Kaplan Diagnostic Tests; Ophthalmology

Front 1

What is proliferative diabetic retinopathy?

Back 1

There is neovascularization over the disc, covering much of hte surface area of the retina. Neovascularization differentiates PDR from non-PDR. The aberrant blood vessels are fragile and leaky, causing recurrent retinal and vitreous hemorrhages. Dot-blot hemorrhages, microaneurysms, hard exudates, cotton wool spots, and intraretinal microvascular abnormalities (IRMA) are present in both PDR and non-PDR.

Front 2

What are two major complications of PDR?

Back 2

PDR can lead to retinla detachment and neovascular glaucoma.

Front 3

How is PDR treated?

Back 3

The treatment of PDR is with pan retinal photocoagulation.

Front 4

What is Retinal detachment?

Back 4

Patients wiht retiinal detachment often describe an ascending/descending veil in front of one eye with flashes and floaters. The unilateral loss of vision is sudden and painless.

Front 5

What is the usual cause of retinal detachment?

Back 5

Retinal detachment is usually caused by a retinal tear.

Front 6

How is retinal detachment treated?

Back 6

Retinal detachment is a medical emergency!

Laser surgery or cryoplexy is always used to help reattach the retina. A scleral buckle may be placed like a belt around the outside of the eye to push the wall against the detached retina, or a vitrectomy may be done where the vitreous is removed and replaced with a gas that pushes the retina against the wall of the eye.

Front 7

What are roth spots?

Back 7

Roth spots or cotton wool spots are an infarct with surrounding hemorrhage.

Front 8

What disease is commonly associated with roth spots?

Back 8

Subacute bacterial endocarditis is commonly associated; however, roth spots are not specific for subacute bacterial endocarditis adn may be present in several other disorders, such as:
Leukemia
Anemia
Diabetes
HTN
HIV

Front 9

What causes roth spots?

Back 9

Roth spots in subacute bacterial endocarditis are an immunological phenomenon.

Front 10

for which clinical scenario(s) is slit-lamp exam the appropriate screening?

Back 10

Slit-lamp examination is a microscopic examination of the naterior half of hte eye by projecting a thin beam of light through a slit. The anterior half includes lids, lashes, adnexa, conjunctiva, sclera, cornea, iris, pupil, and lens. When combined with special lenses, the slit-lamp may also be used to examine the posterior eye (cup/disk, macula, vessels periphery).

Front 11

What is a kayser-Fleischer ring?

Back 11

Formed by copper deposits in Descemet's membrane of the cornea. This finding is diagnostic of Wilson's disease, a disorder of copper excretion.

Front 12

When do you answer slit-lamp examination?

Back 12

Answer slit-lamp exam when you are shown a patient wiht a red, painful eye when the pain is worsened by shining a light in the eye or photophobia. When severe photophobia is not associated with miningitis it can be from iritis/uveitis, which is an inflammation of the iris. Slit-lamp is also a very good way to detect cataracts or corneal injury.

Front 13

wht is the most common indication for Gonioscopy?

Back 13

gonioscopy is vascularization of the angle between the cornea and the iris. This is performed to assess for narrow angle or angle closure in glaucoma.

Front 14

How does gonioscopy work?

Back 14

In goinioscopy, light from the slit lamp is deflected obliquely through the cornea using a prism or mirror in order to get a view of the angle between the cornea and iris. The trabecular meshwork and schlemm's canal, the drainage system of the eye, lie in the angle.

Front 15

When do you answer gonioscopy?

Back 15

You answer goinoscopy when you see a case of glaucoma wiht a red, painful eye with a fied, mid-dilated pupil, and tonometry has already confirmed glaucoma. Gonioscopy is used to determine the type of glaucoma after the diagnosis has been made.

Front 16

What is tonometry?

Back 16

Tonometry is the test used to measure intraocular pressure (IOP). It tests for glaucoma.

Front 17

How is tonometry done?

Back 17

There are several ways of performing tonometry:

Pneumotonometry is used as a screening tool. It measures IOP with a puff of air to flatten teh cornea.

Golmann tonometry is the more accurate way to measure IOP. It combines a slit lamp with a special probe that flattens the cornea and a weight that determines the amount of pressure.

Front 18

What is the most accurate form of tonometry?

Back 18

The most accurate test is the electronic indentation tonometry where a small pinlike instrument is placed directly on the cornea and the pressure is read back on a monitor.

Front 19

When do you answer tonometry?

Back 19

Tonometry is both the best initial and most acurate test for glaucoma.