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MBChB - Y2 - Systems - Nervous System > The Red Eye & Adnexal Oncology > Flashcards

The Red Eye & Adnexal Oncology Flashcards

1
Q

What is the acute red eye condition?

A

Uveitis

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2
Q

What is the acute red eye condition?

A

Conjunctivitis:

Bacterial

Viral

Allergic

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3
Q

What is the acute red eye condition?

A

Scleritis

Acute glaucoma

Keratitis / corneal ulcer

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4
Q

What are the different types of uveitis?

A

Anterior

Intermediate

Posterior

Panuveitis

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5
Q

Where does anterior uveitis occur?

A

Iris

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6
Q

Where does intermediate uveitis occur?

A

Ciliary body and vitreous

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7
Q

Where does posterior uveitis occur?

A

Retina

Choroid

Blood vessels

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8
Q

What are the causes of uveitis?

A

Idiopathic

Assocaited with systemic disease

Infection

Masquarade (intraocular lymphoma, leukaemia)

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9
Q

What systemic diseases is uveitis associated with?

A

Ankylosing spondylitis

Behcet’s disease

Sarcoidosis

Systemic lupus erythematosis

Wegner’s

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10
Q

What infections are associated with uveitis?

A

TB

Syphilis

Toxoplasma

Herpes

Lymes

CMV

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11
Q

What is treatment for uveitis?

A

Treat Infection

Topical anti-inflammatories

Systemic steroid

Systemic immunosuppressants

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12
Q

What are signs and symptoms of acute angle-closure glaucoma?

A

Severe pain

Vomiting

Fixed, dilated pupil

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13
Q

What are features of preseptal cellulitis?

A

Pain, redness, lid swelling

Systemically well

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14
Q

What are the common causes of preseptal cellulitis?

A

Lid cyst or insect bite

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15
Q

What are the features of orbital cellulitis?

A

Ø Pain, redness, lid swelling

Ø Systemically unwell

Ø Double vision/limitation in EOEM

Ø Conjunctivitis/chemosis

Ø Exophthalmos (abnormal protrusion of the eyeball or eyeballs.)

Ø Blurred vision

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16
Q

What are the common causes of orbital cellulitis?

A

Sinusitis

Dental infections

Haematological spread

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17
Q

What systemic diseases can cause issues with the eye?

A

Ø Diabetes

Ø Hypertension

Ø Autoimmune

Ø Rheumatoid arthritis

Ø Myaesthenia gravis

Ø Systemic lupus erythematosus

Ø Inflammatory:

Ø Ankylosing spondylitis

Ø Crohn’s disease

Ø Sarcoidosis

Infection

Haematological

Inherited / genetic:

Albinism

Marfans

Thyroid eye disease

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18
Q

What are the three types of adnexal oncology?

A

Eyelid tumours

Lacrimal drainage tumours

Orbital tumours

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19
Q

What are the common types of adnexal oncology pathology?

A

Eyelid tumours: very common (20% of caucasions in their lifetime)

Lacrimal drainage tumours: vanishingly rare - less than 1,000,000 per year - considered to be orbital

Orbital tumours: very rare (2/3 benign, 1/3 malignant), approximately 1 per 100,000 per year

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20
Q

What are the features of benign tumours?

A
  • Normal cells in abnormal numbers and/or location
  • Cells lack the ability to invade local tissue or to metastasise
  • Typically slow growing, mass effect
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21
Q

What are the features of malignant cells?

A
  • Anaplastic cells (loss of form or function)
  • Often rapidly growing, capable of invading surrounding tissue and spreading to distant locations
  • Colloquially known as ‘cancer’
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22
Q

What is a carcinoma?

A

•Derived from epithelial cells (i.e. skin, respiratory tract, GI tract)

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23
Q

What is a sarcoma?

A

•Derived from connective tissue (i.e. bone, cartilage, fat, nerve)

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24
Q

What is a lymphoma?

A

Haemopoietic cells maturing in lymphatic tissue

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25
What is a leukaemia?
•Haemopoietic cells maturing in the blood
26
What is a blastoma?
•Cancers derived from immature ‘precursor’ cells or embryonic cells
27
Give examples of benign eyelid tumours
Squamous cell papilloma Basal cell papilloma Melanocytic naevus Actinitic keratosis
28
What are the malignant eyelid tumours
Basal cell carcinoma (very common - 90-95%) Squamous cell carcinoma (2-5%) Sebaceous cell carcinoma (1-2%)
29
What are the features of squamous cell papilloma?
Pedunculated or sessile (broad-based) Characteristic ‘raspberry’ texture Usually viral
30
What is the treatment for benign eyelid tumours?
Excision or laser ablation
31
What are the features of basal cell papilloma?
ØGreasy, brown, flat, round/oval Ø Similar texture to squamous cell papilloma Ø ‘Stuck on’ appearance Ø Unrelated to sun exposure
32
What is the treatment for basal cell papilloma?
Excision
33
What is melanocytic naevus composed of?
Atypical melanocytes
34
What does the appearance of melanocytic naevus depend on?
location
35
What are the three types of melanocytic naevus and where are they found?
36
What are the early signs of malignant transformation of melanocytic melanoma? Forms malignant melanoma
**ABCDE** ## Footnote A Asymmetry B Border (irregular) C Colour (variegated) D Diameter (\>6mm) E Evolving (growing) **Concerning (suggesting nodular MM)** E Elevated F Firm to touch G Growing
37
What type of benign eyelid tumour has an erythematous pedunculated mass?
Pyogenic granuloma May follow surgery, infection or trauma
38
Which benign eyelid tumour is a common pre-malignant condition and is related to sun exposure?
Actinitic keratosis
39
What is the appearance of actinitic keratosis?
Flat, scaly, hyperkeratotic skin, occasional, forms cutaneous horn
40
What is the treatment for actinitic keratosis?
Excision or medical treatment
41
What is the most common cancer worldwide?
Basal cell carcioma
42
What causes basal cell carcinoma?
Pale skin and sun exposure
43
What is the risk of metastasis of a basal cell carcinoma?
1:1000
44
What percentage of basal cell carcinoma occurs on the face?
70%
45
What are the features of basal cell carcinoma?
Slow, inexorable growth over months Usually non-pigmented, elevated, ulcerated Pearly, rolled, irregular border Telangiectasia Lack of tenderness
46
What are the clinical subtypes of basal cell carcinoma?
Nodular - classic firm pearly nodule Ulcerative - common, may progress from nodular Morpheaform / infiltrative - less common, indurated plaques
47
Where is the most common place for a basal cell carcinoma?
Lower eyelid
48
What is the management of basal cell carcinoma?
Excision Mohs surgery Non-Surgical: Topical (imiquimod, efudex) Chemotherapy (vismodegib) - Gorlin, Muir-Torre Cryotherapy Radiotherapy Photodynamic therapy
49
What is the cause of squamous cell carcinoma?
Sun damaged skin and pre-existing actinitic keratosis
50
What are the features of squamous cell carcinoma?
Scaly surface over a thick plaque Growth over weeks rather than months
51
What is the metastatic risk of a squamous cell carcinoma?
3-10%
52
What is the therapy for squamous cell carcinoma?
Excision
53
Describe the features of sebaceous gland carcinoma
Nodular indurated lid margin Yellowish discolouration (lipid content) Pagetoid spread along conjunctivae (invades upper epidermis from below)
54
What are the three types of malignant melanoma?
55
Tips for taking adequate biopsies
Ø Adequate size Ø Try to include area of normal tissue Ø Try not to crush or use excess cautery Ø Give histologist as much info. as possible
56
What are the common benign orbital tumours?
Cappillary haemangioma Cavernous haemangioma
57
What are the common malignant cancers of the orbit?
Lymphoma Metastatic spread Rhabdomyosarcoma
58
What is one of the commonest tumours of infacy?
Capillary haemangioma
59
What eyelid is often affected by a capillary haemangioma?
Upper
60
What are the issues a capillary haemangioma can cause with the eye?
Amblyopia Astigmatism
61
What is the rate of involution of a capillary haemangioma?
Involution from age 2, 40% by 4, 70% by 7
62
What is the therapy for capillary haemangioma?
Beta blockers Intralesion steroid Surgery
63
What are the featuers of a cavernous haemangioma?
Rare Congenital Well demarcated pink patch Darkens with age, does not involute
64
What is treatment for cavernous haemangioma?
Laser
65

MBChB - Y2 - Systems - Nervous System (48 decks)

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