Optho Flashcards

1
Q

OPHTHAMOLOGY

A

OPHTHAMOLOGY

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2
Q

What should a primary care provider do for a presumed retinal detachment?

A

Refer & position patient with head down

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3
Q

In what age range do you expect to most commonly find amaurosis fugax?

A

Patients older than 50

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4
Q

What is the #1 cause of retinal artery occlusion?

A

Carotid atherosclerotic disease.

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5
Q

When treating herpes keratitis should you use topical antivirals, topical steroids or both?

A

Don’t use steroids. Topical antiviral and refer!

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6
Q

A patient describes his vision loss as a curtain coming down and then going back up. What might the diagnosis be?

A

Amaurosis fugax

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7
Q

A patient presents with a painful, red nodule on the eyelid. What diagnosis should you be thinking of? What treatment should you begin with?

A

Hordeolum (sty). Warm compress and progress to topical antibiotics if necessary.

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8
Q

A fundal exam shows a cherry-red spot. What diagnosis should you be thinking of?

A

Central retinal artery occlusion

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9
Q

A college student presents with a little purulent drainage from one eye and nontender preauricular lymphadenopathy. What diagnosis and pathogen should you be thinking of?

A

Chlamydia conjunctivitis

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10
Q

What should a primary care provider do for presumed central retinal artery occlusion?

A

Ophthalmic emergency! Refer and intermittent pressure and release of the eye.

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11
Q

A patient presents with unilateral blurriness developing over a few days. Fundal exam shows a “blood and thunder” pattern. What is the most likely diagnosis?

A

Central vein occlusion

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12
Q

What is appropriate treatment for central vein occlusion?

A

Typically self limited. Treat underlying disease.

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13
Q

Is glaucoma more prevalent in males or females?

A

Females 3:1

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14
Q

Give two risk factors for glaucoma.

A

African American descent and diabetes

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15
Q

What is the yellow, brown fleshy mass on the conjunctiva which usually does not interfere with vision?

A

Pinguecula

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16
Q

A fundal exam shows a cup to disc ratio of >0.5. There are also vessels bending over the disc. What is the most likely diagnosis?

A

Glaucoma

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17
Q

A patient presents saying that he doesn’t seem to need his glasses anymore after 30 yrs. What is the most likely diagnosis?

A

Cataract

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18
Q

A patient has metamorphopsia and a central blind spot. What is the most likely diagnosis?

A

Macular degeneration

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19
Q

What is the most likely quadrant for a retinal detachment?

A

Superior temporal

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20
Q

A patient presents with pain in one eye. The cornea is hazy and the pupils are fixed. What is the most likely diagnosis?

A

Glaucoma

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21
Q

What is the most common way of testing for metamorphopsia?

A

Amsler grid

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22
Q

You notice drusen deposits on fundal exam. What is the most likely diagnosis?

A

Macular degeneration

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23
Q

A patient presents with irritated, burning and tearing eyes. You notice some scurf and scales. Where do you begin treatment?

A

This is blepharitis. Treatment begins with good hygiene and moves on to topical antibiotics if necessary.

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24
Q

A patient has a history of multiple stys. He now has a painless nodule on his eyelid and minor conjunctivitis. What is the most likely diagnosis?

A

Chalazion

25
Q

What are the most common colors lost in color blindness?

A

Red and green

26
Q

What is the term for eyelids that turn in?

A

Entropion

27
Q

What is the term for bilateral yellow plaques near the eyes?

A

Xanthelasma

28
Q

A fundal exam shows an opalescent retina and boxcarring of arterioles. What is the most likely diagnosis?

A

Central retinal artery occlusion

29
Q

What is the most common preceding event for orbital cellulitis?

A

URI

30
Q

Vision loss described as curtain coming down should make you think of what diagnosis?

A

Retinal detachment

31
Q

You notice a bowing of the iris on exam. What is the most likely diagnosis?

A

Glaucoma

32
Q

A CT scan of the head shows broad infiltration of orbital fat. What is the most likely diagnosis?

A

Orbital cellulitis

33
Q

A patient presents with watery bilateral discharge from the eyes and nontender preauricular adenopathy. What is the most likely diagnosis? What is the most common pathogen?

A

Viral conjunctivitis, adenovirus

34
Q

How do you test for color blindness?

A

Ishihara plates

35
Q

A patient with a history of asthma presents complaining of stringy discharge from both eyes and severe swelling around the eyes. What is the most likely diagnosis?

A

Allergic conjunctivitis

36
Q

What is the name for the triangular or wedge shaped growth on the conjunctiva that may interfere with vision?

A

Pterygium

37
Q

What is the name of the test for dry eyes?

A

Schirmer’s test

38
Q

A patient having recently undergone cataract surgery presents complaining of vision loss in the operative eye. What is the most likely diagnosis?

A

Retinal detachment

39
Q

A patient presents with sudden painless complete unilateral vision loss. What is the most likely diagnosis?

A

Central retinal artery occlusion

40
Q

A dendritic lesion is seen with fluorescein stain. What is the most likely diagnosis?

A

Herpes keratitis

41
Q

Which nerve is involved in herpes zoster ophthalmicus?

A

Trigeminal nerve, CN 5

42
Q

Your attending asks you to come and see an excellent example of Hutchinson’s sign. What diagnosis does the patient have?

A

Herpes zoster ophthalmicus

43
Q

A patient presents with a dense corneal infiltrate and an epithelial defect seen with fluorescein stain. What diagnosis should you be thinking of?

A

Corneal ulcer

44
Q

A feathery border in an eye exam should make you think of what diagnosis?

A

Fungal infection

45
Q

A patient in the recovery room following foot surgery is complaining of severe photophobia. She feels as though there is something in her eye. What is the most likely diagnosis?

A

Corneal abrasion (pt’s scratch their eyes before they are completely awake from anesthesia)

46
Q

What is the treatment for subconjunctival hemorrhage?

A

Reassurance

47
Q

A 19 year old male took an elbow to the face while playing basketball this morning. The whole left side of his face is swollen and he can’t look up. What is the most likely diagnosis?

A

Orbital fracture

48
Q

A patient complains of seeing halos and rainbows around lights. She also complains of moderate photophobia? What is the most likely diagnosis?

A

Glaucoma

49
Q

What is the first thing you should be thinking of if a pediatric patient comes in with blood in the anterior chamber of the eye (hyphema).

A

Child abuse until proven otherwise

50
Q

How long after a radiant energy burn do symptoms typically show?

A

6-12 hours

51
Q

What is the term for eyelids that turn out?

A

Ectropion

52
Q

What is the initial treatment for a chemical burn to the eyes?

A

Irrigate like crazy!

53
Q

Color blindness is transmitted through what genetic pattern?

A

Recessive X-linked

54
Q

What is the term for being nearsighted? What type of lens do you use to correct it?

A

Myopia, concave lenses

55
Q

A college student presents with copious purulent drainage from one eye. What is the most likely diagnosis?

A

Neisseria conjunctivitis

56
Q

What is the first line treatment for orbital cellulitis?

A

IV antibiotics, followed by 2 weeks of oral antibiotics

57
Q

What is the term for being farsighted? What type of lens do you use to correct it?

A

Hyperopia. convex

58
Q

What is tonometry used for?

A

Determining intraocular pressure