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Opthalmology > Questions based on lectures > Flashcards

Questions based on lectures Flashcards

1
Q

Risk factors for diabetic retionpathy

A 
Young-onset diabetes
Duration of diabetes
Hypertension
Dramatically improved diabetic control
Hypercholesterolaemia
Pregnancy
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2
Q

What does OCT stand for

A

Optical coherence tomography

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3
Q

What does IRMA stand for

A

intra-retinal microvascular abnormality

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4
Q

In summary, why do people with diabetic retinopathy lose their vision?

A

Retinal haemorrhage affecting the fovea
Vitreous haemorrhage
Scarring/tractional retinal detachment

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5
Q

What are cotton wool spots?

A

Nerve fibre degeneration

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6
Q

Raised intraocular pressure
Characteristic field defects
Optic disc cupping

A

Glaucoma

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7
Q

Three things to look for/measure to diagnose and monitor glaucoma

A
  • pressure
  • fields
  • optic disc
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8
Q

Methods of testing: glaucoma (3)

A
  • pressure (tonometry)
  • fields (perimetry)
  • optic nerve - clinical exam
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9
Q

Normal eye pressures

A

Under 20mmHG
20-30 - pretty sure you teach this
Above 30mmHg definitely treat

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10
Q

Classic pattern of visual field loss in glaucoma

A

Arcuate

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11
Q

Second most common cause of blindness in the UK

A

Primary open angle glaucoma

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12
Q

How is POAG usually detected

A

Most detected by optometrist at routine examination

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13
Q

Risk factors for primary open angle glaucoma

A
  • age
  • raised IOP
  • afro-carribean origin
  • family origin
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14
Q

Which disease is more common in afro-carribean people

A

Primary open angle glaucoma

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15
Q

Treatment for acute glaucoma

A

1) need to give acetazolamide and mannitol first (to lower pressure and make cornea less cloudy)
2) give all three types of eye drops (beta blockers, prostaglandin analogues and carbonic anhydrase inhibitors)
3) Iridotomy

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16
Q

Sudden painless loss of all or part of visual field

A

Retinal vessel occlussions

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17
Q

Horizontal and vertical field loss, which is in front and which is behind chiasm?

A

Horizontal - in front of chiasm

Vertical - behind chiasm

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18
Q

Which condition might colour vision be reduced in first?

A

Optic neurities

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19
Q

Gradual loss in vision over a couple of weeks, colour vision reduced

A

Optic neuritis

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20
Q 
Over 50
Scalp tenderness
Weight loss
Proximal myalgia (polymyalgia rheumatica)
Jaw claudication
Raised PV/ESR/CRP
A

Giant cell arteritis

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21
Q

How do you treat giant cell arteritis?

A

Steroids

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22
Q

Causes of retinal vein occlusion

A
  • hypertension
  • raised cholesterol
  • increased viscosity e.g. myeloma
  • inflammation
  • Virchows triad (circulatory stress, endothelial injury, hypercoagulable state)
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23
Q

Why is vascular endothelial growth factor bad?

A
  • leaky vessels (oedema)
  • new vessels, which could cause vitreous haemorrhage
  • new vessels, which could cause neovascular glaucoma
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24
Q

How does dry macular degeneration present

A

Gradual loss of central vision

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25
Q

Treatment for age-related ARMD

A

Anti-VEGF intravitreal injections

26
Q

Cells in the anterior chamber
Synechiae
Keratitic precipitates
Hypopyon if severe

A

Anterior uveitis

27
Q

Entropion

A

Eyelid folds inwards

28
Q

Ectropion

A

Eyelid droops outwards

29
Q

Purulent vs watery discharge

A

Purulent - think bacterial

Watery - think viral

30
Q

Mild chemosis

A

Bacterial conjunctivitis

31
Q

Moderate chemosis

A

Viral conjunctivitis

32
Q

Treatment for bacterial conjunctivitis

A

Topical antibiotic e.g. chloramphenicol

fusidic acid may also be used

33
Q

Treatment for viral conjunctivitis

A

Supportive - cool compress/lubricants

34
Q

Young patient, unilateral, FOLLICULAR CONJUNCTIVITIS

A

Chlamydia

do chlamydia PCR swab

35
Q

Risk factors for bacterial corneal ulcers

A

Corneal abrasion
Contact lens wearer
Dry eye
Iatrogenic

36
Q

Treatment for bacterial corneal ulcers

A

Topical antibiotics e.g. ofloxacin hourly

37
Q

Which drugs could cause cataract

A

Steroids

38
Q

Cataract treatment

A

Phaco-emuslfication with intra-ocular lens insertion

39
Q

Most common cause of blindness in western world in the over 65s

A

Age related macular degeneration

40
Q

Investigations for wet ARMD

A

Optic coherence tomography

Fundus fluoroscene angiography

41
Q

Sudden, profound visual loss (<6/60)
Relative afferent pupillary defect (RAPD)
Pale swollen retina with cherry red spot at macula

A

Central retinal artery occlusion

42
Q

CRAO treatment

A

Ocular massage
Paper bag breathing
IV diamox (acetazolamide)
Anterior chamber paracentesis

43
Q

Who is most likely to get anterior ischaemic optic neuropathy?

A

45-65 years
Hypermetropes with small crowded optic discs
Smokers

44
Q

Treatment for anterior ischaemic optic neuropathy?

A

No active treatment, assess and treat risk factors

45
Q

Persisting flashing lights
Burst of new floaters
Dark shadow in peripheral vision, increasing in size

A

Retinal detachment

46
Q

Is retinal detachment more common in myopes or hypermetropes?

A

Myopes (short-sighted)

47
Q

Symptoms:
Variable loss of vision, usually over few days
Washed out colours
Dull ache on eye movements

Signs:
Decreased VA
RAPD
Decreased colour vision
Enlarged blind spot
Optic disc swelling (not in retrobulbar neuritis)
A

Optic / retrobulbar neuritis

48
Q

Optic/retrobulbar neuritis and steroids?

A

IV steroids may hasten recovery but not affect final visual acuity
Oral steroids may worsen outcome

49
Q

When might you see a RAPD?

A

Anterior ischaemic optic neuropathy
Optic neuritis
CRVO
CRAO

No RAPD in macular disease

50
Q

Swollen optic disc with hyperaemia - pale disc later

A

Anterior ischaemic optic neuropathy

51
Q

What does a RAPD test?

A

Test of optic nerve function

52
Q

Lesions anterior to what are associated with a RAPD?

A

Lesions anterior to the lateral geniculate are associated with optic atrophy and RAPD

53
Q

Paralysis of sympathetic nerve supply to the eye

A

Horner’s syndrome

54
Q

Causes of Horner’s

A 
Pancoast tumour
Carotid/aortic aneurysms
Lesions of neck
Congenital
Idiopathic
55
Q

Really bad side effect of chloramphenicol

A

Aplastic anaemia

56
Q

Why would you use Rose Bengal stain?

A

Will stain devitalised areas

57
Q

Why would you use fluoroscein?

A

Shows up de-epithelialised areas

58
Q

Dilating drops and how long they last for

A

Tropicamide (shortest duration but least effective)
Cyclopentolate (lasts 1 day)
Atropine (lasts up to 3 weeks)
Phenylephrine - stimulates dilator pupillae

59
Q

Paediatrics:

Sticky and red eye within first 10 days of birth

A

Chlamydial conjunctivitis

60
Q

Paediatrics:

Sticky and white uninflamed eye

A

Blocked nasolacrimal gland

Opthalmology (7 decks)

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