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gen med 2: eent > Peds and Other Stuff > Flashcards

Peds and Other Stuff Flashcards

1
Q

strabismus

A

misalignment of the eyes

most common in infants and young kids under 3 (can go away for newborns)

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2
Q

some causes of strabismus

A
  • congenital
  • poor muscle control
  • hyperopia
  • stroke/trauma= if nerve gets knocked out
  • down syndrome , cerebral palsy
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3
Q

strabismus is a_______-

what else to note

A

general category

esotropia
exotropia
hypotropia
hypertropia

note: descriptions—> unique one is alternating (one eye muscle gets tired and then the other takes over)

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4
Q

dx tests for strabismus

A

red light reflex
corneal light reflex
**cover uncover test
EOM

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5
Q

esotropia and etiology

A

1 or both turned inward

seen before 6 months of age and not present at birth

1) congenital
2) accommodative = secondary to hyperopia

3) 6th nerve palsy (trauma and stroke)

NOTE: b/w 2 and 3, w accommodative: diplopia is better w distance whereas 6th nerve is worse in the distance

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6
Q

tx of esotropia

A

infantile= surgical correction; BOTOX

accommodative= corrective lens; surgery is not corrected

6th nerve= prism correction (refracts light a certain way so diplopia goes away)–> surgery if it doesn’t leave by 6 months

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7
Q

exotropia

A

1 or both outward

1) congenital –> less common than eso so if its constant, rule out srs etiology
2) intermittent–> trying to focus but outward drift
3) 3rd nerve palsy (rare)–> can be congenital or acquired

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8
Q

which is more common ?

exotropia or esotropia

A

esotropia

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9
Q

tx for exotropia

A

same as eso
corrective lens
prism lens

botox surgical correction

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10
Q

what can mimick eso or exo tropia

A

if kids have extra skin for the epicanthic fold

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11
Q

we are concerned with ________________________________ with hypotropia

A

MASS PUSHING DOWN!!

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12
Q

amblyopia

A

lazy eye–> brain is too dumb to process the blurry image, so it picks the clear one and then ignores the other bad one

PERMENANT decrease in vision–> only in children

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13
Q

amblyopia only occurs in

A

children

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14
Q

causes of amblyopia most common

A

strabismic (the bad eye gets suppressed to prevent diplopia)

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15
Q

most severe cause of amblyopia

A

deprivation

–> excessive patching, corneal opacity, congenital cataract! –> MAKE SURE you aren’t missing a bigger pic bc you will see an ABSENCE of RED LIGHT REFLEX

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16
Q

most insidous cause of amblyopia

A

diff refractive states for each eye

can happen bilaterally if both eyes are out of focus

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17
Q

if a kid keeps running into walls and stuff….. could be_—-

A

amblyopia

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18
Q

ambylopia testing

A

basically everything we did for strabismus

+ UNIQUE: visual acuity (crowding phenomenon)–> harder to see crowded letters

also consider CT or MRI (tumor)

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19
Q

amblyopia treatment

A

correct structural issues (if cataract, fix by 2 months)

patching= cover good eye

glasses= if refractive issue

penalization= atropine drops to blur dominant eye

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20
Q

blepharitis ANDwhat organisms

A

bilateral inflammation of the eye LIDS

staph aureus= acute
seborrheic derm = chronic

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21
Q

anterior blepharitis

A

inflammation along eyelashes!

staph a: see scales and crusting

seborrheic= greasy scales

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22
Q

posterior blepharitis

A

most common
inflammation of the inner eyelid
( maybe seen w derm disease like rosacea or seb derm)

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23
Q

blepharitis sx

A

red swollen eyelids with flaking or scaling

crusty eyelashes

burning, tears, FB sensation

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24
Q

tx for blepharitis

A
  • lid hygeine= baby shampoo , warm compress

if bacterial, bacitracin or erythromycin

if refractory:

  • oral doxy
  • tetra
  • topical steroids short term
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25
Q

entropion

A

eyelid margins turned inward

26
Q

potential causes of entropian

A

spasmotic entropion= spasm of eyelid

scar retraction on inside of eyelid (cicatrical entropion)

surgery= trichiasis= lashes rubbing on the eye irritating cornea and conjunctiva –> can lead to scarring

27
Q

ectropion

1) what is it?
2) etiology

A

eyelid margins out

  1. senile ectropion- most common= age related
  2. cicatrical ectropion
  3. secondary to 7th nerve palsy (Bell’s)
28
Q

tx for ectropion

A

surgery

29
Q

hordeolum and s/s

A

staph infxn of eye glands

localized, red, swollen, tender abscess on eyelid margin

2 types= internal and external

30
Q

internal hordeolum

A

staph infxn Meibomian gland

TOWARDS conjuctival surface

31
Q

course for hordeolum

A

resolves by draining randomly

progress to lid cellulitis (down to maxilla)

become a chalazion (chronic inflammation)

32
Q

external hordeolum

A

Zeis

smaller abcesses on external lid margin

points AWAY

33
Q

which one has more of a FB sensation

external or internal hordeolum

A

internal

34
Q

tx for hordeolum

A

warm compress (usually enough)

could add abx ointment= polymyxin-bacitracin or erythromycin

I&D if not resolved by 48 hours

35
Q

dacryocystitis

A

acute or chronic (usually uni) inflammation of lacrimal sac —> caused by partial obstruction of nasolacrimal duct

-staph, strep, pneumococci, candida

common w infants and older than 40

36
Q

dacryocystitis sx

A

red painful selling nearing medial canthus

reflex of pus from lactrimal puncta

37
Q

workup for dacryocystitis

A

culture right by orbit and nose

consider imaging (make sure nothing deeper)

38
Q

tx for dacro

A

augmentin

dacryocystorhinostomy

39
Q

tx for dacrocystitis in ifants

A

delayed opening in the lower portion of the nasolacrimal duct or inferior meatus

watery eye

massage it several times a day

if chronic (past year) or get infxn–> dacryocystorhinistomy

40
Q

pterygium

A

triangle white, pink /red fibrovascular conjuctival tissue

from medial canthus over the cornea and towards the pupil

point part of triangle towards the pupil

risk factors= frequent exposure to UV light, dust or wind

41
Q

pterygium tx

A

topical lubricants

surgical excision if vision is obstructed (covering cornea)

42
Q

pinguecula

A

yellowish triangle thickening

does NOT grow over cornea

apex away from pupil

43
Q

pinguecula

A

no tx needed

doesn’t grow over cornea and obstruct vision

44
Q

rhabdomyosarcoma

A

rare tumor or muscle/bone w unknown etiology
(other place:head neck, extremity)

most common malignant tumor of orbit in kids (1-10)

45
Q

tx of rhabdomyosarcoma

A

get bx

1) chemo and radiation
2) enucleation

46
Q

what does rhabdomyosarcoma look like

A

ptosis *
proptosis *
change in vision*
eye pain/ swelling

RAPID progression w metastasis to brain and lung

47
Q

metastatic intraocular tumors are most common w

A

in adults

top 3 : breast lung kidney

48
Q

TTK about metastatic intraocular tumors

A

most invade choroid

multiple solid creamy-white lesions with bad borders

can see mottled legion with pigment clumping on surface

can cause retinal detachment or impact vision

49
Q

what is the most common intraocular tumor of childhood

A

retinoblastoma

50
Q

retinoblastoma TTK

A

bilaterally 1/3 of time

present from birth and most dx by age 3

rare but life threatening

51
Q

what are some signs for retinoblastoma

A

white pupil= aka leucocoria –> not seeing red reflex

messed up central vision–> strabismus

52
Q

tx for retinoblastoma

A

enucleation bc posterior chamber is filled w tumor–> no useful vision

very curable unless there is spread of tumor or optic nerve involved

otherstuff is chemo and radiation

53
Q

what dz can cause death from intracranial spread

A

retinoblastoma

54
Q

what is the most primary intraocular tumor of adulthood

A

malignant melanoma

from pigmented cells in choroid(can be mets from skin melanoma)

55
Q

what is special about malignant melanoma and tx

A

often not detected until retinal detachment happens

usually in middle age white

tx= enucleation before tumor spreads to orbit

56
Q

iris nevus vs iris melanoma

A

nevus is little frechles

iris melanoma has lots of color change and assoc w malignant melanoma

57
Q

glioma

A

rare optic nerve tumor

25-50% have neurofibromatosis

dx in kids w decreased VA, proptosis. papilledema, optic atrophy, strabismusm

well circumscribed lesion

58
Q

tx for glioma

A

depends on size

surgery
chemo
radiation

59
Q

neurofibromatosis found means you should

A

work up to make sure you are not missing a glioma

60
Q

neurofibromatosis

A

genetic disorder where tumors for on nerve tissue

gen med 2: eent (3 decks)

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