oral?
ofloxacin, cephalexin serum or EDTA atropine clavamox NSAID
42
4-5 A’s of complicated corneal ulcer therapy in horses antibiotic topical? anti-collagenase? atropine antifungal? anti-inflam oral?
ofloxacin, cephalexin serum or EDTA atropine voriconazole NSAID
43
what can you do as a treatment option for horses with a complicated ulcer to administer medications?
Subpalpebral lavage tube
44
if a dog has a non-healing superficial ulcer present for weeks-months that is not infected, what is it? treatment?
indolent corneal ulcer grid keratotomy or diamond burr debridement
45
dendritic ulcers are pathognomonic of what
FHV-1
46
what does a blue corneal opacity indicate?
edema
47
focal corneal edema is due to what?
epithelial disease
48
generalized diffuse corneal edema is due to what?
endothelial disease
49
corneal edema treatment
hyperosmotics (5% saline)
50
what does a red corneal opacity indicate?
blood vessels = vascularization of the cornea
51
criteria of pannus and what is it?
immune mediated chronic superficial keratitis 1. superficial vascularization 2. corneal degeneration 3. pigmentation 4. fibrosis
52
treatment for pannus
dexamethasone or pred acetate cyclosporine or tacrolimus lifelong (not cured, just controlled) decrease UV exposure
53
what common pigment disease do pugs get and what is the treatment?
pigmentary keratopathy tacrolimus for life long
54
what is the anterior chamber
space between cornea and iris
55
what is the posterior chamber
space between iris and lens
56
what is aqueous flare
protein and cells in anterior chamber that scatters light
57
what other abnormal contents can be seen in the anterior chamber
keratic precipitates neutrophils (hypopyon) hyphema (blood) fibrin lipid
58
what is a specific clinical sign associated with uveitis
miosis
59
common INFECTIOUS causes of canine uveitis
bacterial (lepto, brucella, borrelia, septicemia) fungal (blasto, coccidioides, crypto, histo) rickettsial - ehrlichia, rickettsia
60
common NON- INFECTIOUS causes of canine uveitis
idiopathic (most common)
61
hyphema present in dogs, do what? cats, do what?
dogs - coag panel cat - blood pressure
62
common INFECTIOUS causes of feline uveitis
4 F's and T FIP, FeLV, FIV fungal (crypto, histo, blasto, coccidioides) toxoplasma bartonella
63
common NON- INFECTIOUS causes of feline uveitis
idiopathic (most common)
64
treatment of uveitis
prolonged, recurrence common prednisolone acetate
65
uveitis vs anterior uveitis
uveitis - ciliary flush, corneal edema, episcleral injection, photophobia, epiphora anterior uveitis - discharge, anterior flare, iris changes (hyperemia, hyperpigmentation, synechia)
66
what can causes fly biting behavior in the dog
iris cysts
67
iris cyst treatment
none unless vision changes or increased IOP
68
are intraocular neoplasia more aggressive in dogs or cats
cats
69
common intraocular tumor in cats
feline diffuse iris melanoma