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Quiz 3 Flashcards

1
Q

Dx: Gonococall pharyngitis

A

DNA probe

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2
Q

Gonococcal pharyngitis is an important source of ___.

A

gonococcemia

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3
Q

What is the MC deep neck infection in children and young adults?

A

peritonsillar abscess

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4
Q

Which glands, when infected, become the source of infection in Peritonsillar abscess?

A

Weber’s glands

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5
Q

Risk factors: Peritonsillar abscess

A

Acute tonsillitis, pharyngitis, periodontal disease, smoking

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6
Q

There is a strong association between Peritonsillar abscess and which medication?

A

NSAIDs

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7
Q

SSx: Peritonsillar abscess

A

Appears ill, trismus, drooling, unable to swallow, hot potato voice, unilateral tonsil hypertrophy w/ contralateral displaced uvula

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8
Q

PE: Peritonsillar abscess

A

CxLA on ipsilateral side, palpate for fluctuance (abscess)

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9
Q

Complications: Peritonsillar abscess

A

Airway obstruction, meningitis, septicemia, aspiration pneumonia, GABHS sequelae, carotid artery rupture, Lemierre Syndrome

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10
Q

DX: Peritonsillar abscess

A

Needle aspiration (gold standard), U/S, CT

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11
Q

What is Lemierre Syndrome?

A

Internal jugular vein thrombophlebitis and sepsis

Complication of Peritonsillar abscess

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12
Q

Tx: Peritonsillar abscess

A

Refer for I and D

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13
Q

Etiology: Peritonsillar abscess

A

Polymicrobial

GABHS, Strep pyogenes, Staph A, respiratory anaerobes

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14
Q

Etiology: Diphtheria

A

Corynebacterium diphtheriae

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15
Q

SSx: Diphtheria

A

Blue/white membrane adhered to posterior pharynx

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16
Q

SSx: Retropharyngeal abscess

A

Dyspnea, stridor, hot potato voice, stiff neck, pain referred to post. neck

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17
Q

Etiology: Retropharyngeal abscess

A

2’ to dental infx, foreign body insult, trauma

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18
Q

PE: Retropharyngeal abscess

A

High fever, ant. bulging in post. pharynx

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19
Q

Location: Ludwig’s angina

A

Submental space infx

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20
Q

SSx: Ludwig’s angina

A

Severe trismus, drooling, airway compromise

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21
Q

PE: Ludwig’s angina

A

Collar of brawny edema (neck), elevation of tongue, possible airway obstruction

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22
Q

Etiology: Necrotizing fasciitis

A

Complication of Strep

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23
Q

Population: Epiglottitis

A

2-5 yo (MC)

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24
Q

Etiology: Epiglottitis

A

HiB (MC)

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25
Q

SSx: Epiglottitis

A

Sore throat, high fever, weak voice, hot potato voice, drooling, tripod position, stridor

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26
Q

PE: Epiglottitis

A

Trismus, swollen uvula

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27
Q

What part of the PE for epiglottitis is contraindicated in children?

A

Visualization of the supraglottic area

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28
Q

Dx: Epiglottitis

A

Lateral X-ray (thumbprint sign)

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29
Q

Condition: sore throat < AM, > hot drinks

A

Post-nasal drip

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30
Q

Which vitamin can improve the integrity of esophageal epithelium?

A

Vitamin A

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31
Q

DDx: Chronic sore throat

A

Malignancy, Chronic cough, Vocal abuse, Sick House Syndrome, Smoking, Solvent use, Post-nasal drip, Reflux pharyngitis, Post-nasal drip, Infectious (esp. Mono)

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32
Q

Kawasaki Disease

A

Acute, self-limited vasculitis that occurs in children of all ages

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33
Q

SSx: Kawasaki Disease

A 
Conjunctivits (non-exudative)
Rash (polymorphous non-vesicular)
Edema (or erythema of hands/feet)
Adenopathy (cervical)
Mucosal involvement (erythema, fissures, crusting)
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34
Q

Low-pitch hoarseness is suggestive of ___

A

hypothyroidism

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35
Q

Red flags: hoarseness d/t malignancy

A

Hx of smoking, heavy EtOH use, weight loss, stridor

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36
Q

DDx (Neuro): Hoarseness

A

Parkinson’s, MS, myasthenia gravis

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37
Q

Most vocal cord paralysis is (unilateral/bilateral) and is caused by damage to the ___.

A

unilateral

recurrent laryngeal nerve

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38
Q

Bilateral vocal chord paralysis is MC d/t ___.

A

complication from thyroid surgery

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39
Q

Etiology: Hoarseness d/t chronic vocal laryngitis

A

Smoking, vocal abuse, laryngopharyngeal reflux, allergies, inhaled glucocorticoids

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40
Q

When hoarseness lasts longer than 2 weeks w/o a clear benign cause, ___. An exception to this rule is ___.

A

do a direct or indirect laryngoscopy

patients w/ asthma on inhaled corticosteroids

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41
Q

Etiology: Globus

A

GERD (MC), abnormal UES, psychological and psychiatric d/o, stress, inflammatory dz, thyroid dz

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42
Q

Red flags: Globus

A

Dysphagia, pain, wt loss, hoarseness, neck mass

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43
Q

Conditions associated with globus

A

Cervical osteophyte, TMJ d/o, salivary hypofunction

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44
Q

Tx: Globus

A

Mg, homeopathy, acupuncture

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45
Q

Etiology (endocrine): Hoarseness

A

Hypothyroid, acromegaly

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46
Q

SSx: OSA

A

Overweight, snore loudly, chronic daytime sleepiness

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47
Q

Tx: Mild OSA

A

Abstaining from alcohol and sedatives, losing weight, avoiding supine position during sleep

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48
Q

Tx: Severe OSA

A

CPAP, palatal surgery, jaw surgery, tracheotomy

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49
Q

How is severity of OSA measured?

A

Apnea-hypopnea index (number of sleep events per hour)

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50
Q

Long-term mortality increases in pts treated for OSA with a apnea-hypopnea index > ___.

A

20 events per hour

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51
Q

Morbidities associated with OSA

A

Metabolic syndrome, IHD, HTN, CHF, arrhythmias, cerebral vascular dz, pulmonary vascular dz, memory deficit, inc. risk for accidents/CV events

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52
Q

Bulbar conjunctiva

A

corner of eye

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53
Q

Palpebral conjunctiva

A

under surface of lids

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54
Q

Innervation: cornea

A

CN V

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55
Q

Mydriasis

A

dilation of pupil

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56
Q

Myosis

A

constriction of pupil

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57
Q

What produces aqueous humour?

A

ciliary body

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58
Q

What provides the major blood supply to the eye?

A

Choroid

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59
Q

Differentiate rods vs. cones

A

Both are light receptors

Rods are sensitive to light, insensitive to color, important for night vision and dim light

Cones are sensitive to color

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60
Q

What is the name of the yellow spot in the center of the retina, 2 cm lateral to optic disk?

A

Macula lutea

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61
Q

Where is the highest concentration of cones?

A

Fovea centralis

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62
Q

DDx: Acute vision loss (media problems)

A

Keratitis, hyphema, cataract, vitreous hemorrhage, uveitis

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63
Q

DDx: Acute vision loss (retinal problems)

A

Vascular occlusion, retinal detachment, acute maculopathy

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64
Q

DDx: Acute vision loss (neural visual pathway problems)

A

Optic nerve, optic chiasm, retrociasmal (occipital lobe)

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65
Q

Bilateral vision loss suggests ____.

A

occipital involvement

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66
Q

DDx: sharp superficial eye pain

A

Keratitis

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67
Q

DDx: deep brow pain w/ N/V

A

acute glaucoma, uveitis (no N/V)

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68
Q

DDx: eye pain < movement

A

optic neuritis

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69
Q

DDx: vision loss w/ eye pain

A

Keratitis, acute gluacoma, uveitis, optic neuritis

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70
Q

DDx: vision loss w/ red eye

A

Keratitis, acute glaucoma, uveitis

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71
Q

Nearsighted eyes increase risk for ___.

A

retinal tears -> retinal detachment

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72
Q

Wearing contact lenses increases risk for ___.

A

bacterial keratitis

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73
Q

What is Fluorescein dye used for?

A

corneal ulcers and abrasions

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74
Q

DDx: Unilateral, painless vision loss

A

Lens dislocation, vitreous hemorrhage, acute maculopathy, retinal detachment, retinal vein/artery occlusion, ischemic optic neuropathy

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75
Q

DDx: Unilateral, painful vision loss

A

Corneal abrasion, keratitis, acute glaucoma, hyphema, iritis/uveitis

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76
Q

DDx: Bilateral, painless vision loss

A

Pseudo-tumor cerebri, metabolic or toxic, homonymous field loss

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77
Q

DDx: Bilateral, painful vision loss

A

Bacterial keratitis

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78
Q

Which conditions of the eye require immediate attention?

A

Acute central retinal artery occlusion, acute glaucoma, infectious keratitis, iritis/uveitis, hyphema, retinal detachment

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79
Q

Hyphema

A

Blood in anterior chamber

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80
Q

Hyphema can spontaneously occur in what population?

A

Diabetics

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81
Q

What is a sign of significant vitreous hemorrhage?

A

Decreased red reflex

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82
Q

PE: Central retinal artery occlusion

A

vascular narrowing, pale retina, CHERRY-RED SPOT (macula), afferent pupillary defect

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83
Q

What is a cause of CRAO in older patients?

A

Giant cell (temporal) arteritis

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84
Q

Onset: CRAO vs. CRVO

A

CRAO - acute

CRVO - subacute

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85
Q

PE: Central retinal vein occlusion

A

“Blood and thunder” fundus

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86
Q

SSx: Retinal detachment

A

Sudden onset of new floaters and black dots, photopsias, dec. red reflex, afferent pupillary defect (if macular involvement)

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87
Q

Etiology: acute maculopathy

A

severe age-related macular degeneration, diabetic retinopathy

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88
Q

SSx: Acute maculopathy

A

Central blind spot, blurred vision w/ visual distortion

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89
Q

Optic neuritis is associated with what other condition?

A

MS

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90
Q

SSx: Optic neuritis

A

Eye pain < movement, reduced visual acuity, washed-out color vision, afferent pupillary defect, normal/swollen optic disc

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91
Q

SSx: Papilledema

A

B/L optic nerve swelling w/o afferent nerve defect

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92
Q

Chiasmal visual field defects involve what visual fields?

A

Temporal

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93
Q

DDx: Painful red eye

A

corneal abrasion, foreign body, ulcer, infection, keratitis, scleritis, acute angle closure glaucoma, iritis/uveitis

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94
Q

DDx: Painless red eye

A

Subjunctival hemorrhage, conjunctivitis

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95
Q

Significant eye pain suggests involvement of ___

A

Cornea/iris b/c they are well-innervated

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96
Q

DDx: Red eye w/ impaired vision

A

Allergic, acute glaucoma, iritis, corneal dz

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97
Q

DDx: Abrupt onset of red eye

A

Trauma
Foreign body
Chemical/UV exposure
Gonococcal conjunctivitis

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98
Q

DDx: Subacute onset of red eye

A

Non-gonococcal conjunctivitis

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99
Q

DDx: Chronic/Persistent onset of red eye

A

Infection (Staph, Chlamydia, Moraxella)

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100
Q

DDx: Recurrent red eye

A

Allergic conjunctivitis, reactive arthritis

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101
Q

Eye discharge is suggestive of ___.

A

conjunctivitis

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102
Q

DDx: Red eye w/ photophobia

A

Iritis, corneal dz, acute angle closure glaucoma

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103
Q

What test is used to differentiate between refractive errors and serious structural disease?

A

Pinhole test

104
Q

DDx: Location of injection

A

Periphery - conjunctivitis
Ciliary (perilimbal) - sign of deeper structures
Localized - foreign body, abrasion, ulcer
Margins of lid - blepharitis

105
Q

What is the MC pathogen for external hordeolums (stye)?

A

Staph aureus

106
Q

Glands involved: External vs. internal hordeolum

A

External - Zeiss/Moll glands

Internal - Meibomian glands

107
Q

Term: Chronic internal hordeolum

108
Q

Pain: External vs. internal hordeolum

A

External - more

Internal - less

109
Q

What is the MC type of malignant eyelid tumor?

110
Q

Papillary changes (red bumps) underneath the eyelids are suggestive of ___.

A

bacterial/allergic conjunctivitis

111
Q

Follicular changes (pale patches) underneath the eyelids are suggestive of ___.

A

Chlamydia/viral conjunctivitis

112
Q

DDx: Serous conjunctival d/c

A

Viral, allergic, toxic conjunctivitis

113
Q

DDx: Mucoid conjunctival d/c

A

Allergic, dry eyes, blepharitis

114
Q

DDx: Purulent conjunctival d/c

115
Q

DDx: Mucopurulent conjunctival d/c

A

Chlamydial

116
Q

SSx: Gonococcal conjunctivitis

A

Hyperacute onset, red/swollen eye, copious thick purulent d/c

117
Q

Dx: Gonococcal conjunctivitis

A

Gram stain

118
Q

Tx: Gonococcal conjunctivitis

119
Q

SSx: Adenoviral conjunctivitis

A

Mild photosensitivity, morning crust w/o pain, U/L or B/L, normal vision, mildly erythematous eyelid

120
Q

Which type of adenoviral conjunctivitis is more severe and presents with a foreign body sensation?

A

Epidemic keratoconjunctivitis

121
Q

Vision: Adenoviral conjunctivitis vs. Epidemic keratoconjunctivitis

A

Adenoviral - normal vision

Epidemic - decreased by 2-3 lines

122
Q

SSx: Bacterial conjunctivitis

A

Thick yellow d/c, acute onset, crusting, painless, normal cornea/anterior chamber

123
Q

How to do eye irrigation

A

Wash medial to lateral to avoid infection of lachrymal apparatus

124
Q

Herbs for bacterial conjunctivitis

A

Hydrastis, Berberis, Hamamelis, Fennel, Calendula, Euphrasia

125
Q

Antibiotic tx for bacterial conjunctivitis

A

Erythromycin ophtalmic ointment

126
Q

Bacterial conjunctivitis: Ars

A

Burning/edema, hot d/c, intense photophobia, > warmth

127
Q

Bacterial conjunctivitis: Allium cepa

A

Streaming eyes/nose, sneezing, sore nose d/t d/c

128
Q

Bacterial conjunctivitis: Euphrasia

A

Catarrhal conjunctivitis, constant watering of eyes, burning/acrid d/c, burning/swelling of lids, constant blinking

129
Q

Bacterial conjunctivitis: Puls

A

Profuse yellow d/c, no excoriation, itching/burning eyes, < warm room

130
Q

Course: Viral conjunctivitis

A

Sxs may get worse for 3-5 days and persist for 2-3 weeks

131
Q

SSx: Chlamydia conjunctivitis

A

Doesn’t response to topical tx, follicular conjunctivitis, chemosis, lid edema, mucopurulent d/c, usu B/L, mb preauricular adenopathy

132
Q

What % of pts with chlamydia conjunctivitis develop GU sxs?

133
Q

Tx: Chlamydia conjunctivitis

A

Azithromycin 1 g dose

134
Q

Supplement that increases tear quality and quantity

135
Q

What deficiencies can cause blepharitis?

A

B6, biotin, riboflavin, zinc

136
Q

Dacryocystitis

A

Swelling/redness of lacrimal sac from infection

137
Q

Supplement that may improve meibomian gland function

138
Q

Dacryostenosis

A

Obstruction of nasolacrimal duct

139
Q

How do you assess patency of nasolacrimal duct?

A

Apply fluorescein to affected eye and insert cotton swab in ipsilateral nare -> dye should be visible within one minute

140
Q

Violaceous hue of the eye suggests ___.

A

H. influenza infection

141
Q

SSx: Periorbital cellulitis

A

Swelling/redness/pain of eyelids, acute onset, low-grade fever

NO exophthalmos, ophthalmoplegia, and visual loss

142
Q

Preferred antibiotic tx of periorbital cellulitis in children

A

Ceftriaxone

143
Q

What is the MC predisposing factor for orbital cellulitis in children?

A

Ethmoid sinusitis

144
Q

SSx: Orbital cellulitis

A

Swelling/redness/pain of eyelids, acute onset, low-grade fever

PLUS diplopia, pain w/ eye movement, vision loss, proptosis, sluggish light reflex or afferent pupillary defect

145
Q

Complications: Orbital cellulitis

A

Cavernous sinus thrombosis, brain abscess, meningitis, death

146
Q

Supplement to prevent blindness in children

147
Q

SSx: Iritis

A

Eye pain, photophobia, decreased visual acuity, small/irregular pupil, ciliary injection

148
Q

What is an important PE finding in iritis?

A

Presence of cells/flare in the anterior chamber w/ slit lamp exam (“light in fog”)

149
Q

Adjunctive naturopathic tx: Iritis

A

Bromelain, curcumin, mydriatic drops, hydro

150
Q

Patients with uveitis have lower serum levels of ___.

A

Zinc, Selenium

151
Q

What types of drugs can exacerbate keratoconjunctivitis sicca?

A

Retinoids, tranquilizers, diuretics, antihypertensives, OCPs, anticholinergics

152
Q

Aqueous tear-deficient keratoconjunctivitis sicca is MC found in what population?

A

Post-menopausal women

153
Q

What test can be used to diagnose aqueous tear-deficient keratoconjunctivitis sicca?

A

Schirmer test

154
Q

What syndrome can also cause keratoconjunctivitis sicca?

A

Sjogren’s syndrome

155
Q

Correlations have been seen between dry eyes and ___.

156
Q

What vitamin deficiencies are associated with dry eyes?

A

Vitamin A, D

157
Q

SSx: Superficial punctate keratitis

A

Photophobia, foreign body sensation, lacrimation, conjunctival hyperemia, deceased visual acuity

158
Q

PE: Superficial punctate keratitis

A

Slit lamp exam shows superficial lesions that stain with fluorescein dye

159
Q

SSx: Corneal abrasion

A

Pain < movement, slightly blurred vision

160
Q

PE: Corneal abrasion

A

Abrasion will produce an apple-green fluorescence under cobalt-blue light

161
Q

Tx: Corneal abrasion/ulcers

A

Antimicrobial drops

162
Q

SSx: Corneal ulcer

A

Pain, photophobia, visual impairment if central cornea is involved

163
Q

SSx: Herpes Simplex Keratitis

A

Red eye, photophobia, foreign body sensation, watery d/c

164
Q

PE: Herpes Simplex Keratitis

A

U/L, mild conjunctival injection, epithelial dendrites on slit lamp w/ fluoresceine stain

165
Q

Complications: Herpes Simplex Keratitis

A

Vision loss, decreased corneal sensation

166
Q

Tx: Herpes Simplex Keratitis

167
Q

What vitamin decreases the duration of vaginal HSV sxs by 57% and TF mb helpful in Herpes Simplex Keratitis?

168
Q

SSx: Herpes Zoster Ophthalmicus

A

Pain, HA, photophobia, mb decreased visual acuity

169
Q

PE: Herpes Zoster Ophthalmicus

A

Painful maculopapular rash w/ vesicles, Hutchinson’s sign, mb ocular involvement

170
Q

PE (ocular sxs): Herpes Zoster Ophthalmicus

A

keratitis, uveitis, glaucoma, scleritis, optic neuritis

171
Q

Hutchinson’s sign

A

Vesicles on the tip of the nose –> Herpes Zoster Ophthalmicus

172
Q

Vitamin supplementation: Herpes Zoster Ophthalmicus

A

B12 (dec. post-herpetic neuralgia sxs), Vit E

173
Q

Episcleritis

A

Inflammation of CT under conjunctiva

174
Q

Acne rosacea is a less common cause of what eye condition?

A

Episcleritis

175
Q

Eye pain: Episcleritis vs Scleritis

A

E - Mild

S - Severe

176
Q

Onset of sxs: Episcleritis vs Scleritis

A

E - Sudden

S - Gradual

177
Q

Visual changes: Episcleritis vs Scleritis

A

E - No blurred vision/photophobia

S - Blurred vision/photophobia

178
Q

DDx: Episcleritis

A

Scelritis, Conjunctivitis

179
Q

Course: Episcleritis

A

Resolves spontaneously within days

180
Q

What is the MC known cause of scleritis

181
Q

SSx: Scleritis

A

Red eye (UL or BL), blurred vision, photophobia, significant eye pain

182
Q

What is the eye pain like in scleritis?

A

Deep, boring, toothache-like radiating to the eyebrow/cheeks/temples

183
Q

PE: Scleritis

A

Decreased visual acuity, localized/raised hyperemia of sclera, elevated scleral vessel,

184
Q

Blanching with topical Phenylephrine: Episcleritis vs Scleritis

A

E - Blanches

S - Does NOT blanch

185
Q

Use of topical phenylephrine is contraindicated in what condition?

186
Q

DDx: Scleritis

A

Episcleritis, conjunctivitis, iritis, acute angle-closure glaucoma

187
Q

What vitamin deficiency has been associated with scleritis?

A

Vitamin B12

188
Q

What herbs can be used for tissue repair in scleritis?

A

Gotu kola, bilberry

189
Q

Course: Scleritis

A

Months-years

190
Q

Complications: Scleritis

A

Scleral thinning or perforation, vision loss

191
Q

What is the leading cause of impaired vision and blindness in the US?

192
Q

What is the #1 surgery done per year for patients on Medicare?

193
Q

Hx: Cataract

A

Gradual loss of vision, difficulty driving at night

194
Q

What is the significance of the red reflex in evaluating for cataracts?

A

If the red reflex is present, it is unlikely that the cataracts are the cause of visual problems

195
Q

Risk factors: Cataracts

A

Ocular dz/injury/surgery, DM, Galactosemia, UV light, Smoking, Genetics, Slow acetylators

196
Q

Use of what drug class has been associated with increased cataract incidence?

197
Q

What is the evidence for use of antioxidants in prevention of cataracts?

198
Q

What diet is associated with lower incidence of cataract?

A

Mediterranean

199
Q

What enzyme increases polyols, which cause diabetic cataracts?

A

Aldose reductase

200
Q

Which natural agents have been shown to inhibit aldose reductase?

A

Ginger, Curcumin, Quercitin, Flavonoids

201
Q

If dysglycemia is a contributing factor for risk of cataracts, treat with ___.

202
Q

What herb has been used traditionally as an alterative to prevent cataracts?

203
Q

What lymphagogue has been seen clinically to stabilize or reduce cataracts?

A

Cineraria maritime

204
Q

What herb stopped progression of cataracts in 97% of subjects in an observational trial?

A

Vaccinium (bilberry)

205
Q

Pathophysiology: Presbyopia/Myopia

A

Lens lose ability to accomodate w/ age -> loss of near vision

206
Q

There is a strong association between presbyopia and increased ___.

A

homocysteine

207
Q

Asthenopia

A

Weakness/fatigue of eyes

208
Q

Tx: Asthenopia

209
Q

Tx: Myopia

A

Vit D3, Calcium

210
Q

Sxs: Acute angle closure glaucoma

A

Red eye, N/V, diminished vision

211
Q

PE: Acute angle closure glaucoma

A

Perilimbal injection, cloudy cornea, narrow anterior angle, fixed/dilated pupil

212
Q

Above which level is intraocular pressure associated with risk for glaucoma?

213
Q

Risk factors: Primary open-angle glaucoma

A

Age, darker skin, increased IOP, myopia, DM, HTN, EtOH, hypothyroid, FHx, low antioxidant status

214
Q

One theory for POAG is that deficiencies in ___ lead to high intraocular levels of ___, a known neurotoxin.

A

Glutathione

Glutamate

215
Q

Progression of vision loss in POAG?

A

Peripheral initially, progressing to central

216
Q

PE: Primary open-angle glaucoma

A

Loss of peripheral fields, increased cup-disc ratio, increased IOP

217
Q

What type of agents should be avoided in Primary open-angle glaucoma?

A

Vasoconstrictors (coffee, nicotine)

218
Q

Conventional Tx: Primary open-angle glaucoma

A

Beta-blockers, cholinergics

219
Q

MOA: Vitamin C in Primary open-angle glaucoma

A

Helps restore normal collagen metabolism, decreases IOP via osmotic effect

220
Q

Which class of natural agents have neuroprotective and antioxidant characteristics and can be helpful in glaucoma?

A

Flavonoids

221
Q

Eye drops of what herb have been shown to decrease IOP?

A

Forskolin, Fennel

222
Q

Which natural agent works by increasing levels of Vitamin C, CoQ10, and Glutathione?

A

Alpha lipoic acid

223
Q

3 Theories of Primary open-angle glaucoma pathophysiology

A

Mechanical (IOP), Vascular (HTN), Glutamate toxicity

224
Q

What is the area of greatest visual acuity in the eye?

225
Q

What % of 75 yo have some degree of ARMD?

226
Q

What is the MC type of ARMD?

A

Dry (80-95%)

227
Q

Sxs: Dry ARMD

A

Gradual loss of vision, esp. central vision

228
Q

PE: Dry ARMD

A

Drusen bodies are evident before onset of central vision loss

229
Q

Onset: Dry vs. Wet ARMD

A

D - Gradual

W - Acute

230
Q

Risk factors: Wet ARMD

A

Age, smoking, FHx, cataract surgery, HTN, obesity, hyperlipidemia, oxidative stress, Caucasian, sun exposure

231
Q

ARMD is associated with ___(2).

A

CV risk factors, early dementia

232
Q

What mineral has been shown to improve ARMD?

A

Zinc sulfate

233
Q

What are two carotenoids found in high concentrations in the macula and mb useful in ARMD?

A

Lutein, Zeaxanthin

234
Q

What amino acid is found in high concentrations in the retina and mb useful in ARMD?

235
Q

Blood vessels: Dry vs Wet ARMD

A

Dry - No new BV

Wet - New, fragile BV

236
Q

Vision loss in diabetic retinopathy is secondary to __(2).

A

Hemorrhages -> scar tissue -> retinal detachment

237
Q

What natural agent retards progression of retinopathy and partly recovers visual acuity?

A

Pycnogenol

238
Q

Amblyopia

A

When a child does not use one eye

239
Q

Etiology: Amblyopia

A

Strabismus, Congenital cataracts, refractive errors

240
Q

Screening for amblyopia

A

Hirschberg corneal reflection test and Cover/Uncover test

241
Q

SSx preceding retinal detachment

A

Floaters (large, dark, irregular), flashes of light, blurred vision

242
Q

PE: Retinal detachment

A

Irregularity, folded/darkened blood vessels

243
Q

Subconjunctival hemorrhage

A

Spontaneous hemorrhage over the sclera w/ normal vision

244
Q

Tx: Subconjunctival hemorrhage

A

Reassurance

245
Q

With blunt visual trauma, refer when ___(5)

A

Diminished vision, Disturbed/asymmetric pupils, Evidence of retinal damage, diplopia, hyphema

246
Q

Disturbed/asymmetric pupils are a concern when the difference is >___%.

247
Q

Homeopathy (eye trauma): Aconite

A

Trauma/abrasion to eye

248
Q

Homeopathy (eye trauma): Symphytum

A

Specific for blunt trauma to eye/orbit

249
Q

Homeopathy (eye trauma): Arnica

A

Injuries to orbit, w/ typical arnica picture

250
Q

Diminished vision in the setting of eye trauma is significant when ___ and suggests ___(3).

A

> 1 line decrease

corneal abrasion, retinal detachment, lens dislocation

251
Q

History: Conjunctivitis vs Iritis

A

C - Painless, normal vision

I - Pain, decreased vision

252
Q

Hordeolum

A

Acute focal infx of the eye involving either glands of Zeis or moll glands

253
Q

Chalazion

A

Benign, painless, bump or nodule inside upper or lower eyelid d/t blocked oil gland

254
Q

Blepharitis

A

Inflammation of the eyelids

255
Q

Tx: Wet ARMD

A

VEGF inhibitor

EENT (3 decks)

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