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Mnemonics in Ophthalmology > Systemic disease and the eye > Flashcards

Systemic disease and the eye Flashcards

1
Q

Hypertensive retinopathy pathophysiology:

A

Problems with autoregulation of blood flow in the precapillary and capillary lead to ischemia.

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2
Q

Hypertensive retinopathy grading:

A

0-4

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3
Q

Hypertensive retinopathy grade 0 finding:

A

No change

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4
Q

Hypertensive retinopathy grade 1 finding:

A

Minimal arterial narrowing (segmental or the entire vessel)

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5
Q

Hypertensive retinopathy grade 2 finding:

A

Venous narrowing at AV crossing

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6
Q

Hypertensive retinopathy grade 3 finding:

A

DBP of 110
Retinal bleeding (dot, Blot, Flame)
Cotton wool spot
NO microaneurysms.

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7
Q

Hypertensive retinopathy grade 4 finding:

A

DBP 130, SBP 200

Swollen disc

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8
Q

Contrary to diabetic retinopathy, there are no_____ in Hypertensive retinopathy.

A

no microaneurysms.

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9
Q

changes in ____ grades are due to chronic hypertension, and changes in _____grade are due to acute hypertension

A

changes in 1-2 grades are due to chronic hypertension, and changes in 3-4 grades are due to acute hypertension

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10
Q

______ Blood pressure is more important for RF

A

DBP

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11
Q

In the 3-4 hypertensive retinopathy grades there is _____ involvement, that can lead to ______

A

Choroidal, RD due to fluid escaping (serotic)

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12
Q

Can VA remain damaged after signs have passed?

A

Yes, especially damage to ON, macula, RPE

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13
Q

Graves ophthalmopathy - the percentage of hypo, EU, and hyper thyroidsim.

A

5% - EU
1% - hypo
Above 90% - hyper

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14
Q

Graves ophthalmopathy - There is a correlation between the degree of thyroid disease and the degree of ophthalmopathy. True/False?

A

False! There is NO correlation between the degree of thyroid disease and the degree of ophthalmopathy.

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15
Q

Graves ophthalmopathy - ocular involvement can be remembered through _____.

A

NO SPECS:
N - no signs
O - Only signs

S - Soft tissue 
P - Proptosis
E - Extraocular muscles involvement
C - Corneal damage
S - sight loss
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16
Q

Graves ophthalmopathy - What is the soft tissue involvement?

A

Lids: lid lag, lid swelling
Conjunctiva: not diffuse (at the insertion of the muscles)

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17
Q

Graves ophthalmopathy - Extraocular muscles involvement is progress in what pattern?

A

Starts at the IR and continues in a counter-clockwise fashion.

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18
Q

Graves ophthalmopathy - Extraocular muscles involvement pathology?

May lead to?

A

Spindle hypertrophy and doesn’t involve the tendons, and may lead to diplopia.

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19
Q

Graves ophthalmopathy - Corneal damage pathophysiology?

A

Exposure keratopathy (SPK is usually seen)

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20
Q

Graves ophthalmopathy - sight loss is due to _____

A

Pressure on the ON

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21
Q

Graves ophthalmopathy - therapy:

A

דרדס

דמעות
רדיולוגי
דה-קומפרסיה
סטרואידים

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22
Q

RA ophthalmopathy - ocular involvement can be remembered through _____.

A

Dry CURVES

Dry - kertocunjictivitis sicca
C - Choroiditis
U - Ulceration
R - RD
V - Vasculitis
E - Episcleritis
S - Scleritis
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23
Q

Kertocunjictivitis sicca - Dx?

A

Schirmer dry eye test - <5mm in 5 minutes

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24
Q

Kertocunjictivitis sicca - Tx?

A

Tear replacement, Punctum plug

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25
Q

Episcleritis vs Scleritis finding?

A 
The 5 P's - Scleritis presents with:
P - Pain 
P - Purple (red-purple)
P - Photophobia
P - profound (deep) vessel involvement
P - Phenyephrine test positive
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26
Q

Scleritis can be seen with?

A 
WIPS:
W - Wegner
I - IBD
P - PAN
S - SLE
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27
Q

Scleritis mandates _____.

A

systemic review

28
Q

Episcleritis vs Scleritis vs Nec. Scleritis finding Tx.

A

Episcleritis - Tears + NSAIDS/ Steroid drops

Scleritis - systemic steroid therapy.

Nec. Scleritis - surgical with immunosuppressive and cytotoxic therapy.

29
Q

Corneal ulceration Tx:

A

surgical, steroids, cytotoxic therapy.

30
Q

JRA uveitis- % of uveitis, and most common type of JRA

A

80%, Pauciarticular.

31
Q

JRA uveitis - possible complications

A

CaGeS:
C - Cataracts
G - Glaucoma
S - Sight loss

32
Q

JRA uveitis - signs:

A 
K-SHIP:
K - Kerato-precipitants (KP, on the endothelial side) 
S - Sight loss
H - Hypopion
I - IOP
P - Pain
33
Q

JRA uveitis - Tx:

A

Steroids and Cycloplegia (to prevent posterior synechiae)

34
Q

Spondyloarthropathies uveitis percentage involvement?

A 
RAPI!
R - Reiter, 40%
A - Ankylosis spondylitis, 25%
P - Psoriatic arthritis, 20%
I - IBD, 10%
35
Q

Important milestones:

A

2 months (6-8 weeks) - social smile
2.5 months (8-10 weeks) - 180 degree follow
2-3 months - fixation reflex
4 months - reaching attempts

36
Q

Children vision analysis?

A 
BS CHiC
B - Behavior fixation
S - Shaps usage
C - Cards (acuity)
H - HOTV
C - Chart (snellen)
37
Q

Bad signs regardind children vision loss:

A

Light WORN:

Light indifference

W - Wandering eye movements
O - Oculodigital sign
R - Response lacking
N - Nystagmus

38
Q

Phoria VS Tropia

A

Phoria - only in specific situations

Tropia - most of the time (can be intermittent or constant)

39
Q

Strabismus - light reflex tests:

A

Hirshberg test and krimsky test

40
Q

Hirshberg test - every 1 mm means a deviation of_____

A

7 degrees or 15 prism diopters

41
Q

Pseudo-Strabismus happens when____

A

difference of epicanthal folds

42
Q

Strabismus workup tests:

A

light reflex tests or cover/uncover test or mix.

43
Q

Congenital vs acquired strabismus:

A

before or after 6 months

44
Q

Fixation behavior strabismus classification:

A

Alternating fixation - both eyes display strabismus.

monocular fixation - only one eye fixates.

45
Q

Strabismus etiologies:

A 
CAIR:
Congenital
A - Accommodative
I - Idiopathic
R - Restrictive
46
Q

Strabismus workup:

A 
FARMS:
F - Fundoscopy
A - Accuity
R - Refraction
M - movement exam
S - Slit lamp
47
Q

Two common pathologies leading to strabismus:

A

Rb and Occilcutaneus albinism

48
Q

Every _____ finding mandates an ophthalmology exam

A

Strabismus

49
Q

Accommodative esotropia pathophysiology:

A

Hypermetropia (+2 to +10) -> Accommodation + Miosis + Convergence -> esotropia

50
Q

Accommodative esotropia peak onset:

Age

A

2-3 years old.

51
Q

Accommodative esotropia Tx:

52
Q

Congenital esotropia mnemonic

A

“Most common Uppedy BItCH”

The most common type of strabismus.

Vertical componnent (UP)

B - Bilateral
I - Idiopathic
C - Cross fixation
H - Hypermetropia

53
Q

Congenital exotropia is accompanied by ___ and thus mandates ____

A

EXotropia has EXtra stuff.

Many systemic, Neurologic, structural (skull) diseases. Pediatric neurologist and imaging (CT or MRI)

54
Q

Intermittent exotropia is a type of ____ strabismus

55
Q

When does Intermittent exotropia usually present?

A

6 months to 4 years

56
Q

Intermittent exotropia goes away when looking at ______

A

nearby objects

57
Q

Intermittent exotropia - indications for surgery

A

DICk

D - Depth vision loss
I - Incidence increase (above 50%)
C - Close object exotropia

58
Q

Strabismus Tx:

A

The BG’S
B - Botox
G - Glasses (prism/accommodation)
S - Surgery (Resection/Recession)

59
Q

Amblyopia etiologies:

A

SAD I (eye)

S - Strabismic
A - Anisometropic
D - Deprivation of sensory info (most common)

I - Isometropic

60
Q

Amblyopia Tx:

A 
PULP:
P - Patch
U - Underlying cause
L - Lens
P - Penaziation (Atropin, unfitting glasses)
61
Q

Sensory deprivation Amblyopia common position of the kid

62
Q

Sensory deprivation Amblyopia common position of the kid

63
Q

Anisometropic amblyopia - amblyopia is worse with hyperopia or myopia?

64
Q

Amblyopia is seen when there is VA difference between the eye that is at least ______

A

VA difference between the eye that is at least 2 rows

65
Q

Amblyopia incidence in the general population?

66
Q

Amblyopia - what is the critical period?

A

The period at which the child should have a clear image projected on both retinas together - allows for the proper maturation of the visual brain.
From a week to the first months of life.

67
Q

Amblyopia - what is the amblyopic period?

A

The period at which the maturation of the visual brain is complete.
About 7-8 years of age.

Mnemonics in Ophthalmology (16 decks)

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