Brainscape's Knowledge GenomeTM

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


See full index

X. neuro ophthalmology > Orbital Disease > Flashcards

Orbital Disease Flashcards

1
Q

Non-infectious causes of Inflammatory Orbital Syndromes (7)

A
  1. TED
  2. IOIS
  3. Immunoglobulin 4 Related Disease
  4. Sarcoidosis
  5. Wegener Granulomatosis
  6. Giant Cell Arteritis
  7. Polyarteritis Nodosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IOIS is likely mediated by what immune cells?

A

T and B cells

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

IOIS: lacrimal involvement in ___% of cases

A

25

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

How to distinguish TED from IOIS

A

IOIS involves pain and rapid onset

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

T/F: imaging is required to confirm dx of IOIS

A

TRUE

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

CT scan of IOIS shows…

A

Ill-defined orbit opacity + loss of definition of contents

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

IOIS demographics

A

No clear predilection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5 Categories of IOIS

A
  1. Anterior
  2. Diffuse
  3. Apical
  4. Lacrimal Gland
  5. Myositis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

IOIS: What is the mechanism that causes GLC from Posterior Scleritis?

A

Scleritis causes choroidal effusion pushing anterior structures forward and blocking the angle

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

IOIS:
T/F — Posterior Scleritis is dramatically responsive to steroid therapy

A

TRUE

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

What is the most common form of IOIS in children?

A

Posterior Scleritis

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

IOIS: Posterior Scleritis manifests uni- or bi-laterally?

A

Either

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

Myositis

A

IOIS affected EOMs

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

How to differentiate between Myositis and TED

A

Tendon involvement noted on CT/MRI and A/B Scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Course of IOIS

A
  1. Spontaneous remission
  2. Intermittent episodes
  3. Severe prolonged inflammation (leads to fibrosis — “frozen orbit”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

IOIS: What is an effective and common treatment prior to initiating steroids?

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F: in mild causes, observation is the treatment for IOIS

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management for IOIS: (6)

A
  1. Biopsy to r/o neoplasm
  2. NSAIDs
  3. Systemic steroids (oral prednisolone)
  4. Radiotherapy
  5. Anti metabolites
  6. Systemic infliximab (tumor necrosis factor inhibitor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Granulomatous Orbital Diseases

A
  1. Wegener’s
  2. Sarcoidosis
  3. Polyarteritis Nodosa
  4. Histocytic Disorders (overproduction of WBCs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What signs/symptoms suggest sarcoidosis in orbital inflammation?

A
  1. Lacrimal gland enlargement
  2. Perineuritis
  3. EOM enlargement
  4. Proptosis
  5. Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Wegener’s is also referred to as

A

Granulomatosis with Polyangiitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Wegener’s Granulomatosis

A

Granulomatous inflammation and necrotizing vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Wegener’s is mediated by

A

T-cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Wegener’s presents uni/bi-laterally?

A

Bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What tests are useful in confirming Wegener’s?

A

cANCA serology or biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Involvement of what other system/body part is particularly associated with orbital inflammation, 2º to Wegener’s?

A

Sinus involvement (esp paranasal sinuses or nasopharynx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment for Wegener’s

A

Steroids and immunosuppressants (cyclophosphamide)

28
Q

Polyarteritis Nodosa

A

Vasculitis of medium and small nerves
Involves heart, kidney, liver, GI, and occasionally orbit

29
Q

Acute onset of orbital inflammation is likely associated with

A

Infectious etiology

30
Q

Insidious onset of orbital inflammation is usually associated with…

A

Neoplasm or TED
(Unless spreading from sinus)

31
Q

CT of Preseptal Cellulitis shows

A

Opacification anterior to orbital septum

32
Q

Preseptal Cellulitis

A

Lid erythema with periorbital edema

33
Q

Tx for Preseptal Cellulitis

A

IV antibiotics (augmentin)

34
Q

Common causes of Preseptal cellulitis

A
  1. skin trauma
  2. Eye infection
  3. Dacryocystitis
  4. Sinusitis
  5. Spread of remote infection (URI, ear, etc) spread by blood
35
Q

T/F: sinus congestion can be used to differentiate Preseptal cellulitis and orbital cellulitis

A

FALSE

36
Q

Why can Cavernous Sinus Thrombosis appear like orbital syndrome?

A

Impaired venous drainage —> orbital congestion

37
Q

Common causative agents for Orbital Cellulitis

A
  1. S. Pneumoniae
  2. S. Aureus
  3. S pyogenes
  4. H influenza
38
Q

Orbital Cellulitis CT scan will show

A

Orbital opacity posterior to orbital septum

39
Q

Which is more urgent: Preseptal or orbital cellulitis?

A

Orbital ☠️

40
Q

Cavernous Sinus Thrombosis is usually a complication of severe ____, ____, or ____ infection

A

Facial, sinus, or orbital

41
Q

T/F: patients with Preseptal cellulitis will often present with malaise and fever

A

FALSE

42
Q

What are two non-infectious cavernous sinus disorders that can imitate orbital inflammation?

A

Cavernous Sinus Fistula and Orbital Varix

43
Q

Cavernous Sinus Fistula should be considered in all patients with (3)

A
  1. Elevated IOP
  2. Mild HAs
  3. Bruit + Red eye, esp in elderly women
44
Q

Orbital varix should be considered when

A
  1. Eye bulging in crying infant
  2. Proptosis during valsava maneuver
  3. Orbital ecchymosis
45
Q

Describe orbital lymphomas

A

Painless
Grow slow
Conform to shape of orbital tissue

46
Q

What conj lesion is indicative of Orbital Lymphoma?

A

Salmon Patch

47
Q

Origin of lymphomas

A

B cells

48
Q

Anterior lymphomas have what type of consistency?

A

Rubbery

49
Q

T/F: lymphomas generally have good prognosis

A

TRUE

50
Q

Lacrimal tumors cause a lack of sensation where?

A

Region of orbit supplied by lacrimal nerve

51
Q

T/F: lacrimal tumors are typically malignant

A

FALSE; 50/50

52
Q

Half of lacrimal tumors are ____ in nature

A

Epithelial

53
Q

T/F: lacrimal tumors have a high mortality rate

A

TRUE

54
Q

Neurogenic Tumor examples

A

Glioma
Schwannoma
Meningioma

55
Q

Most benign tumor of periorbital areas in children

A

Capillary Hemangioma

56
Q

how do you treat capillary hemangioma?

A
  1. Laser
  2. Steroid (IV + po)
  3. BB
  4. Resection
  5. Peds work up
57
Q

Gender preference for capillary hemangioma

A

Girls

58
Q

Capillary hemangiomas should be treated if…

A
  1. Amblyopia
  2. Compression of ON
  3. Exposure keratopathy
  4. Severe blemish, necrosis, or infections
59
Q

After _____, the orbit is the most common site for metastatic invasion

A

Choroid

60
Q

Most common primary tumor?
Second?

A

Most — breast
2nd — Melanoma

61
Q

From where can non-metastatic tumors spread to orbit?

A

Paranasal cavities or maxillary sinus

62
Q

Silent Sinus Syndrome aka

A

Chronic Maxillary Atelectasis

63
Q

T/F: Silent Sinus Syndrome is not a tumor

A

TRUE

64
Q

Silent Sinus Syndrome

A

Painless onset of enophthalmos + vertical DV in upgaze, 2º to resorption of orbital floor bones (from chronic maxillary sinusitis)

65
Q

CT scan of Silent Sinus Syndrome

A

Bowing of maxillary sinus

X. neuro ophthalmology (10 decks)

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