Therapeutics Flashcards

Question

Marcus Gunn Jaw Winking

Answer 1

synkinesis between nerve supply to pterygoid muscles and levator palpebrae superioris not serious; when jaw moves to opposite side of ptotic lid, the ptotic lid elevates

Answer 2

benign soft tissue tumor composed of blood vessels - most common orbital tumor in childhood located usually on palpebral conjunctiva or upper lid - superficial bright red mass that will blanch with pressure, bleed spontaneously, and enlarge when crying 100% by 6 months + most spontaneously regress - 30% by 3 years old and 75% by 7 years old concerned with amblyopia if occlusion of visual axis by lid or induced corneal astigmatism Eval: cardiac/neuro work up and CT/MRI orbit - Posterior Fossa Malformation - Hemangioma - Arterial Anomalies - Cardiac Defects - Eye abnormalities

Answer 3

inflammation of blocked meibomian gland swollen lid + oily MG can recur with children Tx: topical, oral, sx (>10mm) and hot compress if chronic: omega-3 supplements

Answer 4

1kg = 2.2 lbs and 1 tsp = 5 ml need to know kids weight and dose formulations for drugs (on label) 1) find the min + max range 2) pick closest to middle out of the formulations

Answer 5

infection of anterior portion of lid (septum) - should still have normal VA, EOM, Pupils due to insect bite, chalazion, sinus infection, trauma - s. pneumoniae most common

Answer 6

infection of lid but more serious because decreased VA, restricted EOMs, abnormal pupils seen with proptosis (bulging eyes) Tx: go to hospital for IV antibiotics

Answer 7

location in eyes, location in lens, size, shape, duration - more posterior = poor prognosis - >3mm is significant in vision - congenital or acquired (duration)

Answer 8

60% idiopathic 30% hereditary without systemic disease 5% metabolic syndrome 3% maternal infection 2% ocular anomalies Meds (steroids, radiation) Bilateral: more work up if no family history - CBC, BUN, TORCHS, ca/P, urine

Answer 9

80% idiopathic 20% ocular anomalies like Uveitis 10% traumatic Unilateral: may not require systemic work up - hx, lens eval, maybe TORCHS to find cause

Answer 10

oil droplet cataract - galacitol in lens leads to refractive lens change if you remove galacitol from diet, lens will clear up (not TRUE cataract)

Answer 11

small (<3mm), central, abnormal separation from lens vesicle and surface ectoderm

Answer 12

conical, surrounding cortical changes usually bilateral

Answer 13

located in the embryonic/fetal nucleus between y sutures unilateral or bilateral often Autosomal Dominant + poor VAs

Answer 14

Congenital thinning of posterior capsule with bowing of thinned area and becomes opacified over time usually unilateral may get irregular astigmatism - ambylopic

Answer 15

blue/white opacities in lens cortex autosomal dominant (genetic mutation) associated with down syndrome

Answer 16

HISTORY (family, duration, meds, trauma, health, prematurity) VA visual preference RE + DFE (IOP + lens assessment)

Answer 17

114 infants (1-6 mos) with unilateral cataracts sx 81% IOL got glaucoma vs 56% CLS got glaucoma children should be left aphakic and treat with cls until IOL implant is necessary

Answer 18

Infants: the earlier the intervention the better outcome - if no treatment: can lead to deprivation amblyopia if unilateral: sx by 4-6 weeks (ASAP) vs if bilateral (6-8 wks) Toddler: sx only if severe - VA worse than 20/50, RE, patch, dilate with PEP for improvement School-Age: 8+ year old - if congenital and no prior tx: poor prognosis - if acquired, more conservative tx Aphakia gls/ BIFOCAL TX NECESSARY monitor for glaucoma!!

Answer 19

lens subluxation due to disorders that disrupt the microfibrils of the zonules remain attached usually but can detach Caused by Homocystinuria + Marfan's Syndrome

Answer 20

methionine catabolism disorder which leads to developmental delays and blood clots and pupil Block glaucoma Dx: urine test Tx: B6 + diet changes

Answer 21

mutation in gene for fibrillin-1 tall stature, MVP, aortic root dilation -- cardiac defects Myopia (>3D), Ectopia Lentis, FMHx, and genetic tests

Answer 22

onset 1-2 year olds where angle structures seen at 7-8 mos of gestation are now seen as congenital glaucoma - they do not develop fully CB and Iris positioned more anteriorly and overlap TM causing decrease in aqueous outflow Caused by: cataract removal (up to years later) or Juvenile Onset Open Angle Glaucoma (autosomal dominant) 66% bilateral 86% dx by 1 year old ``` Signs: tearing, photophobia, blepharospasm (eye twitch), megalocornea (>12mm), Buphthalmos (enlarged eye), Myopia, corneal opacities, increased IOP (>21mmHg) - reproducible VFD - increased corneal diameter :newborn >11mm :infant >12mm :1+year >13mm - increasing cupping and diff of 0.2 or more - focal rim thinning - progressive myopic shift ``` Work up: IOP, Gonio, Dilation/ON, EUA (under anesthetic) Tx: sx or meds