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32 Cards in this Set
- Front
- Back
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Prevalence and Incidence of Uveitis
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Prevalence 115:100,000
Incidence 50:100,000 |
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Symptoms of Uveitis: anterior, Intermediate and Posterior
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Anterior: redness, pain, photophobia
Intermediate: floaters and blurring Posterior: Scotoma or no sx |
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Signs of Uveitis
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Skin, conj, cornea, corneal endothelium (granulomas, kp, fibrin, pigment)
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What causes red eye in uveitis
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ciliary flush - vessels dive into iris
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Keratic Percipitates large triangle vs small diffuse
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Inf triangle - granulomatous like sarcoid
small diffuse: herpetic |
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What is 4+ flare
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Can't seen details of iris, lots of fibrin
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Iris atrophy think ___
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HSV
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iris heterochromia think___
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fuchs
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koppe and busacca nodules
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granomatous dz
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voseus ring
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on ant lens capsule
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Snowbanking -> think _
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pars planitis
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necrotic retinitis ->think _
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herpetic dz
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RPE changes in uveitis indicate what
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Chronic uveitis
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What cells are involved in uveitis
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t cell mediated lymphocyte infiltration
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2 signs of granulmatous reaction in the eye
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iris nodules and KP
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Steroids for uveits from light to heavy duty (4)
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Topical corticosteroids (prednisolone acetitate suspension)
Periocular corticosteroids - suptenons and intraocular, kenalog 20-40mg periocular, 2-4mg intraocular Oral corticosteroids Retacert - floronated steroid, high risk of glaucoma, may need trab |
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3 Indication for Immunosuppression
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Can't taper steroids, stuck on oral steroids
Brittle DM Kids |
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3 diseases that require rx stronger than steroids from the start
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Bhecets
Ocular Cicatricial Pemphegoid Serpigenous Choroiditis that is vision threatening (sometimes bad scleritis and Wegeners that do not respond to 80mg steroids) |
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Methotrexate dose
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12.5 to 20mg once per week
subq bypasses liver, good in GI dz |
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4 Contraindications to MTX
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ETOH
Liver Dz Hepatitis Monitor LFTs |
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MTX first line in what 2 diseases
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JIA
Sarcoid |
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Cyclosporine A mechanism
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T cell activation blocker, use 4-5 mg/day neoral formulation b/c microlipophilic, good absorption
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Cyclosporine side-effects name 5
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*HTN
*Renal disease Hirsutism Gingival Hyperplasia Tremors |
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Cyclosporine used in what 3 diseases
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Bhecets
Serpigenous Scleritis |
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Azathioprine - antimetabolite like mtx, used when
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to boost steroids at low levels, synergistic with cyclosporine (can use all three)
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Azathioprine is toxic to what
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bone marrow, monitor CBC
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Cellcept common side effects
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GI, monitor LFTs
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Which TNF alpha inhibitors works well for uveitis
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remicade (infliximab) is preferred
avoid embaral (etanorcept) |
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4 Indications for TNF alpha inhibitors
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RA
B27 spondilyarthropathis Crohn's disease Bhecets |
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TNF alpha inhibitors 3 side effects
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DVT - use asa
lupus like syndrome transfusion reaction |
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Alkylating agents used when
What 2 agents |
Last resort
Chlorambucil and cyclophosphamide WBC plts suppression |
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MTX takes how long to work
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4-6 weeks for clinic affect
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