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Lecture 2 Flashcards

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1
Q

sx for allergic conjunctivitis

A

seasonal allergies with clear to white stringy discharge*

  • itching
  • tearing
  • redness
  • FB sensation
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2
Q

treatment for allergic conjunctivitis

A

cromolyn sodium 4% sol.

1-2 drops in each eye 4-6 times daily till controlled, 1 bottle no refill

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3
Q

pt education of allergic conjuctivitis

A

Cool compress, wash hands face etc

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4
Q

where do you see cobblestone on upper tarsal conjuctiva

A

vernal keratoconjuctivitis

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5
Q

chronic seasonal allergies diagnosis

A

vernal keratoconjuctivits

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6
Q

treatment for vernal keratoconjuctivitis

A

cromolyn sod. 4% 1-2 drops in each eye 4-6 times daily for 2 weeks, 1 bottle no RF

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7
Q

s&s of vernal keratoconjuctivitis

A
  • watery to mucoid discharge
  • FB sensation
  • COBBLESTONE
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8
Q

epidemiology for bacterial conjunctivitis

A

Staph aureus, strep pneumonia, Hem. influenza, M. catarrhalis

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9
Q

a mucopurulent discharge with sudden onset is indicative of

A

bacterial conjunctivitis

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10
Q

treatment for bacterial conjunctivitis

A

erythromycin 0.5% ointment 1cm

-4xs a day, 5-7 days, 1 tube no RF

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11
Q

pt education for bacterial conjuctivitis

A

warm compress to infested eye,

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12
Q

referral for bacterial conjuctivitis

A

referral to opth if not improved in 4 days

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13
Q

difference between bacterial and bacterial gonorrhea conjuctiva

A

COPIOUS mucopurulent discharge, sudden onset

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14
Q

epidemiology: bacteria gonorrhoeae

A

Neisseria gonorrhoeae

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15
Q

diagnostic studies for bacterial gono

A

stat gram stain AND culture

-report to public health if pos

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16
Q

complications of bacterial gono conj.

A

vision loss; urgent refer to ophth

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17
Q

treatment for bacterial gono conj.

A
  • Ceftriaxone 1gm IM (pt wt >150 kg) or 500 mg (pt wt <150)
  • Azythromycin 1gm PO now,
  • bacitracin opth ointment every 3-4 hrs for 10 days, 1 tube no RF
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18
Q

pt education for bacterial gono conj.

A

discuss safe sex practices,

  • warm compress, wash face
  • offer STD workup
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19
Q

referral for bacterial gono con.

A

referral to opth urgent (1-2) days

-F/U after optho

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20
Q

epidemiology for chlamydia conjunctivitis

A

chlamydia trachomatis

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21
Q

difference in sx b/w between gono and chlamydia conjunctivitis

A

chlamydia: redness, light sensitivity, CLEAR to mucopurulent discharge and GRADUAL onset 1-4 weeks, no blurring vision
gono: sudden onset, and COPIOUS mucupurulent discharge

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22
Q

diagnostic studies for chlamydia

A

swab discharge - culture

  • report if pos
  • offer STI workup
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23
Q

complications of chlamydia conj.

A
  • corneal vascularization
  • epithelial keratitis
  • corneal scarring
  • inclusion conjuctivitis
  • blindness
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24
Q

treatment for chlamydia

A
  • Azythromycin 1 gm PO now

- Bacitracin ointment 3-4 hours for 10 days

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25
referral for chlamydia
``` optho urgent (1-2 days) f/u after ```
26
pt fell asleep with contacts in... diagnosis?
contact lens conjuctivitis
27
epidemiology for contact lens
pseudomas aeruginosa
28
s&s for contact lens conj.
FB sensation - no blurry vision - mild discomfort
29
diagnostic studies for contact lens conj.
Fluorescein stain for corneal abrasion or corneal ulcer
30
complications of contact lens conj.
corneal abrasion or corneal ulcer
31
treatment for contact lens conj.
``` ciprofloxacin HCL (Ciloxan) 0.3% opth sol, 1 drop (gtts) hourly during the day, and 1 drop every 2 hours at night for 2 days then 1 drop every 4 hours for 5 days for contact conjunctivitis, 1 bottle no RF ``` -alternative : tobramycin 0.3% opth sol.
32
pt education for contact lens conj.
don't sleep with contacts give tetanus booster if abrasion, wash hands
33
essential dx for fungal conj.
work in area with fungus and a piece got in eye or not cleaning contacts
34
s&s of fungal conj.
pain, redness, tearing, FB sensation
35
what should you do when pt comes in with FB sensation
evert eye
36
diagnostic studies for fungal conj.
- fluorescein stain | - fungal wet mount and culture**
37
medication for fungal conj.
Natamycin 5% opth suspension: | -1 drop 4-6 times daily for 7 days, 1 bottle no RF
38
non Pharma for fungal conj.
throw out contacts, clean regularly, wear eye protection
39
follow up for fungal conj.
f/u in 2-3 days, ER if change in vision
40
epidemiology with adenovirus is indicative of
Viral (non herpetic) conjunctivitis
41
a FB sensation with COPIOUS clear watery discharge is indicative of
Viral (non herpetic) conjunctivitis
42
risk factors of Viral (non herpetic) conjunctivitis
contacts schools,, swimming pool or public places
43
complications ofViral (non herpetic) conjunctivitis
can get secondary bacterial conjunctivitis
44
treatment for Viral (non herpetic) conjunctivitis
none- self limiting, don't rub eyes, wash hands | *contagious*
45
a pt with pain, blurry vision*, watery discharge and | *an injection near the limbs and dendrites appear on fluorescein stain* is indicative of
viral (HERPETIC) conjunctivitis
46
epidemiology of viral (HERPETIC) conjunctivitis
herpes simplex 1
47
diagnostic studies of viral (HERPETIC) conjunctivitis
fluorescein stain with dendrites
48
complications of viral (HERPETIC) conjunctivitis
herpes zoster opthalmicus
49
treatment for viral (HERPETIC) conjunctivitis
trifluridine 1% opth soln. 1 drop every 2 hours up to 9 drops for 2 days, then 1 drop every 4 hours for 5 days *STEROIDS ARE CONTRAINDICATED*
50
referral for viral (HERPETIC) conjunctivitis
EMERGENT referral to optho (today)
51
diagnosis for pt with CNV1 extremely painful, unilateral
herpetic zoster opthalmicus
52
epidemiology for herpetic zoster opthalmicus
Varicella- zoster virus (VZV) | *contagious*
53
s&s for herpetic zoster opthalmicus
Hutchison sign-lesion*** - CNV - pain - photophobia - tearing - ocular redness - blurred vision
54
diagnostic studies for Herpetic Zoster
tzanck smear OR polymerase chain rxn (PCR) or direct fluorescent antibody (DFA) testing
55
complications of Zoster
vision loss, herpes zoster postherpetic neuralgia
56
treatment for Zoster
acyclovir 800 mg PO 5 times a day for 7 days, | or valacyclovir 1 g PO TID x 7 days or famciclovir 500 mg PO TID x 7 days (renal dosing adjustment*)
57
non pharm for Zoster
keep eye covered in public, clean area with vesicles, don't scratch, wash hands
58
keratoconjuctivitis Sicca (KCS) s&s
chronic dryness bilateral and dry mouth
59
risk factors of Keratoconjuctivitis Sicca (KCS)
hx of sjogren's syndrome (can have dry mouth too)
60
epidemiology of Keratoconjuctivitis Sicca (KCS)
autoimmune inflammatory disorder
61
diagnostic studies of Keratoconjuctivitis Sicca (KCS)
schrimer test x 5 min
62
referral for KCS
routine consult - possible punch plugs - rheumatologist routine - f/u after opth
63
treatment for Keratoconjuctivitis Sicca (SCC)
OTC artificial tears | -dont wear contacts
64
keratitis s&s
red eye, painful eye, CORNEAL OPACITY
65
epidemiology of keratitis
viral, bacterial (s aureus, pseudomonas aerginosa, staph, strep pneumo), fungal, or parasites
66
treatment for keratitis
emergent consult to opth | -can spread
67
pinguecula s&s
yellow bump/growth on conjuctiva of eye, rarely grows
68
epidemiology of Pinguecula
deposit of protein, FAT, or calcium caused by aging
69
treatment for pinguecula
none: reassurance
70
pterygium symptoms
triangular* wedge on conjuctiva that crosses cornea
71
risk factors (might cause) of pterygium
surfers, farmers, lawn care workers, construction workers, increase sun, sand, or dust exposure
72
treatment for pterygium
routine optho consult once it crosse VA - wear eye protection - no tx until cross VA*
73
treatment for corneal abrasion
erythromycin opth 0.5% ointment 1 ribbon 4-6 times per day, continue for 48 hrs after healed *tetanus booster -f/u in 24 hrs
74
epidemiology of corneal ulcer
pseudomonas aeruginosa, moraxella species and staphy
75
pt came in with acute painful red eye and circum-corneal injection, excess tearing is indicative of
corneal ulcer
76
treatment for corneal ulcer
-fluoroquinolones -levofloxacin 0.5% opth sol. (Quixin) 2 drops every two hours while awake -Ciprofloxacin 0.3% opth sol. (ciloxan) 2 drops every 15 min for 6 hours -tetanus booster ------- wear eye protection, no contacts
77
UV keratitis epidemiology
burns into cornea
78
UV keratitis s&s
severe pain, severe photophobia ---- not aware of UV exposure until 6-12 hrs later
79
diagnostic studies of UV keratitis
fluorescein- punctate staining to both cornea
80
treatment for UV keratitis
emergent consult optho- both eyes may need to be patched
81
infection of the lacrimal sac can lead to
dacryocystitis
82
epidemiology of dacryocystitis
staph aureus
83
complications of dacryocystitis
orbital cellulitis
84
treatment for dacryocystitis
emergent consult to optho for surgery
85
a secondary to blunt or penetrating ocular trauma, with instant vision change on a younger pt indicated
cataract- traumatic
86
diagnostic studies for traumatic cataract
dilated eye exam with slit lamp- glass blowers cataract
87
a gradually progressive blurred vision with no pain or redness, lens opacities (no red reflex w white pupil) in a pt >60 yo with DM can be indicative of
cataracts (non traumatic)
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