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73 Cards in this Set
- Front
- Back
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_____operate under dim conditions and _______ operate in daylight conditions
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Rods
Cones |
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Vitreous hemorrhage, retinal detatchment, retinal artery/vein occlusion, optic neuritis, and giant cell arteritis are common causes of _________
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Acute vision loss in the uninflammed eye
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What is the etiology of vitreous hemorrhage?
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fragile neurovascular vessels that proliferate on the surface of the retina in DM, Sickle Cell and ischemic ocular diseases
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Abrupt onset of floaters that increase in severity, and a complaint of bleeding within the eye indicates _________
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vitreous hemorrhage
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What is the most common site of retinal detachment?
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superior temporal area
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__________is due to preretinal fibrosis, seen in DM retinopathy or retinal vein occlusion
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traction retinal detachment
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Light flashes in the eye, sudden or gradual increase in floaters, and the appearance of a curtain over the field of vision are symptoms of ________
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retinal detachment
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A retina that appears dome shaped and changes position with a change in patient posture, along with accumulation of subretinal fluid indicates ___________
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retinal detachment
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What will you seen during the ophthalmoscopic exam of a patient with a retinal vein occlusion?
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disk swelling
venous dilation tortuosity of veins retinal hemorrhage cotton wool spots |
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A patient presents with sudden profound monocular vision loss. On exam you see swelling of the retina, cherry red spot at the fovea, and "box car" segmented veins. What is the suspected diagnosis?
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retinal artery occlusion
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Aside from referral to an ophthalmologist, what is the treatment regimen for retinal artery occlusion?
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lay patient flat
ocular massage high O2 concentrations IV Diamox anterior chamber paracentesis |
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Unilateral vision loss over a few days, marked loss of color vision, and pupillary defect are symptoms of ___________
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optic neuritis
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Which eye disorder is associated with MS, and is sometimes the 1st manifestation of the disease?
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optic neuritis
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__% of patients with optic neuritis will develop MS within 10 years
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40%
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What are the risk factors for optic neuritis?
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1)female
2)multiple white lesions on brain MRI 3)CSF oligoclonal bands 4)serum antimyelin antibodies |
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What is the treatment for optic neuritis?
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1)IV then oral methylprednisone
2)urgent referral |
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systemic inflammation of medium and large sized arteries
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giant-cell arteritis
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A patient presents with high ESR, headaches, thickened & tender temporal artery, and scalp tenderness. What do you suspect is the diagnosis?
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giant-cell arteritis
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What are the bad complications of giant-cell arteritis?
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ischemic optic neuropathy
diplopia with sudden blindness |
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What is the treatment for giant-cell arteritis?
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1)ASAP ophthalmology referral
2)Start tx asap if pt has symptoms 3)glucocorticoids 4)ASA 81 mg |
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______ uveitis is characterized by inflammatory cells within the aqueous.
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anterior
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_______ uveitis is characterized by inflammatory cells within the vitreous.
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posterior
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A small irregular pupil, along with hypopyon and fibrin with the anterior chamber indicates_______
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severe anterior uveitis
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Acute unilateral eye pain, redness, photophobia, visual loss and ciliary flush are clinical findings associated with __________
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anterior uveitis
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injection of bulbar conjunctiva around limbus
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ciliary flush
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Inflammatory lesions in the retina or choroid, bilateral involvement, macular edema, and gradual vision loss are signs/symptoms associated with _______
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posterior uveitis
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What is the treatment for uveitis?
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*ophthalmology referral
topical steroids periocular steroid injections systemic steroids pupil dilation |
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closure of the pre-existing narrow angle chamber
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primary acute angle-closure glaucoma
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_______ acute angle-closure glaucoma is due to enlargement of the lens in the elderly, and it may be precipitated by prolonged pupil dilation
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primary
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______acute angle-closure glaucoma is associated with anterior uveitis, dislocation of the lens, and Topiramate therapy (anti-seizure med)
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secondary
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What are the 2 most common non-traumatic ocular emergencies?
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corneal ulcers
glaucoma |
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What is the most common traumatic ocular emergency?
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open globe injuries
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Which ocular emergency requires visual acuity be delayed and immediate treatment started?
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chemical injury
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What is the first step when you see patients with signs and symptoms of retinal artery occlusion?
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immediate referral to ophthalmologist
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Why does a retinal artery occlusion require an immediate referral to ophthalmologist?
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irreversible damage occurs in as little as 100 minutes
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A patient presents with moderate eye irritation and pain, chemosis, limbal blanching and corneal edema. What is your diagnosis?
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alkali chemical injury
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What is the treatment for alkali chemical injuries (other than referral)
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immediate irrigation
topical corticosteroids cycloplegia (Scopolamine) control IOP oral Ascorbic Acid Oral Tetracycline Topical antibiotics artificial tears/bandages/contacts |
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What are the hey symptoms of acute retinal detachment?
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flashes
floaters "curtain" over part or all of vision |
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What are the clinical findings associated with acute retinal detachment?
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elevated retina
cells in the vitreous (pigment) possible vitreous hemorrhage |
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What is the first step when you diagnose a patient with acute retinal detachment?
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referral to retina specialist
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What is the cause of Cryptococcal Meningitis?
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Fungus - Cryptococcus Neoformans
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Where is the fungus found that causes Cryptococcal Meningitis?
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dirt / soil / bird droppings
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What is the route of transmission for Cryptococcal Meningitis?
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airborne
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What are the symptoms of Cryptococcal Meningitis?
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fatigue
fever headache stiff neck blurred vision confusion & behavioral changes |
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If a pt presents with suspected Cryptococcal Meningitis, what tests should be ordered?
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CrAg Serum
India Ink Stain *CSF culture |
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Who is susceptible to Pneumocystis carinii Pneumonia infection?
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immunocompromised pts - HIV, organ transplant
malnourished, premature infants |
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What are the symptoms of Pneumocystis carinii Pmx (PCP)?
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fever
non-productive cough SOB |
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Which diagnostic tests are indicated for the diagnosis of PCP?
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culture of lung sputum
---organism: P. jiroveci Xray will show bilateral infiltrates |
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What are the mortality rates for non-HIV pts who contract PCP?
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30-50 % mortality
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What is the treatment for PCP?
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Drug of choice = Septra
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What gene encodes for gp 120 (surface glycoprotein) and gp41 ( transmembrane glycoprotein)?
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ENV
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What is HIV's genetic material?
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2 identical RNA strands
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Which enzymes are required for HIV replication?
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reverse transcriptase
integrase protease |
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Which protein encodes for reverse transcriptase?
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POL
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Which structure in HIV is bullet-shaped?
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viral core (capsid)
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Which enzyme catalyzes the replication of double-stranded DNA from single-stranded RNA?
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Reverse Transcriptase
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What are the chances that you will contract HIV from being stuck with a needle that was used to inject a HIV pt?
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0.3-0.45%
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What test is the most SENSITIVE when screening for HIV?
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ELISA
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What test is the most SPECIFIC for Anti-HIV antibodies?
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Western Blot
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What fluids can be used in the ELISA test?
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Saliva
Blood Urine |
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Which HIV diagnostic test uses microscopy to interpret the results?
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Indirect Immunofluorescence Assay (IFA)
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What is the window period for seroconverting to HIV?
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3-6 months
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What is the MOA for Erythromycin?
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binds to 50s subunit to inhibit aminoacyl translocation reaction and initiation complex
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Erythromycin is the drug of choice for ________?
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Corynebacterial infections, Pertussis
Chlamydial infections (respiratory, neonatal, ocular, genitals) Community-acquired pneumonias (M. pneumoniae, C. pneumoniae, Legionella) |
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What is Erythromycin indicated as treatment for?
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Strep infections of throat & skin
pts allergic to PCN pregnant women when Tetracycline is indicated lung infections Syphilis, Chlamydia, Gonorrhea |
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What is the prophylaxis treatment for endocarditis?
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Erythromycin
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Which drugs should be avoided or used with caution when combined with Erythromycin?
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Theophylline
Digoxin & Warfarin Terfenadine (Seldane) Phenytoin (Dilantin) Carbamazepine (Tegretol) |
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Which HIV proteins can cause neuronal damage leading to HIV dementia?
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GP120
REV TAT |
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How does HIV enter the brain - what type of cells?
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monocytes
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In which stage of Aids Dementia Complex does the patient lose the ability to follow the news and have trouble sustaining conversations?
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3
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What are the S/S of end-stage HIV dementia?
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Paraplegic
Vegetative Mute |
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What is the main treatment for HIV related cognitive disorders?
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HAART (highly active antiretroviral therapy)
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What is the hallmark of AIDS dementia complex?
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HIV encephalitis in the white and grey matter
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