Brainscape's Knowledge GenomeTM

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


See full index

Ocular Disease > Anterior Uveitis - part 2 > Flashcards

Anterior Uveitis - part 2 Flashcards

1
Q

when is uveitis considered “chronic”?

A

when it relapses less than 3 months after discontinuing treatment

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

which chronic diseases cause non-granulomatous uveitis?

A

JRA, herpes family and Fuch’s heterochromic iridocyclitis

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

which chronic diseases cause granulomatous uveitis?

A

TB, Sarcoidosis, syphilis, cat scratch fever, and fungal infections

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

what is Ankylosing Spondylitis?

A

a chronic proliferative inflammation in joint capsules and intervertebral ligaments (arthritic syndrome)

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

what is the hallmark sign of ankylosing spondylitis?

A

calcification of sacroiliac joint (hips) - causes limited motion in lumbar spine

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

what gender is most commonly affected by ankylosing spondylitis?

A

males are affected 4x more than females

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

which HLA typing is present in ankylosing spondylitis?

A

HLA-B27 (80% of patients are positive)

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

what type of uveitis occurs with ankylosing spondylitis?

A

unilateral and 50% occurs after 15 years of having the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how is ankylosing spondylitis treated?

A

steroids and non-steroidals = Indomethacin and Sulindac

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

what causes Behcet’s syndrome?

A

viral etiology with many immunological features

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

which HLA typing is associated with Behcet’s?

A

HLA-B5 about 70% of the time

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

what is the typical demographic for Behcet’s?

A

young adults, asian races, women 2x more than men

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

what are the 3 main areas affected by Behcet’s?

A

mouth, genitals, skin (oral open sores)

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

what is the treatment for Behcet’s?

A

steroids and antimetabolites (Chlorambucil)

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

what are 2 causes for reactive arthritis (Reiter’s syndrome)?

A

post-venereal exposure (chlamydia) and post-dysentery (shigella)

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

what is the clinical triad for reactive arthritis?

A

“can’t see, can’t pee, can’t climb a tree”

conjunctivitis/anterior uveitis, urethritis, and arthritis (usually mono-articulate)

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

what happens in the primary state of syphilis?

A

isolated chancre about 21 days after infection

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

what happens in the secondary state of syphilis?

A

plantar/palmar rash

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

what happens in the tertiary state of syphilis?

A

cardiac and neurologic effects, Gumma, 3-5 years after infection

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

what type of organism cases syphilis?

A

Treponema pallidium - spirochete

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

what do you test for inactive syphilis conditions?

A

FTA-ABS

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

what do you test for active syphilis conditions?

A

FTA-ABS and VDRL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are 4 ocular findings associated with syphilis?

A

granulomatous uveitis (anterior, posterior, pan), interstitial keratitis, argyll-robertson pupil, chorio-retinitis (salt/pepper fundus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is argyll-robertson pupil?

A

both pupils are constricted and irregular, near light dissociated and dilate poorly in dark/respond poorly to dilating agenss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are 4 other conditions besides syphilis that have argyll-robertson pupils?

A

diabetes, chronic alcoholism, MS, and sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the Hutchinson’s triad seen in congenital syphilis?

A

eyes/ears/teeth = interstitial keratitis, notched incisor teeth and deafness (+ flattened nasal bridge)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the treatment for syphilis?

A

penicillin, oral and topical steroids for keratitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some diagnostic tests for Crohn’s disease and ulcerative colitis?

A

barium enema, sigmoidoscopy and intestinal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are 2 diseases of the GI tract that may cause uveitis?

A

crohn’s disease and ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are the 2 most common demographics for juvenile rheumatoid arthritis?

A

children and female (4x more)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the signs/symptoms for JRA?

A

swollen, stiff, warm, tender joints with limited range of motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

which lab tests are run for JRA?

A

no specific ones - the non-specific ones are: rheumatoid factor (RF), ANA, and HLA typing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the treatment for JRA?

A

NSAIDs for arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is included in the still’s triad seen in JRA?

A

iridocyclytis, band keratopathy, and uveitis cataract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is psoriaritic arthritis?

A

starts with red scaly patches on skin, nails affected then arthritis follows, affects few joints on fingers/toes and uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are 3 ocular findings in juvenile xanthogranuloma (JXG)?

A

anterior uveitis, epibulbar mass and spontaneous hyphema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what triad is seen in systemic lupus erythematosus (SLE)?

A

joint pain, fever, rash (malar on cheeks) and discoid rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

name the diagnostic tests for sarcoid (4)

A

lymph node/tissue biopsy, Kveim test (spleen biopsy intradermal injection), Hilar adenopathy in chest x-ray and blood work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the most common demographics for sarcoidosis?

A

young/black females in southeastern US and Sweden

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the treatment for sarcoidosis?

A

NSAIDs, steroids, and anti-malarials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is the etiology of tuberculosis?

A

mycobacterium tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are the diagnostic tests for TB?

A

chest x-ray, PPD and tissue biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what are 2 ocular findings associated with TB?

A

phlyctenular conjunctivitis and anterior uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is the treatment for TB?

A

systemic isoniazid, ethambutol, rifampin and streptomycin

45
Q

what organism causes lyme disease?

A

Borrelia burgdorferi - tick bite (bulls eye rash)

46
Q

what is the treatment for lyme disease?

A

Doxycycline

47
Q

what are 3 causes of uveitis associated with Herpes?

A

viral load in aqueous, autoimmune component, and anterior chamber reaction

48
Q

what are 4 ocular presentations that occur in herpes simplex?

A

conjunctivitis, corneal epithelial disease, neurotrophic ulcer, uveitis and retinitis

49
Q

what is the treatment for herpes simplex uveitis?

A

0.25% scopolamine TID, oral acyclovir 400mg 5x a day, topical 1% trifluridine 9x per day, systemic steroid 40-60mg QD, and 400gm Acyclovir BID (prophylaxis)

50
Q

what is Hutchinson’s sign and what condition is it present in?

A

Herpes zoster = lesion seen on the nose predicts that you will have ocular involvement (whole nerve is affected)

51
Q

which CN is herpes zoster located?

A

first division of CN 5 - unilateral and doesn’t usually involve lower lid

52
Q

what is the treatment for herpes zoster uveitis?

A

0.25% scopolamine TID, topical steroid 1% prednisolone acetate QID, acyclovir 800mg 5x per day and aqueous suppressants if needed

53
Q

how is the treatment for herpes zoster different than herpes simplex?

A

the dose of antiviral - acyclovir is doubled in zoster (800mg vs. 400mg) and in zoster you use a topical steroid

54
Q

who typically gets herpes zoster?

A

older patients or immune compromised younger patients (HIV, malnutrition, certain medications and bone marrow tumors/lymphoma)

55
Q

who typically gets herpes simplex?

A

younger patients

56
Q

what was the conclusion from of the HEDS1 study?

A

there is no benefit to oral acyclovir if the patient is already on topical acyclovir and topical steroids

57
Q

what was the conclusion of the HEDS2 study?

A

lower recurrence of HSV when patient is on long term oral acyclovir (400mg BID x 1 year)

58
Q

what causes varicella zoster virus?

A

chicken pox

59
Q

when would a patient have stromal keratitis with uveitis after chicken pox?

A

4-6 weeks following chicken pox

60
Q

what is the treatment for varicella zoster virus?

A

topical steroid 1% prednisolone acetate QID, 0.25% scopolamine BID and erythromycin ointment to lesions

61
Q

what is the cause of vogt-harada-koyanagi syndrome (VKH)?

A

autoimmune disease with inflammation of melanocytes

62
Q

what is the typical demographic for VKH?

A

darker pigmented people = asian, native american, japansese and 20-50 year olds

63
Q

what are the findings for VKH?

A

peri-limbal vitiligo, alopecia, poliosis, VA loss, hearing loss/tinnitus and neurologic signs (seizures, paralysis)

64
Q

why is there VA loss in VKH?

A

it attacks retinal melanocytes = bilateral VA l

65
Q

who typically gets uveitis from rubella?

A

always congenital

66
Q

which organism is responsible for leprosy (hanson’s disease)?

A

mycobacteria

67
Q

what are the 3 signs of leprosy?

A

skin sores, chronic uveitis and low grade hypopion

68
Q

what are some masqueraders of uveitis?

A

retinoblastoma, leukemia, FB, retinal detachment, RP, lymphoma and MS

69
Q

when is lab testing mandatory for uveitis?

A

it it is recurrent, bilateral or granulomatous

70
Q

what do elevated hemoglobin levels indicate?

A

associated with lung disease = TB, sarcoid, smokers, high altitudes, leukemia

71
Q

why would you test the mean platelet volume in a CBC?

A

looking for inflammatory bowel diseases

72
Q

what do high levels of neutrophils indicate?

A

bacterial infection or arthritis

73
Q

what do elevated levels of lymphocytes indicate?

A

viral infection or active allergies

74
Q

what do elevated levels of monocytes indicate?

A

systemic infection

75
Q

what do elevated levels of eosinophils indicate?

A

allergic reactions, parasitic and collagen vascular disease

76
Q

what do low numbers of basophils indicate?

A

low numbers + uveitis = leukemia

77
Q

what are 3 lab tests for venereal diseases?

A

VDRL, FTA-ABS and RPR

78
Q

what can you determine using a VDRL blood test?

A

if there is an active venereal infection - titer falls as disease gets better

79
Q

what does a positive FTA-ABS indicate?

A

there was a history of a venereal infection = positive for life

80
Q

which 4 conditions may give false positive with VDRL and RPR?

A

HIV, lyme, malaria and lupus

81
Q

what is the angiotensin-converting enzyme (ACE) test for?

A

highly sensitive and specific for sarcoid

82
Q

what may give you a false negative with ACE?

A

chronic oral steroids, diabetes, TB, hyperthyroidism, leprosy and ACE inhibitors

83
Q

what are 4 conditions that use ANA testing?

A

JRA, RA, lupus, and chronic infections (syphilis, sjogren’s, sarcoid)

84
Q

what does ANA screen for?

A

antibodies

85
Q

if you have less than 500 cells/mm^3 of T-lymphocytes (CD4) - what does that indicate?

A

immune suppression

86
Q

if you have less than 500 CD4 cells/cubic mm what are you at risk for?

A

TB and lymphoma

87
Q

if your CD4 count is less than 200 cells/cubic mm what are you at risk for?

A

toxoplasmosis

88
Q

if your CD4 count is less than 100 cells/cubic mm what are you at risk for?

A

CMV retinitis, herpes zoster retinitis, and cryptococcal choroiditis

89
Q

what is the erythrocyte sedimentation rate (ESR) test?

A

specific test for inflammation - non-specific for diseases (proteins stick to RBCs)

90
Q

which conditions have elevated ESR?

A

systemic lupus, polymyalgia rheumatica and giant cell arteritis

91
Q

what are the norms of ESR for men and women?

A

men = age/2 women = age + 10/2

92
Q

what is c-reactive protein a marker for?

A

inflammation - more direct than ESR - indicates plasma protein elevated

93
Q

what does the rheumatoid factor (RF) test for?

A

detects auto-antibodies that bind to IgG

94
Q

which other tests do you combine with RF?

A

ANA, ESR and C-protein

95
Q

what are 2 lab tests for herpes simplex?

A

GIEMSA stain and ELISA titer (but a positive titer is non-specific)

96
Q

why would you prescribe topical cycloplegic and mydriatic agents for uveitis?

A

to reduce pain, prevent synechiae and stabilize blood aqueous barrier to prevent more protein leakage or flare

97
Q

which cycloplegic do you use only in office to open pupil and prevent synechiae?

A

0.25% scopolamine BID

98
Q

what type/dose of cycloplegic do you prescribe to the patient to take home?

A

5% homatropine QID

99
Q

why is 1% atropine a bad option for patients to use?

A

immobilizes pupil for too long at a time and may encourage synechiae to form

100
Q

what is the steroid you give to patients?

A

1% Pred Forte q3-4 hours (need brand name - no substitutions)

101
Q

what anti-inflammatory is prescribed to patients?

A

oral ibuprofen 1600-2400 mg/day for adults

102
Q

why do you avoid prostaglandins and pilocarpine in uveitis?

A

they will create more inflammation and want to keep pupil dilated not constricted

103
Q

when should the patient return to clinic for uveitis follow-up?

A

24 hours after initial exam - should stabilize with medications 48-72 hours

104
Q

what do you do it the condition is stabilized at the 24 hour appointment?

A

use steroid for 1 week then rapidly taper the steroid for 1 week

105
Q

what do you do if synechaie form?

A

1gt 10% phenylephrine q15 min in office, YAG laster may also work

106
Q

Which condition would have an x-ray like this one?

A

Tuberculosis

107
Q

what condition has mouth sores like this picture?

A

Reactive arthritis (Reiter’s syndrome)

108
Q

what is this condition?

A

Behcet’s

109
Q

which condition would have a chest x-ray like this one?

A

sarcoidosis

Ocular Disease (10 decks)

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