random Flashcards
how can you tell L from R eye on fundoscopy?
optic nerve is always medial in fundoscopy
eye complications of diabetes
retinopathy and maculopathy
macular oedema
dot haemorrhages
retinal detachment
cataract - due to high surgar interfering with metabolism of the fluid in lens
reduced corneal sensaition and healing
Rubeosis- blood vessels developing in the iris
CN palsies - most commonly 3 and 6
management of diabetic eye
conservative
- diet and exercise
- stop smoking
- BP control
medical
- diabetic med, hptn, cholesterol meds
- anti VEGF injections
surgical
- laser
complications of hypertensive eye disese
arteriolar narrowing
vessel sclerosis
venuole compression
microaneurysms
retinal haemorrhages
silver wiring
autoimmune diseases that affect the eye
Graves
Sjogrens
features of graves eye disease
pain
diplopia- coordination of eye movements not aligned
visual loss
proptosis
lid retraction
exposure keratopathy- eye lids not closing so cells on top of eye get dry and damaged
optic neuropathy
features of sjogrens syndrome
primary or secondary
associated with RA , SLE and systemic sclerosis
dry eyes, dry mouth
conditions associated with anterior uveitis
B27 associated:
ank spond
IBD
psoriatic arth
reactive arth
other:
infections (HSV,HIV, toxo)
sarcoidosis
bechets
eye problems in gout
conjunctival deposits of monosodium glutamate
eye problems in:
SLE
conjunctivitis
eye problems in:
RA
epi/scleritis
eye problems in:
ANCA vasculitis
scleritis
what is anterior uveitis
inflammation of front of eye (iris and ciliary muscle) causing adhesions i the front of the lens
features of ant uv
red eye
acutely painful
reduced acuity
lacrimation
irregular small pupil
hypopyon
management of ant uv
steroid drops-
metabolic disorder
causes of cataract
hypoparathyroidism
wilsons
different types of cataract
- nuclear
- cortical
- posteroir cataract
eye signs on HSV infection
pain
photophobia
corneal haze
red eye
keratitis
fluorescein dye- problem with front of cornea showing green dendritic pattern
eye signs of VZV
infection of V1 branch of trigeminal nerve supplies eye so if VZV in this nerve it can also infect the eye
keratitis
uveitis
Hutchinsons sign- rash on tip of nose is a sign that eye will probably be affected
eye complications of HIV
kaposi sarcoma can affect eye
TB- Rx can cause anterior uveitis
toxo and CMV can cause chorioretinitis and posteror uveitis
most common cause of infectious blindness in the world
chlamydia trachomanis- trachoma
characteristic findings of trachoma
watery eyes
conjunctival injection
pannus
entropion and corneal irritation
follicles that rupture and scar
river blindness
onchocerciasis- nemetode transmitted by flies around stagnent water
oncological eye problems
retinoblastoma
BCC- lower eyelid more common
sebaceous cell cancer (mebomian gland tumor)- upper eyelid more common
important questions to ask with ear problems
hearing
pain
discharge
vertigo
tinnitus
itch
features of otitis media
pain in ear
associated with URTI
best imaging for RA
USS and MRI
Xray not sensitive
hallmark- erosions of cartilage and bone
new blood vessel formation and hypertrophy of synovium (panis formation)
when to consider antibiotics
complications
systemically unwell
ottothoea
<2yr old with bilateral infections
similarities between RA and OA on xray
loss of joint space
subchondral cysts (RA: geodes)
boney erosions
X ray findings in RA
loss of joint space
soft tissue swelling
periarticular osteopenia (darkness around joint space due to cytokine production)
Management of RA
treat early and aggressively
can start immediately on hydroxychloriquine before bloods return
NSAIDs
IM steroid injection
DMARDs- eg. methotrexate, azathioprine, sulfasalazine
biologics if 2 diffferent DMARDs not working
anti TNFa therapy
before starting biologics must test for HIV and TB.
28 joint count and ESR for disease monitoring
antibiotic of choice for MRSA
vancomycin
