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UCL Medical Retina 2 > Unit 7 - Benign lesions > Flashcards

Unit 7 - Benign lesions Flashcards

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USMLE® Step 1 flashcards
1
Q

What is a congenital anomaly which has a loss of RPE, temporal to fovea pointing towards the fovea?

A

Torpedo maculopathy

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2
Q

Which variant of CHRPE is of concern?

A

Multiple irregular CHRPE in all 4 qudrants that are pisciform in shape and bilateral. Linked to familial adenomatous polyposis

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3
Q

Are CHRPE elevated?

A

May be minimally elevated

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4
Q

Which associations are there with Angioid streaks?

A

P – PXE (ABCC6)
E - Ehlers Danlos syndrome (probably not_
P - Paget’s disease of bone
S- Sickle cell disease (and thalassaemia)
I – Idiopathic

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5
Q

What are the four common types of haemangiomas

A

Capillary
Cavernous
Vasoproliferative
Racemouse

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6
Q

Which haemangioma is more likely in VHL?

A

Capillary haemangioma

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7
Q

Which haemangiomas either don’t respond to treatment or don’t need it?

A

Racemouse
Cavernous

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8
Q

Which haemangioma is more likely if there is a history of ocular disease?

A

Vasoproliferative tumour of the ocular fundus

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9
Q

How often does VHL present with a capillary haemangioma?

A

68%

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10
Q

What types of choroidal haemangioma are there?

A

Diffuse
Circumscribed

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11
Q

Which type of choroidal haemangioma has systemic associations?

A

Diffuse, may have other haemangiomas on fac and or Sturge-Weber

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12
Q

What will a diffuse choroidal haemangioma look like on ultrasound?

A

HIgh reflectivity

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13
Q

What signs would you see in a diffuse choroidal haemangioma?

A

Tortuous vessels, srf, subretinal fibrosis

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14
Q

What types of hamartoma are there?

A

Simple
Astrocytic
Combined hamartoma of retina and rpe

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15
Q

Which lesion is termed a mulberry lesion?

A

Astrocytic hamartoma

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16
Q

Which hamartoma is due to glial proliferation?

A

Combined hamartoma of retinal and RPE

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17
Q

What are the signs of a simple hamartoma?

A

retinal exudation and pigmented vitreous cells (20%)
Minimally dilated feeder vessels
solitary pigmented nodule

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18
Q

In which layer of the retina is an astrocytic harmartoma located?

A

nerve fibre

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19
Q

Which hamartomas may be asscoiated with NF?

A

Type 1 - astrocytic
Type 2 - Combined

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20
Q

What does a choroidal osteoma look like?

A

Yellow well defined lesion
Looks like aero on FAF
Highly reflective on US

21
Q

How does vision loss occur with choroidal osteomas?

A

Bone de-calcifies and kills photoreceptors

22
Q

Which peripheral retinal degeneration has an association with RD and by how much?

A

Lattice - 1% risk of RD

23
Q

What types of Ret tels are there?

A

Coats,
Mac tel 1,2,3
Sickle cell

24
Q

Describe Coat’s disease?

A

Unilateral severe form of tel
Light bulb aneurysm, exudation, capillary dropout and fibrosis

25
Q

Which mac tel is congenital?

A

Type 1 - probably a form of Coats

26
Q

Which Mac Tel is associated with cerebrovasculopathy?

A

Type 3

27
Q

With which mac tel can you get CNVM?

A

Type 2

28
Q

Which mac tel patients retain good vision?

A

Type 1 - 6/12 ish

29
Q

If you see drusen in young people what do you want to check for?

A

Membranoproliferative glomerulonephritis type 2

30
Q

Which patients are more likely to get choroidal melanoma?

A

White, fair, blue eyed men with NF1, BAP gene with a naevus of ota and are welders!

31
Q

What is the mortality of choroidal melanoma?

A

50% at 5 years

32
Q

What treatment is more successful plaque brachytherapy or enucleation?

A

Equally

33
Q

Is choroidal melanoma similar to cutaneous melanoma?

A

No different disease

34
Q

what types of retinoblastoma are there?

A

Exophytic, subretinal growth
Endophytic, growth into virtreous cavity

35
Q

How can you differentiate Coats from exophytic retinoblastoma?

A

Don’t get lightbulb telangiectasia in retinoblastoma

36
Q

Which type of retinoblastoma simulates Coats?

A

Exophytic

37
Q

What is the survival in retinoblastoma?

A

95%, worse if extraocular

38
Q

Which mac tel is bilateral?

A

Type 2, and type 3

39
Q

What features does Alport syndrome have?

A

Kidney failure
Deafness
Corneal RE
Dot and fleck retinopathy
Mid peripheral flecks
Temporal macular thining
Anterior lenticonus

40
Q

What is the genetics in Alport syndrome?

A

X-linked 85%
15% AR
AD is very rare

41
Q

Who gets adult onset vitelliform macular dystrophy and why?

A

women in their 30-40s
May be heriditary trait
Yellow material is thought to be lipofuscin and photoreceptor debris

42
Q

What will the FFA show with adult onset vitelliform macular dystrophy

A

Hyper fluorescent staining with a corona sign present

43
Q

What is the prognosis in adult onset vitelliform macular dystrophy?

A

VA quite good until GA develops

44
Q

What is the diff dx in AFMVD

A

Best’s disease but would be present earlier
AMD but AFMVD lesions appear earlier and have more discrete sub-foveal deposits

45
Q

What symptoms do you get with primary intraocular lymphoma?

A

Vitreous floaters
Systemic history of lymphoma

46
Q

What are the sign in primary intraocular lymphoma?

A

Subretinal yellow infiltrates
VA better than signs
Mean age 50-60
60-80% develop intracranial lymphoma within 29 months

47
Q

What is often the problem in primary intraocular lymphoma?

A

Treated as a uveitis with steroids. Need to be off steroids for 2 weeks before biopsy

48
Q

What percentage of uveal metastases are choroidal?

A

88%

UCL Medical Retina 2 (30 decks)

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