Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS 871: NP Role in Illness > Week 01.Eyes > Flashcards

Week 01.Eyes Flashcards

(84 cards)

Start Studying
1
Q

4 major causes of vision loss in older adults

A

age-related macular degeneration
age-related cataracts
glaucoma
diabetic retinopathy

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

How to delay vision loss in glaucoma? What is the downside of this?

A

eye drops that reduce intra-ocular pressure
–> adherence is poor

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

What medication can be used for diabetic retinopathy?

A

fenofibrate

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

Other than fenofibrate, what else can be done for diabetic retinopathy?

A

intraocular steroid injections

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

What delays progression of diabetic retinopathy? What else must be considered?

A

tight control; must be balanced against risk of hypoglycemia and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How often should older adults be screened for vision issues? According to whom?

A

after age 65, every 2 years, based on EXPERT OPINION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is used to screen for progression of macular degeneration? How does it work?

A

Amsler Grid. Fix gaze on black dot in middle of grid and report if any lines appear distorted (meaning abnormal vision).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can be used to slow the progression of age-related macular degeneration?

A

antioxidant supplements, specifically lutein plus xeaxanthin; avoid original forumulation (AREDS) for smokers due to the risk of lung cancer from beta-carotene

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

What studies looked at the use of antioxidant supplements to slow progression of age-related macular degeneration?

A

AREDS and AREDS2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Under what names can patients buy antioxidant supplements to slow the progression of age-related macular degeneration? Of what do patients need to be cautious?

A

AREDS and AREDS2
If smoker, avoid AREDS (original formulation) in smokers due to the association of beta carotene with lung cancer

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

How are cataracts detected in primary care?

A

red reflex appears dull, extinct, or shady

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

What vision issues warrant referral to an ophthalmologist?

A

impaired vision
glare sensitivity
difficulty w/ nighttime vision, especially while driving

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

Only effective treatment for cataracts that compromise vision

A

surgery

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

What 2 things are associated with accelerated cataract formation?

A

UV light and smoking

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

Smoking is linked to what to disorders that commonly cause vision in older adults?

A

cataracts
macular degeneration

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

define MYOPIA

A

nearsightedness

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

describe REFRACTIVE ERROR

A

most common cause of decreased visual acuity
results from inability of eye to focus light precisely on retina
may be due to irregularities in cornea, lens, or shape of globe

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

define ASTIGMATISM

A

abnormally curved cornea or lens that causes blurred vision

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

define HYPEROPIA

A

farsightedness

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

Name some classes of medications that can induce myopia

A

sulfonamides
thiazides
anticholinergics

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

major refracting surface of the eye

A

cornea

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

briefly summarize FUCHS CORNEAL DYSTROPHY

A

bilateral corneal endothelial dysfunction
causes impaired vision
leading cause for need for corneal transplantation in U.S.

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

what is the defining clinical feature of Fuchs corneal dystrophy

A

Guttae = thickenings and excrescences of the basement membrane underlying corneal endothelial cells

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

What can accelerate the development of cataracts?

A

diabetes
chronic corticosteroid use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Floaters are a condition of what part of the eye?
vitreous fluid
26
A patient complains of new-onset floaters; what do you do? Why?
they are associated with retinal tears and retinal detachment (can compromise vision), so they should be referred to an opthalmologist
27
ARMD is what?
age-related macular degeneration
28
Neovascularization in the eye: what is it and why is it concerning?
it is the genesis of new blood vessels in the eye resulting from ischemia; these new vessels are fragile and are a associated with retinal edema and bleeding
29
What triggers increased vascular permeability and angiogenesis in the eye?
vascular endothelial growth factor
30
name a leading cause of legal blindness (20/200 or worse)
age-related macular degeneration (ARMD)
31
What kind of vision is impaired with ARMD? What vision remains intact?
impaired: central intact: peripheral
32
Who needs to assess their vision daily with an Amsler grid?
those with macular degeneration
33
Who is at risk for cytomegalovirus retinitis?
HIV patients whose CD4 counts are less than 200
34
name some symptoms of cytomegalovirus retinitis
new onset floaters and loss of vision
35
You see a "brushfire" pattern on fundoscopic evaluation of the eye; what do you suspect?
CMV retinitis
36
symptoms of retinal detachment
shower of floaters field defects flashing lights visual field defect like a shade being drawn
37
what is AMAUROSIS FUGAX?
sudden vision loss in one or both eyes due to lack of blood flow to retina
38
What is the retina?
the layer at the back of the eye that is sensitive to light; it passes impulses to the optic nerve which sends signals to the brain
39
symptoms of central retinal artery occlusion
sudden painless profound loss of vision ophthalmoscopic findings: pale optic disc attenuated arterioles boxcar veins hazy edematous retina cherry-red macula
40
symptoms of a branch retinal artery occlusion
visual field defect retinal findings: retinal edema, attenuated arteriole
41
most common embolic sources of a branch retinal artery occlusion
atheromatous plaque from: 1. ipsilateral carotid artery 2. vegetation from cardiac valve leaflet
42
optic neuritis is inflammation of the \_\_\_\_\_\_\_\_
optic nerve
43
with what is optic neuritis associated?
multiple sclerosis
44
What is HOMONYMOUS HEMIANOPSIA?
visual field defect person sees only one side of the visual world; this happens in both eyes
45
slight decrease in night visual acutity: normal or abnormal?
normal
46
optic neuropathy: patients often complain of \_\_\_\_\_\_\_
blurred vision at night
47
acute loss of vision is suggestive of \_\_\_\_
vascular event or retinal detachment
48
progressive painless vision loss is suggestive of \_\_\_\_
chronic issues, like * cataracts * macular degeneration * glaucoma
49
preceding episodes of amaurosis fugax can indicate \_\_\_
* central retinal artery occlusion or * giant-cell arterits
50
fixed pupil + red eye what do you suspect?
acute angle-closure glaucoma
51
afferent pupillary defect: what do you suspect?
* optic neuritis * central retinal artery occlusion * giant-cell arteritis * retinal diseases
52
diseases that cause a sudden visual loss DO not cause a red eye except for what?
* trauma * acute glaucoma * infection
53
Someone over age 50 is complaining of sudden visual loss; what should be checked?
temporal arteritis symtpoms: palpate cranial arteries for tenderness, enlargement, and loss of pulsation also check ESR
54
signs of acute angle-closure glaucoma
* fixed modposition pupil * redness * hazy cornea
55
differentiate hyphema from subconjunctival hemorrhate
* hyphema: blood in aterior chamber of eye (between cornea and iris)--suggestive of internal injury * subconjucntival hemorrhage: blood on the surface of the eye--occurs in both trauma and nontrauma
56
patients with dry eyes complain of:
* grittiness * itching * burning * soreness * difficulty in moving/opening eyelids * foreign body sensation * excessive tears (from reflex tearing)
57
what medications can cause dry eyes?
* diuretics * anticholinergics * antihistamines * TCAs * bladder relaxants * psychotropics
58
name some systemic diseases that can cause dry eyes
* Sjögren syndrome * sarcoidosis * Hodgkin disease
59
if someone presents w/ complaints of dry eyes, what other systemic s/sx should be investigated?
* skin (rosacea) * eyelids (blink rate, malposition, closure, discharge) * proptosis * crainal nerve function (e.g cranial nerve VII) * joints (for s/sx of RA)
60
patient has exopthalmos; what is the first task and why?
* determine if it is unilateral or bilateral * bilateral usually (not always) indicates Graves disease * unilateral requires a much more extensive workup
61
with bilateral exopthalmos, what studies should be ordered?
thyroid indices: * TSH * total tiiodothyronine * free thyroxine index
62
What is required in patients with unilateral exopothalmos? Why?
* orbital imaging: MRI and CT with axial and coronal views * looking for: * tumor * inflammatory and infectious diseases * vascular anomalies
63
why is cessation of smoking important in treatment of inflammatory symptoms of exopthalmos (periorbital edema and ocular discomfort)?
treatment = corticosteroids and orbital radiation smoking decreases their efficacy
64
When does a patient with exopthalmos need referral?
when the exopthalmos is * unilateral * severe * unexplained
65
With exopthalmos, when is emergency admission needed?
with orbital cellulits
66
What is a good imaging test if you want to see the bony structures of the eye?
CT scan
67
What is a good imaging test if you want to visulaize the sinus cavities?
CT scan
68
What is a good imaging test if you want to visualize the soft tissues of the eye?
MRI
69
What is dacryocystitis?
infeciton or inflammation of nasolacrimal sac
70
How is dacryocystitis treated?
* hot compresses QID and * systemic antibiotics * Augmentin 500mg BID or * erythromycin 250mg QID
71
# define DRUSEN
* deposits in the macula * pinhead-sized, yellow-white lesions
72
With what condition are drusen associated?
macular degeneration
73
A patient has macular degeneration in their family history; is this patient more at risk?
yes; there is a genetic component for AMD
74
Aside from genetics, what are other risk factors for macular degeneration?
* advancing age * caucasian * cardiovascular disease * atherosclerotic risk factors * sun exposure * diet (lack of antioxidants, zinc) * cigarette smoking * low vitamin D
75
Differentiate "wet" and "dry" age-related macular degeneration
* neovascularization --\> wet AMD * dry: no neovascularization
76
What pharmacologic option can be beneficial for wet AMD? How is it administered?
* anti-vascular endothelial growth factor * bevacizumab = Avastin (cheapest) * ranibizumab = Lucentis * aflibercept = Eylea (every 8 weeks instead of every 4) * administered via injection
77
Which is generally worse, wet or dry AMD?
wet, as neovascularization is present (by definition)
78
Macular degeneration usually affects central or peripheral vision?
central
79
Some patients with AMD get laser surgery on their eyes. What does it do?
80
Amsler grid changes may signify what concerning change?
a conversion from dry to wet AMD
81
name for a sudden change in vision
metamorphopsia
82
Risk factors for cataracts
* age * smoking * alcohol consumption * sunlight exposure * diabetes * systemic or topical corticosteroid use
83
What medications (class of them) can negatively affect cataract surgery due to permanent changes in the eye?
* tamsulosin * alpha-1 antagonists = alpha blockers * (due to intraoperative floppy iris syndrome = IFIS)
84
Patient education for cataract prevention
* avoid/stop smoking * wear brimmed hats and UVB protection for eyes/protective eyewear * limit dose/duration of systemic and inhaled steroids * encourage a diet rich in fruits and vegetables, but refrain from recommending antioxidant supplements

NURS 871: NP Role in Illness (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions