HEENT QUIZ 3- EYES

Question 1

causes of arterial occlusion

Answer 1

atherosclerosis, emboli, inflammation

Question 2

sx of arterial occlusion

Answer 2

amarousis fugax: Aarterial spasm that lasts seconds to minutes
as if a dark shade is being lowered in the field of vision

Question 3

what would the retina look like in some with arterial occlusion

Answer 3

-cherry red spots in the macula
-pale and edematous retina
-if occlusion last greater than 1 hour, then optic nerve may atrophy

Question 4

incidence of venous occlusion

Answer 4

more common than arterial occlusion
-2nd most common cause of blindness due to retinal vascular disease `

Question 5

causes of venous occlusion

Answer 5

increased blood viscosity, HTN, COPD, diabetes

Question 6

retinal findings in venous occlusion

Answer 6

-flame hemes
-pale and swollen ONH
-engorged retinal vessels
-stormy retina
-CRVO: blood and thunder

Question 7

which type of vein occlusion is more common

Answer 7

BRVO is more common than CVRO

Question 8

who is more likely to have a vitreous hemorrhage?

Answer 8

diabetics and hx of floaters

Question 9

how would a vitreous hemorrhage show up in retinal exam?

Answer 9

unable to see retina due to blood in vitreous humor

Question 10

incidence of retinal detachment

Answer 10

-DM
-Trauma
-ROP

Question 11

sx of retinal detachment

Answer 11

floaters, flashing lights and descending curtain

Question 12

PE findings in retinal detachment

Answer 12

retina becomes pearly grey and retinal folds

Question 13

retinal findings in a patient with cataracts

Answer 13

decreased red reflex; hard to see through the cataract

Question 14

how will a child with cataracts present

Answer 14

squinting and amblyopia (Crossing of the eyes)

Question 15

what is the usual cause of cupping?

Answer 15

chronic glaucoma

Question 16

Sx of chronic open angle glaucoma

Answer 16

• blind spots in vision (negative scotomas)
  -usually have normal VA until later in the z

Question 17

retinal findings in chronic glaucoma

Answer 17

-atrophic changes to optic nerve : pale optic disc with cupping

Question 18

retinal findings in stage 1 diabetic retinopathy

Answer 18

-cotton wool spots
-superficial flame hemes, deep blot hemes
-retinal sichemia
-soft exudates: proteinous material that leaks from vessels
-hard exudates: fatty deposits
-macular edema: leads to decreased VA

Question 19

what is the #1 cause of preventable blindness

Answer 19

diabetic retinopathy

Question 20

how often should diabetics have an eye exam

Answer 20

type 2 at the time of dx and yearly
type 1 within 5 years

Question 21

retinal findings in proliferative stage diabetic retinopathy

Answer 21

same findings as stage 1 but with neovacularization near optic disc

Question 22

retinal findings in hypertensive retinopathy

Answer 22

-cooper-silver wiring
-a/v nicking
-soft exudates
-flame hemes
-papilledema

Question 23

sx of senile macular degeneration

Answer 23

loss of central field of vision
usually bilteral

Question 24

retinal findings in senile macular degeneration

Answer 24

macular drusen
pigmented macula, exudates

Question 25

Hyphema

Answer 25

hemorrhage in anterior chamber caused by trauma

Question 26

negative scotomas

Answer 26

dark spot in field of vision

Question 27

positive scotomas

Answer 27

moving luminous patches
usually in one eye only
usually bening

Question 28

causes of keratitis

Answer 28

non-infectious or infectious causes

Question 29

symptoms of keratitis

Answer 29

-severe and persistent pain
-photophobia
-little to no D/C
-(+) f/o stain for damaged epithelium
-hypopyon may be seen

Question 30

should a referal be given form keratitis ?

Answer 30

yes, refer to opthalmologist immediately

Question 31

what type of ulcers will be seen in a slit lamp exam of a patient with herpetic eye dz (HSV-1)

Answer 31

dentritic ulcers with terminal bulbs

Question 32

(HSV1) sx of herpetic eye dz

Answer 32

• begins on cornea with keratitis
  -pain may or may not be present
  -decreased v/a

Question 33

chance of recurrence for herpetic eye dz (hsv 1)

Answer 33

25% chance of recurrence

Question 34

what is the name for anterior uveitis that involves the cilliary body too

Answer 34

iridocyclitis

Question 35

causes of anterior uveitis

Answer 35

-granulomatous: infections like TB, syphillis, sarcoidosis
-non-granulomatous: CT disoders

Question 36

sx of anterior uveitis

Answer 36

-dull, aching pain in temple, periorbital area, worse with accomodation
-tearing with no d/c
-decreased V/A
-decreased IOP
-photophobia
-redness

Question 37

pathophysiology of anterior uveitis

Answer 37

breakdown in blood/ocular barrier with causes an influx of WBCs and protein into aqueous humor

Question 38

physical exam findings in anterior uveitis

Answer 38

-ciliary flush
- f/o stain: cells, flares, hypopyon
-small pupil initially , irregular later
-decreased IOP

Question 39

What is a possible complication for anterior uveitis

Answer 39

can lead to cataracts and glaucoma

Question 40

what is the most common cause of acute closed angle glaucoma

Answer 40

pupillary block: anterior iris becomes stuck to the trabecular meshwork and the angle closes: causes impared drainage of aqueous humor and increased IOP

Question 41

other causes of acute closed angle glaucoma

Answer 41

-meds: sulfa, bronchodialators
-plateau iris: genetically narrow angle that becomes occluded with pupil dilation
-lesions of the brain

Question 42

sx of acute closed angle glaucoma

Answer 42

-severe pain with nausea and vomitting
-unilateral vision loss or halo vision

Question 43

physical exam findings in acute closed angle glaucoma

Answer 43

-hazy cornea and diffuse redness
- large and fixed pupils- not reactive to light and accomodation
-eye feels hard
-iop:40-80