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gen med 2: eent > Peds and Other Stuff > Flashcards

Peds and Other Stuff Flashcards

1
Q

strabismus

A

misalignment of the eyes

most common in infants and young kids under 3 (can go away for newborns)

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2
Q

some causes of strabismus

A
  • congenital
  • poor muscle control
  • hyperopia
  • stroke/trauma= if nerve gets knocked out
  • down syndrome , cerebral palsy
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3
Q

strabismus is a_______-

what else to note

A

general category

esotropia
exotropia
hypotropia
hypertropia

note: descriptions—> unique one is alternating (one eye muscle gets tired and then the other takes over)

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4
Q

dx tests for strabismus

A

red light reflex
corneal light reflex
**cover uncover test
EOM

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5
Q

esotropia and etiology

A

1 or both turned inward

seen before 6 months of age and not present at birth

1) congenital
2) accommodative = secondary to hyperopia

3) 6th nerve palsy (trauma and stroke)

NOTE: b/w 2 and 3, w accommodative: diplopia is better w distance whereas 6th nerve is worse in the distance

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6
Q

tx of esotropia

A

infantile= surgical correction; BOTOX

accommodative= corrective lens; surgery is not corrected

6th nerve= prism correction (refracts light a certain way so diplopia goes away)–> surgery if it doesn’t leave by 6 months

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7
Q

exotropia

A

1 or both outward

1) congenital –> less common than eso so if its constant, rule out srs etiology
2) intermittent–> trying to focus but outward drift
3) 3rd nerve palsy (rare)–> can be congenital or acquired

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8
Q

which is more common ?

exotropia or esotropia

A

esotropia

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9
Q

tx for exotropia

A

same as eso
corrective lens
prism lens

botox surgical correction

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10
Q

what can mimick eso or exo tropia

A

if kids have extra skin for the epicanthic fold

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11
Q

we are concerned with ________________________________ with hypotropia

A

MASS PUSHING DOWN!!

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12
Q

amblyopia

A

lazy eye–> brain is too dumb to process the blurry image, so it picks the clear one and then ignores the other bad one

PERMENANT decrease in vision–> only in children

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13
Q

amblyopia only occurs in

A

children

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14
Q

causes of amblyopia most common

A

strabismic (the bad eye gets suppressed to prevent diplopia)

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15
Q

most severe cause of amblyopia

A

deprivation

–> excessive patching, corneal opacity, congenital cataract! –> MAKE SURE you aren’t missing a bigger pic bc you will see an ABSENCE of RED LIGHT REFLEX

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16
Q

most insidous cause of amblyopia

A

diff refractive states for each eye

can happen bilaterally if both eyes are out of focus

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17
Q

if a kid keeps running into walls and stuff….. could be_—-

A

amblyopia

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18
Q

ambylopia testing

A

basically everything we did for strabismus

+ UNIQUE: visual acuity (crowding phenomenon)–> harder to see crowded letters

also consider CT or MRI (tumor)

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19
Q

amblyopia treatment

A

correct structural issues (if cataract, fix by 2 months)

patching= cover good eye

glasses= if refractive issue

penalization= atropine drops to blur dominant eye

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20
Q

blepharitis ANDwhat organisms

A

bilateral inflammation of the eye LIDS

staph aureus= acute
seborrheic derm = chronic

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21
Q

anterior blepharitis

A

inflammation along eyelashes!

staph a: see scales and crusting

seborrheic= greasy scales

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22
Q

posterior blepharitis

A

most common
inflammation of the inner eyelid
( maybe seen w derm disease like rosacea or seb derm)

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23
Q

blepharitis sx

A

red swollen eyelids with flaking or scaling

crusty eyelashes

burning, tears, FB sensation

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24
Q

tx for blepharitis

A
  • lid hygeine= baby shampoo , warm compress

if bacterial, bacitracin or erythromycin

if refractory:

  • oral doxy
  • tetra
  • topical steroids short term
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25
entropion
eyelid margins turned inward
26
potential causes of entropian
spasmotic entropion= spasm of eyelid scar retraction on inside of eyelid (cicatrical entropion) surgery= trichiasis= lashes rubbing on the eye irritating cornea and conjunctiva --> can lead to scarring
27
ectropion 1) what is it? 2) etiology
eyelid margins out 1. senile ectropion- most common= age related 2. cicatrical ectropion 3. secondary to 7th nerve palsy (Bell's)
28
tx for ectropion
surgery
29
hordeolum and s/s
staph infxn of eye glands localized, red, swollen, tender abscess on eyelid margin 2 types= internal and external
30
internal hordeolum
staph infxn Meibomian gland TOWARDS conjuctival surface
31
course for hordeolum
resolves by draining randomly progress to lid cellulitis (down to maxilla) become a chalazion (chronic inflammation)
32
external hordeolum
Zeis smaller abcesses on external lid margin points AWAY
33
which one has more of a FB sensation external or internal hordeolum
internal
34
tx for hordeolum
warm compress (usually enough) could add abx ointment= polymyxin-bacitracin or erythromycin I&D if not resolved by 48 hours
35
dacryocystitis
acute or chronic (usually uni) inflammation of lacrimal sac ---> caused by partial obstruction of nasolacrimal duct -staph, strep, pneumococci, candida common w infants and older than 40
36
dacryocystitis sx
red painful selling nearing medial canthus reflex of pus from lactrimal puncta
37
workup for dacryocystitis
culture right by orbit and nose consider imaging (make sure nothing deeper)
38
tx for dacro
augmentin | dacryocystorhinostomy
39
tx for dacrocystitis in ifants
delayed opening in the lower portion of the nasolacrimal duct or inferior meatus watery eye massage it several times a day if chronic (past year) or get infxn--> dacryocystorhinistomy
40
pterygium
triangle white, pink /red fibrovascular conjuctival tissue from medial canthus over the cornea and towards the pupil point part of triangle towards the pupil risk factors= frequent exposure to UV light, dust or wind
41
pterygium tx
topical lubricants surgical excision if vision is obstructed (covering cornea)
42
pinguecula
yellowish triangle thickening does NOT grow over cornea apex away from pupil
43
pinguecula
no tx needed doesn't grow over cornea and obstruct vision
44
rhabdomyosarcoma
rare tumor or muscle/bone w unknown etiology (other place:head neck, extremity) most common malignant tumor of orbit in kids (1-10)
45
tx of rhabdomyosarcoma
get bx 1) chemo and radiation 2) enucleation
46
what does rhabdomyosarcoma look like
ptosis * proptosis * change in vision* eye pain/ swelling RAPID progression w metastasis to brain and lung
47
metastatic intraocular tumors are most common w
in adults top 3 : breast lung kidney
48
TTK about metastatic intraocular tumors
most invade choroid multiple solid creamy-white lesions with bad borders can see mottled legion with pigment clumping on surface can cause retinal detachment or impact vision
49
what is the most common intraocular tumor of childhood
retinoblastoma
50
retinoblastoma TTK
bilaterally 1/3 of time present from birth and most dx by age 3 rare but life threatening
51
what are some signs for retinoblastoma
white pupil= aka leucocoria --> not seeing red reflex messed up central vision--> strabismus
52
tx for retinoblastoma
enucleation bc posterior chamber is filled w tumor--> no useful vision very curable unless there is spread of tumor or optic nerve involved otherstuff is chemo and radiation
53
what dz can cause death from intracranial spread
retinoblastoma
54
what is the most primary intraocular tumor of adulthood
malignant melanoma from pigmented cells in choroid(can be mets from skin melanoma)
55
what is special about malignant melanoma and tx
often not detected until retinal detachment happens usually in middle age white tx= enucleation before tumor spreads to orbit
56
iris nevus vs iris melanoma
nevus is little frechles iris melanoma has lots of color change and assoc w malignant melanoma
57
glioma
rare optic nerve tumor 25-50% have neurofibromatosis dx in kids w decreased VA, proptosis. papilledema, optic atrophy, strabismusm well circumscribed lesion
58
tx for glioma
depends on size surgery chemo radiation
59
neurofibromatosis found means you should
work up to make sure you are not missing a glioma
60
neurofibromatosis
genetic disorder where tumors for on nerve tissue

gen med 2: eent (3 decks)

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