MTB 1

Question 1

Presentation of episcleritis

Answer 1

Acute onset
Mild-moderate discomfort
Photophobia, watery d/c
PE: Diffuse, localized bulbar conjunctival injection

Question 2

Presentation of Hordeolum

Answer 2

Stye

Acute infxn of gland(s) of eye

Question 3

Presentation of Viral Conjunctivitis

Answer 3

Bilateral
Watery Discharge
Easily transmissable
Normal vision
Itchy
Preauricular adenopathy
No tx

Question 4

Presentation of Bacterial Conjunctivitis

Answer 4

Unilateral
Purulent, thick Discharge
Poorly transmissable
Normal vision
Not Itchy
No adenopathy
Topical Abx

Question 5

Presentation of Chalazion

Pathophys

Answer 5

Painful swelling progresses to nodular rubbery lesion
Obstruction of meibomian gland - granulomatous
If persistent, think meibomian gland carcinoma (sebaceous ca)

Question 6

Basal Cell Carcinoma on eye

Answer 6

Solitary nodule on lid margin
MC malignant tumor of eye
Fair skinned ppl
Hx - sun exposure
Pearly quality, rolled edges
Bleed, ulcerate
Thinning of eyelashes

Question 7

Itchy eyes, discharge, normal pupils

Answer 7

Conjunctivitis

Question 8

Pain and fixed midpoint pupil

Answer 8

Glaucoma

Question 9

Trauma and feels like sand in eyes

Answer 9

Abrasion

Question 10

How does open angle glaucoma present

Answer 10

Gradual onset

Loss of peripheral vision = tunnel vision

Question 11

How does acute angle-closure glaucoma present

Answer 11

Sudden onset
Extremely painful
Red eye
Hard on palpation
Pupil does not react to light
Greater than 0.3 cup to disc ratio

Question 12

How is acute angle-closure glaucoma diagnosed

Answer 12

Tonometry

Question 13

How is chronic glaucoma diagnosed

Answer 13

Tonometry shows increased IOP

Question 14

Tx for Chronic Glaucoma

Answer 14

1. PG Analogues - latanoprost, etc
2. Topical Beta blockers - Timolol, Carteolol…
3. Topical CA Inhibitors - Dorzolamide
4. Alpha 2 agonists - Apraclonidine
5. Pilocarpine
6. Laser btrabeculoplasty

Question 15

TX for acute angle-closure glaucoma

Answer 15

1. IV Acetazolamide
2. IV Mannitol - osmotic draws fluid out
3. Pilocarpine and beta blockers constrict pupil, increase drainage
4. Laser Iridotomy

Question 16

What is keratitis

Answer 16

Infxn of cornea

Question 17

Presentation of Herpes Keratitis

Answer 17

Red
Swollen
Painful

Question 18

Test for Herpes Keratitis

Answer 18

Fluorescein staining - confirms dendritic pattern

Question 19

TX for Herpes Keratitis

Answer 19

Oral Acyclovir, Famiclovir, Valacyclovir
Topical antiherpetic: trifluridine, idoxuridine
Do NOT use steroids = worsen

Question 20

Presentation for CMV Retinitis

Answer 20

Painless

Fundoscopic exam: hemorrhages, fluffy granular lesions around retinal vessels

Question 21

TX for cataracts

Answer 21

Surgically remove the lens

Question 22

What is a vitreous hemorrhage

Answer 22

Sudden
Loss of vision
Onset of floaters
MCC - DM Retinopathy
Fundus - Hard to visualize

Question 23

Presentation of retinal detachment

Answer 23

Sudden
Painless
Unilateral loss of vision
Floaters
"curtain coming down"

Question 24

Etiology of retinal detachment

Answer 24

Trauma
Myopia
Diabetic retinopathy

Question 25

TX for retinal detachment

Answer 25

Reattachment via: | Mechanical methods - surgery, laser, cryotherapy, injection of gas

Question 26

MCC blindness in older individuals in U.S.

Answer 26

Macular Degeneration

Question 27

How does Macular Degeneration present

Answer 27

Bilateral Visual loss Older pts Normal external appearance of eye Loss of Central vision

Question 28

Best initial TX for Macular Degeneration

Answer 28

VEGF Inhibitors - Ranibizumab, Bevacizumab | Vit C, E, Zinc, Copper, B-Carotene

Question 29

Retinal vessel Occlusion Presentation

Answer 29

Sudden Painless Loss of vision - Monocular

Question 30

Retinal Artery v. Retinal Vein occlusion

Answer 30

Artery -Cherry Red Spot in fovea | Vein - more gradual, Cotton wool spots, retinal hemorrhages

Question 31

Cherry Red Spot

Answer 31

Retinal Artery Occlusion Tay Sachs Neiman Pick

Question 32

Tx for Retinal Artery occlusion

Answer 32

100% Oxygen Acetazolamide Thrombolytics

Question 33

TX for Retinal Vein occlusion

Answer 33

Laser Photocoagulation

Question 34

What are Cataracts

Answer 34

Clouding of lens Progressive vision loss Difficulty w night driving opacity of lens, decreased red reflex

Question 35

Red eye + CVD

Answer 35

Uveitis | Scleritis

Question 36

Red eye + corneal ulceration

Answer 36

HSV Keratitis

Question 37

Red eye + itching

Answer 37

Allergic

Question 38

Red eye + colored halos

Answer 38

Acute angle closure glaucoma

Question 39

Red eye + Preauricular LN

Answer 39

Viral

Question 40

Red eye + dry eyes

Answer 40

Keratoconjunctivitis | Sjogrens

Question 41

Red eye + shallow anterior chamber

Answer 41

Acute angle closure glaucoma