PEDIA (Syndrome & Learning Disabilities) Flashcards
Caused by a genetic defect in the type IV collagen
Alport’s syndrome
Hereditary nephritis syndrome
Alport’s syndrome
In Alport’s syndrome, what could develop if the disease progresses?
Tubular atrophy,
Interstitial inflammation
Fibrosis & foam cell
What are the ocular features of Alport’s syndrome?
-Bilateral anterior lenticonus & perimacular retinal flecks
-Thinned basal lamina w basement membrane disruptions
-Posterior lenticonus
-Perimacular yellow flecks
-Corneal finding:
-Posterior polymorphous dystrophy
-Corneal arcus
-Recurrent nontraumatic corneal erosions
What is seen in the figure in Alport’s?
a. Perimacular flecks
b. Peripheral flecks
What are the systemic features of Alport’s? (TTHIMP)
-Thrombocytopenia
-Macrothromocytopathia
-Hypoparathyroidism
-Polyneuropathy
-Ichthyosis
-Thyroid abnormalities
What are the treatments for Alport’s
- Renal plantation is usually very successful
- Dual sensory loss in px create urgent need for appropriate vision & care and rehabilitation
A syndrome of retinal degeneration combined with obesity, diabetes mellitus, and sensorineural hearing loss
Alstrom Syndrome
What are the ocular features of Alstrom syndrome?
-Posterior subcapsular cataracts
-Iris & ciliary body lacy vacuolization & asteroid hyalosis
- Retinitis pigmentosa & large, superficial optic nerve drusen
-Infantile cone & rod dystrophy
What are the treatment for Alstrom?
-No treatment for vision loss secondary
-Mx of endocrine, cardiac, and kidney disease is critical, although a shortened lifespan is expected
Prognosis for Alstrom
Rapid & progressive loss of visual function to less than 20/200 by 10 years of age & no light perception
What does CHARGE stand for?
-Coloboma
-Heart defects
-Atresia Choanae
-Growth Retardation
-Genital Abnormalities
-Ear abnormalities
In CHARGE, Choanal atresia is present in ____% of patients
58%
Growth deficiency is usually postnatal & affects all body in a symmetrical fashion
CHARGE Association Syndrome
Mental development is affected & Genital hypoplasia is more prone to recognized
CHARGE Association syndrome
Ocular features of CHARGE (BIP-COM)
-Iris colobomas, posterior colobomas of choroid of optic nerve w no visual impairment
-Microphthalmia
-Optic nerve hypoplasia
-Persistent hypoplastic primary vitreous
-Congenital glaucoma
-Bilateral Marcus-Gunn jaw winking phenomenon
Individuals with CHARGE who survive initial neonatal & infantile period merit ______ ________ of the sensory function to enable _________ development
Vigorous rehabilitation, psychomotor
_________ is indicated in individuals with swallowing difficulty
Nasogastric feeding
In presence of facial palsy, avoid scarring by using ______
artificial tears
In males with CHARGE, what therapy for penile growth
Androgen therapy
Too severe form of erythema multiform with extensive skin & mucous membrane involvement along with fever and affection of kidneys, gastrointestinal tract & central nervous system.
Stevens-Johnson Syndrome
In Stevens-Johnson, ocular involvement is much less common in _________
Toxic epidermal necrolysis
In Stevens-Johnson, who is more affected
Males are more than affected than females
What are the ocular features of Steven-Johnsons (CCCCSKPD)
-Crusty eyelids associated with transient, self-limiting papillary conjunctivitis
-Severe membranous or pseudo membranous conjunctivitis with patchy conjunctivital infarction is less common
-Reticular scarring of the upper tarsal plate
-Conjunctival keratinization & forniceal shortening
-Dry eye resulting from loss of the goblet cells & destruction of lacrimal gland ductules
-Corneal keratinization
-Keratopathy secondary to cicatricial entropion, aberrant lashes & infection
-Posterior lid margin disease w opening of meibomian orifices onto ocular surface
-Conjunctival scarring & symblepharon formation
Treatment for Steven-Johnsons? (SMLLT)
-Systemic diseases: maintain hydration
-Debridement & replacement of sloughing skin
-Systemic steroids are occasionally prescribed
-Lubrication & prevention of exposure
-Topical steroids & antibiotics
-Lysis of conjunctival adhesions
Characterized by presence of abnormalities of the eye, aorta, and skeleton
Marfan’s Syndrome
About ______ of patients, do not develop lens subluxation
355
Cause due to mutation of the fibrill in gene chromosome
Marfan’s Syndrome
Ocular features of Marfan’s
-Subluxation of crystalline lens
-Myopia, microcornea, keratoconus, and occasionally retinal detachment & glaucoma
-Stretched zonular fibers can be seen through the dilated pupil
-Coloboma of the lens
-Microspherophakia
-Iridodonesis results from lens subluxation
-Strabismus
Characterized by mental handicap, epicanthic folds, upward slanting palpebral fissures, broad short hands & a protruding tongue
Down Syndrome
What are the systemic features of Down Syndrome
-Mental handicap
-Upward slanting palpebral fissures
-Epicanthic folds
-Broad short hands & a protruding tongue
Ocular features of Down Syndrome
Cataract of varying morphology occurs in about 75% of px. The opacities are usually symmetrical & often develop in childhood
Self-limited illness caused by the fastidious gram-negative bacillus
Cat-scratch disease
Transmitted via the scratch or bite of a cat or kitten
Cat-scratch disease
Characterized by lymphadenopathy of local lymph nodes draining the site of infection
Cat-scratch disease
Ocular features of Cat-scratch disease
-VA is impaired to a variable degree
-Papillitis associated with peripapillary & macular edema
-Macular star composed of hard exudates
-After several months VA improve
-The fellow eye occasionally becomes involved but recurrences in the same eye are uncommon
-Parinaud oculoglandular syndrome
-Focal choroiditis
-Intermediate uveitis
-Exudative maculopathy
-Retinal vascular occlusion
-Panuveitis
Treatment for Cat-scratch disease
The most effective antibiotics are Rifampin, Ciprofloxacin, Intramuscular Gentamicin & Trimethoprim - Sulfamethoxazole