ClinMed_test1

Question 1

What are some of the risk factors for Plaquenil?

Answer 1

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

Question 2

T/F?

Dosage for plaquenil should be based on weight?

Answer 2

False.

Should be based on height.

Question 3

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

Answer 3

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

Question 4

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

Answer 4

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

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

Question 5

Name some screening procedures for PLaquenil patients

Answer 5

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

Question 6

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

Answer 6

Parafoveal loss of visual sensitivity.

May appear before changes on fundus examination

Question 7

What finding is noticed for pts on plaquenil on FAF?

Answer 7

Reduced autoflourescence: Subtle RPE defects.

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

Question 8

What finding is noticed for pts on plaquenil on OCT?

Answer 8

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

Question 9

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

Answer 9

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

Question 10

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

Answer 10

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

Question 11

What is the pathogenesis for crystalline maculopathy?

Answer 11

Increased accumulation of glutamate which leads to axonal degeneration

Question 12

What kind of maculopathy results from Tamoxifen?

Answer 12

Crystalline Maculopathy.

Refractile intraretinal crystalline deposits concentrated primarily in the perifoveal area.

Question 13

Describe VA and Tamoxifen?

Answer 13

Visual acuity decreases are usually secondary to foveal cyst development.

Question 14

Give more examples of drugs that can cause crystalline maculopathy?

Answer 14

Canthaxanthine - reversible

Nitrofurantoin

Question 15

What causes Talc retinopathy?

Answer 15

Cocaine
heroin
Ritalin
Oxycontin

Question 16

What is nitrofurantoin used for?

Answer 16

Antibiotic used for trt of UTI

Question 17

What is and use for canthaxanthine?

Answer 17

Carotenoid

Oral artifical tanning agent

Question 18

What does phenothiazine do to the retina?

Answer 18

Pigmented retinopathy.

Salt and pepper pigmentary loss.

Question 19

Name some drugs that causes macular edema?

Answer 19

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

Question 20

Name some conditions that need interferon therapy?

Answer 20

MS
Hepatitis
Other viral diseases.

Question 21

Describe interferon retinopathy

Answer 21

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

Question 22

What do ED drugs do to the retina? Eyes?

Answer 22

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

Question 23

What are the vascular risk factors for NAION?

Answer 23

Myocardial infarction
Hypertension
Hypercholesterolemia
Diabetes

Question 24

Mechanism of nitric oxide?

Answer 24

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

Question 25

What meds causes CSC?

Answer 25

``` PDE-5 inhibitors Pseudoephedrine Steroids COld meds Diet pills ```

Question 26

What causes retrobulbar optic neuritis?

Answer 26

Ethambutol

Question 27

What drug causes binasal visual field defects?

Answer 27

Vigabatrin. | An antiepileptic drug

Question 28

Which drugs lead to an increase in IOP

Answer 28

``` Corticosteroids Animuscarinic agents Antihistamines Phenothiazines TCA ```

Question 29

Which drugs lead to a decrease in IOP

Answer 29

Beta blockers Ethyl alcohol Cardiac glycosides Cannabinoids

Question 30

Which drug causes pupillary block and angle closure glaucoma?

Answer 30

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

Question 31

What drugs cause subconj hemes?

Answer 31

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

Question 32

What is an adverse effect for lutein?

Answer 32

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

Question 33

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

Answer 33

Actos | Avandia

Question 34

Name some adverse effects of omega 3?

Answer 34

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