Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

WSUNeurology > Ophthalmology - exam and Dx (150pp) > Flashcards

Ophthalmology - exam and Dx (150pp) Flashcards

1
Q

Eleven causes of transient vision loss

A 
Vascular - Migraine, embolus, carotid, central ret. aa., GCA,Takayasu,APL/SLE
CNII - Papilledema
Early tumor
Glaucoma
Viral neuroretinitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Three types of floaters

A

physiologic
hemorrhage
retinal detachments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Two causes of light flashes

A

traction of the vitreous on the retina

Ischemic insults to occipital cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Five causes of night blindness

A 
Refractive error
aging
cataracts
retinitis pigmentosa
Vitamin A deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Five causes of photophobia

A 
CNS inflammation
Lightly pigmented 
mucous
lens or corneal opacities
retinal degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Seven types of HA pertinent to ophtho

A 
Blurred vision/ tension imbalace
Tension
Migraine
SInusitis
Menstraul
Nerve irritation (sharp)
Those that have focal neuro defecits.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Five Causes of persistent vision loss

A 
Focusing
Diabetes 
Macular Degeneration
Cataracts
Glaucoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Van Herick Test and how do you perform it ?

A

Estimates angle width

Bring narrow beam in temporally at 60 and compare corneal width vs. anterior chamber width

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

5 changes that can be seen in diabetes /sign of

A 
large change in refraction
cataracts
retinopathy
rubeosis (neovascularization of iris)
CN II, IV, and VI palsies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cause of Bull’s Eye maculpathy

A

Hydroxyxhloroquine ( Plaquenil) think about in SLE patients etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Four retinotoxic medications

A

phenothiazines
Niacin
Tomxifen
IFNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Drug that can cause optic neuritis

A

Ethambutol ( TB tx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Corticosteroids can increase risk of what 3 things

A

herpes keratitis
glaucoma
cataract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pilocarpine can cause what ?

A

cataracts (used to treat glaucoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Durg that thins the iris dilator mm.

A

Flomax (tamsulosin (complication in cataract surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Xaltan, Lumigan, and travatan for glaucoma can cause what three things

A

increase lash number
darken iris
darken peri-orbital skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does Latisse do ?

A

Increases lashes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drugs suspect in NAION

A

Viagra,Cialis, Amiodarone,Levitra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What Abx can cause conjuctivitis ?

A

Neomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What fundus exam finding can be helpful to indicate likely ICP when the pts. optic disc is of normal morphology.

A

Presence of Spontaneous Venous Pulsations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A patient’s visual acuity is less than 20/20 what technique do you then preform ?

A

Pinhole to confirm need for spectacles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What level of vision do you need in at least one eye to drive in most states ?

A

20/50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is legally blind ?

A

20/200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Patient cannot read chart at appropriate distance then what?

A

NUmerator becomes distance at which they can see first line (x/400)
CF/2ft then HM/3ft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does NLP mean in terms of visual acuity

A

no light perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Define Emmetropia

A

light is focused on the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Define Ametropia

A

light is not focused on the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Define hyperopia

A

farsighted = sees more clearly at a distance need convex positive lens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Define Myopia

A

nearsighted = sees more clearly up close needs concave lense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Two types of myopia

A

axial (longer eye) and refractive (increased curvature of cornea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

define astigmatism

A

rays of light are not being refracted uniformly in all meridians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what does a keratometer do ?

A

measures curvature of cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pachymeter

A

thickness of cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Three types of refractive surgery

A

LASIK - Laser in situ keratomileusis
PRK = photorefractive keratectomy
epi-LASIK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What diopter range is appropriate for LASIK,epi-lasik and PRK

A

4-8 if outside range then IO lens is indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

advantage to epi-lask

A

does not take any stroma with it but this causes slower healing time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

advantage to PRK and 2 disadvantages

A

painful and slower to heal but more natural as flap is not needed because an artificial abrasion is created.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

advantage to LASIK and one disadvantage

A

most popular, quick healing but dry eye is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

EOM of CN III and their action

A

Medial rectus - adducts
Inferior rectus - depresses, slightly extorts and adducts
superior rectus - elevates, slightly intorts and adducts
Inferior oblique - extorts, elevates and abducts slightly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

PANS of CNIII

A 
pupil constrictor (light and near focus) 
Ciliary muscle (focuses lens for near
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

EOM of CNIV

A

Superior oblique - mainly intorts, depresses and abducts slightly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

EOM of CNVI

A

lateral rectus - abducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

3 Roles of SANS in eye

A

Mullers muscle - elevates upper lid
pupil dilator
skin of lid (sweat glands)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

phorias can become

A

tropias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

two types of ambylopia and by what age should they be corrected ?

A

refractive and strabismic

by age 5 , after 8 years nearly impossible to correct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is NPC and when is considered insuffficient

A

Near Point Convergence - considered abnormal if the NPC is >8cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what do you need to measure tropias

A

prism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Visualize six cardinal fields of vision beginning in the superomedial field

A

inferior oblique –> medial rectus –> superior oblique –> inferior rectus –> lateral rectus –> superior rectus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Three causes of a CNIII palsy and what does exam reveal

A

pupil down and out with mydriasis (except DM)

DM, Uncal herniation, PCA aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

CN most susceptible to trauma and what exam would show

A

CN IV , head tilt towards opposite should to “mechanically intort the eye”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is spasmus nutans

A

pendular nystagmus that begins around 6mo and ends at 2 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Horner’s in kid, r/o what ?

A

Neuroblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

3 orders of neurons of horner’s syndrome and 4 causes of each

A

1- C8-T2 from hypothalm - syringomyelia, demyelination,tumor,trauma
2- superior cervical gang. - Pancoasts tumor, goiter, neck injury, surgery
3- to mullers and eye from above - dissection, migraine, cavernous sinus, orbital disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Three general causes of miosis

A

increased cholinergic tone (pilocarpine and morphine)
decreased sympathetic tone (Horner’s, aldomet, reserpine)
Constrictor mm. irritation ( Iritis, HISTAMINE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Three general causes of mydriasis

A

decreased cholinergic tone (atropine,CNIII palsy,Adie’s,Anti-hist)
increased sympathetic tone (phenylephrine,epi,anxiety,cocaine,decongestants)
damaged constrictor - >40 IOP, trauma (hyphemas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Home test for patients with mild or suspected macular degeneration

A

Amsler Grid central 20 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is metamorphopsia

A

wrinkled retina in macular disease, wavi lines

58
Q

What is a tangent screen

A

using small balls tests central 60

59
Q

What does a perimeter test

A

the full 170 horizontal and 130 of the vertical

60
Q

define scotoma

A

loss of part of the field relative equals small things , absolute is total blindness

61
Q

A scotoma test is unreliable if…

A

you can’t find the physiologic scotoma 15degrees temporal

62
Q

generally an easy way to localize a visual field cut to the chiasm or posterior to it …

A

cut in both eyes.

63
Q

how long does homonymous hemianopsia last in a migraine spasm

A

15-20 minutes

64
Q

pulsating exolphthalmos

A

carotid-cavernous fistula

65
Q

non-pulsating exolphthalmos

A

cavernous sinus thrombosis

66
Q

what are the four L’s of the external exam ?

A

Lymphnodes, Lids, Lashes, lacrimal gland

67
Q

lymph drainage of eye , 2 sites

A

lateral conjuctiva –> preauricular

nasal conj –> submandibular

68
Q

3 components of tear film and their source

A

oils (miebum) –> meibomian glands
water –> lacrimal gland
mucous conj goblet cells

69
Q

What percent of dry eye cases is caused by meibomian gland dysfunction

A

86%

70
Q

Proper way to admin. eye drops

A

close eyes for 60 seconds while pressing on puncta

71
Q

blinking occurrs how often and how does it move tear film

A

q4seconds (15/min) moves film nasally

72
Q

fancy name for dry eye and tearing

A

keratoconjunctivits sicca, epiphora

73
Q

Rx causes of dry eye and one other general cause

A

anticholinergics, antihistamines, tranquilizers
diuretics, vitamin A def.
Autoimmune diseases

74
Q

What is cyclosporine

A

Restasis BID, increases tear production

75
Q

Two causes of epiphora

A

emotion/irritation

improper drainage

76
Q

What is an infection of the nasolacrimal duct

A

dacryocystitis (think actinomyces israelii etc.

77
Q

Three causes of wrinkled/droopy lids (not neuromuscularptosis)

A

Floppy eye syndrome (increased risk of sleep apnea)
Dermatochalasis (aging)
Allergies (edema stretches skin)

78
Q

two causes of ectropion

A

CNVII palsy, aging

79
Q

Define ptosis

A

drooping of the lid with narrowing of the palpebral fissure

80
Q

Can ptosis be caused by aging ?

A

yes because the levator can degenerate

81
Q

how long should a patient look up for MG etc

A

5 minutes

82
Q

Define trichiasis and madarosis

A

Trich is inturned lash causing irritaion

madarosis is loss of eye lashes or loss of eyebrows

83
Q

squamos ceel carcinoma on the eye lid could also be…

A

keratoacanthoma which is benign

84
Q

Tuberous sclerosis 4 possible findings

A

sebaceous adenomas, mental deficiencies, seizures, retinal astrocytoma (looks like a white mulberry)

85
Q

Two things to monitor in sturge-weber syndrome

A

glaucoma

hemangiomas in the CNS or choroid

86
Q

Finding in NF on the iris

A

Lisch nodules (94% of patients) circular tan spots with clear borders.

87
Q

6 sequelae of belpharitis

A

conjuctivitis, sties, chalazions, dry eye, corneal ulcers, lid cellulitis.

88
Q

How many times do you blink a day ?

A

about 50k

89
Q

General tx for blepharitis

A

baby shampoo and warm compress

90
Q

Stie vs. chalazion

A

Stie is infection of glands of Zeis and moll around lashes that point externally
Chalazion is a cystic enlargement of the meibomian glands that point internally

91
Q

Three borders of the orbit

A

periosteum, orbital septum to tarsal plate

92
Q

CT scans may be responsible for what percent of all future cancers in the US

A

1.5-2%

93
Q

Serious signs of periorbital cellulitis and possibly orbital cellulitis

A

exophthalmos or enophthalmos, swollen and/or chemosis, ophthalmoplegia is very ominous

94
Q

most common cause of exophthlamos in adults and kids, what else should you also consider/r/o

A

thyroid disease u/l or b/l
orbital cellulitis in kids
r/o solid mass, hemorrhage or thrombosis

95
Q

Four signs of an orbital blow out fracture

A

Enophtalmos, hypesthesia over maxilla, inferior rectus entrapment, conjuctiva hemorrhage

96
Q

Where are corneal stem cells located

A

Limbua, within 24 hours 40% of the cornea can regenerate

97
Q

Most densely packed sensory nerve fiber location

A

stroma of the cornea. (between bowman’s and the posterior Descemet’s membrane)

98
Q

What are guttata

A

seen in Fuch’s Dystrophy, round spots of thickening of Descemet’s membrane

99
Q

What is keratoconus and 2 things about it

A

central thinning and subsequent bulgin go the central epithelium.
Munson’s sign when looking down the inferior led bulges due to the chape of the cornea. Often genetic

100
Q

Wilson’s disease where is the Cu

A

descemet’s membrane, Kayser-Fleischer ring

101
Q

bulging/swelling of the conjuctiva or chemosis is seen in what 2 things

A

orbital venous congestion and allergies

102
Q

Pterygium from wind/UV light vs. Pinguecula

A

Pterygium is wing shape extending from the medial canthus and possibly covering part of cornea
Pinguecula is benign and a yellowish elevation on conj.

103
Q

You lift a patients eyelideand you see the upper or lower fornix….

A

Floppy-Eyelid syndrome (associated with sleep apnea)

104
Q

What is trichiasis

A

Inward growing eyelash

105
Q

What is a trachoma

A

seen in chlamydia, pannus (superior to cornea, vascularized), essentially severe keratoconjunctivits

106
Q

scleritis vs. episcleritis

A

pain vs tender but not painful

107
Q

Then sclera = and seen in ….

A

blue d/t choroidal pigment shine through. seen in RA or OI

108
Q

bilirubin binds to what in the sclera

A

elastin, often first sign of increased levels (>12 tbili is toxic in adults

109
Q

Glaucoma normal ranges and name for each (2)

A

10-20 = nl 21-27 glaucoma suspect/ ocular htn, >28 glaucoma

110
Q

One reason for falsely elevated pressures

A

thick cornea

111
Q

5 stages of optic nerve damage in glaucoma

A

C/D ration increased normal is

112
Q

half of the nfl layer may be lost when what happens in glaucoma

A

visual changes

113
Q

Four pathognomonic visual field signs of glaucoma

A

bjerrum’s scotoma arc extending nasally from blind spot
Island scotomas
constricted firlds before loss of central vission
Ronne’s is loss of peripheral nasal field above or below the horizontal meridian

114
Q

5 classes of medications for Glaucoma management

A

BB, CAI, Alpha agonist, PG analogues, Cholinergic

115
Q

sogns of angle closure glaucoma and 4 drug classes to avoid

A

pain,halos,mid-dialted pupil,nausea

anticholinergics,antihistamines, phenothiazenes, adrenergics.

116
Q

primary open angle should be monitored during use of what medication

A

corticosteroids (high dose and long term)

117
Q

How could trauma cause glaucoma

A

hyphema and ciliary body is torn from iris

118
Q

One type of juvenile glaucoma associated with 3 other findings

A

Sturge-Weber, angiomatosis of face and meninges with cerebral calcification in seizures

119
Q

What is the uvea

A

ciliary body, iris and choroid

120
Q

Morning Glory sign =

A

Moya Moya

121
Q

What do you use to dilate pupils and what should you have just in case this happens…

A

2.5 % Phenylephrin +/- .5-1% Tropicamide to dilate to >6mm. If acute angle closure occurs use pilocarpine

122
Q

What are the three components of the uvea

A

choroid, iris, and ciliary body

123
Q

Type of cancer common to the uveal structures

A

malignant melanoma (choroid 85% of the time)

124
Q

Three causes of rubeosis iridis and what could it lead to ? ?

A

Central retinal vein occlusion, DM, carotid stenosis

could lead to glaucoma

125
Q

5 anticholinergics used to dilate the eye , their action time and primary use

A

Atropine - 2 weeks - prolonged/severe ant. uveitis
Scopolamine - 4 days - alt. to above
Homatropine - 2 days - ant. uveitis
Cyclopentoate - 1 day - iritis usually combined with ster.
Tropicamide - 6 hours - used with phenyl 2.5 %

126
Q

Three causes of inflamed eye and how the look .

A

Iritis - inflammation that is centrifugal
Conjuctivits - inflammation that is centripetal
Angle closure - inflmmation that is rapid and diffuse

127
Q

5 conditions associated with iritis

A 
Ankylosing spondylitis
juvenile RA 
IBD
Psoriatic Arthritis 
Reactive arthritis
128
Q

3 conditions associated with band keratopahty

A

juveinile RA
Sarcoid
Hyypervitamanosis D

129
Q

Toxo vs. hisot on retinal exam

A

toxo had black rings with sclera showing.

histo are small punched out spots

130
Q

2 signs of choroiditis

A

White exudates on the retina, cell in the vitreous

131
Q

5 causes of choroiditis

A

Bacterial - syph. TB
Viral - HSV, CMV (AIDS esp.)
Fungal - Toxoplasma and toxocara
Immunosupression - predisposed to the above
Autiimmune - Behcet’s (mouth/genital ulcers)

132
Q

what should be examined last to minimize miosis and discomfort with ophth.

A

macula

133
Q

5 signs of papilledema

A

blurred disc margins, engorged veins, lack of SVPs, flame hemorrhages, enlarging blind spot.

134
Q

what type of CN palsy can you get with papilledema

A

CN VI

135
Q

Three non mechanical causes of papilledema

A

tetracycline, retinoids used for severe acne/psoriasis, vitamin a toxicity

136
Q

Causes of pseudopapilledema

A

malignant HTN
CRVO
Drusen

137
Q

Whats a quick thing to due in retinal artery occlusion

A

breath into bag to induce hypercapnia to dilate arteries , ocular message too.

138
Q

type of vision loss in macular degeneration

A

central

139
Q

type of vision loss in retinitis pgimentosa

A

peripheral and night vision

140
Q

what visual symptoms does a patient report with PVD ?

A

flashing lights

141
Q

what visual symptoms does a patient report with RD ?

A

flashes, floaters, and curtain-like visual loss

WSUNeurology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions