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Flashcards in QUESTIONS Deck (136):
1

How do you treat post op pupillary block

cycloplegia, LPI

2

How do you treat post op ciliary block?

cycloplegia, LPI (to r/o pupillary block), aqueous suppression

3

patients with elevated IOP from ICE syndrome...what is best therapy?

tube shunt vs trabeculectomy. laser angle surgery doesn't work due to angle abnl

4

What serologic markers are most associated with uveitis in JIA patients?

postive ANA with negative RF

5

First line treatment for fungal keratitis?

natamycin--only available topical anti fungal in US

6

When should you consider giving steroids in EKC?

SEIs or pseudomembranes

7

prostaglandin ocular side effects?

macular edema, uveitis

8

topical carbonic anhydrase ocular side effects?

K edema

9

laser trabeculoplasty is good for patients for what kind of angle structure?

open angles such as in pseudo exfoliation syndrome

10

what is Kasabach Merritt syndrome?

infantile hemangioma on organs leading to thrombocytopenia due to sequestration

11

anterioposterior width of lens at birth and in adult?

3.5 mm and 5 mm in adults

12

what's the width of a phase tip?

1.6mm

13

what optic disc features are seen in NTG?

larger CDR, sloping, PPA, disc hemorrhage

14

what is scleromalacia perforans?

necrotizing scleritis WITHOUT inflammation. Associated with RA and is painless. High mortality--manage with a rheumatologist

15

redundant periumbilical fold is associated with what condition?

axenfeld rieger

16

interrupted PKP sutures are best for what kind of patients?

inflamed K, children, thin cornea, and vascularized corneas.

allows sutures to be removed individually if needed

17

rubella infection of second trimester is associated with what?

retinopathy

18

rubella of first trimester is associated with sequestration of virus in lens leading to cataracts... what other association is almost never seen at the same time with cataracts in these patients

congenital glaucoma

19

myasthenia gravis is also associated with what comorbid condition?

Graves and thymoma
Get TSH and CT chest/neck

20

salt pepper fundus

congenital rubella mostly associated with second trimester infection

21

describe Lisch Epithelial Corneal Dystrophy?

X link dominant condition with micro cysts in epithelium forming whirl like pattern. Similar to Meesman's

22

definition and width of perifovea

1.5 mm, area of the very peripheral macula

23

width of parafovea

0.5mm, area surrounding fovea. It is where ganglion cells are the thickest

24

foveola definition. width of foveola?

area where there's only cones.
250 microns

25

where is foveola in relations to optic nerve?

0.4mm temporal, and 0.8mm inferiorly

26

What is the width of fovea?

1.5mm--aka 1 disc diameter

27

thickness of K epithelium?

50 microns

28

thickness of Bowman's layer?

8-14 microns

29

Thickness of decedent's membrane?

3 microns at birth ---increases to 10 microns in adulthood

30

nevus of Ota is associated with what condition?

glaucoma in 10% pts

31

Feldenstrucktur muscle is at what NMJs for what movements

at En grappe NMJs for smooth pursuits

32

Fibrillenstruktur muscle is at what NMJs for what movements

en plaque NMJs for saccades

33

Cidofovir ocular side effect?

uveitis, hypotony

34

what conditions are associated with enlarged K nerves/

neurofibromatosis 2
MENIIB
leprosy

MeN2 large k nerves

35

how many % of melanomas come from PAM (with atypic)? de novo? nvus?

70% from PAM. de novo 20% rest from nevus

36

dieffenbachia plant exposure causes what?

corneal calcium oxalate crystals called raphides

37

treatment for toxo?

oral: pyrimethamine, sulfadiazine, folic acid...(triple therapy)... then later on prednisone

or IV of clindamycin and dexamethasone

38

LASIK. what organisms are common infections in <10 days post op? what about >10 days post op?

Gram + <10 days
Fungal or atypical mycobacteria >10 days

39

Lens capsule is thickest where?

posterior pre equatorial 23 microns

40

anterior lens capsule thickness?

14microns

41

direct eye lid closure is used for what size of eye lid defects?

<33%

42

how do you close lid defect 33-50%?

lateral canthotomy then rotate flap (Tenzel flap)

43

what is Cutler-Beard procedure?

for UPPER lid defects of >50% by using lower lid as flap

44

What is the modified Hughes procedure?

to fix lower lid defects >50% with upper eyelid flap to construct posterior lamella

45

what is echothiophate?

indirect Miotics. Do NOT give succinylcholine with it as it may prolong paralysis

46

What is central cloudy dystrophy of Francois?

exactly the same appearance as crocodile shagreen. Except for crocodile shagreen develops over time and central cloudy dystrophy of Francois is from birth (it's a dystrophy)

47

what are the two flattest quadrants of the cornea?

superior and nasal

48

fovea size

1.5mm same as ON

49

microscopic breaks in bowman's layer is associated with early stages of what condition?

Keratoconus

50

What is the difference between CHED and CHSD?

CHSD is extremely rare --there is no corneal edema, but there's thickening with flaky stromal lesions.

51

what is astigmatism keratotomy?

parallel corneal incisions about 1mm from apex in order to flatten steep meridian and steepen the flat meridian (coupling)

52

what effect do radial incisions on the cornea have on the curvature?

radial incisions flatten both the meridian at hand as well as 90 degrees from it

53

Cidofovir is used for CMV retinitis. what are its side effects?

anterior uveitis.
hypotony
renal toxicity

54

what is the only medicine proven to reduce rebleed s/p traumatic hyphema?

aminocaproic acid

55

christmas tree cataract are associate with what two conditions?

myotonic dystrophy
hypoparathyroidism

56

what kind of collagen is associated with decemet's membrane

type IV

57

corneal power total? anterior? posterior?

total is 43. anterior is 48, posterior is -6

58

sudden vision loss with disc edema/peripapillary telangiectasia. waht condition? pattern of inheritance?

Leber hereditary optic neuropathy. mitochondrial

59

symptomatic patients and what % of carotid occlusive disease should get CEA? what's the periop risk of stroke in CEA? how does stenting compare?

70-99%. Periop risk of stroke for CEA is 6%. vs higher with stenting

60

ONTT. how many % of patients with optic neuritis had pain with EOM?

92%

61

square wave jerks. associated with what condition? it's nystamoid movement but not nystagmus because?

parkinson's and cerebellar/pontine disease.

It is saccdic intrusion and does not have fast/slow phase.

62

How many posterior short ciliary arteries enter the globe around the optic nerve? how many posterior short ciliary nerves?

20 arteries
10 nerves

63

what's the length of intraorbital portion of optic nerve?
what's the length of intrascleral portion of optic nerve?
what's the length of intra canal portion of optic nerve?

24mm
1mm
10mm

64

whats the difference between prolapsed orbital fat and lipodermoid

lipodermoid is choristoma present at birth vs prolapse happen with age

65

rate of aqueous production

2 microliters/min

66

what substances are at increased concentration in Aqueous than blood

vit C, hydrogen, chloride

67

type 2 parafoveal telangiectasia is associated with what lab test finding?

impaired glucose tolerance

68

Duane type 1. preferred surgical procedure?

medial rectus recession

69

Duane type 2. preferred surgical procedure?

lateral rectus resection

70

the orbits are separated by how many mm?

25

71

light induced scotoma that improves with laying down. dx? diagnostic studies?

ocular ischemic syndrome. also could present as hypotony and mid-peripheral DBH

can do FA, CTA, MRA, carotid doppler--carotid endarterectomy

72

volume of vitreous cavity

5ml

73

volume of AC

200 microliters

74

which immunemodulator is associated with drug induced lupus?

infliximab

75

vitrectomy induces what kind of cataract?

nuclear

76

silicon oil induces what kind of cataract

PSC

77

average power of the lens is how many diopters?

20

78

ectopia lentis et pupilae. mode of inheritance

autosomal recessive

79

what is the most common cause of congenital unilateral cataract?

persisting fetal vasculature (PFV)

80

how often is Rb bilateral

1/3 of the time

81

beer belly cornea, crab claw on keratometry. Dx?

pellucid marginal degeneration

82

what is snowflake degeneration?

degenerative changes to PMMA IOLs.

83

IOL calcifications happen with what kind of IOL material?

hydrogel

84

glistening occur with what kind of IOL material

hydrophobic

85

encephaloceles are associated with what two optic nerve abnormalities?

morning glory nerve
optic nerve hypoplasia

86

what is Heerford syndrome?

It's uveitis, parotidis, and fever (uveoparotid fever)
can be a presentation of sarcoid

87

What is Lofgren's syndrome?

erythema nodosum, hilarious LAD, and arthritis

88

what are the signs of intraoperative suprachoroidal hemorrhage?

tense eye, shallowing AC, loss of red reflex.

89

What do you do in the case of intraoperative suprachoroidal hemorrhage.

close wound with suture

90

the two oblique muscles are at how many degrees from visual axis?

51 degrees

91

the superior and inferior rectus muscles are at how many degrees from visual axis?

23 degrees

92

What is spherical aberration?

4th order aberration. Due to stronger focusing at peripheral corneal vs central. Risk factors: young, large pupil, myopic corneal ablation
night myopia is a side effect

93

What is coma?

coma and trefoil are 3rd order aberrations.
Coma is due to eccentric light focusing causing light to look like a comet

94

what are second order aberrations?

myopia (positive defocus) and hyperopia (negative defocus)

95

What are first order aberrations?

prisms.

96

What are ophthalmoplegic migraines?

intermittent 3rd nerve palsy. Almost always in Peds.
Always a diagnosis of exclusion (lymphomas, sarcoid..etc). enhancement on MRI is seen

97

what are the three FA patterns seen with central serous chorioretinopathy--- in order of most common to least common?

expansile dot pattern, smoke stack (10%), diffuse

98

CN with the longest intracranial course?

CN 4

99

which sub nuclei of CN III are fused (and thus supplies both eyes)?

levator palpebrae

100

which EO muscle receives innervation from both ipsilateral and contralateral nerve fibers?

Superior rectus... from both CNIII fibers

101

Saltzmann's nodules are in what layer of the K?

Bowman's.
Middle age women--trachoma/interstitial keratitis/phlyctenules

102

most common hormone deficiency in de Morsier syndrome?

growth hormone

103

what is a contraindication to azathioprine?

hx of treatment with alkylating drug or hx of allergy

104

What is Foster-Kennedy Syndrome vs Pseudo Foster-Kennedy Syndrome? How do you distinguish?

Foster Kennedy syndrome: mass compression induced optic neuropathy/atrophy. Then compression of CSF flow results in unilateral papilledema in other eye.

PSeudo Foster Kennedy syndrome: sequential NAION at least 6 weeks apart. One nerve is atrophic already and one is swollen.

Both have one atrophic and one swollen nerve
distinguished by VF defect of the swollen side--> pseudo Foster Kennedy will have altitudinal or arcuate defect like NAION. Pseudo FK will have only enlarged blind spot

105

latent nystagmus is associated with what kind of deviation? when does it occur?

congenital estropia with fast beats AWAY from viewing eye.
Occurs when binocularity is disrupted.

106

What settings of PRP increase chance of choroidal neovascular membrane?

higher power, longer duration, and SMALLER spot size (breaks through Bruch's membrane)

107

what's the magnification of a simple magnifier equation?

Msimple magnifier=D x distance

108

what is oscillopsia?

subjective sensation that environment is moving in patients with nystagmus or nystamtoid eye disorders

109

what are some drugs that causes uveitis?

rifabutin, bisphosphonates, sulfonamides, OCPs

110

What meds are associated with uveitis

metoprolol, travaprost.

111

proliferative sickle cell retinopathy should be treated how?

low intensity PRP to ischemic regions

112

benefits of YAG contact lens?

stabilizes eye, reduces depth of field, and magnifies image.

113

Bacterias that can penetrate intact K epitheliuM?

No Hard or Soft Contact Lenses
Neisseria (both), Haemophilis aegyptus, Shigella, Corynebacterium, Listeria

114

What is Sherrington's law? what condition violates Sherrington's law?

When one rectus muscle contracts the opposite muscle relaxes. Duane's violates Sherrington's thus the globe retracts

115

What is Herring's law?what condition violates this?

The two eyes are yolked together. so refixation of a hyperopic eye should result in corresponding downward movement of the other eye. Dissociative vertical deviation (DVD) violates this

116

What is the lens maker's equation?

Power (D)= (n'-n)/r

n'=index of refraction of lens. n=index of refraction of air. R is focal length

117

how many degrees do you treat when doing CPC?

270 --so that 90 degrees are spared--decreases anterior segment necrosis risk.

118

Plateau iris is diagnosed s/p doing LPI and pressure is still elevated. What should you do to treat plateau iris?

ALT

119

Touton giant cells are associated with what condition?

Erdheim-Chester (two tons of chest nuts)
Associated with early cardiac disease
Skin findings of Juvenile Xanthogranuloma (little red bumps)
yellow iris lesions

120

Unilateral ischemic eye disease with mid periphery retinal hemorrhage seen on exam. What condition is this? what's the work up?

Ocular ischemic syndrome.
You need to do carotid US

121

Neuroblastoma associations in children?

periorbital ecchymosis
Horner's syndrome

122

Forster Fuch's spots. what are they. what condition do you seen them in?

RPE changes/hyperpig spots. In high myopia

123

Dalen Fuch's spots. What conditions do you see them in?

Sympathetic ophthamia
VKH

124

neuroretinitis with macular star and papilledema. What's the organism that causes this?

Bartonella

125

magnification of image with a lens is calculated how?

Mag=power of eye/power of lens

126

Bird shot chorioretinitis is characterized by what HLA marker

HLA A29
best tested with ERG and VF

127

Young child who has bilateral ptosis and cannot look up.

congenital fibrosis extra ocular muscle syndrome 1. autosomal dominant hesitance of muscle fibrosis.

128

chandler's

iris atrophy, k edema

129

energy pathway of the lens? (glucose)

anerobic glycolysis

130

what is pseudoxanthalasma elasticuma?

xanthalasmas on skin
Fundus has angio streaks and peau d'orange appearance. These eyes are prone to CNVM, choroidal hemorrhage.

131

how do retinoblastoma escape the eye and disseminate?

via optic nerve

132

what is bilateral diffuse uveal melanocytes proliferation (BDUMP)

leopard spots withOUT leakage on FA. associated with lung cancer.

133

uveal effusion syndrome

leopard spots WITH. leakage on FA
not associated with lung cancer

134

uncontrolled IIH with progressive vision loss--tx? uncontrolled HA--tx?

optic nerve fenestration for vision loss.
lumboperitoneal shunt for headache

135

When you do surgery on the inferior rectus the lower eye lid tend to go in the direction where you move it. Recession --> lower lid retraction, Resection -->lower lid elevation

---

136

dieffenbachia house plants can cause what complication?

corneal crystals. painful