quiz 5 part 1

Question 1

proliferative diabeteic retinopathy

Answer 1

-VEGFA drives neovascularization
-new vessels grow on the surface of the retina and can bleed into the eye
-poor prognosis untreated

Question 2

non proliferative d.r.

Answer 2

-early stage
-dilation of veins, microaneurysms, retinal hemorage
-no new vessels
-due to vessels being weak body releases VEGFA

Question 3

nonproliferative tx

Answer 3

control blood glucose and photocoagulation

Question 4

proliferative tx

Answer 4

vegfa and photocoagulation

Question 5

hypertensive retinopathy

Answer 5

high bp damages the vessels
-they narrow, rupture, optic nerve swells (papilledema), exudate
-vascular wall changes
-arteriovenous nicking on fundoscopy

Question 6

thicker vascular walls from hypertension

Answer 6

copper wiring

Question 7

more advanced hardened vessels from hypertension

Answer 7

silver wiring

Question 8

conditions associated with hypertensive reti.

Answer 8

pheochromocytoma, malignant hypertension and preeclampsia-eclampsia

Question 9

retinal artery occlusion

Answer 9

-blocked by embolism
-painless blindness
-decrease intraocular pressure
-atherosclerotic plaques and tempral arteritis

Question 10

how can temporal arteritis cause central retinal artery occlusion

Answer 10

causes inflammation of opthalmic artery that becomes central artery occlusion

Question 11

physical findings retinal artery occlusion

Answer 11

-poor pupillary response to light on bad eye
-light on the good eye causes both to contract
-arteries may appear bloodless

Question 12

central artery occlusion tx

Answer 12

-past 72 hrs treatment might not improve vision
-tx within 24 hrs
-once the retina has infarcted it is perm
-occular massage, lay flat, high concentration oxy, iv acetazolamide, anterior chamber paracentesis

Question 13

conjunctivitis pathogens

Answer 13

-virus, bacteria, fungal, parasite, hsv
-viral can lead to blindness
-sti if follicular conjunctivitis or preaural adenipathy
-gonococcal if neonates (can perforate cornea or be purulent)

Question 14

main three causes of conjunctivitis

Answer 14

chlamydia, adenovirus, hsv

Question 15

clear watery discharge

Answer 15

viral conjunctivitis

Question 16

lots of discharge, minimal pain, staph, strep

Answer 16

bacterial conjunctivitis

Question 17

what can chlamydia conjunctivitis lead to

Answer 17

scarring, lid derangement, ingrown eyelashes
-trachoma= main cause of blindness

Question 18

bacteriak, conjunctivitis tx

Answer 18

sulfacetomide

Question 19

chamidyae conjunctivitis tx

Answer 19

oral azithromycin

Question 20

gonococcal conjunctivitis

Answer 20

IM ceftriazone

Question 21

what is there is pain with conjunctivitis

Answer 21

it is viral or bacterial

Question 22

allergic conjunctivitis

Answer 22

-stringy discharge, no pain, coble stone papillae, vision loss

Question 23

allergic conjunctivitis tx

Answer 23

topical corticosterois, histamine h1 antagonist, watch for cataracts, glaucomma, hsv

Question 24

neiserra conjunctivitis

Answer 24

tx with abx to prevent secondary infection, artificial tears
*corticosteroids can be bad if pt has hsv wait for opthalmalogist

Question 25

episcleritis

Answer 25

-superficial, collagen and vascular disorder, asymptomatic, mild pain *no symptoms

Question 26

scleritisi

Answer 26

*symptoms -deep, idiopathic, collagen vascular disease -zoster, sarcoids, RA -deep dull pain **wakes them at night**

Question 27

scleritis tx

Answer 27

nsaid or prednisone

Question 28

shingles

Answer 28

hutchinson sign, acyclovir

Question 29

uveitis anterior

Answer 29

acute recurrent and chronic -red eye, low vision, photophobia, idiopathic -paneuveitis (all 3 uvea layers)

Question 30

uveitis posterior

Answer 30

-choroditis, vitritis (vitreous inflammation), retinal vasculitis, retinitis, shingles, sarcoids, toxo, tb, syph etc -pupil can be irregular and small -not as painful or red -panuveitis (all 3 uvea layers)

Question 31

glaucomma open angle

Answer 31

-iop >21, large optic cup, field loss, older women

Question 32

glaucomma closed angle

Answer 32

-ocular and face pain, headache, vom, abd pain, haloes, fixed mid dilated pupil, shallow anterior chamber -emergency

Question 33

open angle tx

Answer 33

timolol, alphagen, prostaglandin agonist

Question 34

closed angle

Answer 34

acetazolamide, timolol, pilocarpine, prednisone acetate, iridotomy

Question 35

amaurosis fugax

Answer 35

-temp vision loss due to retinal blood flow -painless loss unilateral -returns when blood flow is restored -fleeting blindness -curtain across the vision -CAD or AFIB

Question 36

retinitis pigmentosa

Answer 36

-rod degenerative disease -night vision and tunnel vision start -lose periphery

Question 37

retinal vein occlusion can cause

Answer 37

-neurovascularization of the retina or iris with a secondary glaucomma weeks to months after the occlusion

Question 38

what is retinal vein occlusion

Answer 38

-sudden or gradual vision loss dx with fundoscopy, distended veins, congestion, edematous retinal hamorrages, wool spots, optic disc swells -vision may return if perfusion is restores

Question 39

pharygitis caused by

Answer 39

-virus or bacteria, viral more common -tonsillitis can happen simultaneously -influenza a and b -h1n1, rsv, adenovirus

Question 40

rare pharyngitis causes:

Answer 40

hsv, neusseria gonorrhoeae

Question 41

serious pharyngitis strains?

Answer 41

strep, group a beta hemolytic strep

Question 42

viral pharyngitis sx

Answer 42

-sneeze, rhinorhea, cough

Question 43

pharygitis signs

Answer 43

-red tonsils, swollen, yellow or thin white membrane that peels without bleeding, white matter, large lymph, dry mucous membrane

Question 44

GABHS pharyngitis sx

Answer 44

-headache, exdudate, painful swallowing, gi symptoms, chills, high fever, hoarse, *NO COUGH

Question 45

centor criteria

Answer 45

-fever -exudate -tender adenopathy -no cough 1 no abx 2 abx w (+) rapid 4 abx empiric

Question 46

pharyngitis labs

Answer 46

WBC, monospot, lateral neck radiograph to rule out pharyngeal abscess, culture

Question 47

pharygitis tx

Answer 47

-salt gargaras, pnc (adult= amoxicillin, IM benzathine/ procraine (not used)) -2ndry: azithromycin, erythromycin, clindamycin

Question 48

when to get tonsillectomy

Answer 48

if the upper airway is obstructed, dysphagia, sleep disorder or febrile convulsions from tonsillitis -3 or more infection per yr or being a carrier consider it

Question 49

complications pharygitis

Answer 49

-RF, glomerulonephritis, preterm deliver -supperative: peritonsillar abscess, impetigo, OM, mastoiditis, sinusitis, meningitis, nfascitis, cellulitis

Question 50

mono triad

Answer 50

lymphadenopathy, fever, sore throat w or w out exudate