Midterm Exam

Front 1

Step 1 of Interview, Histories and Write Ups

Back 1

Set the stage for the interview (30-60 sec)

Front 2

Step 2 of Interview, Histories and Write Ups

Back 2

Elicit chief concern & set agenda (1-2 min)

Front 3

Step 3 of Interview, Histories and Write Ups

Back 3

Begin the interview with non-focusing skills that help the patient to express him/herself (30-60 sec)

Front 4

Step 4 of Interview, Histories and Write Ups

Back 4

Use focusing skills to learn 3 things: Symptoms story, personal context, and emotional context (3-10 min)

Front 5

Step 5 of Interview, Histories and Write Ups

Back 5

Transition to middle of the interview (clinician-centered phase) (30-60 sec)

Front 6

Step 6 of Interview, Histories and Write Ups

Back 6

Obtain a chronological description of the HPI (History of present illness)

Front 7

Step 7 of Interview, Histories and Write Ups

Back 7

Past medical history

Front 8

Step 8 of Interview, Histories and Write Ups

Back 8

Social history

Front 9

Step 9 of Interview, Histories and Write Ups

Back 9

Family history

Front 10

Step 10 of Interview, Histories and Write Ups

Back 10

Review of systems

Front 11

Step 11 of Interview, Histories and Write Ups

Back 11

End of the Interview: diagnosis, prognosis, plan

Front 12

History of present illness (HPI)
Should include the seven attributes:

Back 12

1) Location-ie:
2) Quality-
3) Quantity or severity-
4) Timing/Onset-
5) Setting-
6) Factors aggravating or alleviating-
7) Associated manifestations-

Front 13

REVIEW OF SYSTEMS: General

Back 13

Wgt Δ; weakness; fatigue; fevers

Front 14

ROS: Skin

Back 14

Rash; lumps; sores; itching; dryness; color change; Δ in hair/nails

Front 15

ROS: Head

Back 15

Headache; head injury; dizziness

Front 16

ROS: Eyes

Back 16

Vision Δ; corrective lenses; last eye exam; pain; redness; excessive tearing; double vision; blurred vision; scotoma

Front 17

ROS: Ears

Back 17

Hearing Δ; tinnitus; earaches; infections; discharge

Front 18

ROS: Nose/Sinuses

Back 18

Colds; congestion; discharge; itching; hay fever; nosebleeds

Front 19

ROS: Throat

Back 19

Bleeding gums; dentures; last dental exam; sore tongue; dry mouth; sore throats; hoarse

Front 20

ROS: Neck

Back 20

Lumps; swollen glands; goiter; pain; neck stiffness

Front 21

ROS: Breasts

Back 21

Lumps; pain; discomfort; nipple discharge

Front 22

ROS: Pulmonary

Back 22

Cough—productive/non-productive; hemoptysis; dyspnea; wheezing; pleuritic pains

Front 23

ROS: Cardiac

Back 23

Chest pain or discomfort; palpitations; dyspnea; orthopnea; PND; edema

Front 24

ROS: GI

Back 24

Appetite Δ; jaundice; nausea/emesis; dysphagia; heartburn; pain; belching/flatulence; Δ in bowel habits; hematochezia; melena; hemorrhoids; constipation; diarrhea; food intolerance

Front 25

ROS: Urinary

Back 25

Frequency; nocturia; urgency; dysuria; hematuria; incontinence

MALES:  caliber of urinary stream; hesitancy; dribbling

Front 26

ROS: G/U (General)

Back 26

Sexual habits; interest; function; satisfaction; use of birth control methods; HIV exposure

Front 27

ROS: Male G/U

Back 27

Discharge from or sores on penis; testicular pain/masses

Front 28

ROS: Female G/U

Back 28

Menarche; frequency/duration of menses; dysmenorrhea; PMS symptoms: bleeding between menses or after intercourse; LMP

Vaginal discharge; itching; sores; lumps Menopause; hot flashes; post-menopausal bleeding;

Front 29

ROS: Peripheral Vascular

Back 29

Claudication; leg cramps; varicose veins; hx of blood clots

Front 30

ROS: MSK

Back 30

Muscle or joint pain; joint stiffness

Front 31

ROS: Neuro

Back 31

Syncope; seizures; weakness; paralysis; numbness/tingling; tremors; involuntary movements

Front 32

ROS: Heme

Back 32

Hx of anemia; easy bruising or bleeding; blood transfusions

Front 33

ROS: Endo

Back 33

Heat or cold intolerance; excessive sweating; polydipsia; polyphagia; polyuria;  glove or shoe size

Front 34

ROS: Psych

Back 34

Nervousness/anxiety; depression; memory changes; suicide attempts

Front 35

The width of the cuff should be

Back 35

about 40% of the upper arm circumference.

Front 36

Appropriate cuff size is mandatory

Back 36

if too big will falsely read Low, and if too small will falsely read high.

Front 37

Subclavian steal (Dx from BP on both arms)

Back 37

- narrowing of the proximal subclavian artery causing retrograde flow from vertebral or carotid arteries to supply the arm with blood

- Lung cancer, or lightheadedness.

Front 38

Blood pressure should be taken in both arms at least once. If a pressure difference of more than 10-15 mm Hg may be signs of

Back 38

Subclavian Steal syndrome or aortic dissection.

Front 39

Aortic dissection (Dx from BP on both arms)

Back 39

- Tear in the inner arterial wall of the aorta causing blood to flow between layers of the artery and tearing them apart.

- This is associated with severe chest pain radiating to the back typically.

Front 40

Pre-hypertension

Back 40

120-139/ 80-89

Front 41

Hypertension

Back 41

Stage 1 140-159/ 90-99
Stage 2 >160/>100

Front 42

Hypertension Urgency

Back 42

>180/ >100

* no signs ofend organ damage

Front 43

Hypertension Emergency

Back 43

>210/ >110

***signs of end organ damage (EOD)

Front 44

Unequal blood pressures in Arms and legs

Back 44

could signify Coarctation of the aorta or Occlusive aortic disease

Front 45

Coarctation of the aorta

Back 45

- narrowing of the thoracic aorta resulting in lower blood pressures in the legs compared to hypertension in the arms.

* normal in children

Front 46

Occlusive aortic disease

Back 46

- has HTN in the arms and low in the legs due to narrowing of the aorta.

- In adult male may lack hair on legs.

Front 47

Orthostatic hypotension

Back 47

fall of SBP > 20 mm Hg

or

rise in heart rate >10-20

Front 48

Pulsus alternans

Back 48

- abnormal pulse that alternates amplitude (intensity) from beat to beat despite the rhythm being regular.

- indicates left ventricular failure and may be accompanied by S3 beat

Front 49

Pulsus paradoxical

Back 49

- decrease in amplitude on quiet respirations and usually increases with quiet inspiration.

- found in cardiac tamponade, constrictive pericarditis, and COPD

Front 50

Cheyne-Stokes

Back 50

- deep breathing alternating with periods of apnea

- could signify heart failure, uremia, respiratory depression from drugs or brain damage

Front 51

Obstructive Breathing

Back 51

- expiration phase is prolonged because of narrow airways that increases resistance.

Front 52

Kussmual

Back 52

- deep and labored ax with acidosis, DKA and renal failure

- a form of hyperventalation

Front 53

Fever

Back 53

temperature of >100.5

Front 54

Estimate Average weight for adult

Back 54

- Male: 106 lbs for 5’ + 6 lbs for every inch above

- Female: 105 lbs for 5’ + 5 lbs for every inch above

Front 55

Acromegaly- presentation

Back 55

- Elongated head, prominence of the boney forehead, and lower jaw.

- Soft tissue – large elongated ears, nose and lips

Front 56

Turner Syndrome (genetic defect in females)- presentation

Back 56

- Significant edema of the hands and feet at birth may be a sign.

- Short statue, broad chest, low hair line, webbing of the neck, low set ears, lymphedema, reproductive sterility, amenorrhea

Front 57

Down Syndrome: (trisomy 21) - presentation

Back 57

- most common chromosomal abnormality

- Congnitive dysfunction, wide flat nasal bridge, small oral cavity my result in protruding tongue, short stature, low set ears

Front 58

Marfan syndrome - definition

Back 58

- a genetic disorder causing connective tissue abnormalities.

Front 59

Marfan syndrome - presentation

Back 59

* Unusually tall, with long limbs, and long thin fingers, weak wrists.

* Abnormalities in the heart valves and aorta are the most serious complication.

Front 60

Hirsutism - definition

Back 60

a clinical sign of abnormal androgenic (male) pattern of hair growth in women. Typically in locations women don’t grow terminal body hair.

Front 61

Hirsutism - causes

Back 61

* increase androgenic hormones.

* Typically seen in obesity, PCOS (polycystic ovarian syndrome), Cushing syndrome and other

Front 62

Cushing Disease - definition

Back 62

an increased adrenal cortisol production.

Front 63

Cushing Disease - presentation

Back 63

“moon facies”, red cheeks, hirsutism, buffalo hump, obesity, striae, menstrual abnormalities, hypertension, elevated glucose.

Front 64

Precocious puberty - definition

Back 64

excessive sex hormones resulting in puberty in an unusually early age (prior to age 7). Typically caused by tumors, trauma, and some infections.

Front 65

Anorexia Nervosa - S/S

Back 65

Dry skin, dental caries, anemia, osteoporosis, hypotension, amenorrhea, BMI <17.5, muscle wasting

Front 66

PE: Common Complaint of the Eyes

Back 66

1) visual disturbance
2) spots (scotomas)
3) flashing light
4) corrective lenses
5) Px, redness, excessive tearing,
6) diplopia
7) symmetry, pitosis, EOM, acuity

Front 67

PE: Common complaints of the Head

Back 67

1) headache
2) injury
3) symmetry
4) hair, scalp

Front 68

PE: Common complaints of the Ears

Back 68

1) hearing loss, ringing (tinnitus)
2) virtigo
3) Px/discharge

Front 69

PE: Common complaints of the Nose

Back 69

1) drainage, congestion, sneezing, bleeding
2) symmetry, swelling,
3) tubinates, concha
4) cysts, polyps, deviation

Front 70

PE: Common complaints of the oropharynx

Back 70

1) sore throat, hoarseness
2) gum bleeding
3) petecia, rash, swelling, plaques,
4) tonsils?

Front 71

PE: Common complaints of the Neck

Back 71

1) swollen glands
2) goiter
3) swollen lymph nodes, masses
4) thyroid
5) symmetry

Front 72

Types of Primary Headaches (3)?

Back 72

A. Migraine
B. Tension
C. Cluster

Front 73

Types of secondary headaches?

Back 73

A. Analgesic Rebound: normally narcotics
B. Secondary to Eye disorder
C. Sinus
D. Meningitis
E. Subarachnoid hemorrhage
F. Tumor/Mass
G. Giant Cell (Temporal) Arteritis
H. Posttraumatic
I. Cranial Neuralgias

Front 74

What NT is likely involved in migraines?

Back 74

Seratonin

Front 75

What process/system is likely involved in migraines?

Back 75

craniovascular modulation

Front 76

Migraines - definition

Back 76

Primary neuronal dysfunction, possibly of the brainstem origin, causing imbalance of excitatory and inhibitory neurotransmitters and affecting craniovascular modulation

* (has to do with vessale and NT that are involved, likely seratonin)

Front 77

Migraines - presentation for each pt will be?

Back 77

* similar quality, location, associations, and prodrome

Front 78

Migraines - presentation (MC S/S)

Back 78

* Unilateral 70%. Throbbing/aching with severity variable
* Onset- rapid
* 4-72 hours, 1st occurrence usually mid adolescence
* nausea, vomiting, photophobia, phonophobia, aura
* MC in women

Front 79

Aura associated with visual changes called

Back 79

Scintillating Scotomas – an alteration in vision typically described as flickering or zigzagging lines or light.

Front 80

Tension Headaches may be associated with?

Back 80

muscular contractions or vasoconstriction

Front 81

Tension Headaches - presentation

Back 81

* usually bilateral, occipital, upper neck/shoulders,
* pressing or band like
* onset gradual lasting minutes to weeks
*

Front 82

Tension Headaches -
* Associated, Aggravating, and Alleviating factors

Back 82

* occasionally phono and photophobia
* muscular tension
* massage and relaxation

Front 83

Cluster Headaches- Etiology

Back 83

Unknown, possibly extra cranial vasodilation from neural dysfunction with trigeminovascular pain

Front 84

Cluster Headaches- presentation

Back 84

* intense pain in cyclic patterns
* Unilateral or behind or around an eye
* Deep continuous pain that is severe
* rapid onset, may last minutes/hours in cyclisc fashion over weeks
* MC in men

Front 85

Clucter Headaches - Associated factors

Back 85

lacrimation, rhinorrhea, mioisis, ptosis, eye lid edema, corneal injection

Front 86

Analgesic Rebound - definition

Back 86

* due to withdrawal from analgesic (pain treating) medicine.

Front 87

Secondary to Eye disorder - definition

Back 87

* typically associated with eye musculature

* Steady and aching.

Front 88

Sinus - definition

Back 88

* usually bi-frontal or over maxillary sinus

* throbbing

Front 89

Meningitis - definition

Back 89

* due to infection of the meninges surrounding the brain.

* Generalized location with steady throbbing pain

Front 90

Subarachnoid hemorrhage - definition

Back 90

* due to bleeding into the subarachnoid space.

* Generalized location with very severe pain

* “the worst headache of my life”

Front 91

Tumor/Mass - definition

Back 91

* due to displacement or traction on pain sensitive areas of the brain.

* Variable location.

* Constant ache

Front 92

Giant Cell (Temporal) Arteritis - definition

Back 92

* vasculitits from immune response of the elestin layer of the artery

* throbing, unilateral, temporal.

Front 93

Posttraumatic - definition

Back 93

dull ache near injured area or contralateral to area of injury.

Front 94

Cranial Neuralgias - definition

Back 94

* Trigeminal Neuralgia – compression of cranial verve V, often by aberrant loop of artery or vein.

* Located over cheek, jaw, lips, or gums (divisions of the nerve 2 and 3 >1).

* Shock-like, lancinating, stabbing, burning; typically severe.

Front 95

PE of hair should include?

Back 95

Inspect: distribution, quantity, texture, foreign bodies

Palpate: texture

Front 96

PE of scalp should include?

Back 96

Inspect: scaling, nevi, lumps/masses, rashes

Palpate: tenderness, masses

Front 97

PE of skull should include?

Back 97

Inspect: size, contour, pain, masses, fontanels

Palpate: lumps, contour, masses, tenderness, fontanels

Front 98

PE of face should include?

Back 98

Inspect: shape, expression, contours, symmetry, edema, masses, movements

Palpate: sinuses, parotids

Front 99

PE of skin should include?

Back 99

Insepct: color, pigmentation, hair distribution, lesions, texture, masses

Palpate: texture, temperature

Front 100

PE of sinuses should include?

Back 100

percuss maxillary and frontal, light

Front 101

PE findings on cushings (picture)

Back 101

Front 102

PE findings on acromaglia (picture)

Back 102

Front 103

PE of external eyes

Back 103

1) Lacrimal apparatus: Lacrimal gland and sac for swelling
2) Upper and lower lids
3) Width of palpebral fissures
4) Edema, color, lesions
5) Condition and direction of eyelashes
6) Adequacy of closed eyelids

* Look for: Ptosis, Entropion, Ectropion, Lid retraction and Exophthalmos, sty/chalazion, Xanthelsma, Dacryocystitis, Blephritis

Front 104

Ptosis - definition/Causes

Back 104

* Drooping of the upper eye lid.

* Causes include: myasthenia gravis, damage to the oculomotor nerve (III) (ctrls EOM and pupils), damage to the sympathetic nerve supply Horner’s syndrome.

Front 105

Horner’s syndrome - definition and causes

Back 105

* A constellation of symptoms that result from alterations of one side of the cervical or thoracic sympathetic chain.

* Causes range from congenital, relatively benign, to serious (such as tumor as in Pancoast tumor of the lung)

Front 106

Horner’s syndrome - S/S

Back 106

1) Unilateral
2) Ptosis
3) Possible loss of sweating on the forehead (anhidrosis)
4) Pupil constriction w/ preserved pupillary reflex

Front 107

Eye condition often seen in Horner's syndrome

Back 107

heterochromia

Front 108

Lid retraction: Usually an area of

Back 108

visible sclera between the upper lid margin and the iris

Front 109

Exophthalmos or Proptosis- definition/causes

Back 109

* anterior displacement of the eye globe.

* Grave’s hyperthyroidism, intracranial trauma

Front 110

Define PE findings of a Sty/Hordeolum

Back 110

* a painful, tender red infection in the gland at the margin of the eyelid

* usually well defined and on the outside of the lid

Front 111

Define PE findings of a Chalazion

Back 111

* a subacute nontender and usually painless nodule involving a meibomian gland.

* Unlike a sty usually points inside the lid rather than on the lid margin

Front 112

Define PE findings of a Xanthelsma

Back 112

* a slightly raised, yellowish, well-circumscribed plaque

* appear along the nasal portions of one or both eyes.

* lipid disorders

Front 113

Define PE findings of a Dacryocystitis

Back 113

* inflammation of the nasolacrimal duct by either obstruction or infection.

* painful red area over the nasolacrimal area.

Front 114

Define PE findings of a Blephritis

Back 114

* inflammation or irritation of the eyelid or boarder.

* Characterized by red, flaking, and crusting of the eyelid margin.

Front 115

PE of pupils -

Back 115

size, shape, symmetry, reaction to light (direct and consensual), and near reaction

Front 116

PE of the Conjunctiva and Sclera -

Back 116

Inspect with lid retracted in opposite direction of gaze:

1) Color, vascular pattern, nodules, and swelling
2) Bulbar conjunctiva
3) Palpebral conjunctiva – visualized by everting the lid

Front 117

PE of Conjunctiva and sclera

Back 117

Color, vascular pattern

Front 118

Physical finding in Conjunctivitis -

Back 118

* diffuse dilatation of the conjunctival vessels w/ redness that tends to be maximal peripherally.

* Vision may be blurry due to discharge.

* Discharge: Watery, mucoid, or mucopurulent discharge.

* No change on pupils.

Front 119

Scleral Icterus - definition

Back 119

Yellowing of the sclera indicates jaundice.

Front 120

Subconjunctival hemorrhage - definition/causes

Back 120

leakage of blood outside of the vessels, producing a sharply demarcated, red area that fades over days to yellow then disappears.

Causes: trauma, cough, sneeze from increased venous pressure

Front 121

Physical finding of Subconjunctival hemorrhage -

Back 121

* No pain, vision not affected, pupil not affected.

* hemorrhage seen with blood in sclera

Front 122

Pterygium - PE/definition

Back 122

* triangular thickening of the bulbar conjunctiva that grows slowly across the cornea

* Usually nasal side. May interfere with vision

Front 123

Pinguecula - definition

Back 123

a harmless yellowish triangular nodule in the bulbar conjunctiva on either side of the iris. Does not affect vision (stops at the limbus). Direct correlation with UV exposure.

Front 124

Episcleritis - definition

Back 124

a localized ocular redness from inflammation of the episcleral vessels.

Front 125

Physical findings in Episcleritis

Back 125

* Vessels appear pink and are movable over the scleral surface. "Just a spot"

* Abrupt onset of mild pain, itching, watery eyes,

* doesn’t affect vision.

Front 126

Light reaction of the pupil test which CN?

Back 126

* Cranial nerve II afferent limb of the reflex (sensory)

* Cranial nerve III efferent limb of the reflex (motor)

Check both direct and indirect reaction

Front 127

Miosis

Back 127

pupil constriction (parasympathetic)

Front 128

Mydriasis

Back 128

pupil dilation (sympathetic)

Front 129

Near reaction test which CN?

Back 129

* Oculomotor nerve III – the pupil constricts when moving gaze from one object to another.

Front 130

Anisocoria

Back 130

Unequal pupil reaction

Front 131

Define anisocoria greater in bright light than in dim light -

Back 131

the larger pupil is unable to constrict.

Front 132

Define anisocoria is greater in dim light than in bright light -

Back 132

smaller pupil cannot dilate properly

Front 133

Causes of Dim/Bright anisocoria?

Back 133

Bright: eye trauma, open angle glaucoma, impaired parasympathetic supply to the iris ( Tonic pupil and Oculomotor nerve palsy)

Dim: Horner’s syndrome

Front 134

Tonic Pupil and CN III palsy

Back 134

* Parasympathetic damage, absent light reaction, slow near reaction

* Fixed light reaction and near reaction, ptosis

Front 135

Argyll Robertson's pupils - definition

Back 135

small irregular pupils that accommodate but do not react to light

Front 136

Corneal abrasion/Ulceration - definition

Back 136

injury or infection of the cornea resulting in ciliary injection

Front 137

Physical findings in Corneal abrasion/Ulceration

Back 137

* dilation of deeper vessels that are visible as radiating vessels around the limbus.

* Moderately painful, decreased vision, watery or purulent discharge.

* No pupil changes.

* Visible ulceration of abrasion with fluorescein staining.

Front 138

Acute Iritis - definition

Back 138

* inflammation of the iris and the anterior chamber

* Causes: infectious and systemic disorders (autoimmune)

Front 139

Acute Iritis - PE findings

Back 139

* Ciliary injection.

* Moderate pain

* Vision decreased, minimal to no discharge.

* Pupil changes – may be small and irregular. (Funking irregular pupils)

Front 140

Open angle glaucoma - PE findings

Back 140

* Painless gradually progressive visual field loss,

* increased cup-to-disc ratio (CTD ratio)

* do not have acute attacks

Front 141

Acute closed angle glaucoma - PE findings

Back 141

* Ciliary injection
* severe aching pain
* vision decreased, no discharge.
* Fixed dilated pupil with steamy/cloudy cornea.
* 90 degree angle light exam for crescent shadow on opposite side

Front 142

Corneal Arcus - definition

Back 142

* a thin grayish white arc or circle near the edge of the cornea.

* Normal aging, but could represent hyperlipoproteinemia

Front 143

Hyphema - definition

Back 143

* Blood in the anterior chamber of the eye.

* Can affect vision and cause permanent vision loss.

Front 144

Wilson’s disease - definition

Back 144

- genetic disease in which copper accumulates in:
1) liver 2) brain 3) other tissues

* causes liver, neurologic, and psychiatric manifestations

Front 145

Wilson’s disease - PE on eye exam

Back 145

Kayser-Fleischer ring – a brownish stained ring on the edge of the iris

Front 146

Visual fields by confrontation - PE procedure

Back 146

Ask the patient to gaze at your eyes and ask to identify fingers moving. Should be similar to yours.

* Cover one eye at a time to confirm abnormalities

Front 147

Extraocular Eye Movements (EOM): PE procedures

Back 147

* have patient follow fingers while making an roman numeral X.

* Finish with back and forth in center and accommodation test

Front 148

Which nerves are tested during an EOM PE exam?

Back 148

CN III, IV, and VI

Front 149

CN III is tested during a EOM PE by?

Back 149

* medial movements
* laterally superior and inferior

* CN - Oculomotor

Front 150

CN IV controls which EOM muscle

Back 150

Superior Oblique - moves the eye down and inward

* CN - Trochlear

Front 151

CN VI controls which EOM muscle?

Back 151

Lateral rectus - moves the eye laterally

* CN - Abducens

Front 152

Esotropia - definition

Back 152

a form of strabismus in which one or both eyes point inward

Front 153

Exotropia - definition

Back 153

a form of strabismus in which one or both eyes pint outward

Front 154

Cover Test - PE procedures and findings

Back 154

* helps differentiate problematic eye and differentiate from palsy.

* The affected eye corrects with covering of none affected eye.

Front 155

Myopia - definition

Back 155

impaired far vision (nearsighted)

Front 156

Presbyopia - definition

Back 156

impaired near vision (farsighted)

Front 157

Contraindications to mydriatic (dilating) drops

Back 157

1) head injury where pupil reactions need observance,

2) suspicion for narrow angle glaucoma

Front 158

Papilledema - PE findings

Back 158

Disc is hyperemic and edematous, disc vessels curve over the boarders of the disc, cup not visible

Front 159

Papiledema - definition

Back 159

* due to increased intracranial pressure from disorder of the brain, meningitis, subarachnoid hemorrhage, trauma, masses.

* The increased pressure increases the edema of the optic nerve head.

Front 160

Drusen bodies - definition

Back 160

* undigested cellular debris resulting in yellowish round spots that vary from tiny to small.

* Edges may be soft or hard

Front 161

Drusen bodies - causes?

Back 161

normal with age, including age related macular degeneration.

Front 162

Soft Exudate: Cotton Wool patch - definition

Back 162

* white colored or grayish, ovoid lesions with irregular soft boarders.

* Usually smaller than the disc in size.

* Infarcted nerve fibers

Front 163

Soft Exudate: Cotton Wool patch - causes

Back 163

hypertension and other.

Front 164

Hard Exudates - definition

Back 164

* creamy or yellowish lesions with well define or hard boarders.

* Small and round and coalesce into larger irregular spots

Front 165

PE findings of arteries and veins during ophthalmic scope exam?

Back 165

arteries – light red and smaller, lay over veins
veins - dark read and larger

* Artery/vein crossings (AV crossing)
AV nicking – seen in hypertension with hypertensive retinopathy.

Front 166

Back 166

Glaucoma Cupping - increased intraocular pressure causing increased cupping (CTD ratio >1:2)

Front 167

Back 167

Drusen Bodies - normal with age, including age related macular degeneration.

Front 168

Back 168

Papilledema - increased intracranial pressure from disorder of the brain, meningitis, subarachnoid hemorrhage, trauma

Front 169

Back 169

Normal eye

Front 170

Back 170

Hard Exudate - Diabetes and hypertension

Front 171

Back 171

Cotton Wool Spots - hypertension and other.

Front 172

Back 172

Superficial Hemorrhage - hypertension, papilledema, retinal vein occlusion, others

Front 173

Back 173

Preretinal hemorrhage - sudden increased intracranial pressure

Front 174

Back 174

Deep – Small round irregular red spots (blot hemorrhage) Causes: diabetes

Front 175

Back 175

Microaneurysms - tiny round red spots, typically in macula. Causes: diabetes and other

Front 176

Back 176

Neovascularization - Numerous, tortuous, narrow vessels. Causes: diabetic retinopathy

Front 177

Back 177

Central Retinal Vein Occlusion - Pools of blood and indistinct margins, minimal to no vessels

* typically due to atherosclerosis of the overlying arteries leading to increased pressure & occlusion of the vein

Front 178

Back 178

Retinal Artery Occlusion - Cherry red spot on exam, pale retina

Front 179

Retinal Hemorrhage, Superficial - definition

Back 179

small linear flame shaped red streaks in the fundus

causes: hypertension, papilledema, retinal vein occlusion, others

Front 180

Retinal Hemorrhage, Preretinal - definition/causes

Back 180

blood escapes into potential space between retinal and vitreous

causes: sudden increased intracranial pressure

Front 181

Retinal Hemorrhage, Deep - definition/causes

Back 181

Small round irregular red spots (blot hemorrhage)

Causes: diabetes

Front 182

Retinal Hemorrhage, Microaneurysms - definition/causes

Back 182

tiny round red spots, typically in macula

Causes: diabetes and other

Front 183

Retinal Hemorrhage, Neovascularization - definition/causes

Back 183

formation of new blood vessels. Numerous, tortuous, narrow vessels.

Causes: diabetic retinopathy

Front 184

Diabetic Retinopathy - definition

Back 184

deterioration of the retina due to microvascular damage that can lead to permanent vision loss.

Front 185

Stages of diabetic retinopathy?

Back 185

1) Nonproliferative Moderately Severe
2) Nonproliferative Severe
3) Proliferative – neovascularization occurs. Normal vision but risk of vision loss is high.
4) Proliferative Advanced – visual disturbance

Front 186

Retinal Artery Occlusion - definition

Back 186

Occlusion of the retinal artery typically secondary to carotid artery disease or emboli

* Cherry red spot, emergency

Front 187

Central Retinal Vein Occlusion - definition

Back 187

* typically due to atherosclerosis of the overlying arteries leading to increased pressure and occlusion of the vein.

* Results in increase intraocular pressure (glaucoma), neovascularization, macular degeneration, and edema