MRCP Part 1 & 2 > Ophthalmology > Flashcards

Ophthalmology Flashcards

(22 cards)

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1
Q

Lacrimal duct problems
Dacryocystitis
Congenital lacrimal duct obstruction

A

Dacryocystitis
- watering eye (epiphora)
- swelling and erythema at the inner canthus of the eye
Tx: PO ABx

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2
Q

Orbital cellulitis vs pre-septal cellulitis

A

Orbital cellulitis: reduced visual acuity, proptosis, ophthalmoplegia/pain with eye movements

Ix: CT contrast

Mx: IV Abx

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3
Q

RAPD

A

affected and normal eye appears to dilate when light shone in affected
lesion in optic nerve or retina

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4
Q

PVD vs retinal detachment vs vitreous haemorrhage

A

PVD - 4Fs (floaters, flashes, visual field loss and fall in acuity)
Retinal detachment - dense shadow that progresses peripherally to centrally, veil/curtain over field of vision
Vitreous haemorrhage: floaters - dark spots - sudden visual loss

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5
Q

RA: ocular manifestations

A
  • keratoconjunctivitis sicca (most common)
  • episcleritis (erythema)
  • scleritis (erythema and pain)
  • corneal ulceration
  • keratitis
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6
Q

Acute angle closure glaucoma

A

associated with:
- hypermetropia (myopia for primary open angle glaucoma)
- pupil dilation e.g. TCAs, anticholinergics

Tx:
1. IV acetazolamide
2. Eye drops
- pilocarpine (parasympathomimetic)
- timolol
- apraclonidine (alpha 2 agonist)
3. Iridotomy

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7
Q

Holmes-Adie pupil

A

benign condition, commonly seen in women

  • unilateral in 80% of cases
  • dilated pupil
  • once the pupil has constricted it remains small for an abnormally long time
  • slowly reactive to accommodation but very poorly (if at all) to light
  • syndrome associated with absent ankle/knee reflexes
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8
Q

Retinitis Pigmentosa

A
  • night blindness is often the initial sign
  • tunnel vision due to loss of the peripheral retina/rod dysfunction (occasionally referred to as funnel vision)

fundoscopy: black bone spicule-shaped pigmentation in the peripheral retina, mottling of the retinal pigment epithelium

vs

Choroidermia: X-linked, VF loss and night blindness but cause RPE and choriocapillaris atrophy in mid periphery
Usher’s syndrome: associated with retinitis pigments but also cause deafness

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9
Q

Primary open angle glaucoma: Tx

A
  1. Latanoprost (prostaglandin analogue): increase uveoscleral outflow
  2. Timolol (beta blocker): reduce aqueous humour production
    - first line = 1+2
  3. Brimonidine (sympathomimetic): both
  4. Dorzolamide (carbonic anhydrase inhibitor): reduce aqueous humour production
  5. Pilocarpine (anti-muscarinic): increase uveoscleral outflow

Refractory - trabeculectomy

drugs - TCA, antihistamines, anti-PD, APs and sulphonamide

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10
Q

Argyll-Robertson pupil

A
  • small, irregular pupils
  • no response to light but there is a response to accommodate

Causes
- DM
- syphilis

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11
Q

Angioid retinal streaks

A

Associated with SLAPPERS:
Sickle cell disease
Lead poisoning
Acromegaly
Pagets disease
Pseudoxanthoma elasticum
Ehlers-Danlos
Raised calicum/phosphate
Short sature

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12
Q

Stargadt’s disease

A

AR

macula disease and cone dysfunction

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13
Q

Band keratopathy

A

calcium deposition in cornea

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14
Q

Hyphaema

A

IV CA inhibitor

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15
Q

Ocular ischaemic syndrome

A

think if asymmetric diabetic retinopathy

due to atherosclerosis
visual loss with or without pain
dilated veins but not tortuous like central vein occlusion
>90% occlusion of carotid artery

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16
Q

Orbital swelling

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A

rare but important - lymphomatous infiltration

17
Q

DM eye disease

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A

Panretinal photocoagulation - diffuse retinopathy, neovascularisation
Focal laser therapy, anti-VEGF - maculopathy

18
Q

Chorioretinitis

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A

Candida - multiple yellow/white ball-shaped, haematogenous spread in neutropenic pts

Toxoplasma - white areas with focal retinitis, pigmented retinal scarring

19
Q

Hypertensive retinopathy

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A

1 - arteriolar narrowing and tortuosity, increased light reflex, silver wiring
2 - AV nipping
3 - cotton wool exudates, flame and blot haemorrhage
4 - papilloedema

20
Q

Uveitis

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A

Mx: steroid + cycloplegic/mydriatic drops

21
Q

Kearns-Sayer Syndrome

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A

triad of:
chronic progressive external ophthalmoplegia
pigmentary retinopathy
cardiac conduction defects

22
Q

CRAO

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A

GCA: IV methylpred
Thromboembolic: PO aspirin and referral for intra-arterial thrombolytic therapy

MRCP Part 1 & 2
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