Random Diseases / Conditions

Question 1

Cavernous Sinus Thrombosis

Answer 1

Same physical signs as carotid cavernous fistula:
Common clinical features include headache, unilateral periorbital edema, proptosis (eye bulging), photophobia and cranial nerve palsies.
However, in “cavernous sinus thrombosis,” the abducens nerve (CN VI) is most commonly affected.

Question 2

Carotid Cavernous Fistula

Answer 2

due to internal carotid artery rupture
Same physical signs as cavernous sinus thrombosis:
Common clinical features include headache, unilateral periorbital edema, proptosis (eye bulging), photophobia and cranial nerve palsies

Question 3

Diabetic Papillopathy

Answer 3

optic disc edema due to diabetes. if due to diabetes, it’s unilateral; if not, it’s bilateral (papilledema–raised intracranial pressure)

another potential ocular complication from diabetes, is a self-limiting, sometimes bilateral disease that may affect both type 1 and type 2 diabetics. It is characterized by optic disc swelling caused by vascular leakage and axonal edema in and around the optic nerve head.

Question 4

Exudates

Answer 4

hard exudates are lipoproteins from leaking blood vessels. They are deposited primarily in the outer plexiform layer of the retina (deep capillary plexus)–not the superficial capillary plexus found in the ganglion cell layer & nerve fiber layer.

Exudates take a little longer to go away, while hemorrhages go away quickly.

Question 5

Drusen

Answer 5

drusen are lipoproteins that accumulate between the retinal pigment epithelium and Bruch’s membrane (specifically the inner collagenous layer). These are found in normal aging eyes and eyes with AMD.

Question 6

Goiter

Answer 6

enlarged thyroid gland due to hyperthyroidism or hypothyroidism

Question 7

Gout

Answer 7

form of arthritis where pain and inflammation occur when too much uric acid crystallizes and deposits in the joints—often in the big toe at night

Question 8

Graves’ disease

Answer 8

autoimmune disease that causes hyperthyroidism

Question 9

Peripheral Neuropathy

Answer 9

loss of sensitivity in the hands and feet due to damaged nerves. Often caused by diabetes, which results in the loss of foot sensitivity due to excess blood sugar levels.

Question 10

Papilledema

Answer 10

bilateral optic disc edema caused by raised intracranial pressure.

Question 11

Syncope

Answer 11

Fainting, or a sudden temporary loss of consciousness due to a fall in blood pressure
In other words, passing out from low BP.

Note: angle the exam chair so blood flows to the head. Use an ammonium inhalant (smelling salt) to wake the individual. This irritates the membranes of the nose and lungs, and thereby triggers an inhalation reflex. This reflex alters the pattern of breathing, resulting in improved respiratory flow rates and possibly alertness.

Question 12

Atherosclerosis (branch of Arteriosclerosis)

Answer 12

thickening or hardening of the arteries. It is caused by a buildup of plaque in the inner lining of an artery causing obstruction of blood flow. Plaques may rupture causing acute occlusion of the artery by clot.
Atherosclerosis often has no symptoms until a plaque ruptures or the buildup is severe enough to block blood flow.

Risk factors may include high cholesterol and triglyceride levels, high blood pressure, smoking, diabetes, obesity, physical activity, and eating saturated fats.

Question 13

Encephalopathy

Answer 13

broad term for any brain disease that alters brain function and structure

Question 14

Emphysema

Answer 14

condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness

Question 15

Ocular Ischemic Syndrome (OIS)
Symptoms:
occurs mainly in elderly men (65+) with a gradual vision loss over weeks to months.
Periorbital Pain due to ocular angina–described as a dull ache

Answer 15

rare but vision threatening condition that is caused by chronic ocular hypoperfusion due to severe occlusion of the ICA.

Pathophysiology: atherosclerosis-induced carotid stenosis resulting in <90% occlusion of the ipsilateral ICA.

Case Study: Pt has a HX of HTN, hyperlipidemia, and possibly DM. Presents with reduced vision either unilateral or bilateral, and shows anterior & posterior segment signs.

Anterior Segment: painless NVI–blood vessels start at the periphery–(66% of ppl have this), cells and flares (20-50%), conjunctival & episcleral injection, sluggish light reflex (this can be from any microvascular condition due to poor vasculature of dilator/sphincter muscles)

Posterior Segment: Dilated non-tortuous veins (90%), Narrowed retinal arteries (90%), Mid-peripheral retinal hemes (80%), and microaneurysms (80%)