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Clinical medicine HEENT > quiz 5 part 1 > Flashcards

quiz 5 part 1 Flashcards

1
Q

proliferative diabeteic retinopathy

A

-VEGFA drives neovascularization
-new vessels grow on the surface of the retina and can bleed into the eye
-poor prognosis untreated

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2
Q

non proliferative d.r.

A

-early stage
-dilation of veins, microaneurysms, retinal hemorage
-no new vessels
-due to vessels being weak body releases VEGFA

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3
Q

nonproliferative tx

A

control blood glucose and photocoagulation

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4
Q

proliferative tx

A

vegfa and photocoagulation

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5
Q

hypertensive retinopathy

A

high bp damages the vessels
-they narrow, rupture, optic nerve swells (papilledema), exudate
-vascular wall changes
-arteriovenous nicking on fundoscopy

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6
Q

thicker vascular walls from hypertension

A

copper wiring

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7
Q

more advanced hardened vessels from hypertension

A

silver wiring

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8
Q

conditions associated with hypertensive reti.

A

pheochromocytoma, malignant hypertension and preeclampsia-eclampsia

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9
Q

retinal artery occlusion

A

-blocked by embolism
-painless blindness
-decrease intraocular pressure
-atherosclerotic plaques and tempral arteritis

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10
Q

how can temporal arteritis cause central retinal artery occlusion

A

causes inflammation of opthalmic artery that becomes central artery occlusion

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11
Q

physical findings retinal artery occlusion

A

-poor pupillary response to light on bad eye
-light on the good eye causes both to contract
-arteries may appear bloodless

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12
Q

central artery occlusion tx

A

-past 72 hrs treatment might not improve vision
-tx within 24 hrs
-once the retina has infarcted it is perm
-occular massage, lay flat, high concentration oxy, iv acetazolamide, anterior chamber paracentesis

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13
Q

conjunctivitis pathogens

A

-virus, bacteria, fungal, parasite, hsv
-viral can lead to blindness
-sti if follicular conjunctivitis or preaural adenipathy
-gonococcal if neonates (can perforate cornea or be purulent)

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14
Q

main three causes of conjunctivitis

A

chlamydia, adenovirus, hsv

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15
Q

clear watery discharge

A

viral conjunctivitis

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16
Q

lots of discharge, minimal pain, staph, strep

A

bacterial conjunctivitis

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17
Q

what can chlamydia conjunctivitis lead to

A

scarring, lid derangement, ingrown eyelashes
-trachoma= main cause of blindness

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18
Q

bacteriak, conjunctivitis tx

A

sulfacetomide

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19
Q

chamidyae conjunctivitis tx

A

oral azithromycin

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20
Q

gonococcal conjunctivitis

A

IM ceftriazone

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21
Q

what is there is pain with conjunctivitis

A

it is viral or bacterial

22
Q

allergic conjunctivitis

A

-stringy discharge, no pain, coble stone papillae, vision loss

23
Q

allergic conjunctivitis tx

A

topical corticosterois, histamine h1 antagonist, watch for cataracts, glaucomma, hsv

24
Q

neiserra conjunctivitis

A

tx with abx to prevent secondary infection, artificial tears
*corticosteroids can be bad if pt has hsv wait for opthalmalogist

25
Q

episcleritis

A

-superficial, collagen and vascular disorder, asymptomatic, mild pain
*no symptoms

26
Q

scleritisi

A

*symptoms
-deep, idiopathic, collagen vascular disease
-zoster, sarcoids, RA
-deep dull pain wakes them at night

27
Q

scleritis tx

A

nsaid or prednisone

28
Q

shingles

A

hutchinson sign, acyclovir

29
Q

uveitis anterior

A

acute recurrent and chronic
-red eye, low vision, photophobia, idiopathic
-paneuveitis (all 3 uvea layers)

30
Q

uveitis posterior

A

-choroditis, vitritis (vitreous inflammation), retinal vasculitis, retinitis, shingles, sarcoids, toxo, tb, syph etc
-pupil can be irregular and small
-not as painful or red
-panuveitis (all 3 uvea layers)

31
Q

glaucomma open angle

A

-iop >21, large optic cup, field loss, older women

32
Q

glaucomma closed angle

A

-ocular and face pain, headache, vom, abd pain, haloes, fixed mid dilated pupil, shallow anterior chamber
-emergency

33
Q

open angle tx

A

timolol, alphagen, prostaglandin agonist

34
Q

closed angle

A

acetazolamide, timolol, pilocarpine, prednisone acetate, iridotomy

35
Q

amaurosis fugax

A

-temp vision loss due to retinal blood flow
-painless loss unilateral
-returns when blood flow is restored
-fleeting blindness
-curtain across the vision
-CAD or AFIB

36
Q

retinitis pigmentosa

A

-rod degenerative disease
-night vision and tunnel vision start
-lose periphery

37
Q

retinal vein occlusion can cause

A

-neurovascularization of the retina or iris with a secondary glaucomma weeks to months after the occlusion

38
Q

what is retinal vein occlusion

A

-sudden or gradual vision loss dx with fundoscopy, distended veins, congestion, edematous retinal hamorrages, wool spots, optic disc swells
-vision may return if perfusion is restores

39
Q

pharygitis caused by

A

-virus or bacteria, viral more common
-tonsillitis can happen simultaneously
-influenza a and b
-h1n1, rsv, adenovirus

40
Q

rare pharyngitis causes:

A

hsv, neusseria gonorrhoeae

41
Q

serious pharyngitis strains?

A

strep, group a beta hemolytic strep

42
Q

viral pharyngitis sx

A

-sneeze, rhinorhea, cough

43
Q

pharygitis signs

A

-red tonsils, swollen, yellow or thin white membrane that peels without bleeding, white matter, large lymph, dry mucous membrane

44
Q

GABHS pharyngitis sx

A

-headache, exdudate, painful swallowing, gi symptoms, chills, high fever, hoarse,
*NO COUGH

45
Q

centor criteria

A

-fever
-exudate
-tender adenopathy
-no cough
1 no abx
2 abx w (+) rapid
4 abx empiric

46
Q

pharyngitis labs

A

WBC, monospot, lateral neck radiograph to rule out pharyngeal abscess, culture

47
Q

pharygitis tx

A

-salt gargaras, pnc (adult= amoxicillin, IM benzathine/ procraine (not used))
-2ndry: azithromycin, erythromycin, clindamycin

48
Q

when to get tonsillectomy

A

if the upper airway is obstructed, dysphagia, sleep disorder or febrile convulsions from tonsillitis
-3 or more infection per yr or being a carrier consider it

49
Q

complications pharygitis

A

-RF, glomerulonephritis, preterm deliver
-supperative: peritonsillar abscess, impetigo, OM, mastoiditis, sinusitis, meningitis, nfascitis, cellulitis

50
Q

mono triad

A

lymphadenopathy, fever, sore throat w or w out exudate

Clinical medicine HEENT (10 decks)

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