631 -15 Retinal Inflammatory Disease, Vkg To The End

Front 1

name three systemic diseases that change skin and hair color (types of VKH?)

Back 1

poliosis, vitiligo, and alopecia

Front 2

what type of anterior uveitis is seen in VKH granulomatous or nongranulomatous

Back 2

granulomatous

Front 3

a sun glow is seen with what disease

Back 3

VKH

Front 4

a person has granulomatous anterior uveitis, posterior uveitis, multifocal choroiditis that can lead to sensory retina detachment, retinal hemes and a sunset glow. what do they have

Back 4

VKH

Front 5

what lab test woud you want to run on a pt with VKH

Back 5

HLA typing

Front 6

how do you Tx a pt that has ocular symptoms due to VKH disease

Back 6

treat the uveitis with intensive steroids (IV, oral and periocular). if steroids are not tolerated use drugs such as cytotoxic or immunosuppresive agents

Front 7

what is the Px of a pt that has ocular Sx due to VKH

Back 7

could result in blindness unless treated aggressively

Front 8

if untreated what complications could lyme disease cause

Back 8

cardic, joint and neuro complications

Front 9

what occurs in stage 1 of lyme disease, including ocular

Back 9

rash accompanied by flu like illness, conjunctivitis and periorbital edema

Front 10

what occurs in stage 2 of lyme disease, including ocular

Back 10

dissemination in organs such as the skin, heart, joints and CNS. granulomatous anterior uveitis, retinal vasculitis and choroiditis

Front 11

what occurs in stage 3 of lyme disease, including ocular

Back 11

can follow a disease free period and may continue to produce problems for many years especially arthritis. episcleritis, stromal keratitis

Front 12

what is the most sensitive test for DDX of lyme disease

Back 12

wetern blot

Front 13

what is used for systemic Tx of lyme dz

Back 13

tetracycline 100mg or doxy

Front 14

is there a vaccine for lyme dz

Back 14

LYMErix

Front 15

acute multifocal posterior placoid pigent epitheliopathy (AMPPPE), serpinginous choroiditis, multifocal choroiditis, multiple evanescent white dot syndrome (MEWDS), birdshot retinochoroidopathy are all what type of syndromes

Back 15

Idiopathic multifocal white dot syndromes

Front 16

describe acute multifocal posterior placoid pigent epitheliopathy (AMPPPE)

Back 16

multifocal inflammatory disorder with yellow white gray posterior circumscribed flat lesions at the level of the RPE and choroid

Front 17

what are the symptoms a pt will have if they have acute multifocal posterior placoid pigent epitheliopathy (AMPPPE)

Back 17

flu like symptoms, bilateral painless vision loss over several days with a preceding viral illness. and possible HA and scotomas/floaters

Front 18

you have a pt with flu like symptoms and has had gradual vision loss for a couple of days. you see vitritis and anterior uveitis. you also see lesions at the level of RPE what could it be

Back 18

acute multifocal posterior placoid pigent epitheliopathy (AMPPPE)

Front 19

how long does it take for the lesion in the RPE to heal in acute multifocal posterior placoid pigent epitheliopathy (AMPPPE)

Back 19

9 to 14 days but the scotomas may remain for weeks to several months

Front 20

what is crucial for the management of acute multifocal posterior placoid pigent epitheliopathy (AMPPPE), what do you look for

Back 20

angiography looking for early hypo and late hyperfluorescence

Front 21

ICG angio could also be used for something likeacute multifocal posterior placoid pigent epitheliopathy (AMPPPE), what is this better for?

Back 21

deeper vessels

Front 22

is it rare or is there a good possibility that acute multifocal posterior placoid pigent epitheliopathy (AMPPPE) will recur

Back 22

rare

Front 23

when would you treat acute multifocal posterior placoid pigent epitheliopathy (AMPPPE)

Back 23

only if there is central vasculitis

Front 24

complications with acute multifocal posterior placoid pigent epitheliopathy (AMPPPE) include

Back 24

cnvm, central seous RD, choroidal vasculitis, CRVO, hemorrhagic maculopathy, optic veuropathy meningoencephalopathy and cerebral vasculitis

Front 25

how often on average to you want a person to RTC if they have acute multifocal posterior placoid pigent epitheliopathy (AMPPPE)

Back 25

every three months depending on severity

Front 26

serpinginous choroiditis is AKA

Back 26

geographic helicoid perippapillary choroidopathy (GHPC)

Front 27

a pt b/t 30 and 70 with blurry vision, you see properlike pseudopods extend out from the ONH that have creamy lesions near the edges. what could this be

Back 27

serpiginous choroiditis

Front 28

what type of drugs would you use to treat sepiginous choroiditis

Back 28

immunosuppressive agents and oral steroids

Front 29

what type of follow ups should you do with a person that has serpiginous choroiditis

Back 29

send home with an amsler grid and RTC q 6 months

Front 30

a common name for all of these is, multifocal choroiditis with panuveitis, subretinal fibrosis, punctate inner choroidopathy, chorioretinopathy with anterior uveitis, multifocal choroiditis with disciform macular degeneration, and pseudohistoplasmosis.

Back 30

multifocal choroiditis

Front 31

what is the avg age of onset of multifocal choroiditis and what is the unique factor with females

Back 31

14 to 34 yo and women tend to be mildly myopic

Front 32

what choroidal problem may be related to EBV

Back 32

multifocal choroiditis

Front 33

is multifocal choroiditis usually bilateral or unilateral

Back 33

80% of the time bilateral

Front 34

what type of drugs are used in the treatment of multifocal choroiditis (general class)

Back 34

steroids

Front 35

during the active phase of multifocal choroiditis what kind of changes occur to the lesions that are originally gray to yellow white

Back 35

they become gray and fuzzy

Front 36

what type of fluorescence would you expect to see with multifocal choroiditis

Back 36

early hyperfluorescence of active lesions

Front 37

what does MEWDS stand for

Back 37

multiple evanescent white dot syndrome

Front 38

what is described as acute multifocal retinopathy involving RPE and the outer retina

Back 38

multiple evanescent white dot syndrome (MEWDS)

Front 39

what are the demographics of multiple evanescent white dot syndrome (MEWDS) and what do the people complain of

Back 39

17-38 you females that complain of acute unilateral vision loss and photopsia (flashes)

Front 40

do the creamy white dots in the posterior pole of multiple evanescent white dot syndrome (MEWDS) tend to attack the fovea or spare it

Back 40

tends to spare the fovea but you will see a granular appearance of the macula

Front 41

what white dot syndrome has the best visual prognosis?

Back 41

multiple evanescent white dot syndrome (MEWDS)

Front 42

what white dot syndrome will show a hyperfluoroescence wreath like appearance and hyerfluorescence of the ONH

Back 42

multiple evanescent white dot syndrome (MEWDS) - relate this to the fact that there is a chance that they could have an enlarged blind spot also

Front 43

how many weeks will it take for a multiple evanescent white dot syndrome (MEWDS) to recover what might persist

Back 43

6-12 weeks and an enlarged blind spot may persist

Front 44

bierdshot retinochoroidopathy is AKA

Back 44

vitiliginous choroidopathy

Front 45

what is described as multiple oval yellow white spots in the deep retina and choroid with a vascular predilection for the posterior pole

Back 45

birdshot retinochoroidopathy

Front 46

what are the demographics of birdshot retinochoroidopathy

Back 46

women ages 40 to 60. middle aged men are more likely to shoot the woman with a birdshot so the woman is the one with the problem. (I know this is bad but you wont forget it)

Front 47

what are some vision complaints that come with birdshot retinochoroidopathy

Back 47

blurry vision, floaters, photopsia, night blindness, and decreased color vision

Front 48

with birdshot retinochoroidopathy would you expect early hypo of hyper fluorescence

Back 48

hypo with late accumulation

Front 49

90% of people with birdshot retinochoroidopathy have abnormal measurements with this test

Back 49

ERG

Front 50

how do you manage a pt with birdshot retinochoroidopathy

Back 50

low dose steroids and immunosuppressive agents

Front 51

this is a lame ass definition but what is a "devastating complication occurring in about 1:1000 post op cases

Back 51

endophthalmitis

Front 52

what are the two most common bacterial organisms that cause endophthalmitis

Back 52

coagulase negative - staph epi
gram positive - staph aureus

Front 53

what is the most common symptom of endophthalmitis

Back 53

acute vision loss 75% will feel pain

Front 54

what are some external signs you may see on a pt that has endophthalmitis

Back 54

lid edema conjunctival chemosis, corneal edema and wound abnormalities

Front 55

what are a couple internal signs that you may see in a pt that has endophthalmitis

Back 55

severe vitritis adn hypopyon

Front 56

how do you treat endophthalmitis

Back 56

initially with injection of antibiotics vancomycin and amikacin OR vancomycin and ceftazidime.

Front 57

do you use systemic antibiotics on a pt with endophthalmitis

Back 57

could but it is controversial due to the endophthalmitis vitrectomy study. it showed that oral antibiotics show no improvement

Front 58

encephalopathy associated with HIV is characterized by by

Back 58

difficulty concentrating, decreased recent memory, slowed mentation and movement disorders, and progression to severe global dementia.

Front 59

cotton wool spots are common or not in HIV pts

Back 59

yes they are it may be the initial manifestation of AIDS

Front 60

12 to 40% of pts with AIDS will have what type of hemorrhages, dot blot, flame shaped or roth spot?

Back 60

all of the above

Front 61

what are three types of retinopathy related to AIDS

Back 61

cotton wool spots, retinal hemorrhages, and AIDS related cyomegalovirus retinitis

Front 62

what percent of US adults are seropositive for CMV

Back 62

50 to 80% it is just latent. this is how CMV will often show up in AIDS pts - as a reactivation

Front 63

prior to HAART what was the most common cause of ocular opportunistic infection as well as the leading cause of blindness in AIDS pts

Back 63

AIDS related cyomegalovirus

Front 64

what are the symptoms of cmv ocular infection in AIDS patients

Back 64

painless decrease in vision in one or both eyes, hazy vision, floaters, metamorphopsia VF defects. (note it may be asymptomatic)

Front 65

what retinal layers are affected in CMV in an AIDS pt

Back 65

all layers of the retina are affected

Front 66

where do the patchy yellow white areas most often occur in CMV

Back 66

along the arcades or near the ONH

Front 67

vessel attenuation, calcifications in atrophic retina, capillary nonperfusion chorioretinal scarring, loss of VA, optic atrophy and RD are all sequelae for what

Back 67

CMV

Front 68

necrotizing retinitis, papillitis, macular edema, vasculitis and uveitis are all signs of what (relating to a person with AIDS)

Back 68

CMV ocular infection in AIDS pt

Front 69

HAART stands for what

Back 69

highly active antiretroviral therapy

Front 70

three medications listed for the treatment of AIDS

Back 70

ganciclovier, foscarnet, cidofovir

Front 71

what do all three medications for AIDS have in common

Back 71

they all inhibit viral DNA polymerase

Front 72

all three drugs listed for the Tx of AIDS inhibit the viral DNA polymerase what do Foscarnet and Cidofovir have in common

Back 72

the both also inhibit reverse transcriptase

Front 73

what is the name of the eye implant that delivers ganciclovir directly into the vitreous to aid in the treatment of retinitis in pts with AIDS

Back 73

vitrasert- typically you would just inject ganciclovir or foscarnet

Front 74

what is the name of the sarcoma that is associated with AIDS pt

Back 74

kaposi's sarcoma - rare in the US but one of the more common cancers in AIDS in Africa.

Front 75

what is the name of a common wart that is also associated with AIDS that can shed viral particles

Back 75

molluscum contagiosum

Front 76

what is the cause of SPK in AIDS pts

Back 76

microsporidia ( a parasitic protozoan) this occurs when the CD4 count is below 50cells/ml^3

Front 77

RTC when?
CD4 >400
CD4 100-400
CD4 <100

Back 77

q year
q 6 months
q 3 months

Front 78

what is the normal CD4 count and what is the average drop per year for a pt with HIV

Back 78

normal is 1000 and it normally drops 85/year