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184 Cards in this Set
- Front
- Back
strabismus
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Strabismus, also known as "heterotropia", "squint", "crossed eye", "wandering eye", or "wall eyed", is a disorder in which the eyes do not point in the same direction. It typically involves a lack of coordination between the extraocular muscles which prevents bringing the gaze of each eye to the same point in space, preventing proper binocular vision, which may adversely affect depth perception.
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amblyopia
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Amblyopia, or lazy eye, is a disorder of the eye that is characterized by poor or blurry vision in an eye that is otherwise physically healthy and normal. The problem is caused by either no transmission or poor transmission of the visual image to the brain for a sustained period of dysfunction or disuse during early childhood.
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Hirchberg Test
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It is performed by shining a light in the persons eyes and observing where the light reflects off of the corneas. In a person with normal ocular alignment the light lands on the centre of both corneas. For an abnormal result, based on where the light lands on the cornea, the examiner can detect if there is an exotropia (abnormal eye is turned out), esotropia (abnormal eye is turned in), hypertropia (abnormal eye higher than the normal one) or hypotropia (abnormal eye is lower than the normal one).
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orthophoric
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normal
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epicanthal folds
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excess folds of skin that extend from the roof of the nose to the inner termination of the eyebrow and that partially or completely overlap the inner canthus of the eye, may give a false impression of malalignment
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Visually evoked potentials
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A visual evoked potential (VEP) is an evoked potential caused by sensory stimulation of a subject's visual field. Commonly-used visual stimuli are flashing lights, or checkerboards on a video screen that flicker between black on white to white on black (invert contrast).
Visual evoked potentials are very useful in detecting blindness in patients that cannot communicate, such as babies or non-human animals. |
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protanamoly
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color blindness (confusion of grey with pink and blue with greeen
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deuteranomaly
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confusion with gray with pale purple or green
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Asphyxia
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suffocation: suffocation as a result of physical blockage of the airway or inhalation of toxic gases, causing a lack of oxygen and unconsciousness
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Conductive hearing loss
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(middle-ear hearing loss) results from interference of transmission of sound to the middle ear
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Sensorineural hearing loss
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(perceptive or nerve deafness) damage to the inner ear structures or the auditory nerve (ototoxic drugs)
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Mixed conductive-sensorineural hearing loss
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Interference with transmission of sound in the middle ear and along neural pathways- recurrent otitis media
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central auditory imperception-organic type
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reception of auditory stimuli along the central pathways and expression of the message into meaningful communication
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Agnosia
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the inability to interpret sound correctly
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Dysacusis
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difficulty in processing details or discrimination around sounds
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Aphasia
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the inability to express ideas in any form either writing or verbally
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decibel (dB)
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a unit of loudness
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conductive hearing loss
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Conductive hearing loss is a failure in the efficient conduction of sound waves through the outer ear, tympanic membrane (eardrum) or middle ears (ossicles).
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Sensorineural hearing loss
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Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the vestibulocochlear nerve (Cranial nerve VIII), the inner ear, or central processing centers of the brain.
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Evidence of auditory stimuli
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startel reflex, head turning, eye blinking, and cessation of body movement.
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one sign of sensorineural hearing loss is
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difficulty articulating
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mild conductive hearing loss may manifest
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by child speaking in a loud monotone voice, may speak clearly
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most common cause of hearing loss
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otitis media
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Otitis media
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Otitis media is an inflammation of the middle ear segment of the ear. It is one of the two conditions that are commonly thought of as ear infections, the other being otitis externa. Otitis media is very common, and includes a whole range of medical conditions; all of which involve inflammation of the ear drum (tympanic membrane), & are usually assoc. /c a buildup of fluid in the space behind the ear drum (middle ear space).
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Type of hearing loss acquired from rubella
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sendorineural hearing loss
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Type of hearing loss from exposure to noise pollution
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sensorineural hearing loss
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School vision
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aka partially sighted- acuity between 20/70 and 20/200
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Legal blindness
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visual acuity 20/200 and or a visual field of 20 degrees or less in the better eye
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Causes of visual impairment
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herpes, chlamydia, gonocochi, rubella, syphilis, toxoplasmosis, retinopathy of prematurity, trauma, postnatal infections (meningitis and disorders such as sickle cell disease. juvenile rheumatoid arthritis, tay-sachs disease albinism and retinoblastoma.
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Refractive errors
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most common type of visual disorders, means bending of light rays as they pass through the lens of the eye
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Normal eye reaction to light compared to refractive disorders
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light rays enter the lens and fall directly on the retina. In refractive disorders the light rays either fall in front the retina (myopia) or beyond it (hyperopia)
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Myopia
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Myopia/nearsightedness, is a refractive defect of the eye in which collimated light produces image focus in front of the retina when accommodation is relaxed.
Those with myopia typically can see nearby objects clearly but distant objects appear blurred. |
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Hyperopia
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Hyperopia, also known as hypermetropia or colloquially as farsightedness (or, rarely, longsightedness), is a defect of vision caused by an imperfection in the eye (often when the eyeball is too short or when the lens cannot become round enough), causing inability to focus on near objects, & in extreme cases causing a sufferer to be unable to focus on objects at any distance. As an object moves towards the eye, the eye must increase its power to keep the image on the retina. If the power of the cornea & lens is insufficient, as in hypermetropia, the image will appear blurred.
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blindisms
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self-stimulatory activities, such as rocking, finger flicking, or arm twirling
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cat's eye reflex
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sign of retinoblastoma
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treatment of retinoblastoma when there is no hope for useful vision
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enucliation - removal of the affected eye - tx of choice
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savant
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A savant is a learned person, well versed in literature or science, often with an exceptional skill in a specialized field of learning. The term is also commonly used as an abbreviation of autistic savant, formerly "idiot savant". The word is a loanword from the French language.
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General objective in tx of Autism
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promote positive reinforcement, increase social awareness of others, teach verabl communication skills, and decrease unacceptable behavior
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Ways to deal with a Autistic child
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decrease stimulation- private room, avoid extraneous auditory and visual distractions, and encouraging the parents to bring in possessions the child is attached to, minimal holding or eye contact, introduce slowly to new situations
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Acute Otitis media follows
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upper respiratory infection
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Bacteria that causes (AOM) Acute otitis media
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streptococcus pneumoniae, haemophilus influenzae and moraxella catarrhalis
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Symtoms of Acute Otitis media
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acute ear pain, fever and a bulging yellow or red typanic membrane.
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Symtoms of Acute Otitis media with effusion
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rhinitis, cough or diarrhea
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Treatment of choice for otitis media
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oral amoxicillin in high doses
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myringotomy
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surgical incision of the eardrum to alleviate the severe pain of AOM
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Nursing objectives for the child with AOM
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1. relive pain, 2. facilitate drainage when possible, 3. prevent complications or recurrence, 4. educate family in the care of the child,5. provide emotional suport to the child and family
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miotics
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cause pupiliary constriction
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accommodation
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the ability to focus and refocus
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rods and cones
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are long, narrow cells shaped like rods or cones, rods are mainly responsible for night vision or vision in low light, cones provide the best vision for bright light, color vision or fine detail
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optic nerve aka
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Cranial nerve II (CN II)
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physiologic blind spot in the eye
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optic disc/optic nerve head
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OD
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Right Eye
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OS
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Left eye
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OU
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both eyes
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digitalis toxicity with the eye
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may cause color vision deficit
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macular degeneration and color
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macular degeneration -central vision --difficulty identifying colors because central vision identifies color
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neovasculariztion
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growth of abnormal new blood vessels in aged-related macular degeneration
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Tonometry
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measures IOP
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Gonioscopy
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visualizes the angle of the anterior chambers to identiy abnormalities in appearance and measurements
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Color fundus photography
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used to detect and document retinal lesions
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Flourescein angiography
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evaluates clinically significant macular edema, documents macular capillary nonperfusion and identifies retinal and choroidal neovascularization (abnormal growth of new vessels)
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emmetropia
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normal vision
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Ultrasonography
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direct visibility of lesions in the globe or orbit
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retinitis pigmentosa
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night blindness
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intraocular pressure (IOP)
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Intraocular pressure (IOP) is the fluid pressure inside the eye. It may become elevated due to anatomical problems, inflammation of the eye, genetic factors, as a side-effect from medication, or during exercise
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mydriatics
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medications causing pupiliary dilation
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Characteristics of cataracts
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Painless, blurry vision
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diplopia
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double vision
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bullous keratopathy
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formation of blisters that cause pain and discomfort on rupturing
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Persistent edema of the cornea leads to
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bullous keratopathy
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strabismus
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diviation in ocular alignment
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Aphakia
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Aphakia is the absence of the lens of the eye, due to surgical removal, perforating wound or ulcer, or congenital anomaly; causes a loss of accommodation, hyperopia, and a deep anterior chamber. Complications include detachment of the vitreous or retina, and glaucoma.
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keratoconus
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condition characterized by conical protuberance of the cornea with progressive thinning or protrusion and irregular astigmatism
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keratoplasty
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corneal transplantation or corneal grafting
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Refractive surgeries
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cosmetic, elective procedures performed to reshape corneal tissue and correct refractive errors so that eye glasses or contact lens are no longer needed.
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Rhegnomatogenous detachment
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most common form of retinal detachment, - a hole or tear develops in the sensory retina, allowing some of the liquid vitreous to seep through the sensory retina and detach
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Clinical manifestation of retinal detachment
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pt may report the sensation of a shade or curtain coming across the vision of one eye, cobwebs, bright flashing lights, or the sudden onset of a great number of floaters. No c/o pain
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aged macular degeneration
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yellowish spots called drusen
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angiogenesis
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abnormal blood vessel formation
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proptosis
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downward displacement of the eyeball
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Management of soft tissue damage that does not threaten vision
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Cold compresses used early, then warm compresses later
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corneal abrasion with contacts
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pt experiences severe pain and photophobia
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photophobia
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ocular pain on exposure to light
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Treatment for chemical burns
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irrigation with normal saline or tap water immediately
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ocular trauma from foreign body
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no attempt should be made to remove the foreign material, or apply pressure or a patch
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splash injuries are irrigated with
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normal saline
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Caution in topical eye drops and corneal abrasions
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topical anesthetic eye drops are not given to a pt. for repeated use /p corneal injury because their effects mask further damage, delay healing, and can lead to permanent corneal scarring.
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hemorrhagic chemosis
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edema of the conjunctiva
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hyphema
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hemorrhage within the chamber
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MRI is contraindicated in most DX of eye from trauma or foreign bodies because
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most foreign bodies are metallic and magnetic
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panophthalmitis
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inflammation of the whole eye
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Treatment for benign lesions of the eye lid
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no treatment unless vision is affected
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rhabdomyosarcoma
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malignant tumor in children
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S & Sx of Rhabdomyosarcoma
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sudden painless proptosis of one eye followed by lid swelling, conjunctival chemosis and impairment of ocular motility.
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Common site of metastasis of rhabdomyosarcoma
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lung
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evisceration
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the surgical removal of the intraocular contents through an incision or opening in the cornea or sclera
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exenteration
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is the removal of the eyelids, the eye and various amts. of orbital contents
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What are the effects of loosing and eye
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depth perception is lost
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Papilledema
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swelling of the optic disc due to increase IOP
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The ear is the sensory organ with dual functions
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hearing and balance
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auricle aka
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pinna
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tympanic membrane
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aka eardrum
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middle ear bones
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malleus, incus and stapes (transmission of sound)
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organ of hearing
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cochlea
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organ of balance
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semicircular canal
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organ of corti
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end organ of hearing- transforms mechanical energy into neural acivity and separates sounds into different frequencies
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proprioceptive system
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body balance is maintained by the cooperation of the muscles and joints of the body
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a healthy tympanic membrane looks a color of
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pearly grey
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how does the weber test work
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the weber test uses bone conduction to let lateralization of sound, tapping it on the examiner's knee or hand , placed on the pts head or forehead, a person with normal hearing will hear the sound equally in both ears or describe the sound as centered in the middle of the head, with conductive hearing loss, the pt will hear the sound better in the affected ear, in sensorinueral hearing loss the sound is heard well in the better-hearing ear
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drugs that cause hearing loss
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aspirin, aminoglycosides, quinine sulfate
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Contraindications for irrigation when removing foreign objects
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foreign vegetable bodies and insects tend to swell, this irrigation is contraindicated. mineral oil can remove an insect
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Primary cause of acute otitis media
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Streptococcus pheumoniae, haemophilus inluenzae, moraxella catarrhalis
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cholesteatoma
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ingrowth of the skin of the external layer of the erdrum into the middle ear( causes conductve or mixed hearing loss)
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Preventing infection when med in placed in ear canal
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cotton with petroleum jelly to prevent water contamination
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Promoting wound healing in the ear
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no heavy lifting, straiing, exertion and nose blowing for 2-3 wks /p surgery
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Otosclerosis
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result from formation of new spongy bone, especially around the oval window, with resulting fixation of the stapes, sound is prevented because the stapes cannot vibrate
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Menieres disease
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abnormal inner ear fluid balance
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Clinical manifestations of Menieres disease
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tinnitus or a roaring sound, feeling of pressure or fullness in the ear, episodic incapacitating vertigo (most troublesome) accompanied by N/V
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Diet therapy with menieres disease
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Low sodium diet (sodium controls fluid balance in our bodies) since this disease is abnormal inner ear fluid balance
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Labyrinthitis
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inflammation of the inner ear- viral or bacterial
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Clinical manifestations of labyrinthitis
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sudden onset of incapacitating vertigo, /c N/V, various degrees of hearing loss and possibly tinnitus
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Acoustic neuroma
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slow-growing, benign tumor of cranial nerve III
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Diagnostic finding of Acoustic neuroma
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unilateral tinitus and hearing loss with or without vertigo or balance disturbance
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function of the nervous system
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to control all motor, sensory, autonomic, cognitive and behaviral activities
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The basic functional unit of the brain is
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the neuron, composed of a cell body, a dendrite and an axon
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dendrite
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branch-type structure with synapses for receiving electrochemical messages
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axon
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long profection that carries impulses from the cell body
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Temporal lobe
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concentration, abstract thought, information storage/memory, motor function, contains Broca's area, critical for motor control of speech, frontal- respondible for affect, judgement, personality and inhibitions
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Parietal lobe
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sensory lobe, analyzes sensory information , relays the interpretation of this info. to the thalamus and cortical areas, gives awareness of the body in space as well as orientation in space ans patial realations
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Temporal lobe
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auditory receptive areas, provides integration of somatization, visual and auditory areas
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occipital
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responsible for visual interpretation
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basal ganglia
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masses of nuclei located deep in the cerebral hemispheres taht are responsible for control of fine motor motor movements including those of the hands and lower extremities
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Thalamus
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all memory, sensation and pain impulses pass through this section
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Hypothalamus
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involved in olfactory reflexes and emotional response to odors, plays an important role in endocrine sys. it regulates the pituitary secretion of hormones that influence metabolism, reporduction, stress response and urine production. Works with the pituitary to maintain fluid balance, temp., vasodilation and vasocaonstriction
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Which site is the hunger center in the brain
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the hypothalamus- controls appetite
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cerebellum
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responsible for coordination of movements, fine movement, balance, position sense, and integration of sensory input
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Circle of Willis
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The circle of Willis (also called the cerebral arterial circle or arterial circle of Willis) is a circle of arteries that supply the brain
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autonomic nervous system
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regulates the activities of internal organs such as the heart, lungs, blood vessels, digestive organs and glands.(maintaining homeostasis)
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parasympathetic
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controls visceral functions
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Sympathetic nervous system
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fight or flight
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manifestations that are of a neurological nature
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pain, seizures, dizziness, visual disturbances, weakness, abnormal sensation
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assessing cerebral function
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mental status, intellectual function, thought content, emotional status, perception, language ability, impact on lifestyle
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agnosia,
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inability to interpret or recognize objects seen through the special senses
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Romberg Test
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Screen test for balance. Pt stands with feet together, hands at side, eyes closed for 20-30 seconds. Swaying or off balance is a positive Romberg test
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ataxia
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incoordination of vlountary muscle action
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Abnormal Reflexes - sign of
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central nervous system disease
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clonus
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repeated uncontrollable movement of a muscle
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corneal reflexes are absent in
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CVA pts and coma pts
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Gag reflex is absent in pts
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who have had CVA
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How is tactile sensation assessed
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assessed by lightly touching a cotton wisp to corresponding areas on each side of the body. Sensitivity is compared with that of distal parts
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Diseases that can be diagnosed through the eye
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AIDS, CVD, muscular and endocrine disorders, hematologic and neurologic diseases
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Topical anesthetics for the eye
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proparacaine HCl (Ophthaine, Ophthetic and tetracaine HCl (Pontocaine)
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Chalazion
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infection of meibomian glands of the eylids that may produce cysts, causing blocage of the ducts
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Endophthalmitis
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inflammation of structures of the inner eye
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Hordeolum
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local i nfection of eye lash follicles and glands on lid margins
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Keratitis
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corneal inflammation
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Uveitis
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infection of vascular layer of the eye
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Cholinergic agents are aka
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miotics
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Treatment for Glaucoma (open angle glaucoma)
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Miotics/cholinergic agents- used to lower the IOP, increasing blood flow to the retina and ddecreasing retinal damage and loss of vision
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Action of miotics
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Miotics cause a contraction of the ciliary muscle and widening of trabecular meshwork
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herbs contraindicated with Glaucoma
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golden seal
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herbs and opththalmic surgery
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generally are discontinued
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How to prevent systemic absorption of miotics
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gently apply pressure to the lacrimal duct (passage that carries tear into the nose)
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Side effects of miotics
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HA, eye pain, decreased vision, brow pain, and less frequently, hyperemia of the conjunctiva
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Systemic side effects of miotics
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nausea, vomiting, diarrhea, frequent urination, precipitation of asthmatic attacks, increased salivation, diaphoresis, muscle weakness, and respiratory difficulty.
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Toxicity of Miotics
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vertigo, bradycardia, tremors, hypotension, syncope, cardiac dysththmias, and seizures
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Drug used for toxicity of mitotics
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Atropine
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Contraindications of Cholinergic (Pilocarpine)
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retinal detachment, adhesions between the iris and lesn, and acute ocular infections, Caution for clients with asthma, HTN, corneal abrasion, hyperthyroidism, CVD, Urinary tract obstruction, GI obstruction, uler, prkinsonism and bracycardia
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Beta adrenergic on the eye
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derease the production of aqueous humor
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Carbonic Anhydrase Inhibitor
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interferes with production of carbonic acid, leads to decreased aqueous humor formation and decreased IOP. Open angle glaucoma
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Side effects of Carbonic Anhydrase Inhibitor
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lethargy, anorexia, drowsiness, praesthesia, depression, polyuria, nausea, vomiting, hypokalemia, renal calculi, photosensitivity
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Examples of Carbonic Anhydrase Inhibitors
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Diamox, Trusopt, Neptazine, brinzolamide, Daranide,
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Example of Osmotic drugs
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glycerin, Ismotic, Mannitol, urea
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Use of Osmotics
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generally used preoperatively and postoperativelyd to decrease vitreous humor volume and so reducing IOP
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side effects of osmotics
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HA, nausea, vomiting and diarrhea, disorientation resulting from electrolyte imbalance
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Use of midriatics
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dilate the pupils
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Cycloplegics
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paralyze the muscles of accommodation
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Side effects of Midriatics
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headache, brow pain, allergic reaction and worsening of narrow-angle glaucoma
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Caution of midriatics
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pts with cardiac dysrhythmias, and cerebral atherosclerosis, BPH, DM, Parkinsonism
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signs and symptoms to report with midriatics
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blurred vision or loss of sight, difficult breathing, increased perspiration, or flush
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SE of Cycloplegics
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tachycardia, photophobia, dryness of the mouth edema, conjuctivitis and dermatitis
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Symptoms of Atropine toxicity (cycloplegics)
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dry mouth, blurred vision, photophobia, consipation, fever, tachycardia, confusion, hallucinations, delirium and coma
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Treament for toxicity of Atroprine (cycloplegics)
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physostigmine
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How to prevent myopia when instilling miotics
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myopia is minimized by inserting the disk in the upper conjuctival sac at bed time
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