Path from Goljan Flashcards
1
Q
(arcus senilis/ophthalmia neonatorum): gray-opaque ring at the corneal margin, cholesterol deposits in corneal stroma
A
arcus senilis (senilie=elderly). may indicate hypercholesterolemia in older smoker
2
Q
(arcus senilis/ophthalmia neonatorum): conjunctivitis from N gon or C trachomatis
A
opthalmia neonatorum (neonatorum=newborn)
3
Q
in opthalmia neonatorum, which occurs in the first week (N gon/C trach)
A
N gon. (C trach occurs in the second week)
4
Q
(bacterial/viral) conjunctivitis: purulent, pain but no blurry vision
A
bacterial
5
Q
(bacterial/viral) conjunctivitis: watery exudates
A
viral
6
Q
MCC bacterial conjunctivitis
A
S aureus (then S pneumoniae)
7
Q
viral conjunctivitis caused by (adenovirus/HSV1): viral cause of pinkeye, lymphadenopathy, no tx
A
adenovirus
8
Q
viral conjunctivitis caused by (adenovirus/HSV1): keratoconjunctivitis with dendritic ulcers noted with fluorscein staining, tx trifluridine opthalmic
A
HSV1
9
Q
(stye/acanthamoeba infection): due to S aureus, infection of eyelid, tx with hot packs and dicloxacillin
A
stye
10
Q
(stye/acanthamoeba infection): severe keratoconjunctivitis in pts who do not clean their contact lenses properly, tx with propamidine and polymyxin/neomycin/gramicidin
A
acanthamoeba
11
Q
(chalazion/orbital cellulitis): granulomatous inflam involving the meibomian gland in eyelid
A
chalazion
12
Q
(chalazion/orbital cellulitis): periorbital redness secondary to sinusitis
A
orbital cellulitis
13
Q
(chalazion/orbital cellulitis): disappears without tx usually (if not, use surgery or corticosteroid)
A
chalazion
14
Q
(chalazion/orbital cellulitis): caused by S pneumoniae, H influenzae, includes fever, proptosis, opthalmoplegia
A
orbital cellulitis
15
Q
(orbital fracture/pterygium): raccoon eyes, vertical diplopia
A
orbital fracture
16
Q
(orbital fracture/pterygium): raised, triangular encroachment of thickened conjunctiva on the nasal side of the conjunctiva, may grow onto the cornea, due to sun/wind/sand
A
pterygium
17
Q
(pterygium/pinguecula): does not grow onto the cornea
A
pinguecula
18
Q
(pterygium/pinguecula): yellow-white conjunctival degeneration at the junction of cornea and sclera on temporal side of conjunctiva
A
pinguecula, usually requires no tx
19
Q
optic neuritis (inflam of optic nerve): MCC
A
multiple sclerosis (second MCC: methanol poisoning)
20
Q
optic neuritis tx
A
corticosteroids
21
Q
central retinal (artery/vein) occlusion: caused by hypercoagulable state like polycythemia vera
A
vein
22
Q
central retinal (artery/vein) occlusion: caused by embolization of plaque material from adjacent vessels
A
arterial (from carotid or opthalmic artery, giant cell arteritis involving opthalmic artery)
23
Q
central retinal (artery/vein) occlusion: sudden, painless, unilateral loss of vision, swelling of optic disk, blood and thunder appearance
A
vein
24
Q
central retinal (artery/vein) occlusion: boxcar segmentation of blood in retinal veins, and cherry red macula
A
artery
25
central retinal (artery/vein) occlusion: pallor of optic disk
artery (due to narrowed arteries)
26
central retinal (artery/vein) occlusion: tx with acetazolamide to lower intraocular pressure, carbogen, hyperbaric O2
artery
27
central retinal (artery/vein) occlusion: tx with intravitreal injections, laser photocoagulation
vein
28
(chronic open angle/acute angle closure) glaucoma: decreased rate of aqueous outflow into the canal of Schlemm, common with severe near-sightedness, bilateral aching eyes, cupping of optic disks
chronic open angle
29
(chronic open angle/acute angle closure) glaucoma: night blindness and gradual loss of peripheral vision leading to tunnel vision and blindness
chronic open angle
30
(chronic open angle/acute angle closure) glaucoma: narrowing of anterior chamber angle, medical emergency
acute angle closure
31
(chronic open angle/acute angle closure) glaucoma: precipitated by mydriatic agent, uveitis, lens dislocation, severe pain assoc with photophobia and blurry vision, red eye with steamy cornea, pupil fixed and nonreactive
acute angle closure
32
(chronic open angle/acute angle closure) glaucoma: tx with pilocarpine and systemic carbonic anhydrase inhibitor to lower pressure to allow for laser surgery
acute angle closure
33
(chronic open angle/acute angle closure) glaucoma: tx with beta blockers, then prostaglandins, alpha adrenergic agonists
chronic open angle
34
optic nerve atrophy: (red/pale) optic disk, due to optic neuritis or glaucoma, no effective tx
pale
35
(retinitis/uveitis): caused by sarcoidosis, ulcerative colitis, ankylosing spondylitis
uveitis
36
(retinitis/uveitis): caused by CMV (painless) and common in AIDS, VZV (painful)
retinitis
37
(retinitis/uveitis): inflam of iris, ciliary body, choroid. pain with blurry vision, miotic pupil, circumcorneal ciliary body vascular congestion, normal intraocular pressure, adhesions between iris and anterior lens capsule
uveitis
38
(retinitis/uveitis): tx with corticosteroids or atropine
uveitis
39
(retinitis/uveitis): cotton-wool exudates and hemorrhages, tx with ganciclovir or foscarnet
CMV retinitis
40
(dry/wet) type of macular degeneration: disruption of Bruch membrane in retina
both
41
(dry/wet) type of macular degeneration: thinning of retina and formation of yellowish white deposits called drusen
dry
42
(dry/wet) type of macular degeneration: vessels under retina hemorrhage causing retinal cells to die, creating blind spots or distorted central vision
wet
43
antioxidants (increase/decrease) risk of macular degeneration
decrease
44
tx macular degeneration with (pro/anti) angiogenics
anti
45
what type of infection can cause cataracts
rubella (CMV as well in congenital infections)
46
what kind of drugs can cause cataracts
corticosteroids
47
what type of tumor in children gives the 'white eye reflex'
retinoblastoma
48
what type of cancer in adults affects the eye
melanoma
49
choanal atresia: MC congenital anomaly of nose. cyanosis during breast feeding. what causes child to "pink up" again?
crying
50
nasal polyps are (neoplastic/nonneoplastic) tumefactions that develop as a response to chronic inflam
nonneoplastic
51
nasal polyps are commonly assoc with which chronic disease
CF
52
nasal smear in allergic nasal polyps shows numerous (what cell type)
eosinophils
53
obstructive sleep apnea causes respiratory (alkalosis/acidosis) and hypoxemia
acidosis
54
complications of obstructive sleep apnea: secondary ______ and cor pulmonale (pulmonary HTN + right ventricular hypertrophy)
polycythemia
55
confirmatory test for ___: nocturnal polysomnography
OSA-obstructive sleep apnea
56
sinus infections: (maxillary/ethmoid) in adults
maxillary
57
MC bacterial pathogen causing sinusitis: (S aureus/H influenzae/S pneumoniae)
S pneumoniae
58
MCC sinusitis: (bacterial/viral) infection
viral URI
59
Most sensitive imaging test to diagnose sinusitis
CT
60
nasopharyngeal carcinoma: MC cancer of the nasopharynx, increased in Chinese (children/adults) and African (children/adults)
Chinese adults and African children
61
nasopharyngeal carcinoma is assoc with which virus
EBV
62
MCC laryngeal carcinoma: (EBV/cigarette smoking)
cigarette smoking, also alcohol, HPV 6 and 11
63
loss of lung volume due to inadequate expansion of airpsaces
atelectasis
64
resorption atelectasis: MCC fever 24 to 36 hours after _____
surgery. also caused by aspiration of foreign material
65
exudative tonsilitis: most likely pathogen (bacterial/viral)
viral in most cases, use a culture to differentiate
66
hairy leukoplakia pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)
EBV, pre AIDS defining lesion, glossitis assoc with bilateral white excrescences on lateral border of tongue
67
herpes labialis pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)
HSV1
68
mumps pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)
paramyxovirus, with increased serum amylase
69
(mumps/herpes labialis/hand-foot-mouth dz) complications: meningoencephalitis, unilateral orchitis or oophoritis, pancreatitis
mumps
70
herpangina pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)
coxsackievirus
71
herpangina occurs in (adults/children)
children, painful vesicles or small white papules on erythematous base at junction of hard and soft palate
72
hand-foot-mouth dz pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)
coxsackievirus, vesicles located in mouth and distal extremities, children
73
cervicofacial draining sinus tract, sulfur granules in pus pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
cervicofacial actinomyces: actinomyces israelii
74
diptheria genus
corynebacterium. toxin produces "shaggy" gray pseudomebrane in posterior pharynx and upper airways
75
peritonsillar abscess pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
S pyogenes.
76
"hot potato" voice, foul smelling breath, uvula deviates to one side: (diptheria/cervicofacial actinomyces/peritonsillar abscess/Ludwig angina)
peritonsillar abscess
77
Ludwig angina infection from strep/eikenella corrodens, caused by:
dental extraction/trauma to floor of mouth. cellulitis involving submaxillary and sublingual space
78
pharyngitis pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
S pyogenes. potential for rheumatic fever and glomerulonephritis
79
scarlet fever pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
S pyogenes.
80
increased risk for glomerulonephritis but no acute risk for rheumatic fever (scarlet fever/pharyngitis) due to S pyogenes
scarlet fever
81
sialadenitis pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
S aureus. bacterial inflam of major salivary gland, secondary to a calculus which obstructs the duct in postoperative patients
82
molar teeth resemble mulberries, and incisors are tapered like a peg in which congenital infection
syphilis (treponema pallidum)
83
acute necrotizing gingivitis aka Vincent gingivitis pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
anaerobes: prevotella, fusobacterium, spirochetes
84
oral thrush caused by which pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)
candida albicans
85
Kaposi sarcoma in mouth: (soft/hard) palate is most common location, due to HHV8
hard
86
dental caries caused by what pathogen that produces acid from sucrose fermentation
Strep mutans
87
Behcet syndrome: recurrent aphthous ulcers, uveitis, genital ulcers. assoc with HLA-B__ and __
HLA-B51 and HLA-B27
88
what drug discolors newly formed teeth and is therefore not recommended for children under 12
tetracycline
89
what color teeth does congenital erythropoietic porphyria cause
reddish brown
90
(Addison dz/Peutz-Jeghers syndrome): melanin pigmentation of lips and oral mucosa
P-J syndrome
91
(Addison dz/Peutz-Jeghers syndrome): melanin pigmentation on buccal mucosa, increased ACTH stimulates melanocytes
Addison
92
(glossitis/macroglossia) caused by: myxedema (primary hypothyroid), trisomy 21, systemic amyloidosis, MEN syndrome IIb
macroglossia. also caused by acromegaly
93
(glossitis/macroglossia) caused by: iron def, Vit B12 or folate def, Vit C def/Scurvy, Pellagra/niacin def, Scarlet fever, EBV assoc hairy leukoplakia
glossitis
94
hairy leukoplakia can progress via dysplasia to what type of cancer
SCC, therefore always biopsy these lesions
95
MC site of leuko/erythroplakia:
vermillion border on lower lip
96
leuko/erythroplakia risk factors
smoking/alcohol
97
Wickham striae is assoc with what type of dysplasia/cancer
squamous dysplasia/SCC
98
soap bubble appearance in mandible, MC odontogenic tumor
ameloblastoma
99
MC risk factors for malignant tumors of oral cavity
HPV, tobacco, alcohol, denture irritation, lichen planus
100
where do SCCs of the oral cavity metastasize to
superior jugular node
101
(pleomorphic adenoma/Warthin tumor/mucoepidermoid carcinoma): heterotropic salivary gland tissue in lymph node
Warthin
102
(pleomorphic adenoma/Warthin tumor/mucoepidermoid carcinoma): MC salivary gland tumor, female dominant, facial nerve involvement is a sign of malginancy
pleomorphic adenoma
103
(pleomorphic adenoma/Warthin tumor/mucoepidermoid carcinoma): MC malignant salivary gland tumor, MC location is parotid gland
mucoepidermoid: mixture of neoplastic squamous and mucus secreting cells
104
type (I/II) muscle fibers: fast twitch, white, poor in mitochondria, rich in ATPase enzymes
II
105
type (I/II) muscle fibers: slow twitch, red, rich in mitochondria, rich in oxidative enzymes, poor in ATPase enzymes
I
106
how do you get trichinosis?
T spiralis nematode from eating encysted larvae in pig muscles (calcified larvae visible on x ray)
107
(trichinosis/invasive group A strep/tetanus): necrotizing fasciitis, myositis, toxic shock syndrome
group A strep
108
(trichinosis/invasive group A strep/tetanus): caused by a gram positive anaerobic rod
tetanus
109
(trichinosis/invasive group A strep/tetanus): spores in soil enter via closed wounds, skin popping among IV drug users, umbilical cord/circumcision site in newborns
tetanus
110
(trichinosis/invasive group A strep/tetanus): muscle pain, periorbital edema, splinter hemorrhages
trichinosis
111
(trichinosis/invasive group A strep/tetanus): pronounced eosinophilia
trichinosis
112
(trichinosis/invasive group A strep/tetanus): toxin inhibits release of glycine/GABA by binding to ganglioside receptors on spinal afferent fibers
tetanus (tetanospasmin)
113
(trichinosis/invasive group A strep/tetanus): complications include myocarditis, encephalitis.
trichinosis
114
what pathogen causes gas gangrene
c perfringens
115
alpha toxin (lecithinase) is virulence factor in what disease
c perfringens gas gangrene/myonecrosis
116
(MD/DMD): XLR
DMD
117
(MD/DMD): AD
myotonic dystrophy
118
(MD/DMD): CTG trinucleotide repeat
MD
119
(MD/DMD): increased serum CK at birth, decreases as muscles degenerate
DMD
120
(MD/DMD): sagging face, frontal balding, cataracts, testicular atrophy, cardiac involvement
MD
121
how to diagnose myasthenia gravis
tensilon/edrophonium test: inhibits ACh, increase in ACh reverses muscle weakness
122
(myasthenia gravis/lambert eaton): autoantibodies against postsynaptic ACh receptor at NMJ, MC in women
MG
123
(myasthenia gravis/lambert eaton): antibodies against presynaptic Ca2+ channels of NMJ, most commonly due to small cell carcinoma of lung
LE (paraneoplastic)
124
(myasthenia gravis/lambert eaton): involves eyes
MG (LE usually spares the eyes)
125
(myasthenia gravis/lambert eaton): assoc with thymic hyperplasia or thymoma
MG (thymectomy improves symptoms)
126
(myasthenia gravis/lambert eaton): anticholinesterase agents do not improve symptoms
LE
127
fluorescein dye showing dendritic corneal ulcer indicates (retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)
HSV
128
attenuation of retinal vessels and night blindness indicates (retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)
retinitis pigmentosum
129
both genes lost, clumsy, leukocoria, no red reflex indicates (retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)
retinoblastoma
130
blindness and inclusion bodies in a 6 year old, progressive scarring of conjunctiva and cornea indicates (CMV/retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)
C trachomatis
131
capillary microaneuryms and T2DM indicate (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)
diabetic retinopathy
132
shade pulled over eye indicates (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)
melanoma in uvea
133
trauma to one eye then problems with other eye several days later incidates (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)
sympathetic opthalmia
134
medications that target vascular endothelial growth factor treat (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)
macular degeneration
135
decreased vision, headaches, deepening of optic cup with excavation indicate (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)
glaucoma (increased pressure in eye)
136
AR inheritance, build up of keratan sulfate indicates (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)
corneal stromal macular dystrophy
137
complication of sickle cell disease (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)
intraretinal hemorrhage
138
oxygen toxicity in premie causes (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)
retrolental fibroplasia
139
cotton wool spots, waxy exudates, flame shaped hemorrhages indicate (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)
hypertensive retinopathy
140
SLE treatment with glucocorticoids result in (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)
cataracts
141
cloudiness, elderly patient, loss of central vision indicate (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma) due to nuclear sclerosis
cataracts due to nuclear sclerosis (macular degeneration also causes loss of central vision but not cloudiness)
142
eye pain, clouded vision, excavation of optic cup indicates (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)
primary angle closure glaucoma (shallow anterior chamber obstructing aqueous humor outflow)
143
elderly patient with cherry red foveola and sudden vision loss indicates (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)
central retinal artery occlusion
144
rigid contact lenses correct (macular degeneration/keratoconus/papilledema)
keratoconus
145
deposits in Bruch membrane (macular degeneration/keratoconus/papilledema)
macular degeneration
146
increased intracranial pressure due to trauma induced slow growing subdural hematoma causes (macular degeneration/keratoconus/papilledema)
papilledema
147
tender muscles, eosinophilia, diarrhea, fever indicate (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)
trich (from eating poorly cooked meat, parasite)
148
1 year old with flaccid paralysis, atrophy of myofibers, death by age 3 indicate (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)
Werdnig Hoffman
149
weight loss, proximal muscle weakness, cancer indicate (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)
LE (paraneoplastic)
150
flu like illness followed by rapid motor weakness (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)
Guillian Barre
151
fat redistribution, ecchymoses, rounded facies, increasing muscle weakness over 2 months (ALS/Cushing/malignant hyperthermia/dermatomyositis)
Cushing
152
spasms, increased CK, myoglobinuria, Ca channel disorder (ALS/Cushing/malignant hyperthermia/dermatomyositis)
malignant hyperthermia
153
progressive weakness, difficulty swallowing (ALS/Cushing/malignant hyperthermia/dermatomyositis)
ALS
154
antibody and complement mediated damage to microvasculature (ALS/Cushing/malignant hyperthermia/dermatomyositis)
dermatomyositis
155
non progressive weakness, Gomori stain (statin induced/congenital) myopathy
congenital myopathy
