Ohp2 Mt1 - Red Eye

Front 1

EKC has palpable, (tender/non-tender) lymph nodes?

Back 1

tender

Front 2

PCF has palpable, (tender/non-tender) lymph nodes?

Back 2

non-tender

Front 3

HSV has palpable, (tender/non-tender) lymph nodes?

Back 3

tender

Front 4

HZV has palpable, (tender/non-tender) lymph nodes?

Back 4

tender

Front 5

Inclusion conjunctivitis has palpable, (tender/non-tender) lymph nodes?

Back 5

non-tender

Front 6

Hyperacute conjunctivitis has palpable, (tender/non-tender) lymph nodes?

Back 6

tender

Front 7

Pre-septal cellulitis has palpable, (tender/non-tender) lymph nodes?

Back 7

tender

Front 8

Orbital cellulitis has palpable, (tender/non-tender) lymph nodes?

Back 8

tender

Front 9

Oculo-glandular syndromes (syphillis, tularemia, cat scratch, etc) have palpable, (tender/non-tender) lymph nodes?

Back 9

tender (also visible)

Front 10

Your patient has miotic pupils with a red eye during pupil testing. What is a possible DDx that was mentioned in the packet?

Back 10

Iritis

Front 11

Your patient has a fixed mid-dilated pupils with a red eye during pupil testing. What is a possible DDx that was mentioned in the packet?

Back 11

angle closure

Front 12

Your patient has irregular/fixed pupils with a red eye during pupil testing. What is a possible DDx that was mentioned in the packet?

Back 12

posterior synechiae

Front 13

Your patient has APD with a red eye during pupil testing. What is a possible DDx that was mentioned in the packet?

Back 13

orbital cellulitis

Front 14

If your patient has pain or restrictions in EOMs, what are the possible DDx that were mentioned in the packet?

Back 14

Graves, Orbital cellulitis

Front 15

In your red eye patient, you see diffuse, beefy, engorged vessels more prominent in the inferior 1/3 of the conj esp in the fornices - what is the possible cause?

Back 15

bacterial

Front 16

In your red eye patient, you see diffuse injection - what is the possible cause?

Back 16

viral, scleritis, corneal ulcer

Front 17

In your red eye patient, you see very mild diffuse injection, but greater chemosis - what is the possible cause?

Back 17

allergic

Front 18

In your red eye patient, you see circumlimbal injection - what is the possible cause?

Back 18

uveitis, angle closure

Front 19

In your red eye patient, you see sectoral injection - what is the possible cause?

Back 19

episcleritis, pingueculitis, inflamed pterygium, phylectenulosis, foreign body

Front 20

What is INR?

Back 20

International Normalized Ratio - evals how blood clots properly (used in DDx subconj heme)

Front 21

T/F - HTN can contribute to subconj hemes.

Back 21

True

Front 22

Carotid cavernous sinus fistulas cause what kind of injection?

Back 22

corkscrew

Front 23

T/F - Scleritis is less painful than episcleritis.

Back 23

False - vice versa

Front 24

You are trying to figure out what kind of injection is going on in your patient. You apply (this type of drop and concentration) and find that the vessels are not blanching. That means you probably have this kind of injection...

Back 24

Phenylephrine 2.5%, possible scleritis

Front 25

You see an injection in your patient, and you try to move the vessels around with a sterile swab but notice that the vessels do not move. What kind of injection is this?

Back 25

possible scleritis (episcleritis has moveable vessels since more superficial)

Front 26

Your patient has diffuse injection with a bluish hue on the sclera. What does this indicate?

Back 26

scleritis (thinned sclera reveals uvea, which is bluish)

Front 27

Vessels criss-cross less in (episcleritis/scleritis)?

Back 27

episcleritis

Front 28

Papillae is a (humoral/cell-mediated) response.

Back 28

humoral

Front 29

Papillae is a site of release of what type of cells?

Back 29

PMN and eosinophils

Front 30

Papillae are what color and are about what size?

Back 30

small red bumps (0.1-0.2 mm)

Front 31

(Papillae/Follicles) have a central vessel running to the surface.

Back 31

Papillae (remember, follicles are avascular)

Front 32

Why are papillae not very good for DDx?

Back 32

Papillae are least diagnostic, often seen in normal eye due to environmental irritants (smog, etc)

Front 33

Papillae can be a result of what insults?

Back 33

bacterial, allergic, toxic, VKC, SLK, or any chronic irritation

Front 34

GPC are >__mm in size.

Back 34

>1.0mm

Front 35

GPC are (reddish/light colored).

Back 35

reddish (vs VKC cobblestone papillae = light colored)

Front 36

Follicles are (reddish/yellow-white)?

Back 36

yellow-white (avascular thus not reddish)

Front 37

T/F - Follicles are aggregates of lymphocytes.

Back 37

True

Front 38

Which is larger, follicles or papillae?

Back 38

follicles (5x size of papillae)

Front 39

Follicles are about ___mm.

Back 39

0.5-1.0 mm

Front 40

T/F - Follicles are vascular.

Back 40

False - no central blood vessel

Front 41

T/F - Follicles are vascular.

Back 41

False - no central blood vessel

Front 42

Follicles are most marked in the (upper/lower) tarsal conj.

Back 42

lower

Front 43

Follicles are related to these insults...

Back 43

viral, chlamydial (both papillae and follicles), toxic

Front 44

Psuedomembranes are related to what condition(s)?

Back 44

adenoviral conditions

Front 45

True membranes are related to what condition(s)?

Back 45

gonorrhea, steven-johnson, chemical/thermal burn

Front 46

What is the difference between pseudo and true membranes?

Back 46

Pseudo = inflammatory exudates, superficial, no bleeding. True = embedded into conj, bleeds

Front 47

A copious, overflowing mucopurulent discharge indicates what type of conjunctivitis?

Back 47

hyperacute

Front 48

A mucopurulent discharge indicates what type of conjunctivitis?

Back 48

bacterial

Front 49

A watery discharge indicates what type of conjunctivitis?

Back 49

acute allergy or viral

Front 50

A thin, ropy transparent mucous discharge indicates what type of conjunctivitis?

Back 50

chronic bacteria

Front 51

A thin, ropy mucoid discharge indicates what type of conjunctivitis?

Back 51

VKC

Front 52

You see a movable, slightly tender nodule on the conj with sectoral injection. This must be...

Back 52

episcleritis (can also be non-tender) - think episcleritis is more superficial thus more moveable

Front 53

You see a non-moveable, tender nodule on the conj with diffuse injection. You suspect...

Back 53

scleritis (episcleritis = moveable, non tender nodule)

Front 54

What are KPs?

Back 54

Keratititic Precipitates - aggregates of inflammatory material from granulomatous uveitis

Front 55

What is interstitial keratitis?

Back 55

Inflammation of corneal stroma, results in vascularization that regresses and turn into ghost vessels

Front 56

Name the conditions listed in the packet that pannus is involved in.

Back 56

Rosacea, CL overwear, chlamydia, SLK, staph hypersensitivity (blepharitis), HSV, HZV

Front 57

Viral corneal inflammation can cause this type of SPK.

Back 57

Diffuse

Front 58

Bacterial corneal infection can cause this type of SPK.

Back 58

inferior

Front 59

Lagophthalmos can cause this type of SPK.

Back 59

inferior

Front 60

Blepharitis can cause this type of SPK.

Back 60

inferior

Front 61

Toxicity to the cornea can cause this type of SPK.

Back 61

diffuse

Front 62

Dry eyes can cause this type of SPK.

Back 62

inferior

Front 63

RGPs can cause this type of SPK.

Back 63

3-9

Front 64

Pterygiums can cause this type of SPK.

Back 64

3-9

Front 65

SLK can cause this type of SPK.

Back 65

superior

Front 66

Pseudodendrites as seen in (HSV/HZV) stain best with (NaFl/RB)?

Back 66

HZV, RB

Front 67

Dendrites as seen in (HSV/HZV) can be stained with (NaFl only/RB only/both)

Back 67

HSV, both

Front 68

T/F - You can test corneal sensitivity by seeing if a patient tears when the central cornea is touched with a cotton wisp.

Back 68

True

Front 69

What eye should you test first when doing corneal sensitivity?

Back 69

Unaffected eye first

Front 70

What nerve is tested in corneal sensitivity?

Back 70

Ophthalmic branch of trigeminal

Front 71

What instrument is used for qualitative testing of corneal sensitivity?

Back 71

Cochet and Bonnet's aesthesiometer

Front 72

When measuring corneal sensitivity, the thread in the aesthesiometer will be (shorter/longer) with a sensitive cornea.

Back 72

longer (shorter thread = less corneal sensation)

Front 73

What is the average corneal sensitivity as measured on Cochet and Bonnet's aesthesiometer?

Back 73

11.8 g/mm^2

Front 74

What anterior chamber signs can be seen in uveitis?

Back 74

Cells, flare, hypopyon

Front 75

What anterior chamber signs can be seen in corneal ulcers?

Back 75

cells, flare, hypopyon

Front 76

Hyphema in the anterior chamber can be due to...

Back 76

trauma

Front 77

Nodules on the iris is a sign of...

Back 77

uveitis

Front 78

Posterior synechiae is a sign of...

Back 78

uveitis

Front 79

Vitritis can be due to...

Back 79

uveitis, endophthalmitis

Front 80

T/F - HSV/HZV is an indication for a DFE.

Back 80

True - herpes can affect retina

Front 81

What is the RPS Adeno Detector?

Back 81

Test that tells if red eye is viral or not (by colored strips)

Front 82

What are the three most common types of corneal ulcer?

Back 82

Staph, Strep, Pseudomonas

Front 83

T/F - Mucopurulent discharge can be involved with corneal ulcers

Back 83

True

Front 84

T/F - Corneal ulcers are not associated with eyelid edema

Back 84

False - eyelid edema is possible

Front 85

This type of corneal ulcer is related to immunocompromised patients...

Back 85

Fungal

Front 86

You see a grayish-white infiltrate w/ feather borders and stromal loss with an epithelial defect. You also see satellite infiltrates. You suspect...

Back 86

Fungal corneal ulcer

Front 87

T/F - You can see hypopyon in fungal corneal ulcers.

Back 87

True

Front 88

T/F - You can see an AC reaction in fungal corneal ulcers.

Back 88

True

Front 89

T/F - Mucopurulent discharge is associated with fungal corneal ulcers.

Back 89

False (not mentioned in the packet)

Front 90

You see a periorbital abcess - what test is indicated for this sign?

Back 90

Culture and sensitivity testing

Front 91

T/F - Culture and sensitivity testing is indicated for orbital cellulitis.

Back 91

True

Front 92

T/F - Ocular microbial specimens can be collected and identified by optometrists.

Back 92

False - can only collect, but should not be interpreted

Front 93

When is it APPROPRIATE to obtain an ocular culture?

Back 93

>2mm lesion within 2 mm of visual axis, or >2 peripheral ulcerative lesions

Front 94

Review indications for culturing

Back 94

(Just a reminder)

Front 95

T/F - In obtaining an ocular culture, you must first obtain a sample from the conj first.

Back 95

False - order = lids, conj, then cornea

Front 96

T/F - You must anesthetize the conj before obtaining a culture.

Back 96

False - optional

Front 97

T/F - You must anesthetize the cornea before obtaining a culture.

Back 97

True

Front 98

What is a kimura spatula used for?

Back 98

Obtaining corneal scrapings for culture testing

Front 99

Cotton swabs should be used for what ocular tissues only?

Back 99

Lids and conj (NOT cornea)

Front 100

T/F - You should only sample the affected eye in culture and sensitivity testing.

Back 100

False - sample both eyes even if only one eye infected

Front 101

T/F - Anesthetic is optional for the kimura spatula.

Back 101

False - must anesthetize the cornea

Front 102

What is the proper way of using the kimura spatula for obtaining samples from a corneal ulcer?

Back 102

Scrape the base and leading edge of the ulcer firmly, using short strokes in one direction

Front 103

What is an alcohol lamp used for in culture and sensitivity testing?

Back 103

Sterilize the spatula (it's a burner) - be sure to wait for temp to go back to normal

Front 104

What is the procedure for sensitivity testing?

Back 104

Place single isolated colony in broth to grow, then streak onto agar plate. Place AB discs; if bacteria is sensitive to AB disc, it won't grow aroudn the disc. Check area around disc to see how sensitive/resistant the bacteria is.

Front 105

Blood agar is used for ___ bacteria.

Back 105

aerobic

Front 106

Chocolate agar is used for ___.

Back 106

neisseria, haemophilus, moraxella

Front 107

Sabaraud is used for ____.

Back 107

fungi

Front 108

Thayer-Martin is used for ____.

Back 108

Neisseria

Front 109

T/F - Both chocolate agar and Thayer-Martin are appropriate for Neisseria.

Back 109

True

Front 110

Thioglycate broth is used for ____ bacteria.

Back 110

aerobic and anaerobic

Front 111

Lowenstein-Jensen is used for ____.

Back 111

Mycobacteria

Front 112

Non-nutrient agar w/ E. coli overlay is used for ____.

Back 112

Acanthamoeba

Front 113

What is the first step in the gram stain procedure?

Back 113

Heat fix the slide over flame

Front 114

What reagents in what order are used in gram staining?

Back 114

Crystal violet, iodine, safranin

Front 115

Describe the gram stain process.

Back 115

Heat fix slide, crystal violet 1 min, rinse, iodine 30-60 sec, rinse, safranin 1 min, rinse, air dry

Front 116

T/F - Conjunctival cells adhere to Thermanox discs without anesthetic.

Back 116

True

Front 117

Explain the Diff-Quik stain process.

Back 117

Dip 5x each for 1 sec: fixation soln, red stain, blue stain, rinse with distilled water then air dry

Front 118

This type of culture stain is not practical in office because it req a buffer to be mixed up right before staining.

Back 118

Giemsa stain

Front 119

When doing a PAP stain, you are looking for ____ caused by ____.

Back 119

inclusion bodies, chlamydia

Front 120

How do epithelial cells stain (from culture)?

Back 120

Nucleus stains dark, cytoplasm stains purple

Front 121

Which cells are granular?

Back 121

Granulocytes = 'BEN' - Basophils, Eosinophils, Neutrophils

Front 122

What is the difference between a granulocyte and a leukocyte?

Back 122

Granulocytes (PMNs) are a type of leukocyte (WBCs)

Front 123

Which cells are agranular?

Back 123

Agranulocytes (Mononuclear) = Lymphocytes and Monocytes

Front 124

What kinds of cells are seen in viral infections?

Back 124

Lymphocytes and monocytes

Front 125

What kinds of cells are seen in chlamydial infections?

Back 125

lymphocytes + neutrophils in equal quantity

Front 126

What kinds of cells are seen in acute bacterial conjunctivitis?

Back 126

neutrophils predominantly; few lymphocytes and monocytes

Front 127

What kinds of cells are seen in chronic bacterial infections?

Back 127

Less neutrophils, lymphocytes, and monocytes than acute

Front 128

What kinds of cells are seen in allergic conjunctivitis?

Back 128

Predominantly eosinophils, few basophils.

Front 129

Mnemonic for cell type and associated condition.

Back 129

New Balance = Neutrophils Bacterial, Louis Vuitton = Lymphocytes Viral, American Eagle = Allergy Eosinophils

Front 130

What do you write in the 'Rx' portion of a prescription?

Back 130

Drug name, concentration, and formulation (soln, susp, or ung, tabs, caps, etc)

Front 131

What do you write in the 'Disp' portion of a prescription?

Back 131

Amount of drug dispensed e.g. '10 mL bottle' or '30 capsules'