DIT - Neuro/ Ophthalmology Flash Cards

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Title:	DIT - Neuro/ Ophthalmology
Description:	From Step Up, DIT work book, and Boards & Wards
Number of Cards:	33
Save Count:	0
Author:	jaredworchel9
Created:	2012-01-25
Tags:	dit jmwcards
Private	No

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- Question
- Answer
- Side 3

- QH: ______ is the MCC of conjunctivitis.
- Adenovirus
  
  Typically highly contagious and can be spread by contact with towels or linens or by close contact
- QH: Conjunctivitis can occur after sexual contact d/t _________ and ________.
- Neisseria gonorrhoeae and Chlamydia trachomatis
  
  Can occur in the perinatal period if mother is infected with N. gonorrhoeae or C. trachomatis
- QH: ________ angle glaucoma is the MC type of glaucoma
- Open Angle glaucoma is the MC type of glaucoma
- NS: Any pt who requires frequent changes of lens perscriptions should be suspected of having _________.
- Glaucoma.
  
  Frequent changes of lens Rx should be followed up with pressure testing
- QH: _______anlge glaucoma is usually unilateral
- Closed angle glaucoma is usually unilateral
- NS: What should you NEVER do in a pt suspected of having closed angle glaucoma.
- Dilate the pupil. In a pt with closed angle glaucoma, dilating the pupil will acutely worsen the condition
- QH: What is the MCC of bilateral vision loss in the elderly?
- Macular Degeneration is the MCC of bilateral vision loss in the elderly
- Name the condition:
  
  Loss of ADDuction in the right eye, Nystagmus in the ABducting eye
- Interocular Ophthalmoplegia (AKA: MLF syndrome)
  
  Seen in Multiple Sclerosis (MS); d/t lack of communication btw contralateral CN VI nucleus and ipsilateral CN III nucleus
- Name the Cranial Nerve:
  
  a. responsible for vision
  b. responisble for downward medial gaze, inward eye rotation
  c. responsible for ABduction
  d. All other eye muscles
  e. Responsible for conjugate gaze when one eye abducts
- a. Vision =Optic nerve (II)
  b. Down and In = Superior Oblique = Trochlear (IV)
  c. ABduction = Lateral Rectus = Abducens (VI)
  d. all other eye muscles = Oculomotor (III)
  e. Conjugate gaze = Medial Longitudinal Fasiculus (MLF)
- Where is the lesion?
  a. Left Anopia
  b. Bilateral Hemianopia
  c. Right Homonomous Hemianopia
  d. Right Upper quadrantopia
  e. Right Lower quadrantopia
  f. Right homonomous anopia with macular sparing
- a. Left anopia = Left Optic Nerve
  b. bilateral hemianopia = Optic chiasm
  c. Right Homonomous Hemianopia = Left Optic Tract
  d. Right Upper quadrantopia = Left Temporal lobe
  e. Right Lower quadrantopia = Left parietal lobe
  f. Right homonomous anopia with macular sparing = Left occipital lobe
- TX for conjunctivitis?
- Self limited
  
  Topical sulfonimides/ erythromycin, antihistamines
- Uvitis is seen in diseases that have the genetic marker for HLA-B27. What are disorders are associated with HLA-B27 and Uveitis?
- HLA-B27: PAIR
  
  Psoriatic Arthritis
  Ankylosing Spondylitis
  IBS (Crohn's, UC)
  Reitter's Syndrome (cant see, cant pee, cant climb a tree)
- Pt has eye pain and photophobia. Slit lamp examination shows inflammation of the eye and keratin deposits on the cornea
- Anterior Uveitis
- Pt has mild vision abnormalities. Slit lamp examinaiton shows eye inflammation and retinal lesions
- Posterior uveitis
- TX for Uveitis?
- Topical abx if caused by an infection.
  
  Topical or systemic corticosteroids if not caused by infection
- Name the Abnormality and the cause:
  
  Accomodation to near objects, nonreactive to light
- Dx: Argyll-Robertson pupil
  
  caused by syphilis, SLE, DM
- Name the Abnormality and the cause:
  
  Light in affected pupil causes minimal bilateral constriction, Light in normal pupil cuases normal bilateral constriction
- Marcus Gunn pupil
  
  Caused by Afferent Nerve Defect
  + swinging flashlight test - will appear that the affected eye dilates to light
- Name the Abnormality and the cause:
  
  Ptosis, miosis, anhydrosis
- Horner's syndrome
  
  Caused by sympathetic trunk lesion (eg pancoast tumor)
- Name the Abnormality and the cause:
  
  Minimally reactive dilated pupil
- Adie's pupil
  
  Caused by abnormal innervation of the iris
- progressive loss of vision, Cupping of the optic disk, increased IOP...DX?....TX?
- Open angle Glaucoma
  
  TX: [ABCCP] (1) Alpha-adrenergic agonisits; (2) Topical B-blk'rs (Timolol); (3) carbonic anhydrase inhibitors; (4) cholinergic agonists (Pilocarpine), (5) prostaglandin analogues,
- Pop-Quiz: Severe eye pain in an asian woman, eye is hard and the the pupil is dilated and non-reactive.
  
  What do you do?
- Closed angle glaucoma
  
  Tx with (1) Acetozolamide to decrease pressure and (2) pilocarpine to reduce obx
- Gradual loss of vision, central to peripheral... TX?
- Macular Degeneration
  (1) Atrophic (slow) (2) Exudative (fast)
  
  TX: Intravitrial Ranibizumab (VEGF); Vit C, E, copper, zinc
- What's the DX? "window shade pulled over eye", "Numerous floaters"
- Retinal detachment
- Sudden painless loss of vision, cherry-red spot in fovea?
  DX?
  TX?
- Retinal Artery occlusion
  
  Thrombolysis of arterial occlusion should be performed within 8 hrs of onset
  
  Acetozolamide, O2
- Gradual painless loss of vision, cotton wool spots, retinal hemorrhages, dilated veins?
- Retinial VEIN occlusion
  
  Laser photocoagulation
- What are the classic features that distinguish Orbital cellulitis from Periorbital cellulitis?
  
  What is the TX?
- Orbital cellulitis has propitosis, ophthalmoplegia (limited eye mvmt), decreased vision, and pain
  
  TX: immediate IV vancomycin + IV cefotaxime until clinically improved. Then, oral abx for 2-3 wks
- What is the easiest way to distinguish a hordeolum from a chalazion?
- A hordeolum (stye) is at the lid margin
  
  A chalazion is in the lid
- What eye abnormality is seen when there is a lesion to the oculomotor nerve (III)?
- Eye looks down and out and has a Blown pupil (Fixed and dilated b/c the Psymp is taken out and the Symp takes over)
- What is the MCC of blindness in the following age groups?
  
  Over 55
  Under 55
  Blacks of any age
- over 55 = macular degeneration
  Under 55 = Diabetes
  Blacks = Glaucoma
- What dz would you suspect in a 35 yo female with new onset rapid loss of vision and pain when moving the eye? How would you tx this?
- Dx: Optic Neuritis, seen with Multiple sclerosis
  
  Tx: IV steroids
- What causes of red-eye most closely matches the following statements?
  
  1) May indicate a collagen-vascualr disorder
  2) Potential serious complication of corneal ulceration
  3) Colored halos
  4) sealed shut, or Itching eye
- 1) May indicate a collagen-vascualr disorder = Uveitis
  2) Potential serious complication of corneal ulceration = HSV
  3) Colored halos = Acute angle closure glaucoma
  4) sealed shut, or Itching eye = allergic conjunctivitis
- What causes of red-eye most closely matches the following statements?
  
  1) Preauricular lymph node enlargement
  2) Dry eyes
  3) Shallow anterior chamber
- 1) Preauricular lymph node enlargement = viral conjunctivitis
  2) Dry eyes = keratoconjunctivitis sicca (sjogren's: dry eye, dry mouth)
  3) Shallow anterior chamber = acute glaucoma
- What is the MCC of conjunctivitis in the first 24 hrs of life?
- Chemical contact conjuctivitis d/t allergy to abx eye drops