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121 Cards in this Set

  • Front
  • Back
Eye has good far sight but poor near sight
Eye has good near sight but poor far sight
With age (> 40 y.o.) the lens loses its elasticity & causes diminished near sight but continued far sight
What chart is used to check near vision?
Rosenbaum chart
What chart checks vision at 20 feet?
Snellen eye chart
What chart checks vision at 10 feet?
Sloan eye chart
What is the Rosenbaum chart indirectly screening?
Central vision
Which test is used to check peripheral vision?
What kinds of abnormalities can cause visual field deficits?
Scratching, scaring or edema of the cornea, cataracts on the lens; pus or blood in the aqueous or vitreous fluids
Which cranial nerves are being tested with the cardinal planes of gaze exam?
Cranial nerves III, IV and VI
What do the corneal light reflect and cover-uncover test assess?
symmetrical alignment of the eyes and therefore binocular vision (positives would indicate amblyopia and monocular vision)
_______ is an abnormal elevation of the upper lid exposing the sclera between the lid margin & iris. It suggests hyperthyroidism if bilateral or 7th C.N. damage, or tumor behind the eyes if unilateral.
Lid (lag) retraction
__________ is a congenital or acquired weakness of the levator muscle or paresis of a branch of the third cranial nerve causes the upper lid to droop compared to the opposite eye.
Lid (sag) ptosis
________ is inflammation of the eyelash follicles and meibomian glands resulting in red, crusty lid margins
A stye or ______ is a bacterial infection of a gland in an eyelash causing a well circumscribed red, swollen, tender pustule.
A hard, painless papule on the eyelid due to an obstruction of a meibowmian gland.
The loss of orbicularis oculi muscle tone with aging causing the lower lid to turn outward interfering with proper tear drainage; it may also result from 7th C.N. palsy
Inversion of the lower lid due to scar tissue formation of the inner surface of the lid; eyelashes then irritate the conjunctiva and cornea
Inflammation of the tear sac secondary to chronic obstruction or narrowing of the nasolacrimal duct. A painful, swollen nodule develops between the nose and eye with accompanying tearing and discharge. Rare, but usually occurs in infants.
A self-limiting bacterial or viral infection causing red, burning, itchy eyes with a discharge that tends to stick the eyelids together overnight. Pain is minimal, vision is not affected, and blood vessels dilate from the periphery towards the center of the eye.
Contagious conjunctivitis (pink eye)
Have the same signs and symptoms as pink eye but perhaps less thick discharge - caused by environmental irritants
Allergic or chemical conjunctivitis
Yellow elastic fibers form a plaque on either side of the cornea resulting from chronic irritation (sunny, dusty, windy conditions) to the bulbar conjunctiva
Sunny, dusty, windy conditions may stimulate growth of a pinguecula forming a vascular membrane that may extend over the cornea
Microtraumas like coughing, sneezing or straining may cause a conjunctiva vessel to break trapping blood between the clear mucous membrane and the sclera.
Subconjunctival hemorrhage
Name 3 things that can cause the sclera of the eye to become yellow.
1. aging causes the sclera to thin and fatty deposits may show through 2. jaundice 3. antimalarial drugs
Name something that can cause the sclera to appear blue.
Osteogenesis imperfecta
Name something that can cause the sclera to appear brown.
Patches of melanin are common in people with dark complexions
A corneal arcus (half way around) or corneal ring (all the way around) is not considered clinically significant in people over 60. If under 40 it may indicate ______
A golden-brown band around the limbus of the cornea associated with Wilson's disease
Kayser-Fleischer ring (Wilson's disease is a rare inherited disease where copper accumulates in the liver and throughout the body resulting in neurologic symptoms)
Inflammation of the iris due to trauma, secondary to another disease or idiopathic in nature.
Iritis -- Blood vessels touch edge of iris and work their way out
What does the accronym PERRLA stand for?
Pupilas should be equal, round & reactive to light & accommodation
Congenital condition where pupils are inequal in size, however they react to all reflexes and have no companion symptoms
Physiologic anisocoria
Inequality of pupil size, which may be congenital or associated with head trauma or diseases of the nervous system
A fixed, dilated pupil with poor response to the pupillary reflexes; most cases are idiopathic.
Adie's tonic pupil
Failure of the iris to close during fetal development resulting in a keyhole-shaped pupil
An irregular shaped pupil due to an adhesion of part of the iris to the cornea in front of it or the lens behind it; secondary to trauma, surgery, cataracts, glaucoma, iritis or other eye infections
Decreased or absent response to light reflexes yet the pupils respond to accommodation; may be a defect resulting from syphilis
Argyll Robertson pupil
Interruption of sympathetic nerve supply to the eye resulting in miosis (constricted pupil) and mild eyelid ptosis
Horner syndrome
If the canal of Schlemm becomes blocked aqueous fluid builds up rapidly in the eye producing sudden severe eye pain, blurred vision, report of seeing colored lights around bright objects, corneal edema, conjunctival & perilimbal injection and a fixed dilated pupil.
Acute Glaucoma
An abnormal progressive loss of lens transparency (eventually a gray-white opacity) due to degenerative changes usually occurring after age fifty.
In many myopic patients there are areas of dark pigmentation along the border of the optic disc known as a ____________
Choroidal crescent
Fundoscopically it is a swollen, distorted optic disc with blurry borders
Signs include generalized loss of peripheral vision, increased cup size and atrophy (whitening) of nerve fibers in the enlarging cup.
Chronic Glaucoma
Name 4 common retinopathies
1. Papilledema 2. Chronic Glaucoma 3. Diabetes Mellitus 4. Hypertension
What are the most common causes of non-traumatic retinal detachment?
Aging or inflammation
Name 3 red flags of the eye
1. Sudden, marked eye pain
2. Visible flashes followed by partial, peripheral vision loss
3. Developing tunnel vision or central blind spot
Red, burning itchy eyes with slight pain, purulent discharge and lids may stick together during sleep. Kids and the elderly are prone.
Bacterial conjunctivitis
The patient reports an eye injury, marked pain, photophobia, decreased visual acuity is possible. Perilimbal injection on physical exam.
Corneal abrasion
The patient reports marked pain, photophobia in one eye. Physical exam findings are perilimbal injection and pupillary responses are sluggish in that eye.
Acute Iritis
Patient reports marked pain, photophobia, dimmed vision & halos around lights. Physical exam findings are perilimbal injection, dilated pupil, sluggish pupillary responses, increase eyeball tension & disc cupping in that eye.
Acute Glaucoma
Patient reports insidious tunnel vision over the course of many years, and is less than 40 years old. Physical exam reveals enlarged physiologic cup.
Chronic glaucoma
Typical patient is anyone who has had head trauma but spontaneous can occur in elderly. Symptoms are flashes of light, floaters or a dark fixed shadow in periphery.
Retinal detachment
Typical patient is over 50, has slowly progressing vision loss in one or both eyes. Physical exam findings are altered color & configuration of the macula/ fovea
Macular degeneration
An abnormal, benign, boney growth of the temporal bone may occasionally be seen protruding into the canal.
What is the most common cause of otitis externa?
bacterial infection
Children have a shorter, narrower & more horizontal eustachian tube making them more prone to ______________
Suppurative otitis media
What are divers and people who fly prone to?
________ are cystic masses composed of epithelial cells & cholesterol in the middle ear.
Age-related hearing loss (#1 reason for sensorineural hearing loss)
What is the 2nd most common cause of sensorineural hearing loss?
Noise-induced hearing loss
Reduced or distorted hearing and vertigo and is generally thought to be caused by a viral infection; it's rarely painful.
Patients are typically people who irritate the ear canal with excessive cleaning or swimming. They will have a red, swollen canal with debris or discharge.
Otitis externa
Typical patient is anyone but common in children under 5 who have a URI. Will have an earache and fever, and a red, bulging eardrum with possible purulent discharge.
Suppurative otitis media
Typical patient is anyone, but adult males are prone to it. Often follows q-tip usage. Patient will have dark wax occluding the canal. Weber lateralizes and Rinne` is negative on affected side.
Excessive ear wax
Typical patient is anyone, but common in children under 5 who've had an URI. Physical exam reveals normal, yellow or dark tympanic membrane with possible air bubbles or fluid line; Weber lateralizes to affected side and Rinne` is negative.
Serrous or mucoid effusions
Typical patient is an adult most often with family history. Symptom is progressive hearing loss. Physical exam reveals no abnormalities of the canal or eardrum; Weber lateralizes and Rinne` is negative on the affected side.
Typical patient is anyone with a history of recreational or occupational noise exposure. Physical exam reveals no canal or middle ear signs; Rinne` has AC greater than BC but less than 2:1 ratio.
Noise induced hearing loss
Typical patient is elderly. Symptoms are complaints that others are mumbling or that can't understand what's being said when their is background noise. Low frequency sounds & whispers are the first to go.
What are some classic nose and sinus symptoms?
Loss of smell, runny, itchy nose; stuffy nose &/or sinuses; sinus pain or pressure; mouth breathing or snoring
A non-specific term used to describe acute infections of the nose, sinuses, phayrnx, trachea & bronchi
Upper respiratory infection (URI)
Another name for the common cold. Usual symptoms are stuffy nose & sinuses with a watery to thick discharge, sneezing, sore throat, cough & headache. Signs include swollen nasal tissues & cervical lymph nodes.
Viral Rhinitis
Another name for hayfever. Usual symptoms include stuffy nose & sinuses with a watery discharge, sneezing, post nasal drip, cough, itchy eyes, nose & throat persisting beyond 10 days. Signs include swollen nasal tissues & cervical lymph nodes.
Allergic Rhinitis
Affects frontal, maxillary or all sinuses. Usual symptoms include stuffy nose & sinuses, with a green purulent discharge, face, teeth or eye pain that is aggravated by bending over. Signs include swollen nasal tissues & cervical lymph nodes. Digital pressure aggravates the sinuses. Most likely bacterial.
Acute Sinusitis
This is a test of the sinuses using a light to see if the sinuses are clear or blocked.
All sinuses are involved
Adults who've had allergies &/or chronic sinus infections over the years sometimes develop these, which further interfere with nasal drainage. They are grape-like inflammatory swellings of the nasal linings.
Trauma to the nose is the most common cause; many people can recall the incident and remember that breathing difficulties soon followed.
Deviated Septum
A normal cycle of mild congestion (unilateral blood vessel engorgement) & decongestion alternating between nostrils about every four hours making it easier to breath out of one nostril more than the other.
Nasal Cycle
Any child with a one-sided runny nose should be examined for this.
Foreign Objects
The patient should be able to identify familiar scents with each nostril, eyes closed. More than half of the reported cases of loss of smell are due to head injuries, post URIs and nasal/sinus conditions. Which cranial nerve is affected?
C.N. I
You should inspect the 5 Ts with a light and tongue depressor for signs of inflammation, sores, discolored patches & exudates. What are the 5 Ts?
Teeth (malocclusions), Tongue, Tissues, Tonsils (often atrophied & not visible in the adult), Throat (a very limited view)
Another name for a fever blister or cold sore. Caused by a virus and is usually contracted during childhood.
Herpes Simplex Type 1
Another name for a canker sore.
Aphthous stomatitis
A red, swollen smooth tongue due to the loss of the papillae.
A form of glossitis where the papillae are temporarily lost leaving smooth, irregular patches with a white outline. These patches can change locations on a weekly, or sometimes daily basis.
Geographic tongue
Characterized by grooves in the tongue of varying depths & widths. Benign.
Fissured tongue
Results from long-term antibiotic use or failure of the papillae to naturally fall off causing them to elongate; either fungus or bacteria attach to the papillae.
Black hairy tongue
Small white spots on the inside of the cheeks. They precede measels.
Koplik spots
A noncancerous or precancerous oral lesion common to about 1/2-3/4 of people using smokeless tobacco daily. They appear as white leathery ridges on the buccal mucosa.
Red, swollen, sensitive & bleeding gums. Brushing & flossing can prevent or reverse it.
Most commonly affects the sides of the tongue, lips & floor of the mouth. Smoking & smokeless tobacco are associated with 70-80% of the cases. May present as persistent, painless thickening, lump, ulcer or a red or white patch anywhere in the mouth or throat.
Oral carcinoma
A benign exostosis of either the hard palate or mandible that appear around age 30.
Torus palatinus & mandibularis
Usually a self-limiting, viral or bacterial infection of the pharyngeal tonsils. Signs and symptoms are sore throat, painful swallowing, thick voice, fever, swollen cervical lymph nodes and red, swollen tonsils that may be coated or have white spots on them.
Stones form when mucous, sulfur-producing bacteria and debris (food particles, post-nasal drip, etc...) condense into small particles and collect in the crypts on the surface of the tonsils.
Tonsillar debris (tonsil stones)
Accounts for about 60% of sore throats. Clinical features are runny nose, cough, hoarseness, conjunctivitis or diarrhea
Viral Pharyngitis
Accounts for about 40% of sore throats. Clinical features are rapid onset of throat pain aggravated by swallowing. There is usually fever, tender cervical lymph nodes & inflammation with a purulent, patchy white, yellow or gray exudate.
Bacterial Pharyngitis
occurs in about 1% of those who had strep throat. Antibiotics are more than 90% effective in preventing it.
Rheumatic fever
With the onset of puberty oil glands often become overactive and then plugged, resulting in various stages of this condition.
Acne Vulgaris
Another name for blackheads
What are the 4 stages of acne?
1. Comedones (blackheads)
2. Pustules & papules (pimples)
3. Cysts & scarring
4. Involves the thorax & arms
Type 1 herpes appearing on the lips or mouth
Herpes labialis
Type 1 herpes appearing on the eyes
Herpes keratitis
4-7 days after contact soreness or itchy precede red macules on the genitals, which develop into vesicles then ulcerate; the ulcers become crusted and heal in about 10 days.
Genital Herpes (Herpes simplex 2)
Infection of the hair follicle, which appears as pustules with hair growing from the center. Sometimes refered to as "razor bumps."
An inflamed, expanding, well demarcated patch usually secondary to a preexisting skin infection or wound. It is pretty rare, and is often due to a type "A" beta hemolytic streptococcus.
Has the same features as erysipelas, but lacks the sharp raised borders & usually affects the limbs.
A chronic inflammatory disorder resulting in new superficial blood vessels mostly affecting middle-aged women.
Another name for soft tissue swelling that usually occurs in males that is related to Rosacea.
Rhinophyma (rhino = nose phyma = swelling)
An autoimmune disorder more common in young women. Fever, fatigue and weight loss are presenting symptoms. Usually associated with a malar (butterfly) rash.
Systemic Lupus Erythematosus
White spots in the nail, usually due to a mild injury.
Another name for spoon nail. It is usually a hereditary condition causing thin concave nails, but may occur with trauma or iron deficiency anemia.
Name 2 conditions that can cause yellowing of the nails.
Fungal infections and psoriasis
Red or brown longitudinal streaks may occur in cases of sever psoriasis. Pitting may also occur.
Splinter hemorrhages
Placing nails from each hand back-to-back normally creates a diamond shaped space due to the normal 160 degree angle at the nail base. Nail clubbing causes the diamond to disappear due to abnormal enlargement of the distal phalanges.
Schamroth's technique
Name two types of diseases (broad categories) that can cause clubbing of the nails.
Respiratory and cardiovascular diseases
Transverse, white depressions in the nail associated with acute, severe illness such as malnutrition, coronary artery disease or other systemic disease; may also be trauma induced.
Beau's line
The nail is white except for a narrow zone at the distal tip; associated with cirrhosis of the liver.
Terry nails
Infection around the nail presenting as red, swollen, painful tissue
Another name for warts; usually due to the human papilloma virus.
Verrucae Vulgaris
Another name for a flat wart - a small, slightly raised, tan or flesh-colored wart
Verruca Plana
Dyshidrotic eczema which affects hands, sole & sides of the fingers which appear as itchy clusters of small vesicles.