Path XIV

Question 1

difference of anterior ischemic optic neuropathy and papilledema

Answer 1

anterior ischemic optic neuropathy has no venous stasis and no bulging
papilledema has compression optic nerve, venous stasis and decreased axoplasmic transport!

Question 2

meibomian glands

Answer 2

create lipid layer of tear film

blockage lead to evaporative dry eye

Question 3

stye or hordeolum

Answer 3

acute inflamation involving gland of zeis and or orifice of meibomian gland

Question 4

common cause of stye eye

Answer 4

staph

Question 5

chalazion

Answer 5

meibomian gland lipogranuloma
inflammatory reaciton to sebum in tissues
seconary to obstruction of gland
subacute chronic and painless nodule

Question 6

type of cells in chalazion

Answer 6

epithelioid and giant cells surround lipid vacuoles

Question 7

Tx chalazion

Answer 7

surgical therapy, antibiotics if secondarily infected

Question 8

xanthelasma palpebratum

Answer 8

soft flat or raised yellow papules or plaques
inner canthus
HLD and normolipidemic
lipid laden histiocytes in dermis 
cosmetic surgery

Question 9

split nevus in eye

Answer 9

congenital nevus on upper lid and lower

Question 10

nests of nevus cells

Answer 10

interface of epidermis and dermis (junctional)
dermis and epidermis (compound)
only dermis (dermal)

Question 11

most common eyelid malignancy

Answer 11

basal cell carcinoma

Question 12

presentation BCC of eyelid

Answer 12

lower lid or medial canthus usually
nodular, cystic or diffuse
islands of basaloid cells with peripheral palisading and retraction artifact

Question 13

possible characteristics of BCC of eyelid

Answer 13

ulceration or pigmentation

locally invasive

Question 14

SCC eyelid characterizations

Answer 14

elderly fair skinned individuals
lower lid
shallow ulcer with whide elevated indurated border

Question 15

risk mets SCC

Answer 15

potential for local or distant mets

Question 16

histo SCC eyelid

Answer 16

polygonal cells with pink eosinophilic cytoplasm, nuclear atypia, infiltratin cords into dermis, dyskeratotic cells, keratin pearls

Question 17

sebaceous carcinoma

Answer 17

elderly, F>M inc in asians

Question 18

sebaceous carcinoma can mimic what

Answer 18

chalazion or chronic blepharoconjunctivitis

Question 19

where do sebaceous carcinomas arise

Answer 19

upper lid, from meibomian, zeis or caruncle glands

Question 20

histo sebaceous carcinoma

Answer 20

malignant cells with foamy lipid laden cytoplasm, necrosis, pagetoid invasion of skin

Question 21

mets from sebaceous carcinoma of eyelid

Answer 21

direct extension and mets to lung liver brain and skull

Question 22

What is pinguecula

Answer 22

aktinic keratosis of the external surface of the eye

Question 23

signs pinguecula

Answer 23

asymptomatic, small yellow submucosal nodule at limbus
usually adults
tropical places b/c inc sun exposure
does not invade cornea!!
no therapy needed!

Question 24

site of copper deposition in eye in wilsons

Answer 24

descemet membrane

Question 25

pterygium

Answer 25

submucosal growth of CT that migrates to cornea | from UV damage, dust or wind

Question 26

what must you do when investigating pterygium

Answer 26

rule out SCC with histo examination

Question 27

Tx pterygium

Answer 27

comsmetic removal or for irritation reasons

Question 28

where is conjunctival melanoma present

Answer 28

limbus

Question 29

causes of ulcerative keratitis

Answer 29

viral bacterial mycotic parasitic

Question 30

most common cause central corneal ulcer

Answer 30

herpes simplex

Question 31

serpinginous dendritic ulcer in cornea, very painful

Answer 31

herpes, tx imediately

Question 32

bacterial causes of ulcerative keratitis

Answer 32

pseudomonas and staph

Question 33

mycotic ulcerative keratosis

Answer 33

aspergillosis, candida and fusarium

Question 34

parasitic ulcerative keratitis

Answer 34

micrsporidia

Question 35

amoebic keratitis

Answer 35

hot tubs, contact lenses and fresh water ponds

Question 36

presentation of acanthamoeba keratitis

Answer 36

irregular dendritiform epithelial keratitis, looks like herpes will progress to ring ulcer or radial!!!

Question 37

Dx acanthamoeba keratitis

Answer 37

calcoflour white staining!!! | confirmed by culture in special medium

Question 38

double walled cyst in eye

Answer 38

amebic keratitis

Question 39

keratoconus

Answer 39

degenerative deformation of corneal curvature causes irregular myopic astigmatism usually bilateral cornea buldges

Question 40

progressive visual distortion, light sensitigity

Answer 40

keratoconus

Question 41

major refractive surface of eye

Answer 41

cornea

Question 42

munsons sign

Answer 42

when patient looks down you can see eyes forming cone causing lower lid to bulge + in alports if lens + in keratoconus if cornea

Question 43

Tx keratoconus

Answer 43

penetrating keratoplasty =corneal transplant/graft

Question 44

loss of central vision

Answer 44

macular degeneration

Question 45

dry form macular degeneration

Answer 45

no neoangiogenesis

Question 46

wet form macular degeneration and Tx

Answer 46

presence of neoangiogenesis | give agents that inhibit vascularization VEGF antagonists injected to vitreous

Question 47

risk factor for wet type macular degeneration

Answer 47

cigarrette smoking

Question 48

dry macular degeneration

Answer 48

deposits in Brush membrane and atrophy of retinal pigmented epithelium no Tx

Question 49

most common intraocular tumor in childhood

Answer 49

retinoblastoma <3 y.o Dx

Question 50

retinoblastomas assoc with

Answer 50

germ line mutations

Question 51

signs Sx retinoblastomas

Answer 51

leukocoria, strabismus, red painful eye and poor vision

Question 52

Ch with retinoblastoma gene

Answer 52

Chr 13 | tumor suppressor gene

Question 53

hist retinoblastoma

Answer 53

small blue cells | rosettes with empty lumens called flexner wintersteiner rossettes

Question 54

Tx retinoblastoma

Answer 54

enucleaion, photocoagulative ablation and hyperthermia, cryotherapym chemoreduction therapy, external beam radiation, plaque radiotherapy

Question 55

prognosis retinoblastoma

Answer 55

overall survival 85% | most important risk factor is extraocular extension of tumor through ON or sclera