Part 3 Flashcards

1
Q

Small, linear, flmae-shaped, red streaks in the fundi, shaped by the superficial bundles of nerve fibers that radiate from the optic disc. Sometimes the hemorrhages occur in clusters and look like a larger hemorrhage but can be identified by the linear streaking at the edges.

A

Superficial Retinal Hemorrhage

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2
Q

Small, rounded, slightly irregular red spots that are sometimes called dot or blot hemorrhage. They occur in a deeper lyer of the retina than flame-shaped hemorrhages. Diabetes is a common cause.

A

Deep Retinal Hemorrhage

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3
Q

Develops when blood escapes into the potential space between the retina and vitreous. This hemorrhage is typically larger than retinal hemorrhages because it is anterior to the retina, it obscures any underlying retinal vessels.

A

Preretinal Hemorrhage

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4
Q

Tiny, round, red spots commonly seen in and around the macular area. They are minute dilatations of very small retinal vessels; the vascular connections are too small to be seen with ophthalmoscope. A hallmark of diabetic retinopathy.

A

Microaneurysms

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5
Q

Refers to the formation of new blood vessels. They are more numerous, more tortuous, and narrower than neighboring blood vessels in the area and form disorderly looking red arcades. A common feature of the proliferative stage of diabetic retinopathy

A

Neovascularization

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6
Q

Are white or grayish, ovoid lesions with irregular soft borders. They are moderate in size but usually smaller than the disc. They result from extruded axoplasm.

A

Soft Exudates: Cotton-Wool Patches

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7
Q

Are creamy or yellowish, often bright, lesions with well-defined hard borders. They are small and round but may coalesce into larger irregular spots.

A

Hard Exudates

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8
Q

Inflammation has destroyed the superficial tissues to reveal a well-defined, irregular patch of white sclera marked with dark pigment.

A

Healed Chorioretinitis

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9
Q

Are yellowish round spots that vary from tiny to small. The edges may be soft or hard. They are haphazardly distributed but may concentrare at the posterior pole between the optic disc and the macula

A

Drusen

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10
Q

Movement of the auricle up and down. Painful in acute otitis externa.

A

Tug test

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11
Q

Tenderness by pressing firmly just behind the ear

A

Occurs in otitis media

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12
Q

A firm, nodular, hypertrophic mass of scar tissue extending beyond the area of injury. It may develop in any scarred area but is most common on the shoulders and upper chest.

A

Keloid

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13
Q

This chronic inflammatory lesion starts as a painful, tender papule on the helix
or antihelix. Here the upper lesion is at a later stage of ulceration and crusting.

A

Chondrodermatitis Helicis

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14
Q

This raised nodule shows the lustrous surface and telangiectatic vessels of basal cell carcinoma, a common slow-growing malignancy that rarely metastasizes.

A

Basal Cell Carcinoma

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15
Q

A deposit of uric acid crystals characteristic of chronic tophaceous gout. It appears as hard nodules in the helix or antihelix and may discharge chalky white crystals through the skin.

A

Tophi

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16
Q

Formerly called a sebaceous cyst,a dome-shaped lump in the dermis forms a benign closed firm sac attached to the epidermis.

A

Cutaneous Cyst

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17
Q

In chronic rheumatoid arthritis, look for small lumps on the helix or antihelix and additional nodules elsewhere on the hands and along the sur-face of the ulna distal to the elbow, and on the knees and heels.

A

Rheumatoid Nodules

18
Q

Skin of the ear canal is thickened, red, and itchy

A

Chronic otitis externa

18
Q
  • Red bulging drum
  • Amber drum of a serous effusion.
  • Decreased mobility
A

Acute purulent otitis media

19
Q

Unusual prominent short process and a prominent handle that looks more horizontal.

A

Retracted drum

20
Q

No mobility of the ear drum

A

Ear drum perforation

21
Q

The tympanic membrane, is pinkish gray. Note the malleus lying behind the upper part of the drum. Above the short process lies the pars flaccida. The remainder of the drum is the pars tensa

A

Normal Eardrum (Right)

22
Q

Are holes in the eardrum, usually from purulent infections of the middle ear. They may be central, if not involving the margin of the drum, or marginal, when the margin is involved.

A

Perforation of the Eardrum

23
Q

Is a scarring process of the middle ear from otitis media that involves deposition of hyaline and calcium and phosphate crystals in the eardrum and middle ear. When severe it may entrap the ossicles and cause conductive hearing loss.

A

Tympanosclerosis

24
Q

Are usually caused by viral upper respiratory infections (otitis media with serous effusion) or by sudden changes in atmospheric pressure as from flying or diving (otitic barotrauma)

A

Serous Effusion

25
Q

Is commonly caused by bacterial infection from S. pneumoniae or H. influenzae. Symptoms include earache, fever, and hearing loss. The eardrum reddens, loses its landmarks, and bulges laterally, toward the examiner’s eye.

A

Acute Otitis Media with Purulent Effusion

26
Q

Painful hemorrhagic vesicles appear on the tympanic membrane, the ear canal, or both. Symptoms include earache, blood-tinged discharge from the ear, and conductive hearing loss.

A

Bullous Myringitis

27
Q

Testing for Conductive Versus Neurosensory Hearing Loss

A

Tuning Fork Test

28
Q

Test for lateralization (Weber test).
•Normal
• the vibration is_____.

  • Unilateral hearing loss
  • Bilateral conductive or sensorineural deficits
A

Normal
• the vibration is heard in the midline or equally in both ears.

Unilateral hearing loss
• Lateralize to the ear with normal hearing

Bilateral conductive or sensorineural deficits
• No lateralization

29
Q

Describes the normal first phase in the hearing pathway.

A

Air conduction (AC)

30
Q
  • Alternative pathway
  • Bypasses the external and middle ear
  • Used for testing purposes.
A

Bone conduction (BC)

31
Q

A vibrating tuning fork placed on the head stimulates

A

stimulates the cochlea directly

32
Q

AC is more sensitive than BC (AC > BC).

A

Normal hearing

33
Q
  • External or middle ear disorder impairs sound conduction to inner ear. Causes include foreign body, otitis media, perforated eardrum, and otosclerosis of ossicles
  • Childhood and young adulthood, up to age 40 years
  • Abnormality usually visible, except in otosclerosis
  • Little effect on sound
    Hearing seems to improve in noisy environment
    Voice remains soft because inner ear and cochlear
    nerve are intact
  • Tuning fork at vertex
    Sound lateralizes to impaired ear—room noise not well heard, so detection of vibrations improves
  • Tuning fork at external auditory meatus; then on mastoid bone
    BC longer than or equal to AC (BC ≥ AC).
A

Conductive Loss

34
Q
  • Inner ear disorder involves cochlear nerve and neuronal impulse transmission tothe brain. Causes include loud noise exposure, inner ear infections, trauma, acoustic neuroma, congenital and familial disorders, and aging.
  • onset: Middle or later years
  • Problem not visible in the ear canal and drum
  • Higher registers are lost, so sound may be distorted
    Hearing worsens in noisy environment
    Voice may be loud because hearing is difficult
  • Tuning fork at vertex
    Sound lateralizes to good ear—inner ear or cochlear nerve damage impairs transmission to affected ear.
  • Tuning fork at external auditory meatus; then on mastoid bone
    AC longer than BC (AC > BC).
A

Sensorineural Loss

35
Q

Measures the distance between the lateral angle of the orbit and an imaginary line across the most anterior point of the cornea.

A

Exophthalmometer

36
Q

Present in 60% of patients with Graves ophthalmopathy

Common symptoms 
• diplopia and tearing.
• Grittiness 
• Pain from corneal exposure. 
• Eyelid retraction (91%), 
• Extraocular muscle dysfunction (43%), 
• Ocular pain (30%)
• Lacrimation (23%)
A

Exophthalmos

37
Q

Discharge of mucopurulent fluid from the puncta

A

Nasolacrimal Duct Obstruction

38
Q

Reaction when the left-sided optic nerve is damaged in swinging flashlight test

A

Light reaction

39
Q

Defect on the afferent pupil

A

Marcus Gunn pupil