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PD Exam #1 - Ophtho
Fall Semester - 2010
109
Medical
Graduate
10/28/2010

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Cards

Term
What are the three "vital signs" of the eye?
Definition
vision
Pressure
Pupil
Term
What is a major complication of C. Trachomatis (conjunctivitis)?
Definition
Leading cause of blindness in the world
Term
What is a major complication of N. gonorrhea (conjunctivitis)?
Definition
Conjunctival Scarring leading to lid derangement and ingrown lashes
Term
What is a major complication of Chlamydia (conjunctivitis) in infants?
Definition
Chlamydial pneumonia can occur in infants up to 6 m after Chlamydial eye infection
Term
Which type of pupil anomaly is described as a pupil larger than normal and constricts slowly in bright light? What other sign is usually present with this abnormality?
Definition
Adies pupil
DTRs usually absent, especially achilles DTR
Term
Which type of pupil anomaly is described as inability for the pupil to constrict to direct or consensual light, but it DOES respond to accommodation?
Definition
Argyll Robertson's Pupil
Term
How do you test for a Marcus Gunn pupil? What is another name for this condition?
Definition
Swinging Light Test
APD - Afferent Pupillary defect
Term
What type of pupil defect will you see with Horner's syndrome?
Definition
Miotic Pupil (Dilation instead of constriction, or slow constriction in affected eye)
Term
What are examples of systemic diseases that affect the eye?
Definition
RA, HTN, DM, Chylamdia, Gonorrhea, Connective Tissue disorder, HIV, Thyroid Dx
Term
What are the most common pathogens that cause bacterial conjunctivitis?
Definition
Staph and Strep
Term
What 3 structures make up the uvea?
Definition
Iris, Ciliary body and choroid
Term
Term that means - No lens in the eye ?
Definition
Aphakia
Term
Term that means - Pus in the anterior chamber?
Definition
Hypopyon
Term
Term that means - Iris adheres to the cornea or lens?
Definition
Synechiae
Term
Term that means - hole in one of the eye structures?
Definition
Coloboma
Term
Term that means - blood in the anterior chamber of the eye?
Definition
Hyphema
Term
Term that means - swelling or edema of the conjunctiva?
Definition
Chemosis
Term
Term that means - Bacterial infection of the eye?
Definition
Trachoma
Term
Which term describes part of the eye anatomy where there is a serrated junction between the retina and the ciliary body?
Definition
Ora Serrata
Term
Term that means - blind spot?
Definition
Scotomata
Term
Term that means - overflow of tears?
Definition
epiphora
Term
Term that means - congestion of blood in ANY part of the eye?
Definition
Hyperemia
Term
Term that means - different colored eyes? What conditions could this be a sign of?
Definition
Heterochromia; Down Syndrome and Horner's Syndrome
Term
Term that means - Nearsighted?
Definition
Myopic
Term
Term that means - Farsighted?
Definition
Hyperopic
Term
Term that means - age-related far-sightedness?
Definition
Presbyopic
Term
Term that means - "lazy eye" or poor vision of an eye that is otherwise physically normal?
Definition
Amblyopia
Term
Eosinophils on a gram stain signify what type of conjunctivitis?
Definition
Allergic or parasitic
Term
Why are artificial tears prescribed for the eye?
Definition
Help with discomfort or dryness
Term
Why are cold compresses prescribed for use with eye conditions?
Definition
improve swelling and discomfort
Term
Why are broad-spectrum anti-biotics prescribed for the eye?
Definition
prevent secondary bacterial infection
Term
Why shouldn't we use aminoglycosides in the eye?
Definition
toxic to epithelia and retards healing
Term
Term used to describe - excessive dilation of the pupil?
Definition
Mydriasis
Term
Ddx for Mydriasis? (3)
Definition
Uncal herniation
Topical agents (like belladona and anticholinergics)
Acute Angle Glaucoma
Term
With a finding of granulomas on the conjunctiva what might that indicate?
Definition
Sarcoidosis
Term
Term that describes - Triangular thickening of conjunctiva growing ACROSS cornea?
Definition
Pterygium:
Term
Term that describes - Yellowish triangular nodule in the conjunctiva on either side of cornea (Aging)?
Definition
Pinguecula:
Term
A finding on exam of Bitot's spots on the sclera or bulbar conjunctiva is indicative of what condition?
Definition
Vitamin A def.
Term
A finding on exam of a blue discoloration of sclera is indicative of?
Definition
Osteogenesis Imperfecta
Term
When should a fluorescein stain be done?
Definition
Any time the pt feels a foreign body sensation
Term
What is the IOP in chronic open angle glaucoma? What is the IOP in Acute Closed angle glaucoma? Which is an EMERGENCY?
Definition
COAG - IOP of 20 to 30
ACAG - IOP of > 40
Acute Closed Angle Glaucoma is an emergency
Term
What is Seidel's test used to assess? What conditions is it used to screen for?
Definition
The presence of anterior chamber leakage in the cornea. Screens for the presence of corneal post-trauma, corneal perforation and corneal degeneration
Term
What condition is described as acute onset, occasional pruritis, hx of exposure/sick contact, previous hx of keratitis sicca or blepharitis?
Definition
Bacterial Conjunctivitis
Term
Which condition is described as acute or subacute onset, minimal pain level, exposure/sick contact hx, pruritis is common, clear watery d/c, foreign body sensation, preauricular adenopathy?
Definition
Viral Conjunctivitis
Term
Which condition is described as subacute onset, no pain, no exposure hx, pruritis is common, clear watery d/c with mucous?
Definition
Allergic Conjunctivitis
Term
Which condition is described as chronic onset, minimal pain, pruritis, sexual or STD hx?
Definition
Chlamydial Conjunctivitis
Term
What condition is described as occurring mainly in contact lens wearers, excessive pruritis, mucous production and visible papilla on upper lid eversion?
Definition
Giant papillary conj
Term
What nerve are you testing with the swinging flashlight test (Marcus Gunn Pupil)?
Definition
CN II
Term
With what symptom do you use the Marcus Gunn Reflex Technique? What is the Marcus-Gunn Reflex used to distinguish between?
Definition
Pt with unilateral ptosis
Congenital Ptosis and Horner's Syndrome
Term
What findings on the Marcus Gunn Reflex Technique would indicate Congenital Ptosis? Horner's Syndrome?
Definition
Congenital = M-G reflex response or upper eyelid opens with mouth opening
Horner's Syndrome - No change in the upper eyelid with mouth opening
Term
Which stage of Macular degeneration is most common? Which one is more damaging?
Definition
Most Common - Dry Stage
Most Damaging - Wet Stage
Term
In which type of Macular degeneration stage do hemorrhages appear?
Definition
Wet Stage
Term
Which type of cellulitis causes decreased eye movement and decreased visual acuity?
Definition
Orbital Cellulitis
Term
If the CC is Tunnel Vision, what is your DDx?
Definition
Glaucoma, Retinitis pigmentosa, Psychogenic
Term
Which CN causes ptosis?
Definition
CN III
Term
What vision indicates legally blind?
Definition
20/200
Term
Which gland is affected with an internal Hordeolum?
Definition
Meibomian Gland
Term
Which gland is affected by a Chalazion?
Definition
Meibomian gland
Term
Which gland is affected by an external Hordeolum?
Definition
Moll or Zeis
Term
If CC is Exopthalmus what is DDx?
Definition
Hyperthyroidism, tumor
Term
What CN III deficit is described as due to an unopposed lateral rectus (CN VI)?
Definition
Exotropia (walleye) (tropia = paralysis)
Term
What CN III deficit is described as multiple attempts to medially deviate the eye (CN III)?
Definition
Esophoria (phoria = weakness)
Term
What CN III deficit is described as an absolute loss of medial movement in the horizontal axis (CN III)?
Definition
Esotropia (tropia = paralysis)
Term
Which chart is used to test color vision?
Definition
Ishihara Chart
Term
Which chart is used to test visual acuity?
Definition
Snellen Wall Chart or Rosenbaum Pocket Chart
Term
What chart helps asses macular degeneration? What findings will be seen if the dx is present?
Definition
Amsler Visual Grid - central grid is wavy
Term
What chart helps asses gross scotoma? What findings will be seen if the dx is present?
Definition
Amsler Visual Grid -multiple "blind spots" especially in the outside or edges of the grid
Term
What chart helps asses optic chiasm tumor? What findings will be seen if the dx is present?
Definition
Amsler visual grid - lose half of the grid
Term
When the CC is scalp tenderness, what condition would you suspect?
Definition
Temporal (Giant Cell) arteritis
Term
What are the two test for strabismus?
Definition
Hirschberg method and Cover-uncover testing
Most accurate = Cover-Uncover Test
Term
If the pt has a horizontal (Altitudinal) visual field defect, where is the lesion location?
Definition
Branch of central retinal artery
Ischemia of Optic Nerve
Term
If pt has blind rt eye visual field defect, where is the lesion location? blind lft eye?
Definition
blind rt = right optic nerve
blind lft = left optic nerve
Term
If the pt has a Bitemporal Hemianopsia visual field defect, where is the lesion location?
Definition
(Bitemporal = located at both temporals; Hemi = half)
Lesion located in Optic Chiasm
Term
If the pt has a Left Homonymous Hemianopsia visual field defect, where is the lesion location?
Definition
(Homo = same side; Hemi = half)
Right Optic Tract (lesion always on opposite side of vision loss)
Term
Which eye muscle depresses the eye? (CN?)
Definition
Inferior Rectus (CN III)
Term
Which muscle adducts the eye? (CN?)
Definition
Medial Rectus (CN III)
Term
Which muscle Abducts the eye? (CN?)
Definition
Lateral Rectus (CN VI)
Term
Which muscle elevates the eye? (CN ?)
Definition
Superior Rectus (CN III)
Term
Which muscle controls intorsion, depression and adduction of the eye? (CN ?)
Definition
Superior Oblique Muscle (CN IV)
Term
Which muscle controls Excyclotorsion, elevation and adduction? (CN ?)
Definition
Inferior Oblique Muscle (CN III)
Term
The term that describes - pupillary constriction?
Definition
Miosis
Term
What are the 4 signs of Horner's Syndrome?
Definition
Miotic Pupil (dilation instead of constriction)
Ipsilateral Ptosis
Enopthalmus (Upward migration of lower eyelid)
Absent Marcus-gunn jaw wink sign
Term
If CC painful, photophobic RED eye what is your DDx?
Definition
Acute Angle Glaucoma (Especially with Nausea, Vomiting, IOP > 40 and Steamy Cornea)
Term
With CC of chronic pruritis and epiphoria what is DDx?
Definition
allergies and blepharitis
Term
With CC of Floaters or Flashing Lights, what is your DDx?
Definition
Retinal detachment, retinal tears
Term
With CC of Blurry Vision, what is your DDx?
Definition
Acute Glaucoma, Keratitis, Iridocylitis, Adie's pupil,, Retinal Detachment
Term
Which type of nerve injury is caused by uncal herniation or trauma to the orbit?
Definition
CN IV
Term
Which CN Deficit is crosseye/esotropia that is usually caused by congenital deformity or trauma?
Definition
CN VI
Term
Which CN deficit is described as walleye deformity, due to loss of medial movement in the horizontal plane?
Definition
CN III
Term
What are three causes of Mydriasis?
Definition
Uncal Herniation
Topical Agent
Acute Angle Glaucoma
Term
Which of the following is associated with rheumatologic dx, Episcleritis or Scleritis?
Definition
Scleritis
Term
Which of the following will have a mildly tender red macule or papule on section of the sclera, Episcleritis or Scleritis?
Definition
Episcleritis
Term
Which of the following have a diffuse papular red lesion on the sclera and conjunctiva with one or more areas of bluish hue?
Definition
Scleritis
Term
Which ocular condition is described as bulbar conjunctivitis SPARING the limbus, non-exudative and non-ulcerative?
Definition
Kawasaki Syndrome
Term
Which condition is described as painless, self-limited red eye whose cause is usually trauma?
Definition
Subconjunctival Hemorrhage
Term
Which ocular condition is described as a neuronal dendrite seen on fluorescein stain?
Definition
Herpes Simplex Keratitis
Term
Which dx is characterized by a Kayser-Fleisher ring?
Definition
Wilson's Dx
Term
What are lisch nodules? With lisch nodules present on exam, what is your Dx?
Definition
Clumps of pigment in the iris; Neurofibromatosis
Term
What must acute purulent conjunctivitis be evaluated with?
Definition
Gram's stain
Term
What are Brushfield Spots? In what congenital condition are they seen in?
Definition
Hypopigmented structures in the iris; seen in Down's syndrome pts
Term
What red eye condition does pre-auricular adenopathy suggest?
Definition
Viral Conjunctivitis
Term
What red eye condition do follicles on conjunctiva suggest?
Definition
Viral Conjunctivitis
Term
What does synechiae with an irregular pupil suggest? What condition might it be seen in?
Definition
Iridocyclitis; RA
Term
If a crescent shadow is noted on nasal aspect of the iris, what does this indicate?
Definition
Anterior lens displacement as a result of increased IOP which puts the pt at an increased risk for acute narrow angle glaucoma.
Term
What does an absent red reflex indicate? What does leukocoria indicate?
Definition
Cataract; Leukocoria (White Reflex) indicates Retinoblastoma
Term
What does papilledema indicate?
Definition
Increased intercranial pressure
Term
What does the presence of a tear-drop pupil indicate?
Definition
Ruptured Globe
Term
Which type of bacterial infection are contact lens wearers predisposed to?
Definition
Pseudomonas infection
Term
A common lid abnormality in which the eyelashes are directed towards the globe, that is commonly seen with blepharitis is known as?
Definition
Trichiasis
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