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MQW U3 > Robbin's Qs > Flashcards

Robbin's Qs Flashcards

1
Q

Mucor can result in ___

A

Sinusitis

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2
Q

What is presentation of Sialadenitis?

A

Inflammation of salivary gland: localized, tender nodule in oral cavity

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3
Q

How to differentiate Sialadenitis from a Fibroma?

A

Sialadenitis is tender

Fibroma is non-tender

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4
Q

How does oral candidiasis present?

A

Oral thrush: white-gray plaque on tongue

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5
Q

What is the clinical histology of candida?

A

Budding yeast w/ pseudohyphae

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6
Q

How does herpes labialis present?

A

Vesicles that can rupture and ulcerate

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7
Q

Pregnant woman comes in with rapidly growing oral vesicular lesion that regresses on its own.
What is it?

A

Pyogenic granuloma

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8
Q

Clinical difference between thrush and oral hairy leukoplakia:

A

Candidiasis: can be scraped off as pseudomembrane

Oral hairy leukoplakia: can’t be scraped off

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9
Q

Guy with Type 1 Diabetes and ketoacidosis is at risk for:

A

Fungal sinusitis with Mucor

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10
Q

Velvety, erythematous area with focal surface erosion on buccal mucosa
Histology: dysplastic squamous epithelium
What is it?

A

Erythroplakia

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11
Q

Erythroplakia vs Leukoplakia

Which is more likely to progress to SCC?

A

Erythroplakia

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12
Q

How does leukoplakia present?

A

Raised white patch on hard palate; can’t be scraped off

Histology: thickened mucosa

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13
Q

What mutation is often found in oral SCC?

A

TP53

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14
Q

Where are dentigerous cysts usually found?

A

Crown of an unerupted tooth, typically 3rd molar

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15
Q

What are periapical cysts/granulomas?

A

Inflammatory lesions at apex of teeth; complications of long-standing pulpitis

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16
Q

Inflammatory nasal polyps are associated with what chronic condition?

A

Recurrent allergic rhinitis: Type 1 hypersensitivity often called hay fever

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17
Q

Exam: glistening, translucent, polypoid masses filling nasal cavities
What lab finding?

A

Inflammatory nasal polyps –> high serum IgE

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18
Q

Exam: painless progressive swelling of left face
CT: circumscribed multilocular cyst of left mandibular ramus
Histology: cysts lined by stratified squamous epithelium w/ prominent basal layer; no inflammation or granulation

What is it?

A

Odontogenic keratocyst

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19
Q

Presentation: abrupt onset, hoarsness, difficulty breathing and swallowing, throat pain
What is it?

A

Acute bacterial epiglottitis – H. influenzae

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20
Q

3 year old w/ difficulty breathing, harsh cough, inspiratory stridor, steeple sign

What is it? Most common cause?

A

Croup; most commonly from Parainfluenza virus

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21
Q

Postinfectious conditions of Group A strep:

A
  • Rheumatic fever –> Rheumatic heart disease

- Poststreptococcal glomerulonephritis

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22
Q

EBV associated with what cancer in East Asian adults?

A

Nasopharyngeal carcinoma

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23
Q

Male singer who smokes

What does he likely have?

A

Reactive nodules (aka. Vocal cord polyps, singer’s nodules)

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24
Q

What is a potential complication of a kid with chronic otitis media?

A

Cholesteatoma—cystic masses lined by squamous epithelium

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25
Q

Painless movable nodule at neck
If lateral, it is likely what?
If medial, it is likely what?

A 
Lateral= Branchial cyst
Medial= Thyroglossal duct cyst
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26
Q

Where and how do paragangliomas usually present?

A

Solid mass adjacent to carotid bifurcation

Chromogranin and S-100 positive

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27
Q

Old guy with Parkinson’s (being treated) has xerostomia for 3 months. What’s the likely cause?

A

Anticholinergic drug use

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28
Q

Suppurative inflammation of parotid gland. Likely infectious agent?

A

Sialadenitis — S. aureus

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29
Q

Very old/Very young person with blue, translucent nodule on inside of lip. What caused it?

A

Local trauma causing mucocele of a minor salivary gland

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30
Q

Woman with nontender, mobile, discrete mass on face
Histology: ductal epithelial cells in myxoid stroma w/ islands of chondroidlike tissue and bone
What is it?

A

Pleomorphic adenoma

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31
Q

1st and 2nd most common Parotid tumors

A
  1. Pleomorphic adenoma

2. Warthin tumor

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32
Q

What is a malignant tumor of a minor salivary gland called?

A

Mucoepidermoid carcinoma

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33
Q

What is likely to occur 1 week after a nerve graft?

A

Fragmentation of distal axons and myelin sheaths

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34
Q

Regrowth potential with Axonotmesis vs. Neurotmesis:

A

Axonotmesis: Wallerian degenration, no damage to myelin sheath. Regeneration = no problem

Neurotmesis: transection of nerve. Regneration only with exact alignment

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35
Q

Rapidly progressive, ascending motor weakness following sickness. Has lymphocytic infiltrations and segmental demyelination in peripheral nerves
What is it?

A

Guillain-Barre Syndrome

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36
Q

Guy with HIV has relapsing motor and sensor problems in all extremities. Nerve conduction studies show demyelination and remyelination.
What is it?

A

Chronic Inflammatory Demyelination Polyneuropathy

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37
Q

Type of neuropathy associated with Diabetic Mellitus

A

Segmental demyelination

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38
Q

Onion bulb formation on peripheral nerves is found in what disease?

A

Refsum disease — hereditery neuropathy

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39
Q

Young woman with numbneess and tingling in both hands for 5 months.
What is it?

A

Carpal Tunnel Syndrome

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40
Q

Woman has right foot pain for 2 months, worse at end of day. Severe pain at interdigital space between 2nd and 3rd toes.
What does she have?

A

Morton neuroma = plantar nerve trapped between metatarsal heads

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41
Q

Edrophonium restores muscle strength in ___

A

Myasthenia Gravis

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42
Q

Old man w/ weight loss, proximal muscle weakness that does not dimish with repetitive movement, difficulty urinating, no improvement w/ AchE Inhibitor
What does he have?

A

Cancer + Lambert Eaton Myasthenic Syndrome (paraneoplastic)

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43
Q

Man and Wife have blurred vision and weakness for past day, trouble breathing
What likely caused it?

A

Botulism = C. botulinum ingestion

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44
Q

42 y/o man w/: progresssive weakness in all extremities, dysarthria, and dysphagia for 2 years. Now in wheelchair. No muscle pain or tremor
What is it?

A

ALS

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45
Q

30 y/o woman w/: fat redistribution in upper trunk, rounded facies, ecchymoses on extremities, BP 150/90, biopsy showing type II muscle fiber atrophy.
What is it?

A

Cushing Syndrome

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46
Q

Old woman receiving drug to lower cholesterol. CK 2049, Creatinine 2
What is it?

A

Statin-induced myopathy

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47
Q

5 y/o develops increasing muscle weakness. Unable to keep up with other children b/c of quickly becoming tired.CK 689.
What is it?

A

Duchenne Muscular Dystrophy

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48
Q

10 y/o girl with non-progressive muscle weakness since childhood. Histology with Gomori trichrome stain shows subsarcolemmal aggregates of rod-shaped intracytoplasmic inclusions.
What is it?

A

Nemaline rod myopathy - a form of congenital myopathy

49
Q

Infant displays movement difficulty by 1 month and flaccid paralysis by 1 year.
What is it?

A

Werdnig-Hoffman disease - a form of spinal muscular atrophy that starts at infancy

50
Q

Man receives halothane and succinylcholine anesthesia. 30 minutes later, his temp increases to 39.5 and pulse 115.
What mutation does he have?

A

Calcium ion channel (ryanodine receptor) mutation –> malignant hyperthermia

51
Q

42 y/o woman with increasing number of subcutaneous nodules, multiple cafe-au-lait spots, now with posterior left thigh pain.
What does she have?

A

Neurofibromatosis Type 1

52
Q

What causes neurons, especially pyramidal ones in the hippocampus, to exhibit cytoplasmic eosinophilia, central chromatolysis, spheroidal swellings, and nuclear pyknosis?

A
  • Hypoxic and hypoglycemic injury –> “red” neuron” initial reaction
  • Larger pyramidal neurons most sensitive
53
Q

What cells in the brain have a phagocytic/macrophage-like function?

A

Microglia

54
Q

An afebrile patient has severe headache for 2 days; then develops unilateral papilledema, pupil dilation, impaired ocular movement and then later becomes obtunded
How can a glioblastoma cause this?

A
  • Edema
  • -> 3rd nerve palsy –> eye symptoms
  • -> herniation –> obtunded
55
Q

16 y/o boy presenting with 9 months of headaches. CT: large lateral ventricles and 3rd ventricles. LP: normal pressure, clear
He likely has ___ causing ___

A

Ependymoma –> non-communicating hydrocephalus (obstruction below 3rd ventricle)

56
Q

61 y/o man: worsening mental function, confusion, headaches for 1 year; bilateral papilledema; CT: ventricular system enlargement.
How can a pneumococcal infection cause this?

A

Pneumococcal meningitis: usually involves vertex (where arachnoid granulations that reabsorb CSF are found) –> communicating hydrocephalus

57
Q

Patient has an ischemic event that requires 15 minutes to reestablish pulse and BP. Next day: bilateral papilledema, MRI: indistinct cortical gray-white junction, narrowing of ventricles
What intracranial abnormality develped?

A

Cytotoxic edema

  • -due to failure of ATP-dependent ion transport w/ retention of sodium and water
  • -BBB remains intact
58
Q

What causes Duret hemorrhages?

A

Duret hemorrhages = linear midline hemorrhages in the pons

Cerebral edema –> medial temporal lobe (hippocampal) herniation –> Duret hemorrhages

59
Q

What lab abnormality can be found in the mother of an anencephalous fetus?

A

Elevated serum a-fetoprotein level

60
Q

Fetus ultrasound: single cerebral ventricle, fused thalami.
At birth: small, postaxial polydactyly of hands and feet, cyclopia, microcephaly, cleft lip and palate, rocker-bottom feet
What’s the problem?

A

Holoprosencephaly = absent or partial cerebral hemispheric development

Can occur w/ trisomy 13 (Patau syndrome) –> cleft lip, palate, rocker-bottom feet

61
Q

24 y/o man after car accident: impaired pain and temp sensation from shoulder down, normal proprioception and vibratory sense, motor weakness w/ muscle atrophy. MRI: transverse slit-like cavity from C2-C7.
What is it?

A

Syringomyelia = cavity or slit in spinal cord

–Spinothalamic tracts, anterior horns –> sensory and motor deficits

62
Q

21 y/o woman has blow to her head from fall, loss of consciousness for 5 min. Exam: diminished deep tendon reflexes, no CT findings, can’t remember event, recovers next week.
What happened?

A

Concussion:

  • altered consciousness
  • instantaneous onset of transient neurologic dysfunction
  • amnesia for event
  • post-concussion syndrom w/ neuropsychiatric-manifestations
  • no radiologic or pathologic findings
63
Q

Old woman falls backward and hits her head. Exam: arounsable, but somnolent, no motor or sensory deficits, no papilladema.
Where has an acute hemorrhage occured?

A

Inferior frontal lobe –classic “contrecoup”
-Fall backword likely causes contusion to: inferior frontal, temporal tip, inferior temporal

-*Stationary blow to head likely causes “coup” injury”

64
Q

Head trauma –> loss of consciousness –> “lucid interval” –> comatose
What’s the problem? Cause? CT finding?

A

EPIdural hematoma = classic “lucid” interval

  • Injured middle meningeal artery
  • Dura pushed against brain –> lens-shaped
65
Q

Old woman falls downs stairs –> headache and confusion for 30 hours.
Location of hemorrhage? Cause?

A

Subdural hematoma

Tearing of bridging veins below dura

66
Q

Global cerebral eschemia –> brain death.

1 month later, what’s the predominant cell in brain?

A

Macrophages (ongoing liquefactive necrosis, accumulates 2-3weeks later, can persist for months)

67
Q

Old man with 6 episodes of dysarthria, weakness in hands and dizziness. Episodes usually last

A

Transient ischemic attack (TIA)

-Prodrome for Stroke (symptoms >24 hours)

68
Q

What 3 groups of neurons are most sensitive to damage by hypoxia?

A
  • Hippocampal pyramidal cells
  • Cerebellar Purkinje cells
  • Neocortical pyramidal cells
69
Q

Hypertension is usually associated with what cerebrovascular events? Why?

A
  • Hemorrhage: basal ganglia, pontine, or cerebellar
  • Small lacunar infarcts
  • Hyaline arteriolosclerosis prone to rupture
70
Q 
39 y/o afebrile, normotensive man with headache, aphasia, and reduced level of consciousness for 60 hours. LP: lymphocytic pleocytosis. Biopsy: granulomas involving arterioles and venules
What is it? What class of meds can you give? What specific drugs?
A
  • Primary angiitis
  • Immunosuppressives
  • Cyclophosphamide, methylprenisolone
71
Q

Old man with DM has step-wise cognitive decline for 5 years, with multiple acute events that leads to worsening symptoms.
What’s wrong with him?

A

Vascular dementia – classic “step-wise” progression

72
Q

Old man with progressive inability to perform ADLs, memory loss, but no motor or sensory deficits. Histo: Congo red staining plaques, neurofibrillary tangles
What does he have?

A

Alzheimer’s Disease (AD)

73
Q

50 y/o woman w/ sudden severe headache, BP 115/83. LP: numerous RBCs. CT: subarachnoid hemorrhage at base of brain.
What happened?

A

Ruptured berry aneurysm

74
Q

Patient with Neisseria meningitidis infection develops: fever, headache, petichial rash, hypotension and DIC
What is this called?

A

Waterhouse-Friderichsen Syndrome – most severe form of meningococcal septicemia

75
Q

77 y/o man with bacterial meningitis. Gram stain of CSF is likely to show what? (+/- and shape)

A

Gram-positive cocci –

  • Streptococcus pneumoniae is most common in this age group
  • H. influenzae (gram (-) rod) is lower due to immunization
76
Q

Patient with headache and fever for 2 weeks after severe respiratory tract infection. Exam: no papilledema, no sensation or motor deficits, decreased vision on left half of visual field. CT: sharply demarcated 3-cm ring-enhancing lesion on right occipital. LP: numerous leukocytes, high protein, normal glucose
What does she have?

A

Cerebral abscess – abscess ringed by fibroblasts that deposit collagen is characteristic

77
Q

11 y/o boy with Strep pneumonia otitis media.

How can that become an epidural abscess?

A

Otitis media –> infect mastoid air cells –> spread to skull bone –> spread to epidural space –> pachymeningitis

78
Q

65 y/o man is apathetic, irritable, withdrawn, worsening mental function over last year. Exam: (+) Romberg sign, pupils constrict with near focus, but not with exposure to light. LP: lymphocytic pleocytosis, elevated protein w/ increased IgG
What does he have?

A

Tertiary Neurosyphilis from Treponema pallidum infection

  • Argyll Robertson pupil
  • Tabes dorsalis = syphilitic myelopathy, degeneration of dorsal column
79
Q

How to differentiate meningitis caused by:

  1. Cryptococcus neoformans
  2. Echovirus
  3. Listeria monocytogenes
  4. Neisseria meningitidis
  5. Toxoplasma gondii
A
  1. Cryptococal = India ink test positive
  2. Echovirus = self-limiting, in immunocompromised
  3. Listeria = Gram positive rod
  4. N. meningitidis = Gram negative diplococci
  5. Toxoplasmal = CT shows ring-enhancing lesions
80
Q

25 y/o woman with confusion and disorientation has generalized tonic-clonic seizure. CT: 3cm recent hemorrhage in left temporal lobe. LP: few mononuclear cells, normal glucose and protein.
What does she have?

A

Herpes simplex virus encephalitis –> characteristic hemorrhagic lesions of Temporal lobe

81
Q

33 y/o woman has a stillborn, hydropic fetus w/: marked organomegaly, extensive periventricular necrosis of brain w/ focal calcifications.
What caused this?

A

Cytomegalovirus –> characteristic periventricular leukomalacia (necrosis of white matter near ventricles)

82
Q

14 y/o girl from Africa with poor vaccine history has diarrhea over days, then neck stiffness with 3/5 weakness on all extremities and requires mechanical respiration. Symptoms somewhat resolve over next 6 months.
What does she have?

A

Poliomyelitis –> characteristic minor GI illness –> acute major illness –> recovery –> late post-polio syndrome

Polio = enterovirus attacking LMN –> neurogenic muscle weakness and atrophy.

-Anterior horns of spinal cord has LMN

83
Q

12 y/o boy develops fever, occasional headaches, malaise, fatigue, and nausea 1 montha after a dog bite.
What is pathognomonic histo finding?

A

Rabies –> Negri bodies = cytoplasmic inclusions found in hippocampal pyramidal cells and cerebellar Purkinje cells.

84
Q

37 y/o man with HIV-1 has increasing memory problems, depression, motor dysfunction. MRI: diffuse cerebral atrophy, no focal lesions.
What does he have? What is histo finding?

A

AIDS dementia complex –> HIV produced encephalitis –> characterized by microglial nodules (reactive microglial cell collection)

85
Q

52 y/o woman gets chemotherapy for leukemia. 2 months later, develops ataxia, motor weakness in right arm, difficulty swallowing, sensory changes in left leg. MRI: irregular areas of increased attentuation in white matter of cerebral hemispheres and cerebellum. Biopsy: perivascular chronic inflammation, marked gliosis, reactive astrocytes, intranuclear inclusions within oligodendroglia.
What does she have?

A

Progressive Multifocal Leukoencephalopathy (PML) caused by JC virus

86
Q

Healthy young man has 5 day severe headache and new-onset seizure. Exam: papilledema. MRI: multiple small cystic periventricular and meningeal lesions. He ate some undercooked pork.
What does he have?

A

Cysticercosis caused by Taenia solium (pork tapeworm)

  • Cysts causing obstructive hydrocephalus
  • Neurocysteicercosis –> major cause of seizures
87
Q

20 y/o man with HIV has decreased consciousness for 1 week and now has a tonic-clonic seizure. MRI: ring enhancing lesions in cerebral gray matter bilaterally. Biopsy: pseudocysts
What does he have?

A

Toxoplasmosis infection –> abscesses in periphery of brain (bright ring on CT and MRI)

88
Q

63 y/o woman with increasing severe memory loss over 6 weeks. Exam: myoclonus, afebrile. CT: minimal cerebral atrophy
What does she have?

A

Spongiform Encephalopathy – most likely sporadic CJD

89
Q

27 y/o woman with weakness for 3 months. LP: increased IgG with prominent oligoclonal bands. MRI: small, scattered, 0.5cm areas consistent w/ demyelination, mostly located in periventricular white matter.
What does she have?

A

Multiple Sclerosis –lesions in white matter, sparing gray matter

-Most patients develop optic neuritis

90
Q

Patient was drunk driving, has MVA, develops hyponatremia. IV fluids correct it in 2 hours, but she rapidly becomes confused and has limb weakness.
What happened?

A

Central Pontine Myelinolysis – demyelination in basis pontis
-Alcohol abuse increases risk

91
Q

63 y/o man with increasing irritability and weird behaviors for 3 years, but no memory loss developed aphasia. Exam: no motor or sensory deficits. MRI: bilateral marked temporal and frontal lobe atrophy. Autopsy: extensive neuronal loss, remaning neurons had intracytoplasmic, faintly eosinophilic, rounded inclusions.
What did he have?

A

Pick Disease = FTLD-Tau w/ Pick bodies.

92
Q

60 y/o woman with 5 yr history of cogwheel rigidity, festinating gait, expressionless face. Taking L-dopa/carbidopa helped for 2 years, but developed problems performing ADLs and marked cognitive decline and died of aspiration pneumonia. Histo: cortical neurons had spheroidal, intraneuronal, cytoplasmic and eosinophilic inclusions.
What does he have?

A

Dementia w/ Lewy Bodies (DLB) – characteristic a-synuclein Lewy bodies in CORTEX.

“HaLEWYcinations”

93
Q

What is the genetics of Huntington’s Disease?

A

-Autosomal Dominant CAG trinucleotide repeat expansion in huntingtin gene on chromosome 4

94
Q

4 y/o girl has: difficulty with balance while walking, dysarthria, poor hand coordination, absent deep tendon reflexes, bilateral Babinski sign, diminished light touch and vibratory senses, no muscle weakness. In next 5 years, she develops CHF from hypertrophic cardiomyopathy. Autopsy: increased perinuclear iorn deposition in cardiac myocytes.
What genetic mutation did she have?

A

Friedreich ataxia – autosomal recessive GAA trinucleotide repeat expansion in frataxin gene

95
Q

39 y/o man develops progressive, symmetric muscle weakness over 1 year. He can no longer stand, walk or feed himself, but mental function remains intact.
What cells are being affected?

A

Amyotrophic Lateral Sclerosis (ALS)

  • -LMN dysfunction at anterior horn
  • -Cortical UMN
96
Q

53 y/o alcoholic has increasingly clouded sensorium over 2 days and a flapping tremor of outstretched hands. Brain Histo: increased neocortical and basal ganglia astrocytes w/ pale, swollen nuclei. Lab: ammonia 100umol/L
What does he have?

A

Hepatic Encephalopathy

97
Q

10 y/o boy has persistent headaches for 3 months. Exam: afebrile, ataxic gait, dysdiadochokinesia. CT: 4cm cystic mass in right cerebellar hemisphere. Mass histo: cyst w/ thin wall, filled with gelatinous material, GFAP +, long, hairlike processes
What does he have?

A

Pilocytic Astrocytoma

98
Q

40 y/o man with 3cm mass in right parietal centrum semiovale. Mass histo: sheets of cells w/ round nuclei that have granular chromatin, moderate clear cytoplasm, GFAP +. Genetics has 1p and 19q co-deletions
What does he have?

A

Oligodendrogliomas— characteristic 1p,19q co-deletion

99
Q

In children, where do Ependymomas most commonly arise?

A

Floor of the 4th ventricle –> hydrocephalus, papilledema

100
Q

5 y/o boy has headaches for 1 week, ataxic gait and sudden vomiting. He becomes comatose. LP: anaplastic cells w/ dark blue nuclei and scant cytoplasm
What does he have? Where?

A

Medulloblastoma at midline cerebellum (vermi)

101
Q

39 y/o HIV patient who never had antiretroviral therapy has left-sided wewakness and a generalized seizure. CT: no hemorrhage, 4cm mass in right putamen, 3cm mass in right centram ovale, 1cm mass near corpus cullosum. Masses well circumscribed. Cytology: large cells, large nuclei, scant cytoplasm, CD19+
What does he have?

A

Large B-Cell Lymphoma

102
Q

45 y/o woman with unilateral headache for 5 months. CT: mass attached to dura. Mass histo: elongated cells w/ pale, oblong nuclei, pink cytoplasm, occasional psamomma bodies, cytogenetically 22q-
What does she have?

A

Meningioma –benign neoplasm arising from meningothelia cells of arachnoid.

103
Q

76 y/o man with single episode of grand mal seizure. He has 1cm darkly pigmented skin lesion on upper back. MRI: 3 solid mass lesions w/o ring enhancement located at gray-white junction.
What does he have?

A

Metastatic carcinoma –characteristic multiple discrete lesions found at gray-white junction

104
Q

18 y/o student has 14 scattered hyperpigmented skin lesions w/ irregular borders on extremities and torso. Optic nerve glioma is excised after decreased vision. Schwannoma is found on right wrist.
What does she have?

A

Neurofibromatosis Type 1 –characteristic cafe-au-lait spots and propensity for nerve sheath tumors

105
Q

41 y/o woman with diminished hearing for 4 months. MRI: large mass in left cerebellar-pontine angle w/ smaller one on the right.
What does she have?

A

Neurofibromatosis Type 2 –pathognomonic bilateral acoustic schwannomas

106
Q

7 y/o boy has decreased vision for 4 months. Exam: diffuse punctate inflammation of cornea and pannus extending as a growth of fibrovascular tissue from conjunctiva onto cornea. Histo: lymphocytes, plasma cells, neutrophils, and corneal epithelial cells that have cytoplasmic inclusion bodies.
What does he have?

A

Trachoma (C. trachomatis) – most common cause of blindness worldwide.
–Progressive conjunctival scarring w/ eyelid involvment

107
Q

82 y/o man who surfs every week develops cloudy vision on right over 1 year. Exam: whitish irregular lesion on conjunctiva extending to cornea
What does he have?

A

Pterygium “Surfer’s Eye”

108
Q

27 y/o woman has pain w/ cloudiness of vision in right eye for 2 days. Similar episode 1 year ago. Exam: no erythema or vscular injection. Slit lam –> dendritic ulcer on right cornea
What does she have?

A

Herpes Simplex infection – most common cause of corneal dendritic ulcers

109
Q

26 y/o man has severe visual impairment since birth. His astigmatism can’t be better than 20/100 w/ glasses, but can be 20/40 with rigid contact lenses.
What does he have?

A

Keratoconus – corneal thinning with breaks in Bowman layer –> conical shape corneas

110
Q

34 y/o man has decreasing vision for 3 years. Exam: diffuse cloudiness of anterior stroma w/ aggregates of gray-white opacities in axial region of the corneal stroma. Diseased cornea show basophilic deposits in stroma that stain with keratan sulfate.
What does he have?

A

Macular dystrophy – most sever form of corneal stromal dystrophy, autosomal recessive

111
Q

29 y/o woman has SLE and receives long-term high-dose glucocorticoid therapy. What occular complaint is she at high risk for?

A

Cataracts – complication of systemic therapy w/ glucocorticoids

112
Q

77 y/o woman has increasing pain w/ clouded vision on right eye for 36 hours. Fundoxcopic exam: excavation of otpic cup on right.
What does she have?

A

Primary angle-closure glaucoma – manifests in acute pain b/c narrowing of angle at anterior chamber obstructs aqueous flow

113
Q

Patient has a penetrating injury to the left eye. 3 weeks later, he has loss of accomodation, photophobia, and blurred vision on his right eye.
What happened?

A

Sympathetic ophthalmia – release of sequestered antigen from one eye receiving penetrating ocular trauma into the opposite eye causing immune inflammatory reaction

114
Q

61 y/o woman has decreasing visual acuity in right eye for 6 months, then sudden loss of vision, “shade pulled down”. Fundoscopy: dark uveal mass.
What does she have?

A

Melanoma – pigmented uveal mass causing retinal detachment; most common intraocular malignancy

115
Q

75 y/o woman w/ DM and CHF has sudden loss of vision in left eye. Fundoscopy: cherry-red foveola, but pale rest of retina. Right eye normal.
What does she have?

A

Central retinal artery occlusion – thromboembolization

116
Q

Child is healthy at birth but develops blindness and failure to meet neuro-developmental milestones. Fundoscopy: pale retinae w/ prominent red macular regions.
What does he have?

A

Tay-Sachs disease – deficiency in hexosaminadase A

117
Q

Age-related Macular Degeneration is due to choroidal neovascularization driven by ___

A

Vascular endothelial growth factor (VEGF)

118
Q

33 y/o man first develops night blindness, then later daytime visual acuity deficits. Fundoscopy: branching reticulated pattern to retina, optic disc appears pale and waxy.
What does he have?

A

Retinitis Pigmentosa – characteristic waxy appearance of optic disc

MQW U3 (11 decks)

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