Conjunctiva

Question 1

Pilca semilunaris

Answer 1

Small fold of bulbar conjunctiva

Question 2

T/f. Pilca semilunaris is a vestigial organ.

Answer 2

True. It’s a fold that related to body part that has become small and lost its use due to evolution.

Question 3

A caruncle is a

Answer 3

Mucocutaneous junction btwn bulbar conj and skin

Question 4

T/f the conjunctiva has normal flora on it.

Answer 4

True. Staphylococcus epidermis is the #1 microbe on conju. The #1 anaerobes is propionibacterium acne.

Question 5

Who has more anaerobes on the conjunctiva: adults or children?

Answer 5

Adults have more anaerobes. Children have more strep. It shifts as we age

Question 6

What is the leading cause of unscheduled office visits?

Answer 6

Conjunctival disorders

Question 7

___ ____ is a limited response of conjuncct.

Answer 7

Red eye

Question 8

Possible etiologies of conj disorders is

Answer 8

Allergic, viral, infection, inflammation, bacterial

Question 9

T/F you should look before instillation of anesthetic or dyes

Answer 9

True. Phenyleprine is good at constricting blood vessels . Minutes later it will disappear.

Question 10

Anytime you have conj office visit, check where the the redness is.

Answer 10

True. It can help you narrow down which one it is.

Question 11

T/f on checking IOP, you should check the worse eye first

Answer 11

False. Check the good eye first so you dont spread to the other eye

Question 12

Examining the Conjunct.you don’t need to palpate the periauricular or submandibular noes.

Answer 12

False. It’s good to palpate because the lymph drainage is in the nodes. Helps to know if viral infection.

Question 13

In slit lamp examination of conjunctiva can involve (4)

Answer 13

Everting UL, dyes (rose bengal), check before drops,

Question 14

List the different types of conjunctival responses:

Answer 14

Papillae, follicles, membranes/pseudomembranes, chemists, hypermedia, exudates, symblepharon

Question 15

Papillae are usually found on the:

Answer 15

The upper palpebral but can be in lower palpebral

Question 16

T/F papillae are velvety red with vascular network surrounding the papillae.

Answer 16

False. Papillae have a CENTRAL fibrovascular core, but they are velvety red. Follicles have vascular network surround the follicles

Question 17

Papillae are associated with what etiologies

Answer 17

Bacterial, allergic

Question 18

Why do Steriods work well with patients who have papillae?

Answer 18

Because the papillae have an infiltration of inflammatory cells (eosinophils, lymphocytes, )

Question 19

Septa e

Answer 19

Things that seperate papillae, deeper in tissue. Rupture of septa Create giant papillae

Question 20

What color are follicles? Red or white.

Answer 20

White, milky, and transluncent

Question 21

Follices are associated with what type of etiologies?

Answer 21

Viral infections, toxic rxn, chlamydial infection.

Question 22

Follices are more found on upper lid or lower lid?

Answer 22

Follices are more found on lower lid

Question 23

Follicles are

Answer 23

Discrete, round, elevated lesions. -focal hyperplasia of lymphoid tissue. Center is immature lymphocytes and macrophages, periphery is mature lymphocytes

Question 24

Kids tend to have a. Papillae b. Follices

Answer 24

B. Follicles

Question 25

The difference btwn pseudomembrane vs true membrane?

Answer 25

Pseudomembrane is not adherent to epithelium (easy to remove). True membranes is very tightly adherent to epithelium

Question 26

Membranes/pseudomembranes are a conjunctival response composed of

Answer 26

Fibrin and cellular debris

Question 27

Swelling of conjunctiva

Answer 27

Chemiosis

Question 28

The etiology of chemosis

Answer 28

Increased vascular permeability

Question 29

Pic of chemosis. Most common in …..

Answer 29

This conjunc response is most common in allergic responses

Question 30

Pic hyper me Mia

Answer 30

Etiology: pathophysiologice response to injury . Blood still in blood vessels. This can be diffuse or focal.

Question 31

Another word for discharge

Answer 31

Exudates

Question 32

Serous exudate. Etiology? Common in ?

Answer 32

Clear and watery. Etiology: increase vascular permeability. More common in allergic or viral conditions

Question 33

Mucoid exudate. Etiology?

Answer 33

Increased mucus from globet cell irritation . It’s clear to yellow but translucent

Question 34

Pt comes in complaining eyes feel stuck together in am. What type of exudate do you expect?

Answer 34

Mucopurlent-sticky, thicker, more yellow. Etiology: increased mucus combined with inflammatory cells (eosinophils and macrophages)

Question 35

Pur u-lent exudate

Answer 35

Yellow-white to yellow green; opaque, thick. Etiology:high concentration of inflammatory cells(PMNS and macrophages)

Question 36

Fibrinous exudate

Answer 36

Stringy, ropes d/c appearance: white, opaque, follows contour of conjunctiva. Etiology: high degree of fibrin mixed with inflammatory cells ( PMNS and macrophages)

Question 37

Hemorrhagic exudate

Answer 37

Blood is no longer in blood vessels; etiology: RBS in d/c from increased vascular permeability or trauma

Question 38

What is a symblepharon?

Answer 38

A type of conjunctival response that’s an adhesion between bulbar and palpebral conjunctiva

Question 39

Conjunctival chal-asis is

Answer 39

redundant conjunc. More temperol, loss of tenons fascia

Question 40

management of conjun chalasis

Answer 40

supportive lubricants and topical NSAIDS Proslena( not if sulfa allergy) , nevanc, or acular/avail

Question 41

Conjunctival chal-asis looks like

Answer 41

extra tears

Question 42

concreations

Answer 42

small, white to yellow, hard elevations; superficially buried within and beneath the palpebral conjunctiva

Question 43

concreations

Answer 43

recurrent or chronic conjunctivitis

Question 44

Kaposi’s sarcoma

Answer 44

common in patients with AIDs

Question 45

Originate in fornices

Answer 45

Conj. Lymphoma