Ocular & Ear Pathology Flashcards
(186 cards)
1
Q
bacterial infection of orbital tissues
A
Orbital cellulitis
2
Q
Orbital cellulitis is most often associated with this age group
A
Pediatrics
3
Q
This ocular condition is associated with recent sinusitis, especially ethmoidal
A
Orbital cellulitis
4
Q
Orbital cellulitis is associated with having this condition
A
Sinusitis
5
Q
Proptosis is characteristic of this condition which also involves high fever, chemosis, and painful edematous eyelids and painful ocular motions
A
Orbital cellulitis
6
Q
Anti-thyroid antibodies in Graves disease may stimulate these cells
A
Orbital fibroblasts
7
Q
Is there proptosis in orbital cellulitis?
A
Yes
8
Q
Is there proptosis in preseptal cellulitis?
A
No - absent
9
Q
Is there proptosis in Graves opthalmopathy?
A
Yes - is a major finding
10
Q
Proptosis with retrobulbar discomfort that contributes to lid retraction, drying, and tears are often insufficient, is seen in this ocular condition
A
Graves ophthalmopathy
11
Q
Morphology of this ocular condition will show expansion of orbital muscles and fat, that may even protrude beyond lids
A
Graves ophthalmopathy
12
Q
Does expansion of orbital muscles and fat persist after thyroidectomy in Graves ophthalmopathy?
A
Yes
13
Q
This part of the conjunctiva is squamous epithelium with goblet cells
Is under the eyelid
A
Palpebral conjunctiva
14
Q
This part of the conjunctiva is pseudostratified epithelium with numerous goblet cells
A
Fornix
15
Q
This part of the conjunctiva is nonkeratinized squamous epithelium
A
Bulbar conjunctiva
16
Q
Tears are aqueous with this component
A
Mucoid (goblet cells)
17
Q
This is the most common cause of chronic dry eyes
A
Conjunctival scarring
18
Q
A patient with dry eyes that has Anti-SS-A and SS-B autoantibodies may have this condition which can cause keratoconjunctivitis sicca
A
Sjogren’s syndrome
19
Q
This is mucus membrane pemphigoid
Autoimmune disease against various basement membrane antigens
A
Ocular cicatricial pemphigoid
20
Q
In this ocular condition, subepithelial bullae may occur which rupture and scar
A
Ocular cicatricial pemphioid
21
Q
In Ocular cicatricial pemphigoid, subepithelial scarring occurs early, often at this location
A
Inferior fornix of the conjunctiva
22
Q
In the later stage of this condition, formation of a symblepharon-fibrous bridge between lid and bulbar conjunctiva can occur, which causes ocular surface keratinization and dryness/scarring
A
Ocular cicatricial pemphigoid
23
Q
This is a wing-shaped collection of conjunctival fibrous tissue
A
Pterygium
24
Q
This is a medial submucosal solar elastotic fibrovascular tissue
A
Pterygium
25
Pterygium and Pinguicula both occur due to this
Solar damage to conjunctive
26
Pterygium and Pinguicula both occur due to solar damage to this part of the eye
Conjunctiva
27
This is a yellow, greasy appearing subconjunctival deposit
Pinguicula
28
This ocular condition occurs due to degeneration of collagen and elastin
Pinguecula
29
Can Pinguicula or Pterygium progress over globe to the cornea, which may obscure vision or cause astigmatism?
Pterygium
30
Conjunctival and corneal infection with Chlamydia trachomatis
Trachoma
31
This oranism is the world's leading cause of preventable blindness, especially in Africa
Is an obligate intracellular gram negative bacterium
Chlamydia trachomatis
32
Is Chlamydia trachomatis gram positive or negative?
Negative
33
This condition begins as conjunctivitis which establishes partial immunity
Recurrent infections lead to CMI, resulting in conjunctival and corneal scarring
Trachoma
(infection with Chlamydia trachomatis)
34
Trachoma begins as an initial infection of this part of the eye
Forms follicular nodules
Tarsal conjunctiva
35
This condition involves initial infection of tarsal conjunctiva, then a corneal pannus may form, leading to conjunctival scarring and cicatricial entropion
Trachoma
36
This ocular infection may involve cicatricial entropion, causing retraction of eyelid and eye drying due to lashes abrade cornea
Trachoma
37
This is an acellular layer of the cornea beneath the epithlium
Bowman layer
38
This layer of the cornea sits just superior of the endothelium
Descemet's membrane
39
Is the Bowman layer or Descemet's membrane of the cornea just beneath the epithelium?
Bowman layer
40
This is the major refractive force of the eye
Cornea
41
This part of the eye is transparent due to avascularity, collagen alignment, and lack of cellularity
Cornea
42
This is a progressive cone shaped deformity of cornea
Keratoconus
43
Is Keratoconus frequently unilateral or bilateral?
Bilateral
44
This ocular condition involves thinning of the cornea, and degeneration of Bowman's membrane
No inflammation
Keratoconus
45
This layer of the cornea is degraded in Keratoconus
Bowman's membrane
46
These two conditions are associated with Keratoconus
Down syndrome
Marfans syndrome
47
This ocular condition is bilateral accelerated endothelial loss
Fuch's endothelial dystrophy
48
Pathology of this ocular condition involves loss of endothelium, Descement's membrane ingrowth
Cornea cloudy due to edema
Subepithelial bulla
Fuch's endothelial dystrophy
49
The result of this ocular condition is corneal edema and bullous keratopathy
Common indication for corneal transplant
Fuch's endothelial dystrophy
50
This is the most common cause of corneal blindness worldwide
Herpetic keratitis
51
This ocular condition shows a classic dendritic ulcer, and dichotomous branching with terminal bulbs
Highlighted with fluorescein dye
Herpetic keratitis
52
Multinucleated giant cells in cornea, cowdry inclusions, and minimal inflammation are seen histologically in this ocular condition
Herpetic keratitis
53
This is a mucocutaneous infection, that replicates in trigeminal ganglion
Anterograde axonal transport via ocular neurons (causing blepharoconjunctivitis, keratitis)
Herpes
54
Dendritic ulcer in the cornea is characteristic of this infection
Herpes
55
This corneal infection/ulceration is associated with contact lens wearers, such as use of tap water
Acanthamoeba keratitis
56
Cataracts may result from diabetes-accumulation of this, and increased water absorption
Sorbitol
57
A "snowflake" cataract is often caused by this condition
Diabetes
(due to accumulation of sorbitol and increased water absorption)
58
This type of drug is a risk factor for cataract formation
Corticosteroids
59
Myotonic dystrophy, NF-2, and Wilson disease may cause this ocular condition of the lens that is most commonly age-related, possibly due to oxidative injury
Cataract
60
This part of the eye secretes aqueous humor
Ciliary body
61
Aqueous humor is secreted by the ciliary body, and then passes through the pupil to this
Anterior chamber
62
The Canal of Schlemm is located at the angle between these two parts of the eye
Iris and cornea
63
Optic nerve cupping occurs in glaucoma due to loss of nerve fibers and these cells
Glial
64
Is papilledema common in glaucoma?
No
Mostly seen in acute closed angle glaucoma; due to decreased axoplasmic flow
65
In this form of glaucoma, aqueous humor has access to trabecular meshwork but there is increased resistance to fluid outflow
Open angle glaucoma
66
In this form of Open angle glaucoma, there is no structural cause seen
Age related, may be fibrosis of pathways
Most common
Primary Open angle glaucoma
67
This is the most common form of glaucoma
Primary Open angle glaucoma
68
This form of Open angle glaucoma involves possible causes of meshwork/canal obstruction
(such as hemorrhage, cellular debris from iris or lens degeneration, tumor debris)
Secondary Open angle glaucoma
69
Does primary or secondary Open angle glaucoma involve possible meshwork/canal obstruction?
Secondary
70
What type of glaucoma may be caused by hemorrhage, cellular debris and tumor debris?
Secondary Open angle glaucoma
71
This form of glaucoma is due to lens fragmentation debris
Phakolytic glaucoma
72
In this form of glaucoma, drainage of aqueous humor is impeded by narrowing of iris-cornea angle
Angle closure glaucoma
73
In Angle closure glaucoma, occlusion of trabecular meshwork occurs by this structure
Peripheral iris
74
Is Angle closure glaucoma more common in myopia or hyperopia?
Hyperopia
75
This form of glaucoma is more common in hyperopia
Angle closure glaucoma
76
Primary angle closure glaucoma is often due to this
Pupillary block
77
In primary Angle closure glaucoma, the iris and lens contact each other, increasing pressure in this part of the eye
Posterior chamber
leads to bowing of iris into anterior chamber
78
In primary Angle closure glaucoma, increased posterior chamber pressure leads to bowing of this structure into the anterior chamber
Iris
(results in angle closing = no drainage)
79
Anterior or posterior synechiae can cause this type of glaucoma
Secondary Angle closure glaucoma
80
Permanent vision loss is possible with this form of glaucoma, where IOP will increase quickly
Acute Angle closure glaucoma
81
Does pharmacologic mydriasis or miosis cause/predispose to acute Angle closure glaucoma?
Mydraisis
(sympathomimetics, parasympathetic antagonism)
82
Bright light in dark room may cause/predispose to this form of glaucoma
Acute Angle closure glaucoma
83
This part of the retina is the location of retinal detachments
Retinal pigment epithlium
84
This is the external boundary of the retina
Bruch's membrane
85
This part of the retina is the optic nerve and vessels entry point
Optic disk
86
Papilledema is seen in this part of the eye
Optic disk
87
This is a thinned layer of retina, and choroidal vessels are visible beneath this
Double layer of ganglion cells
Macula
88
Does hemorrhage in the nerve fiber layer or deeper hemorrhage cause flame shaped hemorrhage?
Nerve fiber layer
89
Does hemorrhage in the nerve fiber layer or deeper hemorrhage cause dot hemorrhages?
Deeper
90
Retinitis pigmentosa involves inherited mutations resulting in apoptosis of this part of the retina
Retinal pigment epithelium
91
What distinguishes wet from dry ARMD?
Neovascularization (of choroid with degeneration)
92
These are extracellular yellow retinal deposits seen in macular degeneration
Eosinophilic deposits beneath retinal epithelium
Drusen
93
In proliferative diabetic retinopathy, new small vessels form over disk or retina due to increased this compound
VEGF
94
These are soft exudates, ischemia areas, that are seen in non-proliferative diabetic retinopathy as well as hyperintensive retinopathy
Cotton wool spots
95
Retinopathy of prematurity is mediated by this compound
VEGF
96
Retinopathy of prematurity is associated with this toxicity
Oxygen
97
Can traction retinal detachment occur in retinopathy of prematuriy?
Yes
98
Thick walled vessels with arteriolar narrowing and "Silver wires" appearance are seen in this ocular condition
Also "nicking" of vessels at crossing point
Hypertensive retinopathy
99
Retinal vein occlusion may be caused by this condition, which causes arteriolar thickening, turbulence and stasis of blood, thrombosis, and retrograde hypoxia/ischemia and hemorrhage
Hypertension
100
Sudden painless blurred vision, with venous engoregement and tortuosity may be seen in this ocular condition
Retinal vein occlusion
101
This the first branch of the internal carotid artery that is the most often site of atheroembolic from ICA
Ophthalmic artery
102
Cherry red spot at macula is characteristic of this ocular condition
Central retinal arterial occlusion
103
Occlusion of this artery may cause cherry red spot at macula
(intact choroidal vessels visible through thin fovea; surrounding retina is pale due to ischemia)
Central retinal artery
104
Along with painful red eye, strabismus, and vision loss, this is the most common sign of Retinoblastoma
Leukocoria
(white pupil rather than red)
105
Leukocoria is the most common sign of this ocular condition
Retinoblastoma
106
This is a neuroectodermal neoplasm with small blue cells and synaptophysin positive
Flexner-Wintersteiner rosettes also seen
Retinoblastoma
107
Retinoblastoma is positive for this protein that is associated with neuroectodermal tumors
Synaptophysin
108
This is a small blue cell tumor that is Synapthophysin positive
Flexner-Wintersteiner rosettes are also seen
Retinoblastoma
109
Flexner-Wintersteiner rosettes are characteristic of this ocular condition
Retinoblastoma
110
A patient with inherited retinoblastoma is also at risk for this neoplasm
Osteosarcoma
111
A patient with this inherited tumor (due to a mutated tumor suppressor gene) is also at risk for osteosarcoma
Retinoblastoma
112
What are the three structures of the uvea (middle layer of the eye)?
Iris
Ciliary body
Choroid
113
Is Uveitis usually inflammation of the anterior or posterior portion of the uva?
Anterior
(iris and ciliary body)
114
50% of cases with this ocular condition are associated with the seronegative spondyloarthropathies (psoriatic arthritis, reactive arthritis, ankylosing spondylosis)
In addition to IBD
Uveitis
115
50% of cases of uveitis can be associated with this gene
HLA-B27 = the seronegative spondyloarthropathies
(psoriatic arthritis, reactive arthritis, ankylosing spondylosis)
116
Unilateral pain, vision loss, photophobia, miosis, ciliary injection, and hypopyon (collection of WBCs in front part of the eye) are seen in this ocular condition
Uveitis
117
How might closed angle glaucoma occur from uveitis?
Miosis causes iridolenticular synechiae
118
How might open angle glaucoma occur from uveitis?
Hypopyon is inflammatory iris destruction, leading to protein/cells in anterior chamber
119
Synechiae (adhesions) and pigment fragmentation over lens appear with this ocular condition
Uveitis
120
This ocular condition may cause closed angle glaucoma due to iridolenticular synechiae
Uveitis
121
This ocular condition may cause open angle glaucoma due to hypopyon (protein/cells in anterior chamber)
Uveitis
122
This is the most common primary ocular malignancy
Uveal melanoma
123
This part of the uvea is the most common location of uveal melanoma
Choroid
124
This is the favored metastatic site for uveal melanoma
Liver
125
Liver cancer may metastasize, causing this ocular malignancy
Uveal melanoma
126
These types of cells are a better prognosis in uveal melanoma
Spindled cells
127
This ocular pigmented lesion moves freely over sclera
Compound conjunctival nevus
128
This ocular pigmented lesions appears as irregular, pigmented flat areas
Mean age 55
Give rise to 75% of conjunctival melanoma
Nodularity, feeder vessels, change suggest melanoma
Primary acquired melanosis
129
Primary acquired melanosis gives rise to the majority of cases of this neoplasm
Conjunctival melanoma
130
Does iris nevus have risk of melanoma?
Yes - up to 8%
131
This is the most common intraocular malignancy
Peaks at 60 years old
50% mortality at 10 years
Choroidal malignant melanoma
132
Severe demyelinating syndrome of optic nerve with acute myelitis
Neuromyelitis optica
133
These autoantibodies are seen in Neuromyelitis optica
Aquaporin 4
134
Aquaporin 4 autoantibodies are seen in this ocular condition
Neuromyelitis optica
135
Neuromyelitis optica is a severe demyelination syndrome of this structure, with acute myelitis
Optic nerve
136
Is Neuromyelitis optica mostly unilateral or bilateral?
Bilateral
137
Is Neuromyelitis optica more common in males or females?
Females
138
These ethnicities are more common to have Neuromyelitis optica
African and Hispanic
139
What is the mean age of patient with Neuromyelitis optica?
40 years
(note: older than MS, which is 20-40s)
140
Is Neuromyelitis optica serious?
YES
Frequent blindness occurs
More progressive and severe than MS
141
Painful eye movement, decreased vision, Marcus-gunn pupil, and motor, sensory, autonomic systems affected are seen in this condition
Neuromyelitis optica
142
These two tests assess hearing loss
Weber and Rinne tests
143
The Weber and Rinne tests are often the first step in assessing this
Hearing loss
144
This test assesses conductive hearing with tuning fork on top of head
Weber test
145
This test assesses hearing with tuning fork on mastoid process and next to ear
Rinne test
146
In the Weber test, sound that is louder in the better ear indicates this type of hearing loss
Sensorineural
147
In the Weber test, sound that is louder in the poorer ear indicates this type of hearing loss
Conductive
148
Otosclerosis is a common cause of this type of hearing loss
Conductive
149
Otosclerosis is often caused by abnormal remodeling of this bone
Temporal bone
150
Is otosclerosis usually unilateral or bilateral?
Bilateral
151
Otosclerosis has some hereditary component, with this inheritance pattern
Autosomal dominant
152
Is Otosclerosis more common in males or females?
Males
153
What is the common age of patients with Otosclerosis?
20-50 years
154
What is the treatment for Otosclerosis?
Stapedectomy + Prosthesis
(cochelar implant also)
155
Presbycusis is age related hearing loss of this type
Sensorineural
156
This is the most common cause of hearing loss in US
Presbycusis
157
What is the typical age of patients with Presbycusis?
>50-60 years
158
In Presbycusis, hair cell loss begins at this structure
Cochlear base
159
In Presbycusis, are low or high frequency sounds affected first?
High
160
Patients with this age related condition have the most difficulty in noisy environments
Presbycusis
161
Chronic noise exposure leads to this type of hearing loss
Sensorineural
162
Chronic noise exposure involves destruction of these cells
Cochlear hair cells
163
In Chronic noise exposure, are low or high frequency sounds affected first?
High
164
Most cases of acute otitis media follow this
Viral URI (which leads to eustachian tube)
165
In this ear condition, ear pain, tympanic membrane with effusion, TM retracted or bulging, TM may perforate, and conductive hearing loss may all occur
Otitis media
166
Acute otitis media may cause this type of hearing loss
Conductive
167
bacterial extension into mastoid airs cells
Mastoiditis
168
This ear condition mostly follows an acute otitis media episode, and involves ear protrustion, retroauricular swelling, tenderness, erythema, fever, otalgia, and hearing loss
Mastoiditis
169
Squamous epithelial growth within middle ear
Cholesteatoma
170
Cholesteatoma is a squamous epithelial growth within this part of the ear
Middle ear
171
Is Cholesteatoma neoplastic?
No - is benign and non-neoplastic
172
A patient with a history of repeated otitis media with perforation usually, chronic draining ear, and white/brown, pasty material in/on/behind tympanic membrane may develop this condition
Also conductive hearing loss
Cholesteatoma
173
Cholesteatoma can involve this type of hearing loss
Conductive
174
A patient with Cholesteatoma typically has a history of repeated episodes of this condition
Otitis media
(with perforation usually)
175
Otitis externa most commonly is caused by this organism
Pseudomonas
176
Pseudomonas most commonly causes this ear infection
Otitis externa
177
Retroauricular lymphadenopathy is characteristic of this ear condition that also involves pain with pinna/tragus movement
Otitis externa
178
Benign positional vertigo is due to displacement of this
Otolith
179
In Benign positional vertigo, otolith is displaced and enters this structure
Semicircular canal
(gives sensation of motion WITH sudden head movement/position change)
180
How long does an episode of vertigo last in Benign positional vertigo?
<1 minute
181
Benign positional vertigo diagnosis can be made with this test
Dix-Hallpike maneuver
182
Benign positional vertigo may be corrected with this maneuver
Epley maneuver
183
This is a vestibular disorder due to increased endolymphatic fluid
Meniere disease
184
This condition is characterized by recurrent attacks of vertigo, also tinnitus and progressive hearing loss
Meniere disease
185
How long do attacks of vertigo last in Meniere disease?
Minutes to hours
186
Vestibular neuritis or labyrinthitis are usually due to viral infections, and can cause vertigo, and tend to last this long
1-2 days
