Ophthomology

Question 1

Blurred, distorted, scotoma in central vision, white female >65, smoking HTN

Answer 1

Age related macular degeneration

Question 2

Inc/Neovascularity, leaking, scaring in smoker w/ central scotoma

Answer 2

Exudative macular degeneration –> anti-VEGF injections

Question 3

Multiple macular sores, atrophy, yellow Drusen deposits in smoker, central scotoma

Answer 3

Atrophic macular degeneration –> vitamins

Question 4

Loss of ganglion cells, atrophy of optic disc –> cupping, impaired outflow, gradual peripheral loss

Answer 4

Open-angle glaucoma

Question 5

Cupping of optic disc, gradual loss of peripheral vision

Answer 5

Open angle glaucoma –> Timolol, a-agonist, acetazolamide, laser

Question 6

Low light/theater –> dilation, dec flow out of anterior chamber –> inc pressure, rigid eye, pain HA

Answer 6

Angle glaucoma –> dilate w/ alpha and BBs OR laser

Question 7

Mid, fixed, dilated pupil, N/V, halos around light

Answer 7

Angle glaucoma –> Tonometry

Question 8

Pain, redness, mid-dilated pupil, hard eyeball, vision loss

Answer 8

Angle glaucoma –> narcs, mannitol, Acteazolamide, timolol or pilocarpine - NOT ATROPINE

Question 9

Burred vision, dec night vision/glare

Answer 9

Cataract

Question 10

Focal, U/L blotchy redness induced by valsalva

Answer 10

Subconjuctival hemorrhage - resolves

Question 11

Crusty discharge on lashes (anterior) or hyperemic lid w/ telengiectasias (posterior)

Answer 11

Blepharitis = SA –> lid scrubs, warm compress

Question 12

Redness, irritation, dull ache of lining beneath sclera, ?auto-immune, assoc w/ IBD & RA

Answer 12

Episcleritis - resolves, NSAIDs help

Question 13

Deep eye pain, redness, pain palpating eye, assoc w/ RA

Answer 13

Scleritis = emergency –> ophtho STEROIDS

Question 14

Circumcorneal injection, blurred vision, constricted pupil, assoc w/ sarcoid, Reiter, ankylosing, IBD

Answer 14

Anterior uveitis/iridocyclitis –> optho

Question 15

Pain, constricted pupils, kertic precipitates “Mutton fat,” iris nodules

Answer 15

Uveitis

Question 16

Transient monocular vision loss “curtain,” curtain comes & goes, white areas near arteries cause?

Answer 16

Amaurosis fugax = retinal cholesterol emboli –> carotid duplex

Question 17

Sudden vision loss in 1 eye upon waking

Answer 17

Central retinal vein occlusion

Question 18

Sudden vision loss in 1 eye, retinal hemorrhage, dilated veins, cotton wool spots

Answer 18

Central retinal vein occlusion

Question 19

Several episodes of painless vision loss, HTN, HLD, DM, carotid bruit, retina whitening

Answer 19

Central retinal ARTERY occlusion —> ocular massage & Carbogen or hyperbaric O2

Question 20

Sudden painless vision loss, optic disc pallor, red fovea, boxcar segmentation

Answer 20

Central retinal ARTERY occlusion –> hyperventilate, tPA

Question 21

Sudden vision loss in diabetic, floaters, loss of fundus details

Answer 21

Vitreous hemorrhage

Question 22

Vision loss with showers/snow storm of floaters/photopsia, elevated retina

Answer 22

Retinal detachment

Question 23

MVA or HTN, Veil or curtain over eyes - stays (vs. fugax)

Answer 23

Retinal detachment –> Laser

Question 24

Horizontal nystagmus in respective eye w/ ABduction, worse in hot/exercise, young female

Answer 24

MS –> lesion in MLF

Question 25

AV nicking, copper wiring, exudate and hemorrhages

Answer 25

HTN-retinopathy

Question 26

Vertical diplopia and extorsion

Answer 26

Trochlear nerve lesion

Question 27

Convergent strabismus and horizontal diplopia

Answer 27

Abducens nerve lesions

Question 28

Binocular paresthesia, fever, HA, periorbital edema, hyperesthesia in V1,2, proptosis

Answer 28

Cavernous sinus thrombosis ---> MRI, antibiotics

Question 29

Red tender, swollen eyelid, watery discharge, photophobia

Answer 29

Hordeolum - SA --> warm compress --> histo path to r/o CA if recurrent

Question 30

Hard painful --> painLESS rubbery lid nodule, granulomatous lesion of meibomian glands

Answer 30

Chalazion | -- persistence or recurrence = sebaceous carcinoma --> get HISTOPATHOLOGY

Question 31

Rapid impaired vision, pain on eye movement, afferent defect

Answer 31

Optic neuritis - ASSOC w/ MS

Question 32

S/P cataract surgery --> dec vision, exudates in anterior chamber, edematous conjunctiva

Answer 32

Postoperative endophthalmitis = Vitreous infection --> Abx or extraction

Question 33

Transient vision loss w/ changing head position, enlarged blind spot, morning HA

Answer 33

Papiledema --> CT

Question 34

Profuse watery eyes, hyperemia, edema of eyelids, asthmatic pt

Answer 34

Allergic conjunctivitis --> anti-histamine or mast cell stabilizing drops (olopatidine)

Question 35

URI, watery discharge, fall, most common conjuctivitis, preauricular LAD

Answer 35

Viral conjuctivitis/pink eye --> warm/cold compress

Question 36

Painful eye w/ purulent discharge w/ crusting

Answer 36

Bacterial conjuctivitis = Strep pneumo --> erythromycin, fluoroquinolone w/ contacts

Question 37

Conjunctivitis 1st 24hrs, b/l non-purulent

Answer 37

Chemical (Ag-nitrate) = supportive

Question 38

Conjunctivitis day 2-5, b/l eyelid swelling, discharge

Answer 38

Gonococcal --> IM//IV ceftriaxone OR topical erythromycin

Question 39

Conjunctivitis day 5-14, u/l, some eyelid swelling, injection, mucopurulent

Answer 39

Chlamydia

Question 40

Blood-stained eye discharge

Answer 40

Chlamydia --> ORAL Erythromycin 14d can --> hypertrophic pyloric stenosis

Question 41

Most common blindness in world, Trachoma

Answer 41

Chlamydial (A,B,C) --> tetracycline or erythromycin

Question 42

4 y/o unilateral conjunctivitis, nasal discharge, neovascularization/pannus, EGYPT

Answer 42

Trachoma --> topical tetracycline or oral Azithro

Question 43

CAN move eyes, inflammation around eyes

Answer 43

Pericellulitis --> abx

Question 44

Can't move eyes, inflammation around eyes

Answer 44

Orbital cellulitis --> CT scan --> I&D + Abx

Question 45

Orbital cellulitis vs. preseptal

Answer 45

Orbital - diplopia, pain, proptosis, vision impairment --> IV Abx vs. oral

Question 46

PAIN W/ EYE MOVEMENT, proptosis, ophthalmoplegia, diplopia

Answer 46

Ortibal cellilitis (d/t bacterial sinusitis) --> CT scan b/c --> abscess, blindness, death

Question 47

Leukocoria causes

Answer 47

Retinoblastoma --> liver brain mets &

Question 48

Dendritic ulcers, pain, photophobia

Answer 48

Herpes keratitis

Question 49

Tearing, redness, blurred vision, hx of same sx, worse in sun, vesicles, dendritic ulcers

Answer 49

Herpes simplex keratitis

Question 50

Elderly, itching, burning, malaise, vesicular rash in trigeminal, conjunctivitis, dendriform ulcers

Answer 50

Herpes zoster ophthamlicus --> acyclovir

Question 51

Contacts or trauma, hazy cornea w/ central ulcer, stromal abscess, hypopyon

Answer 51

Bacterial Keratitis

Question 52

Contact stuck, corneal hazy, edematous, scleral injection

Answer 52

Contact keratitis = PA --> perf, scarr --> blindness

Question 53

Itchy eyes, thick mucous, photophobia, blurred vision

Answer 53

Atopic keratoconjunctivitis

Question 54

Cortical blindness, strabismus, cataracts, irreversible

Answer 54

Amblyopia = fix b4 it occurs

Question 55

Lazy eye, unequal light reflection

Answer 55

Strabismus --> surgery if at birth, glasses if acquired

Question 56

Newborn, pure white retina

Answer 56

Retinoblastoma (Rb) --> surgery, never radiation --> f/u osteosarcoma

Question 57

Newborn, white cloudy lesions in front of eye - (+) birth = TORCH, (-) birth = galactosemia

Answer 57

Congenital cataracts --> surgery

Question 58

Pre-me, high load O2, growths on retina

Answer 58

Retinopathy of prematurity --> laser ablation

Question 59

Assoc w/ retinopathy of prematurity

Answer 59

NEC, bronchopulmonary dysplasia, IVH

Question 60

Cutting something w/o goggles, eye pain

Answer 60

Corneal abrasion --> copious irrigation --> Flourecin dye +/- surgery

Question 61

Lack of corneal sensation or reflex nerve

Answer 61

V1