Path 29 The Eye

Front 1

causes of inferomedial proptosis (2)

Back 1

inflammation of lacrimal gland (sarcoidosis)
neoplasm of lacrimal gland (lymphoma, pleomorphic adenoma, adenoid cystic carcinoma)

Front 2

causes of axial proptosis (2)

Back 2

Graves (fibrosis of rectus mm, accumulation of ECM proteins)
primary tumor of optic nerve (glioma, meningioma)

Front 3

immunosuppressed and diabetic ketoacidotic pts are susceptible to what type of orbital inflammatory conditions?

Back 3

spreading sinus infections (orbital cellulitis or mucormycosis)

Front 4

persistent pneumonitis w/ BL cavitary infiltrates, chronic sinusitis that often extends into orbit, nasopharyngeal ulceration, and renal disease; PR3-ANCA positive

Back 4

Wegener granulomatosis

Front 5

idiopathic orbital inflammation of the lacrimal gland?

Back 5

sclerosing dacryoadenitis

Front 6

idiopathic orbital inflammation confined to extraocular muscles?

Back 6

orbital myositis

Front 7

idiopathic orbital inflammation confined to Tenon's capsule?

Back 7

posterior scleritis

Front 8

most common primary neoplasms of the orbit?

Back 8

are vascular in origin -
capillary hemangioma (children)
lymphangioma
cavernous hemangioma (adults)

Front 9

chronic blepharitis or neoplasm at the eyelid margin may cause what?

Back 9

chalazion

Front 10

most common malignancies of the eyelid?

Back 10

1. basal cell carcinoma
2. sebaceous carcinoma
3. squamous cell carcinoma

Front 11

neoplasm of the eyelid that has tropism for lower eyelid and medial canthus

Back 11

basal cell carcinoma

Front 12

lymphoid follicles in the conjunctival fornix may be visible on slit lamp exam in ________?

Back 12

viral conjunctivitis

Front 13

granulomas in the conjunctival fornix are indicative of what disease?

Back 13

systemic sarcoidosis

Front 14

important sequela to Chlamydial conjunctivitis?

Back 14

conjunctival scarring leading to dry eye and predisposing to corneal opacification and ulceration

Front 15

submucosal growth of fibrovascular connective tissue that migrates onto the cornea but does not invade pupil

Back 15

pterygium

Front 16

what ocular problems are associated with HPV types 16 and 18?

Back 16

squamous papillomas and conjunctival intraepithelial neoplasia`

Front 17

conjunctival melanomas spread where first?

Back 17

parotid or submandibular LNs

Front 18

ocular complication in RA?

Back 18

scleral immune complex deposits leading to necrotizing scleritis

Front 19

conditions that result in blue sclera (3)

Back 19

- thinning of sclera d/t scleritis or extremely high IOP
- osteogenesis imperfecta
- congenital melanosis oculi (pigmented nevus of uvea)

Front 20

most common pathogenic causes of corneal ulceration?

Back 20

HSV, herpes zoster, Acanthamoeba

Front 21

histologic hallmark of herpes simplex keratitis?

Back 21

granulomatous rxn in Descement membrane

Front 22

calcific band keratopathy is seen especially in pts with what disorder?

Back 22

chronic juvenile RA

Front 23

Actinic band keratopathy is seen in what type of individuals?

Back 23

ones who are exposed chronically to high levels of UV light

Front 24

disorder characterized by progressive thinning and ectasia of cornea w/o inflammation or vascularization

Back 24

Keratoconus

Front 25

rupture of Descemet membrane allowing aqueous humor access to corneal stroma resulting in sudden worsening of vision?

complication of what disorder?

Back 25

corneal hydrops

keratoconus

Front 26

what are the two major clinical manifestations of Fuchs endothelial dystrophy?

Back 26

stromal edema, bullous keratopathy (both related to the primary loss of endothelial cells)

Front 27

causes of cataracts?

Back 27

galactosemia, DM, Wilson dz, atopic dermatitis, corticosteroids, radiation, trauma and intraocular disorders

Front 28

most common form of glaucoma?

Back 28

primary open angle glaucoma

Front 29

causes of neovascular glaucoma?

Back 29

chronic retinal ischemia (up-regulates VEGF)
necrotic tumors (esp RB) induces neovascularization

Front 30

endopthalmitis?

Back 30

inflammation within the vitreous humor

Front 31

panophthalmitis?

Back 31

inflammation in the eye that involves retina, choroid, and sclera and extends into the orbit

Front 32

what parts comprise the uvea?

Back 32

iris, choroid and ciliary body

Front 33

mutton-fat exudates in anterior segment, granulomas in the choroid, and perivasular inflammation of the retina are characteristic of what disease?

Back 33

systemic sarcoidosis

Front 34

BL diffuse granulomatous uveitis usually following penetrating injury to one eye, leading to lymphatic exposure of sequestered retinal antigens

Back 34

sympathetic ophthalmia

Front 35

prognosis of uveal melanomas is based on what 3 things?

what other factors indicate poor prognosis?

Back 35

1. size (lateral extent rather than depth)
2. cell type (epithelioid cells are bad)
3. proliferative index

Bad: lymphocytes in tumor, extra-ocular extension, monosomy 3, trisomy 8

Front 36

where are flame hemorrhages located?

Back 36

the nerve fiber layer (oriented horizontally)

Front 37

where are dot hemorrhages located?

Back 37

external retinal layers (oriented perpendicular to retinal surface)

Front 38

retinal detachment is separation of what layers?

Back 38

neurosensory retina and RPE

Front 39

choroidal tumors and malignant HTN may cause what type of retinal detachment?

Back 39

non-rhegmatogenous

(no break in retina)

Front 40

why does AV nicking occur in retinal arteriolosclerosis?

Back 40

retinal arterioles and veins share common adventitial sheath

Front 41

pathologic cause of cotton wool spots?

Back 41

occlusion of retinal arterioles causes infarcts of nerve fiber layer, interrupts axonal transport, mitochondria accumulate into cytoid bodies

Front 42

most reliable histologic marker of DM in the eye?

Back 42

thickening of BM of epithelium of pars plicata of ciliary body

Front 43

structural and functional abnormalities of angiogenesis located within the retina

Back 43

background diabetic retinopathy

Front 44

common cause of visual loss in diabetic pts?

Back 44

macular edema (d/t leaky retinal microcirculation)

Front 45

pathogenesis of proliferative diabetic retinopathy?

Back 45

nonperfusion of retina d/t microcirculatory chg leads to increase VEGF and retinal angiogenesis; new vessels sprout from existing vessels on optic nerve head or surface of retina

Front 46

cause of retrolental fibroplasia?

Back 46

oxygen therapy given to infants causes constriction of incompletely vascularized temporal retinal vessels resulting in ischemia and increased VEGF; contraction of peripheral neovascular membrane drags temporal retina toward temporal peripheral zone, leading to retinal detachment

Front 47

in what instances is cherry-red macula seen?

Back 47

occlusion of central retinal artery
Niemann-Pick dz
Tay-Sachs dz

Front 48

fragments of atherosclerotic plaques that lodge within retinal circulation are called what?

Back 48

Hollenhorst plaques

Front 49

what is the reaction of the retina with sudden cessation of blood supply?

Back 49

it swells acutely and becomes opaque

Front 50

sequelae of ischemic retinal vein occlusion?

Back 50

neovascularization of retina and surface of optic nerve head, neovascularization of iris leads to angle-closure glaucoma

Front 51

condition characterized by discrete or diffuse deposits in the Bruch membrane and geographic atrophy of RPE

Back 51

non-neovascular ARMD (dry)

Front 52

condition characterized by development of neovascular membranes between RPE and Bruch membrane; possible macular scars, possible retinal or vitreous hemorrhage

Back 52

neovascular ARMD (wet)

Front 53

Tx of choice for neovascular ARMD?

Back 53

injection of VEGF antagonists into vitreous

Front 54

systemic infection with what organism can cause non-age-related choroid neovascular membranes?

Back 54

histoplasma

Front 55

condition characterized by early night blindness, constricted visual fields, loss of central visual acuity, waxy pallor of optic disc, accumulation of retinal pigment around blood vessels?

Back 55

retinitis pigmentosa

Front 56

cause of retinitis in IVDU?

manifestation?

Back 56

hematogenous spread of pathogens to retina

multiple retinal abscesses

Front 57

significant cause of vision loss in IC pts, esp AIDS pts?

Back 57

CMV retinitis

Front 58

Flexner-Wintersteiner rosettes and fleurettes, and focal zones of dystrophic calcification are characteristic of what?

Back 58

Retinoblastoma

(rosettes are indicative of photoreceptor differentiation)

Front 59

retinoblastoma tends to metastasize to where?

Back 59

brain and bone marrow (lungs are rare)

Front 60

most common primary neoplasms of the optic nerve?

Back 60

glioma (pilocytic astrocytomas), meningioma

Front 61

causes of papilledema?

Back 61

compression of nerve (e.g. primary neoplasm of optic nerve) or elevated CSF pressure

Front 62

what fundoscopic finding is unique to glaucoma?

Back 62

optic nerve is both cupped and atrophic

Front 63

pathogenesis of Leber hereditary optic neuropathy?

Back 63

inheritance of mitochondrial gene mutations

(optic nerve health relies on axoplasmic transport of mitochondria)

Front 64

condition characterized by presence of exudate or blood btwn ciliary body and sclera and choroid and sclera; cyclitic membrane; chronic retinal detachment; optic nerve atrophy; intra-ocular bone; thickened sclera

Back 64

Phthisis bulbi (small, atrophic eye that is internally disorganized)