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Step 2 CK > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Features of viral conjunctivitis

A 
Bilateral
Watery discharge
Easy to spread
Normal vision
Itchy
Preauricular adenopathy
No Rx
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2
Q

Features of bacterial conjunctivitis

A 
Unilateral
Purulent, thick discharge
Hard to spread
Normal vision
Not itchy
No adenopathy
Rx w/ topic ABX
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3
Q

Features of subconjunctival hemorrhage

A

Doesn’t affect sight

Spontaneously resolves

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4
Q

Features of Uveitis

A

Caused by autoimmune diseases
Photophobia
Dx - Slit lamp exam
Rx - Topical steroids

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5
Q

Quick features of Glaucoma

A

Presents w/ pain
Fixed midpoint pupil
Dx - Tonometry
Rx - Acetazolamide, mannitol, pilocarpine, laser trabeculoplasty

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6
Q

Features of ocular trauma

A

Feels like sand in the eyes
Dx - Fluorescein stain
Rx - None

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7
Q

Presentation of chronic glaucoma

A

Asymptomatic, found on routine screening

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8
Q

Confirmation of chronic glaucoma

A

Tonometry

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9
Q

Rx chronic glaucoma

A 
Prostaglandin analogs
Topical BBs
Topical carbonic anhydrase inhibitors
Alpha-2 agonists
Pilocarpine
Laser trabeculoplasty (medicine fails)
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10
Q

Presentation of acute angle closure glaucoma

A

Sudden onset extremely painful red eye hard on palpation
Pain precipitated by going from light to dark
Pupil doesn’t react to light
Cup to disc ratio > 0.3

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11
Q

Dx acute angle closure glaucoma

A

Tonometry

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12
Q

Rx acute angle closure glaucoma

A

IV acetazolamide
IV mannitol
Pilocarpine, BBs, Apraclonidine to constrict pupil
Laser iridotomy

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13
Q

Feature of herpes keratitis

A

Infection of cornea

Red, swollen and PAINFUL

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14
Q

Confirm herpes keratitis

A

Fluorescein staining showing dendritic pattern

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15
Q

What to NEVER give in herpes keratitis

A

Steroids

Makes it worse

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16
Q

Rx herpes keratitis

A

Oral acyclovir, famcyclovir, valacyclovir
Topical trifluridine, idoxuridine
Resistant - Foscarnet

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17
Q

Causes of cataracts

A

Old age
Light
Trauma

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18
Q

Dx early cataracts

A

Opthalmoscope

Slit lamp

19
Q

Rx cataracts

A

Surgical lens removal and replacement

No medical therapy

20
Q

What causes diabetic retinopathy

A

Endothelial lining is damaged by glucose precipitation

21
Q

How often should diabetic retinopathy be screened for

A

Annually

22
Q

Management of nonproliferative diabetic retinopathy

A

Tighter glucose control

23
Q

Most accurate test for diabetic retinopathy

A

Fluorescein angiography

24
Q

Rx proliferative diabetic retinopathy

A

Laser photocoagulation

25
Q

Control neovascularization in diabetic retinopathy

A

VEGF inhibitor injection

26
Q

What causes “dot and blot” hemorrhages

A

Back pressure from obstructed vessel leads to vascular aneurysms that eventually rupture

27
Q

Role of vitrectomy in diabetic retinopathy

A

Remove vitreal hemorrhage obstructing vision

28
Q

What is % retinopathy associated with

A

Amount of glucose/A1c

29
Q

What is useless to give with neovascularization in diabetic retinopathy

A

Aspirin

30
Q

Retinal artery occlusion appearance on opthalmoscope

A

Pale retina, dark macula (“cherry red”)

31
Q

Retinal vein occlusion appearance on opthalmoscope

A

Extravazation of blood

32
Q

Rx retinal artery or vein occlusion

A

100% O2, ocular massage, acetazolamide, anterior chamber paracentesis, thrombolytics
Ranibizumab for vein occlusion
Nothing is conclusive

33
Q

Feature of retinal artery or vein occlusion

A

Sudden onset monocular vision loss

34
Q

Risks for retinal detachment

A

Anything stretching the retina

  • Trauma (including surgery for cataracts)
  • Extreme myopia
  • Diabetic retinopathy
35
Q

Presentation of retinal detachment

A

Sudden onset PAINLESS, UNILATERAL vision loss

“Curtain coming down”

36
Q

Rx retinal detachment

A

Reattach

  • Surgery
  • Laser
  • Cryotherapy
  • Inject expansile gas
37
Q

MCC blindness in older people in USA

A

Macular degeneration

38
Q

Types of macular degeneration

A

Atopic (dry)

Neovascular (wet)

39
Q

Features of macular degeneration

A

Older pts
Bilateral
Normal external eye appearance
Loss of CENTRAL vision

40
Q

Which type of macular degeneration is worse

A

Neovascular

41
Q

Features of neovascular macular degeneration

A

Vessels grow between retina and Bruch membrane

90% of permanent blindness from macular degeneration

42
Q

Best initial therapy of neovascular macular degeneration

A

VEGF inhibitor injection every 4-8 weeks

  • Ranibizumab
  • Bevacizumab
  • Aflibercept
43
Q

Rx atopic macular degeneration

A

None

44
Q

Deposits in atopic macular degeneration

A

Drusen

Step 2 CK (21 decks)

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