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Clinical Medicine > ClinMed_test1 > Flashcards

ClinMed_test1 Flashcards

1
Q

What are some of the risk factors for Plaquenil?

A 
Dosage
Obesity
More than 5 years
Older than 60 years
Liver or Renal impairment
Pre-existing retinal condition
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2
Q

T/F?

Dosage for plaquenil should be based on weight?

A

False.

Should be based on height.

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3
Q

What daily dose should we be worried about for those taking Plaquenil?

A

If daily dose is greater than 6.5 mg/kg for HCQ
Greater than 3mg/kg for chloroquine
Risk of irreversible retinal damage.

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4
Q

What cumulative dose should we be worried about for those taking Plaquenil?

A

> 1000 g for HCQ. U get to this in 7 years

>460 g for CQ. U get to this in 5 years

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5
Q

Name some screening procedures for PLaquenil patients

A 
Color vision-Sensitive/specific
Amsler Grid
FUndus Photography
10-2 VF
ERG
Time domain OCT
FA
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6
Q

What kind of VF loss do u see for patients on plaquenil?

A

Parafoveal loss of visual sensitivity.

May appear before changes on fundus examination

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7
Q

What finding is noticed for pts on plaquenil on FAF?

A

Reduced autoflourescence: Subtle RPE defects.

Increased autoflourescence: areas of early PR damage (accumulation of OS debris)

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8
Q

What finding is noticed for pts on plaquenil on OCT?

A

Perifoveal thinning
Loss of inner/outer segment line
Ovoid appearance can appear

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9
Q

What is the most effective way of screening early toxicity for Plaquenil patients?

A

A multifocal ERG.
Central 40 degrees.
It reveals localized paracentral ERG depression.

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10
Q

Is it necessary to follow up w/ patients off of Plaquenil?

A

Yes, progressive damage on OCT was seen after 3 years drugs was discontinued.

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11
Q

What is the pathogenesis for crystalline maculopathy?

A

Increased accumulation of glutamate which leads to axonal degeneration

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12
Q

What kind of maculopathy results from Tamoxifen?

A

Crystalline Maculopathy.

Refractile intraretinal crystalline deposits concentrated primarily in the perifoveal area.

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13
Q

Describe VA and Tamoxifen?

A

Visual acuity decreases are usually secondary to foveal cyst development.

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14
Q

Give more examples of drugs that can cause crystalline maculopathy?

A

Canthaxanthine - reversible

Nitrofurantoin

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15
Q

What causes Talc retinopathy?

A

Cocaine
heroin
Ritalin
Oxycontin

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16
Q

What is nitrofurantoin used for?

A

Antibiotic used for trt of UTI

17
Q

What is and use for canthaxanthine?

A

Carotenoid

Oral artifical tanning agent

18
Q

What does phenothiazine do to the retina?

A

Pigmented retinopathy.

Salt and pepper pigmentary loss.

19
Q

Name some drugs that causes macular edema?

A

Niacin - good for hypercholesterolemia
Gilenya - an immunosuppressant for MS
Statins/Lipitor

20
Q

Name some conditions that need interferon therapy?

A

MS
Hepatitis
Other viral diseases.

21
Q

Describe interferon retinopathy

A

CWS near ONH
Hemorrhaging: retinal, subcon
Macular edema
Ischemic optic neuropathy

22
Q

What do ED drugs do to the retina? Eyes?

A 
Optic neuropathy (NAION). Need trt within 24-36 hours.
CSC
Changes in color perception
Photopsia
Ocular side effects are dose dependent
23
Q

What are the vascular risk factors for NAION?

A

Myocardial infarction
Hypertension
Hypercholesterolemia
Diabetes

24
Q

Mechanism of nitric oxide?

A

Increase in nitrous oxide levels causes a decrease in blood pressure. This decrease leads to hypoperfusion of an already at risk optic nerve

25
Q

What meds causes CSC?

A 
PDE-5 inhibitors
Pseudoephedrine
Steroids
COld meds
Diet pills
26
Q

What causes retrobulbar optic neuritis?

A

Ethambutol

27
Q

What drug causes binasal visual field defects?

A

Vigabatrin.

An antiepileptic drug

28
Q

Which drugs lead to an increase in IOP

A 
Corticosteroids
Animuscarinic agents
Antihistamines
Phenothiazines
TCA
29
Q

Which drugs lead to a decrease in IOP

A

Beta blockers
Ethyl alcohol
Cardiac glycosides
Cannabinoids

30
Q

Which drug causes pupillary block and angle closure glaucoma?

A

Topiramate.
Causes a uveal effusion syndrome
Drug is used for migraine headaches

31
Q

What drugs cause subconj hemes?

A

Ginkgo Biloba
Aspirin therapy like NSAIDs,
Blood thinners like coumadin, heparin; plavix, ticlid. Can lead to spontaneous hyphema

32
Q

What is an adverse effect for lutein?

A

High concentration can incrase risk of cardiovascular disease and cancer.
2. Carotendodermia.

33
Q

What drugs now appear to increase the risk of macular edema in type 2 diabetes?

A

Actos

Avandia

34
Q

Name some adverse effects of omega 3?

A 
Increase the risk of hemorrhagic strokes
BLood thinner
Stomach upset
Loose stools
Nausea.

Clinical Medicine (3 decks)

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