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63 Cards in this Set

  • Front
  • Back
name 5 ways uveitis is classified
based on anatomic inflammation site
based on which structure it affects (anterior/posterior)
granulomatous vs nongranulomatous
clinical
etiological
what is iridocyclitis
uveitis of the iris and ciliary body. this is the most common acute form
what is cyclitis?
uveitis of the ciliary body or the pars plana
what is iridochoroiditis
uveitis of the iris and choroid
how do you classify uveitis based on anatomic inflammation site
iritis, iridocyclitis, cyclitis, or iridochoroiditis
how do you classify uveitis based on the structue that it affects
anterior, posterior or intermediate
what is granulomatous uveitis
granulomatous is a chronic form that contains mutton fat KP's, iris nodules
what is non granulomatous uveitis
often acute with fine KP's
what immunologic marker is associated with uveitis
HLA-B27
is accommodation affected with anterior uveitis
yes it is reduced and painful
is circumlimbal flush 360 deg around the cornea
not always. it is more red right on the limbus.
what will you see with the cornea during during an anterior uveitic attack
edema, and KP's either mutton fat or fine.
how can a person that is a diabetic affect your slit lamp exam (relating to anterior uveitis)
you may see flare in these pt's with out seeing cells.
what type of syneciae could you see with anterior uveitis
posterior synechiae at pupilary edge
what type of nodules are seen with anterior uveitis. location and name
Busacca - white, yellowish, or black lumps away from pupil boarder associated with granulomatous.
Koeppe - round or oval solid tissue located at the pupil border. can cause synechiae.
describe finding with the pupil in a person that has anterior uveitis
the reaction may be normal to sluggish, usually but not always miotic, possible corectopia (off centered), and the pupil may be fixed if they have a 360 synechiae.
will the IOP be reduced or increased in a pt with anterior uveitis
usually reduced 3-6 mm due to reduced production of aqueous be the ciliary body. however it could be increased if outflow is affected by something like inflammatory cells.
is pain worse in acute or chronic anterior uveitis
in acute the pain is usually moderate to severe dull aching pain behind the eye.
with chronic it is usually mild to moderate and sometimes none at all.
describe the photophobia differences with acute and chronic anterior uveitis
acute is distictly photophobic
chronic is only mildly photophobic
what is the difference in the systemic history b/t the acute and chronic form of anterior uveitis
acute will usually have no systemic hx
chronic will have frequent systemic hx
what is the difference in circumlimbal flush b/c chronic and acute anterior uveitis
acute will have moderate and chronic will have mild
what is the difference b/t IOP in acute and chronic anterior uveitis
acute will usually have reduced IOP and chronic will usually have secondary glaucoma.
does acute or chronic anterior uveitis have a greater chance of complications
chronic has a greater chance for potential complications
name 5 things you want to look at when you have a pt with anterior uveitis
VA's, KP's, IOP, synechiae?, and cells and flare.
how long do the effects of each of these last? homatropine 5%, scopolamine, and atropine
homatropine 1 day
scopolamine 5 to 7 days
atropine 1 -2 weeks
what are three main objectives to consider when treating anterior uveitis
protect vision, reduce scarring, and reduce pain.
name some factors that would indicate to you that you should have an anterior uveitis pt get a medical test
chronic cases, poor response to therapy, recurrence, bilateral or alternating, children, any posterior uveitis, or immunocompromised pt's.
what type of medical test/diseases should be tested for that could be related to or causing anterior uveitis
VDLR, RPR, CBC, chest x ray for sarcoid, TB, histo., join x rays. HLA typing.
name 7 conditions Dr. williams went into depth on that are related to anterior uveitis
ankylosing spondylitis, reiters syndrome, juvenile chronic arthritis, sarcoidosis, TB, syphilis, and toxoplasmosis.
what are the two recomended tests when looking for ankylosing spondylitis
sacroiliac x rays, and ESR.
what would be the key systemic symptom in a pt that has anterior uveitis and ankylosing spondylitis
back pain
what drugs would you use in a pt that has anterior uveitis due to ankylosing spondylitis
predforte 1% q2h, and atropine 5%
what is anterior uveitis associated with if you see conjunctivitis, polyarthritis and urethritis
reiters syndrome. commonly seen in
why is oral tetracycline given to someone with reiter's syndrome and anterior uveitis
b/c this could be caused by syphilis and oral tetra will treat the systemic problems as well as the anterior uveitis.
4 yo girl appears to be acutely ill with knee and elbow pain and anterior uveitis. what systemic condition is likely?
juvenile chronic arthritis
what is triad associated with juvenile chronic arthritis
called stills ocular triad, iridocyclitis, band keratopathy, and cataracts.
what are the anterior uveitis findings with a person that has juvenile chronic arthritis.
it is nongranulomatous and may present as a white eye with cells and flare.
what is the most common test to run on a person with juvenile chronic arthritis that has anterior uveitis
ANA this is positive in 80% of pts with JCA and have uveitis but negative in pts with JCA and no uveitis.
what % of people with sarcoid show ocular features
50% but it can affect any organ
what is the tx for a child that has anterior uveitis and JCA?
treat the uveitis as normal and maybe use ASA for joints. no steroids b/c they retard growth.
if a person has syphilis will the VDRL test always be positive? what other tests could be done
no only if it is active. FTA-ABS or MHA-TP these will be positive throughout life. ESR will also be elevated
what are the three stages and associated symptoms for syphilis
primary - painless ulcer
secondary - skin rash (palms,soles, trunk)
tertiary - neurosyphilis
syphilis is associated with many forms uveitis could you use steroids to reduce the inflammation
no it is unresponsive to steroids when related to syphilis.
huntchins sign is what? and is associated with syphilis and what other dz
interstitial keratitis, deafness, and nitched inscisors. it is also associated with measles
what is the prognosis of syphilis
good if treated early, poor if optic neuritis or retinal disease develops.
co management of syphilis may include the use of what drug for therapy
penicilin
what is the protozoan infection that you can get from cat poo, or un homogenized milk
toxoplasmosis
toxoplasmosis is usually acquired congenitally or acquired
generally congenital
the most common cause of chorioretinitis is
toxoplasmosis
what is chorioretinitis
fluffy white lesions that look like headlights in the fog. you will see cells and flare in the vitreous. think of the to o's in ChOriOr and tOxO as headlights. toxoplasmosis is the most common cause of chorioretinitits
your pt has symptoms like mono and you see chorioretinitis. what condtition may they have
toxoplasmosis. tell them to stay out of the toxic cat poo
what drugs are use for tx of toxoplasmosis
systemic steroids, and the antitoxoplamic agents; pyrimethamine, chlortetracycline, sulfadiazine, clindamycin.
what is the ocular prognosis for a person with toxoplasmosis
good if the macula is not involved.
name the top two lab tests when testing for toxoplasmosis
flourescent antibody test and ELISA
tuberculosis and syphilis. are they bacterial or viral
bacterial.
for every red eye you should check
IOP
pars planitis, VKH syndrome and Behcet's disease are all examples of what
non infectious causes of anterior uveitis
a pt with no angle closure, increased IOP, mostly reactive pupils, and a white eye. this could be associated with anterior uveitis. what is it
glaucomatocyclitic crisis.
the most sensitive test for sarcoid is
ACE
the test that is best and most highly coordinated with JRA is
ANA - anti nuclear antibody
what test should you get done for a general overview of health
CBC complete blood count
if you have a pt that has anterior uveitis and complains of joint pain, what test would you do to see if the two could be related
RF. rheumatoid factor is associate with RA which is not associated with anterior uveitis. AS reiters and JRA will test negative to this test.
what test is good for a posterior uveitic pt that may need to be comanaged by a ret specialist
ELISA