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UCL Medical Retina 2 > Unit 7 - Uveitis > Flashcards

Unit 7 - Uveitis Flashcards

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USMLE® Step 1 flashcards
1
Q

Which conditions are termed intermediate uveitis?

A

Pars planitis
Posterior cyclitis
Hyalitis

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2
Q

What are the symptoms of intermediate uveitis?

A

Floaters,
Flashes
Blurred vision
+/- pain

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3
Q

what conditions make up posterior uveitis?

A

Chorioretinitis
Retinitis
Neuroretinitis
Retinal vasculitis

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4
Q

What are the symptoms of posterior uveitis?

A

Floaters
Flashes
Blurred vision
+/- pain

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5
Q

What is panuveitis?

A

Inflammation of A/C, vitreous, retina and choroid

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6
Q

what time course is termed persistent under the SUN classifications?

A

greater than 3 months

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7
Q

What is considered “recurrent” under the SUN classification?

A

Repeated episodes separated by periods of inactivity > 3 months

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8
Q

Why is it difficult to look for RAPD in uveitis?

A

posterior synechiae

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9
Q

What can cause high IOP in uveitis?

A

Possner-Schlossman syndrome
Herpetic kerato-uveitis
Steroid reponder

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10
Q

In which conditions would you expect to see interstitial keratitis?

A

syphilis
Cogan’s syndrome

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11
Q

If the iris details were very hazy what level of A/C flare would you have?

A

3+

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12
Q

If the iris details were visible but there was some flare what grade of flare would that be?

A

2+

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13
Q

What are cells grades in a/c

A

Grade Cells
0.5+ 1-5
1+ 6-15
2+ 16-25
3+ 26-50
4+ 50+

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14
Q

How is vitreous flare graded?

A

Grade
1+ Clear view
2+ Disc/vessels hazy
3+ Disc/vessels very hazy
4+ Posterior pole barely visible
5+ No fundal view

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15
Q

How are vitreous cells graded?

A

Grade Cells
Trace 2-20
1 21-50
2 51-100
3 101-250
4 >251

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16
Q

What retinal changes should you look for in a uveitis examination?

A

Vascular sheathing
Macular oedema
Retinal haems
CWS
Retinal infiltrates
Exudative RD
Retinal necrosis

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17
Q

What signs are we looking for at the optic disc in a uveitis clinical exam?

A

Disc hyperaemia
Papillitis
Papilloedema
Atrophy
Neuroretinitis
Optic neuritis
Optic disc granuloma

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18
Q

What are the common causes of AAU?

A

Idiopathic
HLAB27
JIA
Fuch’s
Ankylosing spondylitis
Inflammatory bowel disease
Syphilis

19
Q

What are the common causes of granulomatous AAU?

A

Microbial infecton e.g. syphilis, TB, herpes, toxoplasmosis
Sarcoid, VKT

20
Q

What is the treatment regime for uveitis?

A

Antibiotics if bacterial
Antiviral treatment
Cycloplegic
Topical steroids
Topical anti-inflammatory

21
Q

If uveitis treatment needs to be escalated what would you try next?

A

Systemic treatment
Oral steroids
Oral anti-inflammatory
Antimetabolites
T-cell inhibitors (cyclosporine)
Biologics: anti-TNF

22
Q

What is considered remission in uveitis treatment?

A

Inactive disease > 3 months after treatment stopped

23
Q

Are men or women more commonly affected by episcleritis?

A

Women

24
Q

What types of episcleritis are there?

A

Simple (75%)
Nodular (25%)

25
Q

what tests can you use to differential between episclertitis and scleritis?

A

Phenylephrine
Cotton wool bud - moving vessels

26
Q

What is the differential diagnosis in episcleritis (beyond scleritis)?

A

Phlyctenular conj - nodular inflammation of conj in response to a foreign antigen
Conj

27
Q

What types of scleritis are there?

A

Posterior (10%)
Anterior (80-85%)

28
Q

What two types of anterior scleritis are there?

A

Necrotising
Non-necrotising

29
Q

What percentage of patients with anterior scleritis will have a systemic association?

A

50%

30
Q

What signs would you get with posterior scleritis?

A

Disc oedema
Myositis (inflamation of muscle causing diplopia/proptosis)
Eye tender to palpation
Choroidal folds due to oedema pushing them up

31
Q

Why should we perform further blood tests in uveitis?

A

Confirm diagnosis
Exclude
Baseline before treatment may impact on them

32
Q

In Retinal vasculitis, which conditions will primarily affect arteries?

A

ARN
LSE

33
Q

In Retinal vasculitis, which conditions will primarily affect veins?

A

Sarcoid
IRN
MS

34
Q

In retinal vasculities which conditions can affect both arteries and veins?

A

Behcet’s
Toxoplasmosis
Chorioretintis

35
Q

What can cause any combination of retinal vasculitis?

A

TB
Syphilis

36
Q

In patients presenting with uveitis and a headache what should we suspect?

A

AMPPE
MS
Behcet’s
Encephalitis
Systemic vasculitis
Syphilis

37
Q

In patients with hypopyon what conditions should you suspec if not infectious?

A

Behcet’s (eye may be otherwise quiet)
Lymphoproliferative disease
AAU with HLAB27 positive

38
Q

In a hot eye with uveitis what are the main disease suspects?

A

Bacterial (most common)
Fungal (rare)

39
Q

How soon after an IVI or cataract surgery would you expect symptoms of enodphthalmitis?

A

2-5 days

40
Q

What treatment is required in toxoplasmosis?

A

Antibiotics make no difference to course of attack
Inflammation is the things that causes vision loss

41
Q

What two types of test are used to test for syphilis and why do you need two?

A

Non-treponemal test - positive in acute disease but also with other diseases
Treponemal test, specific to syphilis (detects antibodies specifci syphilis but not if disease active)

42
Q

What % of sarcoid patients present with ocular symptoms?

A

5-10%

43
Q

What tests should be used in sarcoid?

A

CXR
sACE but not very specific

UCL Medical Retina 2 (30 decks)

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