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Lecture 5 Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

leukocytes in the anterior chamber is indicative of

A

Acute Uveitis (iritis)

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2
Q

epidemiology of Acute Uveitis (iritis)

A

associated with many infections/diseases:
Betche’s, Chrons, gout, Zoster, Reiter’s Syndrome** (triad of arthritis, urethritis and uveitus, r. arthritis, sarcoid and TB

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3
Q

s&s of Acute Uveitis (iritis)

A

pain, photophobia, redness, miosis (small pupil)

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4
Q

tx/management for Acute Uveitis (iritis)

A

emergent opthoalmogist consult

-tx based on cause

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5
Q

sudden monocular loss of vision with cherry-red spot* “box car segment” is indicative of

A

Central Artery Occlusion

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6
Q

risk factors for Central Artery Occlusion

A

> 50 y/o, r/o Giant Cell Arteritis, DM, hyperlipidemia, HTN, oral contraceptives, AFIB, emboli

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7
Q

diagnostic studies for Central Artery Occlusion for Giant Cell Arteritis

A

erythrocyte sedimentation rate ESR, C-reactive protein

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8
Q

diagnostic studies for Central Artery Occlusion screening for DM

A

fasting glucose and A1c

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9
Q

diagnostic studies for Central Artery Occlusion screening for hyperlipidemia

A

fasting lipid levels and LFTs

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10
Q

diagnostic studies for Central Artery Occlusion screening for Cardiac

A

CBC w plt

  • electrolytes
  • TSH/FT4
  • renal fxn
  • carotid arteries (U/S, EKG, echo of heart)
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11
Q

referral for Central Artery Occlusion

A

Admit to hospital

-emergent consult to optho and cardio

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12
Q

treatment for Central artery Occlusion with Giant Cell Arteritis

A

high dose of steroids and possible artery biopsy

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13
Q

treatment for Central Artery Occlusion with cardiac

A

tx underlying cause, may need anticoagulant therapy, at risk for stroke

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14
Q

a pt has sudden monocular loss of vision, no pain, no redness, with “blood and thunder” retinal. This is indicative of?

A

central vein occlusion

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15
Q

risk factors for central vein occlusion

A

DM, HTN, hyperlipidemia, OCs, smoking, glaucoma

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16
Q

diagnostic studies for Central Vein Occlusion

A

fundoscopic exam - blood and thunder retinal and neovascualrization

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17
Q

treatment and management for Central Vein Occlusion

A

refer: emergent consult to optho to prevent retinal detachment
- PCP tx underlying cause (dm etc)

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18
Q

pt has sudden loss of vision and floaters, this indicates….

A

Vitreous Hemorrhage

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19
Q

risk factors of Vitreous Hemorrhage

A

retinal tears, retinal detachment, DM, sickle cell, blood dycrasias, trauma, ARMD

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20
Q

referral for Vitreous Hemorrhage

A

emergent consult to optho

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21
Q

pt has an abrupt monocular (bino) loss of vision (partial or completer) that lasts only a FEW minutes, AKA: ocular transient ischemic attack (TIA); this is indicative of….

A

Amaurosis Fugax

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22
Q

risk factors or Amaurosis Fugax

A

DM, HTN, hyperlipidemia, Giant Cell Arteritis, migraine

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23
Q

epidemiology of Amaurosis Fugax

A

caused by an emboli if vascular

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24
Q

PE of Amaurosis Fugax

A

complete ocular exam, cardiac, and neurological exam

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25
Q

diagnostic studies for Amaurosis Fugax

A

lipid panel

-glucose, A1c, CBC, TSH/FT4, electrolytes, carotid artery U/S, EKG, echo

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26
Q

complications of Amaurosis Fugax

A

central retinal artery occlusion, stroke

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27
Q

treat/referral for Amaurosis Fugax

A

referral emergent consult to optho

tx underlying cause

28
Q

pt has a reduction in VA (> 2-line differences b/w eyes) usually unilateral… this is indicative of

A

Vision abnl - Amblyopia

29
Q

epidemiology of Amblyopia

A

strabismus amblyopia - misalignment

-refractive amblyopia

30
Q

most common cause of pediatric visual impairment

A

Amblyopia

31
Q

risk factors of Amblyopia

A

premature, small size for gestational age, 1st degree relative with amblyopia, neurodevelopment delay

32
Q

tx and management for Amblyopia

A

pediatric optho consult

-tx based on cause

33
Q

an elevated IOOP, progressive loss of VF, pathologic cupping of optic disc (>0.5) is indicative of…

A

Chronic Open-Angle Glaucoma

34
Q

risk factors for Chronic Open-Angle Glaucoma

A

> 40 yo

  • genetics
  • DM
  • Steroid use
35
Q

diagnostic studies for Chronic Open-Angle Glaucoma

A

IOP > 22

36
Q

complications for Chronic Open-Angle Glaucoma

A

blindness

37
Q

referral and f/u for Chronic Open-Angle Glaucoma

A

routine consult to optho
f/u: annually/Q6m optho
sooner if sx inc

38
Q

medication for Chronic Open-Angle Glaucoma

A

timolol 0.25% opth sol

39
Q

non Pharma for Chronic Open-Angle Glaucoma

A

diet modification, no smoking, decrease caffeine

40
Q

if pos FMHx for Chronic Open-Angle Glaucoma when should pt begin screening

A

at 40 yo

41
Q

what should pt with Chronic Open-Angle Glaucoma avoid?

A

beta blocker in pt with asthma, COPD, 2nd and 3rd degree AV block

42
Q

a sudden onset of severe pain, steamy cornea, fixed mid-dilated pupil, halos around lights, blurred vision with shallow anterior chamber is indicative of

A

Acute Closed-Angle Glaucoma

43
Q

risk factors for Acute Closed-Angle Glaucoma

A

-drugs:
some bronchodilators, furosemide, thiazides, antidepressants, sulfonamides, cocaine, ecstasy
-trauma

44
Q

diagnostic studies for Acute Closed-Angle Glaucoma

A

IOP > 22 (40-70mmHg)

45
Q

complications of Acute Closed-Angle Glaucoma

A

cataract, decrease VA, repeat episodes

46
Q

referral for Acute Closed-Angle Glaucoma

A

emergent consult to optho w/in 1 hr of pt presentation

-may go immediate to surgery

47
Q

medications for Acute Closed-Angle Glaucoma

A

1 drop each 1 minute apart: timolol 0.5% apraclonidine 1%, pilocarpine 2%;
possible IV acetazolamide 500 mg (check eye pressure every 30 min) may be d/c PO Rx

48
Q

a painful, diffuse anterior sclera - 50%, local tenderness to touch, sclera edema is indicative of

A

vision loss due to scleritis

49
Q

epidemiology of vision loss due to scleritis

A

inflammatory and autoimmune process

50
Q

risk factors of vision loss due to scleritis

A

RA and Wegeners granulomatosis

51
Q

referral for scleritis

A

emergent consult to optho and rheumatologist

52
Q

medications for Scleritis

A

consider NSADs- indomethacin (25-75 mg PO TID)

-consider glucocorticoids - prednisone 1 mg/kg per day maximum 80 mg (tapering regimen - for d/c prednisone)

53
Q

eye deviation from anatomical position - trope (constant) is indicative of

A

strabismus

54
Q

risk factors for Strabismus

A

positive FMHx, low birth weight, Downs or cerebral palsy

55
Q

epidemiology of Strabismus (2 laws)

A

Herings law or Sherringtons law

56
Q

congenital epidemiology of Strabismus

A
  • congenital: poor central vision, retinoblastoma, trauma with CN palsies
57
Q

acquired epidemiology of Strabismus

A

intracranial hemorrhage, abscess, encephalitis, Guillain- Barre syndrome, measles, orbital fracture, tumors, CN palsy

58
Q

s&S of strabismus

A

diplopia, slit images, HA, n/v, fever

59
Q

diagnostic studies for strabismus

A

MRI and CT; CBC w diff

60
Q

treatment for strabismus

A

consult optho, tx will be based on cause

61
Q

Hering’s law

A

agonist muscles in both eyes receive equal innervation to ensure binocular eye movement (right lateral rectus m. abducts right eye = left medial rectus m. to adduct the left eye)

62
Q

Sherringtons law

A

agonist/antagonist muscle pairs of each eye receive reciprocal innervation (right medial rectus m. contracts adducting right eye; antagonist - right lateral rectus m relaxes)

63
Q

if you have vision loss on an entire eye, a tumor is most likely blocking your …. (visual fields)

A

both optic nerves of eye

64
Q

if your have vision loss on the inner half of an eye, a tumor could be blocking your (visual fields)

A

outer optic nerve

65
Q

if you lose your peripheral vision, tumor is most likely blocking (visual fields)

A

optic chiasm

66
Q

if you lose vision on one side of both eyes.. tumor is affecting …. (visual fields)

A

optic tract or lateral geniculate nucleus

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