Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Evidence Based Medicine > Week 4: GI System > Flashcards

Week 4: GI System Flashcards

1
Q

What are the causes of toxic/ nutritional optic neuropathy?

A

alcoholism, tobacco/ substance use, certain medications, heavy metal exposure, poor nutrition

Poor nutrition: B1 deficiency; B12 malabsorption (pernicious anemia)
High risk meds: chloramphenicol, ethambutol, linezolid, isoniazid, digitalis, amiodarone, streptomycin, chlorpropamide, ethchlorvynol, disulfiram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the signs and symptoms of toxic/ nutritional optic neuropathy?

A
  • VA 20/50-20/200
  • Dyschromatopsia
  • bilateral central or cecocentral visual field defects
  • temporal disc pallor
  • optic atrophy
  • normal appearing disc initially
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which type of scotoma is ALWAYS associated with decreased visual acuity?

A

Central scotoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which type of scotoma involves the point of central fixatio nand the area between the blind spot and the fixation point?

A

cecocentral scotoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which type of scotoma affects an area of the visual field that is nasal or temporal to the point of central fixation?

A

paracentral scotoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What leads to selective degeneration of RGCs in the region of the papillomacular bundle?

A

mitochondrial dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the recommended work up for toxic/ nutritional optic neuropathy?

A
  • case hx: medication, drug, substance use, diet history
  • color vision testing
  • optic nerve assessment
  • VF testing
  • CVC with diff and peripheral smear
  • Serum vitamin B1, B12, and folate levels
  • Heavy metal screen
  • Blood work to rule out Leber Hereditary Optic neuropathy

peripheral smear for morphologic description of RBC’s - helps ID type of anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the treatment for toxic/ nutritional optic neuropathy?

A
  • eliminate causative agent (alcohol, tobacco, medication)
  • Thiamine 100 mg BID
  • Folate 1.0 mg QD
  • multivitamin QD
  • Bitamin B12 1,000 mg IM injection 1x/ month for pernicious anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the follow up for toxic/ nutritional optic neuropathy?

A

Initially monthly, then every 6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most commoly inherited mitochondrial disorder?

A

Leber Hereditary Optic Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the presentation for Leber?

A

Painless progressive vision loss in one eye and then the other eye in quick succession; mild swelling of optic disc that progresses over weeks, eventually optic atrophy; small telangiectatic blood vessels near the disk- not leaky on FA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hydrophoic vitamins are packaged into chylomicrons and taken to which organ for storage?

Chylomicron: lipoprotein that contains triglycerides, cholesterol, fat-soluble vitamins, targeting proteins

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which vitamin deficiency is associated with bleeding?

A

Vitamin K

blood clotting cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which vitamin deficiency is associated with ataxia, peripheral neuropathy and myopathy?

A

Vitamin E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the vitamin A derivatives in the transduction pathway?

A

all-trans-retinal; 11-cis retinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A deficiency in which vitamin is a risk factor for multiple sclerosis?

A

Vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which vitamin is an antioxidant that protects cells from free radicals?

A

Vitamin E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is vitamin K a coenzyme for?

A

carboxylase

enzyme required for synthesis of proteins involved in blood clotting and bone metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Do hydrophilic or hydrophobic vitamins need to be taken more frequently?

A

hydrophilic

removed in urine and not stored in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which type of vitamins are more likely to develop toxic symptoms?

A

hydrophobic vitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which vitamins are water soluble?

A

B’s and C’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which vitamin is thiamine?

A

B1

23
Q

What is B1 used for in the body?

A

mitochondrial membrane development, enzymatic processes in brain function, interneuronal communication and regulation of immune cells and proteins

24
Q

Where is B1 (thiamine) absorbed?

A

jejunum

transported in erythrocytes and plasma; stored in the liver in very small amounts

25
Q

Which vitamin is involved int eh biosynthesis of neurotransmitters and maintains normal levels of homocysteine?

A

Vitamin B6 (pyridoxine)

26
Q

What is the function of vitamin B6?

A

involved in gluconeogenesis, glycogenolysis, immune function and hemoglobin formation

27
Q

Which drug inactivates vitamin B6 and is implicated in toxic/ nutritional optic neuropathy?

A

Isoniozid

28
Q

What is vitamin B9/ folate needed for?

A

Proper cell division; DNA and purine synthesis and conversion of homocysteine to methionine

found in leafy greens, fruits, fortified cereals and meats

29
Q

What condition is a hallmark of folate deficiency?

A

megaloblastic anemia

30
Q

Which vitamin is known as cobalamin?

A

Vitamin B12

31
Q

Deficiency of which vitamin is developed in patients that follow a vegan/ vegetarian diet, have a history of bariatric surgery or have malabsorptive diseases?

A

cobalamin deficiency (B12)

32
Q

What is pernicious anemia?

A

An autoimmune disorder that prevents that absorption of vitamin B12 (cobalamin)

33
Q

Which vitamin is required for collagen production, plays a vital role in wound healing AND can help regenerate other antioxidants in the body?

A

Vitamin C

may also slow the progression of cataracts

34
Q

What ocular structure is believed to be protected by normal gut microbiota?

A

the retina

35
Q

there are 6 normal gut microbiota, which 2 make up 80-90%?

A

firmicutes, bacteroidetes

36
Q

what can result in the translocation of gut bacteria into the circulatory and lymphatic systems?

A

dysbiosis

37
Q

Which systemic inflammatory conditions are associated with gut dysbiosis?

A
  • Rheumatoid arthritis
  • Multiple sclerosis
  • Inflammatory bowel disease
  • Type 1 diabetes
38
Q

What non-infectious eye diseases are associated with gut commensal bacteria?

A
  • autoimune uveitis
  • ARMD
  • Glucoma
  • Diabetic Retinopathy
39
Q

which ocular conditions are associated with dysbiosis of the ocular microbiota?

A

blepharitis, conjunctivitis, bacterial keratitis, trachoma, dry eye syndrome, meibomian gland dysfunction

40
Q

H. pylori is implicated in what conditions?

A

peptic ulcer disease, glaucoma

41
Q

What type of ulcers are a medical emergency?

A

perforated ulcers

cause severe, acute abdominal pain

42
Q

What are the signs and symptoms of peptic ulcer disease?

A
  1. epigastric pain related to meals
  2. bleeding
43
Q

what two conditions make up inflammatory bowel syndrome?

A

ulcerative colitis and crohn’s disease

44
Q

fistulas are found in crohn’s disease/ ulcerative colitis

A

Crohn’s disease

45
Q

What are the 3 classic ocular complications of IBS?

A

episcleritis, uveitis, scleritis

46
Q

what are 4 secondary ocular complications that are seen in patients with IBS?

A

cataracts, neovascular glaucoma, nyctalopia and xerophthamia

47
Q

What autosomal dominant condition is characterized by numerous adenomatous polyps lining the intestinal mucosal surface?

also presents with skeletal hamartomas (tumor like growths on skull, mandible, and long bones)

A

gardner syndrome

progresses to adenocarcinoma by 5th decade

48
Q

What is an ocular manifestation of Gardner Syndrome?

A

presence of atypical CHRPE

bilateral, clusters of flat, well-demarcated lesions with 3-30 in each cluster increasing in size and pigmentation anteriorly toward fundus periphery

49
Q

Which disorders make up the seronegative spondyloarthropathies?

A
  1. ankylosing spondylitis
  2. Reiter’s syndrome (reactive arthritis)
  3. Inflammatory bowel disease
  4. Psoriatic arthritis
50
Q

what are ocular manifestations of inflammatory bowel disease?

A

episcleritis, scleritis, anterior uveitis, optic neuritis

51
Q

xerophthalmia is the leading cause of what?

A

preventable blindness in developing countries

caused by severe vitamin A deficiency

52
Q

what are the clinical signs of xerophthalmia?

A
  • night blindness
  • conjunctival xerosis
  • bitot spots
  • corneal xerosis
  • corneal ulceration
  • corneal scar
  • xerophthamic fundus
53
Q

what is unique about uveitis in regards to patients with IBD when comparing to episcleritis and scleritis?

A

Uveitis does not parallel the disease activity of IBD

Evidence Based Medicine (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions