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MRCP Part 1 > MRCP Opthalmology > Flashcards

MRCP Opthalmology Flashcards

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1
Q

Earliest sign of diabetic retinopathy

A

microaneurysm

  • in fundoscopy or fluorescein angiography
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2
Q

Uveitis
- bilateral
- blurring vision
- light sensitive
- painful

A

sarcoidosis

Mx:
topical steroid
mydriasis

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3
Q

conjunctivitis
- itchy and gritty
- watery discharge
- diffuse redness of eyes
- painless

A

no visual change

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4
Q

episcleritis
- bilateral
- inflamed eye
- minimal pain

A
  • intact vision
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5
Q

scleritis
- bilateral
- PAINFUL
- photophobia
- tearing

A
  • reduced visual acuity
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6
Q

Optic neuritis

A

reduced visual acuity
loss of colour vision
central scotoma
optic disc swelling
painful eye movement

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7
Q

central retinal artery occlusion

A

cherry red spot in macula

  • sudden
  • painless loss of vision
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8
Q

central retinal vein occlusion

A

diabetic, HTN, smoker

  • sudden
  • painless loss of vision
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9
Q

retinal detachment seen in…. needs surgical repair

A

EDS

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10
Q

CMV retinitis seen in…. and treatment is….

A

HIV
valganciclovir

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11
Q

GCA is associated with… which needs urgent…

A

arteritis ischaemic optic neuritis
corticosteroids

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12
Q

Eye features found in neurofibromatosis 1 is called…

A

lisch nodules

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13
Q

Treatment for acute anterior uveitis… and is associated with…

A

prednisolone drops
ulcerative colitis

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14
Q

Surgical 3rd nerve palsy present as…. and typically due to… which is at risk of…

A
  • down and out, dilated pupil
  • posterior communicating artery aneurysm
  • SAH
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15
Q

Eye pathology associated with Marfan’s disease

A

lens dislocation
retinal detachment

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16
Q

Homocysturia vs marfan’s in lens dislocation

A

Homo - downward detachment
Marfan - upward detachment

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17
Q

Kayser fleischer rings

A

Wilson’s- copper

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18
Q

Corneal arcus

A

hyperlipidaemia

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19
Q

Anterior uveitis presents with

A

painful
red
photophobic eye

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20
Q

Hypopyon is… associated with…

A

collection of white blood cells in the front part of the eye
- anterior uveitis

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21
Q

Hyphema is…

A

a medical emergency
due to bleeding in front part of eye
secondary to trauma

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22
Q

Why are pupil dilatation avoided in hypema

A

prevent second bleed

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23
Q

Management of increases IOP due to hypema

A

IV carbonic anhydrase (azetazolamide)
increase drainage

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24
Q

Management for neuromyelitis optica

autoimmune spinal and eye inflammation

A

IV methylprednisolone 1g OD for 5-7 days

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25
pseudoxanthoma elasticum is manifested by..... presenting with....
calcification of elastic fibres in the eye skin and heart. loose skin folds and puckering = plucked chicken appearance angioid streaks with bands radiating in spoke like.
26
Age related macular degeneration
bilateral change risk factors: - smoking - age >75 - family history
27
Two types of macular degeneration are:
dry (90%) - atrophic - drunsen yellow spots in bruch's membrane wet (10%) - exudate/neovascular - choroidal neovascular - leaking serous fluid --> visual loss | Mx: VEGF, photocoagulation
28
Anti-VEGF is effective in ....
WET age related macular degeneration
29
Painful reduced visual acuity with pale optic disc
optic neuritis- MS
30
Vestibulo ocular response is.... and seen in...
doll's eye movement supranuclear gaze palsy (PSP)
31
RAPD with unilateral painful visual loss
optic neuritis
32
Central retinal vein occlusion (CRVO)
unlilateral sudden painless loss of acuity stormy sunset haemorrhage
33
difference between CRAO and CRVO
artery- ischaemia, pale retina, cherry red spot NO haemorrhage vein- stomry sunset haemorrhage both- painless sudden loss of vision UNILATERAL
34
5 Glaucoma medications
prostaglanding analogue (lantanoprost) - increase uveoscleral outlflow beta blocker (timolol) - reduce aqueous production sympathomimetics (brimonidine) - reduce production and increase outflow carbonic anhydrase (dorzolamide) - reduce production miotics (polocarpine) - increase uveoscleral outlflow
35
Sarcoidosis eye involvement
BILATERAL posterior uveitis
36
Temporal biopsy finding in GCA
giant cell infiltrate
37
Age adjusted ESR for GCA
female: age+10/2 male: age/2
38
Rods and cones
Cone (cone opsin)- light adaptation, central Rod (Rhodopsin)-dark adaptation, peripheral
39
What is defective in inherited retinitis pigmentosa
rhodopsin deteriorated night and peripheral vision
40
Altitude visual defect is...
loss of vision in upper and lower half of visual field
41
What is central scotoma
loss of central vision
42
CMV vasculitis fundoscopy appearance
vasculitis with haemorrgage
43
Acute angle glaucoma presents as...
painful eye loss of visual acuity pupillary dilatation
44
Investigation for acute angle glaucoma
tonometry- IOP gonioscopy- slit lamp for angle
45
Medication that may trigger acute angle glaucoma
TCA Antihistamine Anti parkinsonain Antipsychotic Sulphonamide
46
Treatment for acute angle glaucoma
acetazolamide beta blocker eye drop pilocarpine alpha adrenergic eye drop
47
Proliferative diabetic retinopathy
fragile new blood vessels into vitreous prone to bleed causing vitreous haemorrhage
48
Vitreous haemorrhage
painless loss of vision
49
Marfans
autosomal dominant fibrillin 1 gene chromosome 15 extopia lentis means lens dislocation
50
Homocysturia vs marfans
both lens dislocation homocysturia- learning disability
51
3rd nerve palsy
eye is deviated 'down and out' ptosis pupil may be dilated (sometimes called a 'surgical' third nerve palsy) | medical 3rd nerve palsy- pupil sparing
52
53
Holmes adie pupil
enlarged pupil poor reaction to light sluggish accommodation absent ankle jerk
54
Immune reconstitution uveitis
HIV recovery of CD4 causing reduced vision and discomfott in eye
55
Abnormal VEP
Optic neuritis - delayed VEP due to prolonged velocity of action potentials
56
Band keratopathy is deposition of... in the.... as a result of...
calcium bowman layer of cornea hypercalcaemia (PTH to be checked)
57
6th nerve palsy
LR6 eye medially deviated microvascular disease risk resolve in 6-12 weeks
58
What diabetic retinopathy warrants urgent referral to opthalmologist
new vessel in disc risk of vitreous haemorrhage and visual loss
59
surgical 3rd nerve palsy should raise suspicion of...
posterior communicating artery aneurysm | painful, 3rd nerve palsy, dilated pupils
60
61
Anterior ischaemic optic neuropathy fundoscopy
swollen optic disc with haemorrhages
62
flashing or floaters
retinal detachment
63
Ocular ischaemic syndrome (OIS)
gradual visual loss amaurosis fugax (transient monocular blindness) RAPD neovascular iris
64
Diabetic retinopathy non proliferative
ABCDE A4 B2 aneurysm beading cotton wool dot haemorrhage exudate anurysm in 4 quadrant beading in 2 quadrant
65
Fundoscopy finding that puts risk of proliferative retinopathy
anurysm in 4 quadrant beading in 2 quadrant
66
Mild non profilerature (background) diabetic retinopathy
1 microaneurysm
67
Moderate non profilerature (background) diabetic retinopathy
intra-retinal microaneurysm
68
Risk factors for CRVO
SLE HTN
69
Branch retinal vein occlusion vs CRVO
branch- same signs as CRVO but not in all 4 quadrants of retina
70
Radiation optic neuropathy presents similar to.... and occur within...
optic neuritis but painless 1.5 years after radiation gradual
71
Keratitis
inflamed cornea - red eye - painful - photophobia - gritty
72
Thyroid eye disease
proptosis optic neuropathy- rare but need IV steroids!
73
Optic neuropathy presents with
loss of colour vision reduced acuity
74
Keratitis due to...
infected contact lens
75
Wernicke's encephalopathy eye sign
nystagmus opthalmoplegia due to lateral rectus palsy
76
Why does pupil dilate
parasympathetic nerve damage
77
Paralysed upward gaze
PSP
78
4th nerve palsy
diplopia is torsional - superior oblique depress eye and rotate inwards - lesion in this nerve cause outward rotation of eye
79
Urgent neuroimaging for 3rd nerve palsy with...
pupil involvement
80
Features of neurofibromatosis
SODNO Skeletal Ocular Dermatological Neurological Other
81
Lisch nodules (golden) in iris
NF-1 - lisch nodule - axillary frexkles - cafe au lait
82
Ash leaf spots
tuberous sclerosis
83
Ectopia lentis
dislocation of lens
84
Von hippel disease
H - Haemangiomas - cerebellar/retina/spinal cord I - increased risk of clear cell renal cell cancer P - pheochromocytoma P - pancreatic cyst E - Endolymphatic sac tumours L - liver cyst, kidney cyst, epidydmal cyst 3 words in the syndrome - CHR 3
85
Medical cause of 3rd nerve palsy
diabetes
86
Subconjunctival haemorrhage (blood shot eye)
hypertension resolves in 2 weeks BP check
87
Trichiasis
inward direction of eyelash
88
Contact lens related ulcer
medical emergency!
89
Anterior uveitis
cells in anterior chamber (keratic precipitates, fibrin, syncechiae, hypopyon)
90
Horner's syndrome
ptosis miosis (fixed contricted) anhidrosis (loss of sweat) NO 3rd nerve palsy

MRCP Part 1 (14 decks)

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